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 |
|---|---|---|---|---|
| Chromosome analysis 100 CPT 88249 | $259.48 | $520.00 | $173.17 – $468.00 | 27 |
| Chromosome analysis 15-20 cell count CPT 88262 | $265.47 | $532.00 | $125.49 – $339.30 | 27 |
| Chromosome analysis 5 CPT 88261 | $396.21 | $794.00 | $264.34 – $714.60 | 27 |
| Chromosome analys placenta CPT 88267 | $282.43 | $566.00 | $188.57 – $509.40 | 27 |
| Chromosome count additional CPT 88285 | $40.42 | $81.00 | $26.91 – $72.90 | 27 |
| Chromosome karyotype study CPT 88280 | $50.40 | $101.00 | $33.47 – $90.90 | 27 |
| Chromosome study additional CPT 88289 | $51.90 | $104.00 | $34.43 – $93.60 | 27 |
| Chronic urticaria - sendout CPT 86343 | $23.42 | $64.00 | $12.46 – $57.60 | 27 |
| Chylomicron screen, bf - sendout CPT 82664 | $86.95 | $185.00 | $61.50 – $166.50 | 27 |
| Cine/video x-rays CPT 76120 | $355.63 | $671.00 | $79.00 – $603.90 | 27 |
| Cine/video x-rays add-on CPT 76125 | $75.79 | $143.00 | $34.03 – $128.70 | 27 |
| Circumcision (newborn) CPT 54150 | $150.48 | $266.00 | $38.33 – $239.40 | 27 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $443.07 | $989.00 | $329.51 – $890.10 | 27 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $5,460.74 | $13,895.00 | $385.32 – $1,457.10 | 27 |
| Clip ligating vesolock lg HCPCS C1760 | $11,061.52 | $21,904.00 | $74.49 – $281.70 | 27 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $327.96 – $2,518.60 | 6 |
| Clot factor fletcher fact CPT 85292 | $82.00 | $166.00 | $18.93 – $149.40 | 27 |
| Clot factor viii reltd antgn CPT 85244 | $30.63 | $62.00 | $20.42 – $55.80 | 27 |
| Clot factor xii hageman CPT 85280 | $37.54 | $76.00 | $19.35 – $68.40 | 27 |
| Clot factor xiii fibrin scrn CPT 85291 | $13.83 | $28.00 | $9.11 – $25.20 | 27 |
| Clot factor xiii fibrin stab CPT 85290 | $48.41 | $98.00 | $16.34 – $88.20 | 27 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | not published | not published | $149.49 – $2,518.60 | 6 |
| #cmvcul-virus inoculation shell CPT 87254 | $30.27 | $64.00 | $19.56 – $53.10 | 27 |
| Cmv pcr-sendout CPT 87496 | $50.14 | $106.00 | $35.09 – $95.40 | 27 |
| Co2 monitor per day CPT 94681 | $204.61 | $395.00 | $160.76 – $355.50 | 27 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $0.37 | $1.09 | $0.44 – $0.98 | 27 |
| Cocaine hcl nasal (numbrino) HCPCS C9143 | $0.31 | $1.58 | $0.64 – $1.42 | 27 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $233.44 | $594.00 | $74.49 – $281.70 | 27 |
| Cold agglutinin screen (arc) CPT 86156 | $9.15 | $25.00 | $8.07 – $22.50 | 27 |
| Cold agglutinin titer CPT 86157 | $9.15 | $25.00 | $8.06 – $22.50 | 27 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $10,128.08 – $10,128.08 | 1 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | not published | not published | $10,128.08 – $10,128.08 | 1 |
| Collagenase, clost hist inj HCPCS J0775 | $12.19 | $35.75 | $14.55 – $32.17 | 27 |
| Collagen imp urinary 2.5 ml HCPCS L8603 | $10,176.76 | $20,152.00 | $339.25 – $2,425.50 | 27 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $113.42 | $214.00 | $58.65 – $192.60 | 27 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $93.07 | $163.00 | $66.34 – $146.70 | 27 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $94.21 | $165.00 | $67.16 – $148.50 | 27 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $575.40 – $3,372.77 | 6 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | $751.80 – $3,372.77 | 6 |
| Colonoscopy w/ablation CPT 45388 | not published | not published | $751.80 – $2,518.60 | 6 |
| Colonoscopy w/band ligation CPT 45398 | not published | not published | $751.80 – $3,372.77 | 6 |
| Colonoscopy w/control bleed CPT 45382 | not published | not published | $751.80 – $3,372.77 | 6 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $751.80 – $3,372.77 | 6 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $751.80 – $3,372.77 | 6 |
| Colonoscopy w/resection CPT 45390 | not published | not published | $1,771.46 – $2,518.60 | 6 |
| Colpopexy intraperitoneal CPT 57283 | not published | not published | $4,925.87 – $10,128.08 | 6 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $167.17 | $365.00 | $108.14 – $328.50 | 27 |
| Compatibility test each unit electronic CPT 86923 | $167.17 | $365.00 | $108.14 – $328.50 | 27 |
| Compatibility test each unit immediate spin technique CPT 86920 | $167.17 | $365.00 | $108.14 – $328.50 | 27 |
| Complement antigen each component c3 CPT 86160 | $106.87 | $292.00 | $12.00 – $32.40 | 27 |
| Complement fixation each CPT 86171 | $11.35 | $31.00 | $10.01 – $27.90 | 27 |
| Concentration infection agents any type CPT 87015 | $60.54 | $128.00 | $6.68 – $18.90 | 27 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | not published | not published | $1,901.83 – $3,372.77 | 6 |
| Connector tis 2x10mm HCPCS C9352 | $3,083.02 | $6,105.00 | $575.09 – $1,271.70 | 27 |
| Consultation pathology during surgery CPT 88329 | $63.63 | $127.00 | $24.53 – $114.30 | 27 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $35.57 | $71.00 | $12.26 – $63.90 | 27 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $182.86 | $365.00 | $108.14 – $328.50 | 27 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $57.11 | $114.00 | $36.08 – $102.60 | 27 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $42.08 | $84.00 | $24.53 – $75.60 | 27 |
| Consult comp w/report rfrd material CPT 88325 | $182.86 | $365.00 | $108.14 – $328.50 | 27 |
| Contrast baths charges CPT 97034 | $11.42 | $49.00 | $11.66 – $44.10 | 27 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $2,923.54 | $5,168.00 | $248.54 – $4,651.20 | 27 |
| Contrast x-ray gallbladder CPT 74290 | $149.99 | $283.00 | $115.18 – $254.70 | 27 |
| Contrast x-ray of ankle CPT 73615 | $334.65 | $485.00 | $197.40 – $436.50 | 27 |
| Contrast x-ray of elbow CPT 73085 | $339.48 | $492.00 | $200.24 – $442.80 | 27 |
| Contrast x-ray of hip CPT 73525 | $403.65 | $585.00 | $238.09 – $526.50 | 27 |
| Contrast x-ray of knee joint CPT 73580 | $289.11 | $419.00 | $170.53 – $377.10 | 27 |
| Contrast x-ray of wrist CPT 73115 | $210.45 | $305.00 | $124.14 – $274.50 | 27 |
| Controller infinity pt dbs HCPCS C1787 | $7,016.98 | $13,895.00 | $1,162.63 – $4,396.50 | 27 |
| Conversion ext bil drg cath CPT 47535 | $854.26 | $1,776.00 | $728.16 – $1,598.40 | 27 |
| Coombs direct CPT 86880 | $46.48 | $127.00 | $5.39 – $114.30 | 27 |
| Coombs indirect titer reference CPT 86886 | $133.59 | $365.00 | $5.18 – $328.50 | 27 |
| Core ndl bx lng/med perq CPT 32408 | $863.88 | $1,796.00 | $736.36 – $1,616.40 | 27 |
| Cor hlx vlgs double osteot CPT 28299 | not published | not published | $4,542.09 – $5,422.79 | 6 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | not published | not published | $3,860.87 – $4,542.09 | 6 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | not published | not published | $2,052.04 – $3,372.77 | 6 |
| Correction of astigmatism CPT 65772 | not published | not published | $586.92 – $4,768.74 | 6 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | $2,052.04 – $3,860.87 | 6 |
| Cortisol total am CPT 82533 | $151.81 | $323.00 | $16.30 – $52.20 | 27 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $4,795.48 | $9,496.00 | $39.51 – $149.40 | 27 |
| #covid19rsv-rsv CPT 87634 | $99.80 | $211.00 | $70.20 – $189.90 | 27 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $19.40 | $53.00 | $13.03 – $36.00 | 27 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $216.43 | $439.00 | $136.21 – $395.10 | 27 |
| C-peptide CPT 84681 | $29.61 | $63.00 | $20.81 – $56.70 | 27 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $251.92 | $511.00 | $191.73 – $459.90 | 27 |
| Crbrospnl fld flw imag cistern CPT 78630 | $374.88 | $710.00 | $288.97 – $639.00 | 27 |
| C-reactive protein CPT 86140 | $5.86 | $16.00 | $5.18 – $14.40 | 27 |
| C-reactive protein high sensitivity CPT 86141 | $47.95 | $131.00 | $12.95 – $51.30 | 27 |
| C-reactive protein, quantitative CPT 86406 | $29.65 | $81.00 | $10.64 – $53.10 | 27 |
| Creatine kinase CPT 82550 | $25.85 | $55.00 | $6.51 – $18.00 | 27 |
| Creatine kinase isoenzymes CPT 82552 | $27.73 | $59.00 | $13.39 – $53.10 | 27 |
| Creatine kinase mb CPT 82553 | $31.02 | $66.00 | $11.55 – $59.40 | 27 |
| Creatine - sendout CPT 82540 | $28.20 | $60.00 | $4.64 – $54.00 | 27 |
| Creatinine CPT 82565 | $19.74 | $42.00 | $5.12 – $37.80 | 27 |
| Creatinine 24 hour urine CPT 82570 | $34.31 | $73.00 | $5.18 – $14.40 | 27 |
| Creatinine clearance urine CPT 82575 | $13.63 | $29.00 | $9.46 – $26.10 | 27 |
| #creutz-prot.,western blot CPT 84182 | $72.85 | $155.00 | $29.21 – $79.20 | 27 |
| Critical care each additional 30 minutes CPT 99292 | $268.62 | $555.00 | $132.09 – $499.50 | 27 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $539.66 | $1,115.00 | $457.15 – $1,003.50 | 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.