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 |
|---|---|---|---|---|
| Cryoprecipitate each unit HCPCS P9012 | $42.54 | $89.00 | $36.22 – $80.10 | 27 |
| Cryptococcus abs qn - sendout CPT 86641 | $16.10 | $44.00 | $14.41 – $39.60 | 27 |
| Cryptosporidium antigen CPT 87272 | $52.50 | $111.00 | $11.98 – $54.90 | 27 |
| Crystal identification light microscopy CPT 89060 | $10.08 | $22.00 | $7.33 – $19.80 | 27 |
| CT 3d report other modality w/workstation CPT 76377 | $313.54 | $509.00 | $121.14 – $458.10 | 27 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $625.92 | $1,237.00 | $129.45 – $1,113.30 | 27 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $1,336.85 | $2,642.00 | $241.82 – $2,377.80 | 27 |
| CT Angiogram of the Abdomen CPT 74175 | $980.63 | $1,938.00 | $129.45 – $1,744.20 | 27 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $626.63 | $1,322.00 | $129.45 – $1,189.80 | 27 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $787.34 | $1,556.00 | $129.45 – $1,400.40 | 27 |
| CT Angiogram of the Head CPT 70496 | $770.13 | $1,519.00 | $129.45 – $1,367.10 | 27 |
| CT Angiogram of the Neck CPT 70498 | $757.46 | $1,494.00 | $129.45 – $1,344.60 | 27 |
| CT angio pelvis CPT 72191 | $1,029.20 | $2,034.00 | $129.45 – $1,830.60 | 27 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $701.32 | $1,386.00 | $129.45 – $1,247.40 | 27 |
| CT bone density axial CPT 77078 | $42.00 | $83.00 | $34.03 – $74.70 | 27 |
| CT guidance for needle placement CPT 77012 | $313.79 | $662.00 | $157.56 – $595.80 | 27 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $296.30 | $481.00 | $114.48 – $432.90 | 27 |
| CT guid parench tis ablat CPT 77013 | $313.79 | $662.00 | $157.56 – $595.80 | 27 |
| CT limited or localized follow-up study CPT 76380 | $177.75 | $375.00 | $58.65 – $337.50 | 27 |
| CT lwr extremity w/o&w/dye CPT 73702 | $596.07 | $1,178.00 | $129.45 – $1,060.20 | 27 |
| CT scan for localization CPT 77011 | $247.90 | $523.00 | $124.47 – $470.70 | 27 |
| CT scan for therapy guide CPT 77014 | $117.08 | $247.00 | $58.79 – $222.30 | 27 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,273.10 | $2,516.00 | $241.82 – $2,264.40 | 27 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,061.08 | $2,097.00 | $241.82 – $1,887.30 | 27 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $848.56 | $1,677.00 | $166.84 – $1,509.30 | 27 |
| CT t-spine w /wo contrast CPT 72130 | $719.03 | $1,421.00 | $129.45 – $1,278.90 | 27 |
| CT uppr extremity w/o&w/dye CPT 73202 | $667.92 | $1,320.00 | $129.45 – $1,188.00 | 27 |
| Culture aerobic additional method definitive id each CPT 87077 | $48.72 | $103.00 | $8.08 – $22.50 | 27 |
| Culture afb any source CPT 87116 | $29.80 | $63.00 | $10.80 – $29.70 | 27 |
| Culture anaerobic additional method definitive id each CPT 87076 | $55.81 | $118.00 | $8.08 – $22.50 | 27 |
| Culture anaerobic except blood CPT 87075 | $13.72 | $29.00 | $9.47 – $26.10 | 27 |
| Culture bacteria anaerobic CPT 87073 | $13.72 | $29.00 | $9.66 – $26.10 | 27 |
| Culture bact stool aero addl path ea CPT 87046 | $29.80 | $63.00 | $9.44 – $26.10 | 27 |
| Culture body fluid CPT 87070 | $35.48 | $75.00 | $8.62 – $23.40 | 27 |
| Culture fungi definitive id mold CPT 87107 | $65.27 | $138.00 | $10.32 – $55.80 | 27 |
| Culture fungi definitive id yeast CPT 87106 | $64.33 | $136.00 | $10.32 – $55.80 | 27 |
| Culture fungi other (except blood) CPT 87102 | $36.89 | $78.00 | $8.41 – $54.00 | 27 |
| Culture fungi skin/hair/nail CPT 87101 | $27.91 | $59.00 | $7.71 – $53.10 | 27 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $30.27 | $64.00 | $14.61 – $57.60 | 27 |
| Culture mycoplasma any source CPT 87109 | $29.80 | $63.00 | $15.39 – $56.70 | 27 |
| Culture quantitative aerobic other source CPT 87071 | $28.85 | $61.00 | $9.89 – $54.90 | 27 |
| Culture screening strep group a CPT 87081 | $61.96 | $131.00 | $6.63 – $18.00 | 27 |
| Culture typing glc/hplc CPT 87143 | $17.97 | $38.00 | $12.52 – $34.20 | 27 |
| Culture typing immunologic CPT 87147 | $40.20 | $85.00 | $5.18 – $14.40 | 27 |
| Culture urine each isolate CPT 87088 | $11.82 | $25.00 | $8.09 – $22.50 | 27 |
| Cutter lead HCPCS C1773 | $12,481.29 | $31,759.00 | $269.42 – $1,018.80 | 27 |
| Cv line/pic reposition CPT 36597 | $332.85 | $692.00 | $283.72 – $622.80 | 27 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $31.02 | $66.00 | $14.32 – $59.40 | 27 |
| Cyclic citrullinated peptide antibody CPT 86200 | $21.59 | $59.00 | $12.95 – $53.10 | 27 |
| Cyclosporine 2 hour CPT 80158 | $27.26 | $58.00 | $18.05 – $49.50 | 27 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $33,180.52 | $65,704.00 | $200.87 – $759.60 | 27 |
| Cyp2c19 gene com variants CPT 81225 | $392.00 | $875.00 | $291.36 – $787.50 | 27 |
| Cyp2c9 gene com variants CPT 81227 | $235.20 | $525.00 | $174.81 – $472.50 | 27 |
| Cyp2d6 gene com variants CPT 81226 | $606.14 | $1,353.00 | $450.91 – $1,217.70 | 27 |
| Cyp3a4 gene common variants CPT 81230 | $235.20 | $525.00 | $174.81 – $472.50 | 27 |
| Cyp3a5 gene common variants CPT 81231 | $235.20 | $525.00 | $174.81 – $472.50 | 27 |
| Cystatin c CPT 82610 | $26.32 | $56.00 | $18.52 – $50.40 | 27 |
| Cystic fibrosis cftr CPT 81223 | $670.66 | $1,497.00 | $499.00 – $1,347.30 | 27 |
| Cystine urine quantitative CPT 82131 | $42.77 | $91.00 | $22.98 – $81.90 | 27 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $181.26 | $342.00 | $108.99 – $307.80 | 27 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $3,372.77 – $3,574.31 | 6 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $2,230.35 – $3,372.77 | 6 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $2,230.35 – $3,372.77 | 6 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $2,230.35 – $3,860.87 | 6 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $3,200.08 – $3,860.87 | 6 |
| Cystoscopy and treatment CPT 52310 | not published | not published | $1,299.92 – $3,372.77 | 6 |
| Cystoscopy (Bladder Scope) CPT 52000 | not published | not published | $416.71 – $5,570.00 | 7 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $1,299.92 – $5,570.00 | 7 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $1,299.92 – $4,768.74 | 6 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $2,230.35 – $3,860.87 | 6 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $3,200.08 – $5,570.00 | 7 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $3,200.08 – $5,570.00 | 7 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $2,230.35 – $4,768.74 | 6 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $1,299.92 – $3,372.77 | 6 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $1,299.92 – $3,372.77 | 6 |
| Cytogenetics 25-99 CPT 88274 | $63.87 | $128.00 | $42.38 – $115.20 | 27 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $21.96 | $60.00 | $14.39 – $50.40 | 27 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $22.33 | $61.00 | $16.85 – $45.90 | 27 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $56.89 | $114.00 | $36.08 – $102.60 | 27 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $39.92 | $80.00 | $26.61 – $72.00 | 27 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $30.44 | $61.00 | $20.26 – $54.90 | 27 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $41.92 | $84.00 | $24.53 – $75.60 | 27 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $25.45 | $51.00 | $12.26 – $45.90 | 27 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $182.14 | $365.00 | $84.29 – $328.50 | 27 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $95.81 | $192.00 | $36.08 – $102.60 | 27 |
| Cytopath smear oth prep screen & interp CPT 88161 | $26.45 | $53.00 | $17.89 – $47.70 | 27 |
| Cytotoxic antibody screening CPT 86808 | $32.94 | $90.00 | $29.68 – $81.00 | 27 |
| Dch pulmonary stress test CPT 94621 | $470.86 | $909.00 | $191.73 – $818.10 | 27 |
| Dch validity tests CPT 81002 | $5.81 | $11.00 | $3.48 – $9.90 | 27 |
| Deamidated gliadin antibody iga CPT 86258 | $21.59 | $59.00 | $11.53 – $33.30 | 27 |
| Debridement (>20 cm) charge pt CPT 97598 | $30.26 | $53.00 | $21.57 – $47.70 | 27 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,406.94 | $2,464.00 | $1,002.85 – $2,217.60 | 27 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $287.21 | $503.00 | $202.17 – $452.70 | 27 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $344.88 | $604.00 | $245.83 – $543.60 | 27 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $45.68 | $80.00 | $32.56 – $72.00 | 27 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $159.88 | $280.00 | $113.96 – $252.00 | 27 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $940.44 | $1,647.00 | $380.02 – $1,482.30 | 27 |
| Decalcification CPT 88311 | $28.56 | $57.00 | $12.26 – $51.30 | 27 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $118.20 | $207.00 | $84.25 – $186.30 | 27 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $1.41 | $7.27 | $2.96 – $6.54 | 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.