Banner Payson Medical Center
807 South Ponderosa Street, Payson, AZ · Banner Health · · NPI 1063923340
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $0.72 | $2.10 | $0.04 – $1.89 | 27 |
| Calcium ionized CPT 82330 | $24.91 | $53.00 | $13.68 – $37.80 | 27 |
| Calcium total CPT 82310 | $30.55 | $65.00 | $5.16 – $37.80 | 27 |
| Calprotectin fecal CPT 83993 | $117.50 | $250.00 | $19.63 – $225.00 | 27 |
| Campylobacter antibody CPT 86625 | $14.64 | $40.00 | $13.12 – $36.00 | 27 |
| Candida dna CPT 87480 | $28.85 | $61.00 | $20.05 – $54.90 | 27 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $56,405.47 | $111,694.00 | $39.51 – $149.40 | 27 |
| Cap nerve 2x15mm HCPCS C1763 | $42,028.12 | $83,224.00 | $202.30 – $765.00 | 27 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Cap trach decann 15mm HCPCS C1750 | $5,847.90 | $11,580.00 | $74.49 – $281.70 | 27 |
| Carbamazepine free CPT 80157 | $42.30 | $90.00 | $13.25 – $81.00 | 27 |
| Carbamazepine free -sendout CPT 80161 | $42.30 | $90.00 | $18.64 – $52.20 | 27 |
| Carbamazepine total therapeutic drug level CPT 80156 | $24.44 | $52.00 | $14.57 – $46.80 | 27 |
| Carbohydrate deficient transf - sendout CPT 82373 | $25.85 | $55.00 | $18.06 – $49.50 | 27 |
| Carbohydrate urine - sendout CPT 84377 | $107.63 | $229.00 | $5.50 – $206.10 | 27 |
| Carbon dioxide CPT 82374 | $61.57 | $131.00 | $4.88 – $13.50 | 27 |
| Carboxyhemoglobin quantitative CPT 82375 | $35.25 | $75.00 | $12.32 – $33.30 | 27 |
| Carcinoembryonic ag (cea) CPT 82378 | $154.63 | $329.00 | $18.96 – $51.30 | 27 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $1,410.29 | $2,671.00 | $946.81 – $2,403.90 | 27 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $157.82 | $288.00 | $84.14 – $259.20 | 27 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $121.66 | $222.00 | $84.14 – $199.80 | 27 |
| Cardiolipin antibody iga CPT 86147 | $29.28 | $80.00 | $25.45 – $72.00 | 27 |
| Cardioversion (Scheduled Heart Rhythm Shock) CPT 92960 | $422.05 | $872.00 | $354.90 – $784.80 | 27 |
| Carotene CPT 82380 | $31.49 | $67.00 | $9.22 – $60.30 | 27 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $395.24 | $820.00 | $166.84 – $738.00 | 27 |
| Car outp meas drg cath chd CPT 93598 | $341.99 | $711.00 | $169.22 – $639.90 | 27 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | $1,271.93 – $3,372.77 | 6 |
| Cataract Surgery CPT 66984 | not published | not published | $1,507.39 – $7,096.97 | 6 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $847.70 | $2,157.00 | $74.49 – $281.70 | 27 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $5,278.78 | $13,432.00 | $336.29 – $1,271.70 | 27 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $1,211.62 | $3,083.00 | $385.32 – $1,457.10 | 27 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $5,460.74 | $13,895.00 | $641.41 – $2,425.50 | 27 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $4,550.94 | $11,580.00 | $39.51 – $149.40 | 27 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $5,460.74 | $13,895.00 | $640.22 – $2,421.00 | 27 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $4,550.94 | $11,580.00 | $74.49 – $281.70 | 27 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $5,460.74 | $13,895.00 | $141.37 – $534.60 | 27 |
| Cath bi-dir df smarttouch HCPCS C1732 | $8,608.27 | $21,904.00 | $513.37 – $1,941.30 | 27 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $6,886.93 | $17,524.00 | $733.75 – $2,774.70 | 27 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $3,641.14 | $9,265.00 | $74.49 – $281.70 | 27 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $1,514.23 | $3,853.00 | $141.37 – $534.60 | 27 |
| Cath epdrl brevi-stf 12in .043 HCPCS C1755 | $1,514.23 | $3,853.00 | $39.51 – $149.40 | 27 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $5.50 | $12.00 | $3.00 – $10.80 | 27 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $2,343.70 | $4,641.00 | $39.51 – $149.40 | 27 |
| Cath hawkone s directional HCPCS C1714 | $6,886.93 | $17,524.00 | $1,162.63 – $4,396.50 | 27 |
| Cath hemodial 55cm 15.5fr dual lumen straight stacked adlt HCPCS C1881 | $7,016.98 | $13,895.00 | $141.37 – $534.60 | 27 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $6,026.26 | $15,334.00 | $202.30 – $765.00 | 27 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $1,360.97 | $2,695.00 | $141.37 – $534.60 | 27 |
| Cath occl flo-rester 2.25x12mm cor internal vessel occluder HCPCS C1817 | $16,591.27 | $32,854.00 | $3,649.49 – $13,800.60 | 27 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $159.21 | $331.00 | $78.78 – $297.90 | 27 |
| Cath steerable flex adv 12f HCPCS C1766 | $3,641.14 | $9,265.00 | $336.29 – $1,271.70 | 27 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $9,955.57 | $19,714.00 | $640.22 – $2,421.00 | 27 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $1,111.01 | $2,827.00 | $74.49 – $281.70 | 27 |
| Cauterization chemical granulation tissue CPT 17250 | $122.19 | $214.00 | $87.10 – $192.60 | 27 |
| #cbg+cort-cbg CPT 84449 | $25.38 | $54.00 | $18.00 – $48.60 | 27 |
| Cdna analysis for variants CPT 81403 | $276.42 | $617.00 | $185.20 – $500.40 | 27 |
| Cebpa gene full sequence CPT 81218 | $325.25 | $726.00 | $241.90 – $653.40 | 27 |
| #celiac hla-dq8 CPT 81383 | $146.94 | $328.00 | $109.13 – $295.20 | 27 |
| Cell count body fluid CPT 89050 | $6.87 | $15.00 | $4.72 – $13.50 | 27 |
| Cell count w differential body fluid CPT 89051 | $7.79 | $17.00 | $5.60 – $15.30 | 27 |
| Cell function assay w/stim CPT 86352 | $149.33 | $408.00 | $135.86 – $367.20 | 27 |
| Cell marker study CPT 88182 | $299.40 | $600.00 | $36.08 – $540.00 | 27 |
| #cf-97variants CPT 81220 | $748.16 | $1,670.00 | $556.60 – $1,503.00 | 27 |
| Change cystostomy tube simple CPT 51705 | $111.59 | $232.00 | $95.12 – $208.80 | 27 |
| Change of windpipe airway 31502 CPT 31502 | $154.40 | $321.00 | $131.61 – $288.90 | 27 |
| Chemo adm cns w/lmbr punct CPT 96450 | $236.12 | $667.00 | $225.29 – $600.30 | 27 |
| Chemo intralesional over 7 CPT 96406 | $93.46 | $264.00 | $107.45 – $237.60 | 27 |
| Chemo intralesional up to 7 96405 CPT 96405 | $59.47 | $168.00 | $44.93 – $151.20 | 27 |
| Chemotherapy injection 96542 CPT 96542 | $153.99 | $435.00 | $147.54 – $391.50 | 27 |
| Chemotx admn pertl cav impl CPT 96446 | $240.01 | $678.00 | $225.29 – $610.20 | 27 |
| Chest 2 vws w oblique CPT 71048 | $159.85 | $311.00 | $79.00 – $279.90 | 27 |
| Chest apical lordotic proj CPT 71047 | $129.01 | $251.00 | $58.65 – $225.90 | 27 |
| Chest CT scan (with and without contrast) CPT 71270 | $749.39 | $1,481.00 | $129.45 – $1,332.90 | 27 |
| Chest CT scan (with contrast) CPT 71260 | $624.40 | $1,234.00 | $129.45 – $1,110.60 | 27 |
| Chest CT scan (without contrast) CPT 71250 | $499.42 | $987.00 | $79.00 – $888.30 | 27 |
| Chest Physiotherapy (first session) CPT 94667 | $35.50 | $72.00 | $29.30 – $64.80 | 27 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $44.86 | $91.00 | $37.04 – $81.90 | 27 |
| Chest Ultrasound CPT 76604 | $178.02 | $289.00 | $79.00 – $260.10 | 27 |
| Chest X-ray CPT 71046 | $117.71 | $229.00 | $58.65 – $206.10 | 27 |
| Chest X-ray (single view) CPT 71045 | $92.52 | $180.00 | $58.65 – $162.00 | 27 |
| Chg pr pul rehab for copd patients CPT 94626 | $144.74 | $306.00 | $40.35 – $275.40 | 27 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $164.30 | $310.00 | $126.17 – $279.00 | 27 |
| Chimerism anal no cell selec CPT 81267 | $279.10 | $623.00 | $207.46 – $560.70 | 27 |
| Chimerism anal w/cell select CPT 81268 | $350.78 | $783.00 | $260.79 – $704.70 | 27 |
| Chlamydia culture CPT 87110 | $33.58 | $71.00 | $19.60 – $63.90 | 27 |
| Chlamydia trachomatis ag if CPT 87270 | $17.03 | $36.00 | $11.98 – $32.40 | 27 |
| Chlamydia type CPT 87140 | $26.96 | $57.00 | $5.57 – $50.40 | 27 |
| Chlnggrphy intraop addl s&i CPT 74301 | $135.68 | $256.00 | $27.33 – $230.40 | 27 |
| Chloride CPT 82435 | $19.74 | $42.00 | $4.60 – $37.80 | 27 |
| Chloride 24 hour urine CPT 82436 | $8.46 | $18.00 | $5.75 – $16.20 | 27 |
| Cholangiogram percutaneous compl CPT 47532 | $854.26 | $1,776.00 | $728.16 – $1,598.40 | 27 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $153.70 | $290.00 | $36.66 – $261.00 | 27 |
| Cholesterol CPT 82465 | $26.32 | $56.00 | $4.35 – $49.50 | 27 |
| Cholesterol body fluid CPT 84999 | $31.96 | $68.00 | $12.14 – $45.90 | 27 |
| Cholesterol (Lipid) Test CPT 80061 | $25.38 | $54.00 | $13.39 – $45.90 | 27 |
| Cholinesterase CPT 82480 | $28.20 | $60.00 | $7.87 – $54.00 | 27 |
| Chrom analysis CPT 88273 | $52.40 | $105.00 | $34.81 – $94.50 | 27 |
| Chromatography CPT 83021 | $25.85 | $55.00 | $18.06 – $49.50 | 27 |
| Chromogenic substrate assay CPT 85130 | $30.63 | $62.00 | $11.89 – $55.80 | 27 |
| Chromo high res and frag x - sendout CPT 81243 | $77.06 | $172.00 | $57.04 – $154.80 | 27 |
| Chromosome analys amniotic CPT 88269 | $259.98 | $521.00 | $173.66 – $468.90 | 27 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.