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 |
|---|---|---|---|---|
| Fl exam g/colon tube w contrast CPT 49465 | $106.78 | $222.00 | $91.02 – $199.80 | 27 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $575.40 – $2,518.60 | 6 |
| Flow cytometry marker each additional CPT 88185 | $62.87 | $126.00 | $12.26 – $107.10 | 27 |
| Flow cytometry one marker technical component CPT 88184 | $380.24 | $762.00 | $211.16 – $685.80 | 27 |
| Flt3 gene CPT 81245 | $222.66 | $497.00 | $165.51 – $447.30 | 27 |
| Flt3 gene analysis CPT 81246 | $111.55 | $249.00 | $83.00 – $224.10 | 27 |
| Fluidotherapy charges pt CPT 97022 | $16.31 | $70.00 | $16.66 – $63.00 | 27 |
| Fluid pressure muscle 20950 CPT 20950 | $299.11 | $618.00 | $253.38 – $556.20 | 27 |
| Fluorescent antibody titer dna CPT 86256 | $306.34 | $837.00 | $12.05 – $33.30 | 27 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $143.63 | $271.00 | $64.50 – $243.90 | 27 |
| Fluoroguide needle placement CPT 77002 | $239.56 | $452.00 | $107.58 – $406.80 | 27 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $192.39 | $363.00 | $78.97 – $326.70 | 27 |
| Fna bx w/ct gdn 1st les CPT 10009 | $649.83 | $1,351.00 | $450.93 – $1,215.90 | 27 |
| Fna bx w/ct gdn ea addl CPT 10010 | $617.60 | $1,284.00 | $305.59 – $1,155.60 | 27 |
| Folic acid CPT 82746 | $21.15 | $45.00 | $14.70 – $40.50 | 27 |
| Foot X-ray CPT 73630 | $115.54 | $218.00 | $58.65 – $196.20 | 27 |
| Foot X-ray (2 views, both feet) CPT 73620 | $82.15 | $155.00 | $58.65 – $139.50 | 27 |
| Forearm X-ray (both sides) CPT 73090 | $103.35 | $195.00 | $58.65 – $175.50 | 27 |
| Fracture assessment via dxa CPT 77086 | $81.09 | $153.00 | $58.65 – $137.70 | 27 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $2,230.35 – $16,527.07 | 7 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $44.45 | $93.00 | $37.85 – $83.70 | 27 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $44.45 | $93.00 | $37.85 – $83.70 | 27 |
| Fresh frozen plasma thawing ea un CPT 86927 | $167.17 | $365.00 | $90.01 – $328.50 | 27 |
| Fructosamine glycated protein CPT 82985 | $24.91 | $53.00 | $16.76 – $47.70 | 27 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $195.57 | $369.00 | $79.00 – $332.10 | 27 |
| Fusion of big toe joint CPT 28750 | not published | not published | $4,542.09 – $4,768.74 | 6 |
| Fusion of foot bones CPT 28740 | not published | not published | $4,542.09 – $4,768.74 | 6 |
| Gabapentin non-blood CPT 80355 | $26.32 | $56.00 | $13.33 – $50.40 | 27 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $81.31 | $173.00 | $21.07 – $155.70 | 27 |
| Galactose transferase test CPT 82776 | $16.92 | $36.00 | $11.74 – $32.40 | 27 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $475.20 | $900.00 | $273.41 – $810.00 | 27 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $661.58 | $1,253.00 | $354.82 – $1,127.70 | 27 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $3,668.82 – $10,128.08 | 6 |
| Gammaglobulin iga CPT 82784 | $29.61 | $63.00 | $9.30 – $46.80 | 27 |
| Gammaglobulin ige CPT 82785 | $27.26 | $58.00 | $16.46 – $52.20 | 27 |
| Gamma glutamyltransferase CPT 82977 | $29.14 | $62.00 | $7.20 – $19.80 | 27 |
| Gastric emptying imag study CPT 78265 | $686.93 | $1,301.00 | $273.41 – $1,170.90 | 27 |
| Gastric emptying imag study CPT 78266 | $885.46 | $1,677.00 | $354.82 – $1,509.30 | 27 |
| Gastroesophageal reflux test CPT 91034 | $265.08 | $461.00 | $189.01 – $414.90 | 27 |
| Gated heart multiple CPT 78473 | $796.22 | $1,508.00 | $273.41 – $1,357.20 | 27 |
| Generator barostim neo2 2014 HCPCS C1767 | $66,359.02 | $131,404.00 | $6,775.86 – $25,623.00 | 27 |
| Generator emblem MRI sicd subq HCPCS C1722 | $52,890.43 | $109,504.00 | $10,424.40 – $39,420.00 | 27 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $4.38 | $22.56 | $2.62 – $20.30 | 27 |
| Gentamicin peak therapeutic drug level CPT 80170 | $23.50 | $50.00 | $16.38 – $45.00 | 27 |
| G-esoph reflx tst w/electrod CPT 91035 | $695.18 | $1,209.00 | $353.64 – $1,088.10 | 27 |
| Ghs abscess perianal iandd CPT 46050 | not published | not published | $575.40 – $2,518.60 | 6 |
| Ghs abscess postoperative iandd complex CPT 10180 | $175.87 | $308.00 | $125.36 – $277.20 | 27 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $27.73 | $59.00 | $9.81 – $53.10 | 27 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $24.44 | $52.00 | $17.11 – $46.80 | 27 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $371.84 | $830.00 | $102.26 – $747.00 | 27 |
| Ghs antibodies (torch) igm CPT 86694 | $16.10 | $44.00 | $14.39 – $39.60 | 27 |
| Ghs aspiration bladder - needle CPT 51100 | $32.71 | $68.00 | $27.88 – $61.20 | 27 |
| Ghs bladder cath - complex-foley CPT 51703 | $102.93 | $214.00 | $87.74 – $192.60 | 27 |
| Ghs chemo >8 hrs CPT 96416 | $33.13 | $211.00 | $85.88 – $189.90 | 27 |
| Ghs chemo IV push, ea addtl CPT 96411 | $42.13 | $119.00 | $44.93 – $107.10 | 27 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $155.14 | $328.00 | $35.09 – $295.20 | 27 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | not published | not published | $1,009.45 – $2,518.60 | 6 |
| Ghs community re-entry 15 minutes CPT 97537 | $18.17 | $78.00 | $18.56 – $70.20 | 27 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $23.06 | $63.00 | $15.21 – $56.70 | 27 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $350.17 | $728.00 | $298.48 – $655.20 | 27 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $1,718.26 – $3,860.87 | 6 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $7.69 | $21.00 | $6.98 – $18.90 | 27 |
| Ghs fish cytogen CPT 88271 | $403.69 | $809.00 | $21.42 – $58.50 | 27 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $76.85 | $154.00 | $51.19 – $138.60 | 27 |
| Ghs hcv amplificaiton CPT 87521 | $50.14 | $106.00 | $35.09 – $95.40 | 27 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $17.20 | $47.00 | $15.49 – $42.30 | 27 |
| Ghs histoplasma antigen CPT 87385 | $71.90 | $152.00 | $13.25 – $136.80 | 27 |
| Ghs HIV antibody CPT 86703 | $15.37 | $42.00 | $13.71 – $37.80 | 27 |
| Ghs immun0electrophoresis CPT 86320 | $32.94 | $90.00 | $29.92 – $81.00 | 27 |
| Ghs inhibitor screen CPT 85335 | $111.15 | $225.00 | $12.87 – $35.10 | 27 |
| Ghs inj transforaminal cerv single bil CPT 64479 | not published | not published | $596.28 – $1,965.63 | 6 |
| Ghs insertion of needle - bone CPT 36680 | $113.74 | $235.00 | $96.35 – $211.50 | 27 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | not published | not published | $250.73 – $3,372.77 | 6 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $8.66 | $18.00 | $4.28 – $16.20 | 27 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $41.28 | $80.00 | $29.00 – $72.00 | 27 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | not published | not published | $250.73 – $2,518.60 | 6 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | not published | not published | $250.73 – $2,518.60 | 6 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | not published | not published | $250.73 – $3,372.77 | 6 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $12.84 | $26.00 | $8.60 – $23.40 | 27 |
| Ghs mbp CPT 83873 | $29.61 | $63.00 | $17.20 – $56.70 | 27 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $184.23 | $345.00 | $82.11 – $310.50 | 27 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $80.10 | $150.00 | $35.70 – $135.00 | 27 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $50.73 | $95.00 | $22.61 – $85.50 | 27 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $42.72 | $80.00 | $19.04 – $72.00 | 27 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $40.05 | $75.00 | $17.85 – $67.50 | 27 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $402.20 | $831.00 | $227.14 – $498.60 | 27 |
| Ghs nerve blk intercostal, single level CPT 64420 | $338.32 | $699.00 | $191.06 – $419.40 | 27 |
| Ghs nerve block celiac plexus CPT 64530 | $341.51 | $710.00 | $291.10 – $639.00 | 27 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $416.06 | $865.00 | $354.65 – $778.50 | 27 |
| Ghs nerve block sciatic nerve CPT 64445 | $416.55 | $866.00 | $236.57 – $519.30 | 27 |
| Ghs ng placement w fluoro guidance CPT 43752 | $123.14 | $256.00 | $104.96 – $230.40 | 27 |
| Ghs o2 saturation CPT 82810 | $14.10 | $30.00 | $9.77 – $27.00 | 27 |
| Ghs opcc repair cvp without subq port CPT 36575 | $410.29 | $853.00 | $349.73 – $767.70 | 27 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $1,019.45 – $3,372.77 | 6 |
| Ghs ot dds rom CPT 95851 | $15.15 | $65.00 | $15.47 – $58.50 | 27 |
| Ghs ot prosthetic training/15 min CPT 97761 | $13.98 | $60.00 | $14.28 – $54.00 | 27 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $15.38 | $66.00 | $15.71 – $59.40 | 27 |
| Ghs ot work hardening-additional hours CPT 97546 | $21.44 | $92.00 | $21.90 – $82.80 | 27 |
| Ghs pacing - transcutaneous CPT 92953 | $261.84 | $541.00 | $221.81 – $486.90 | 27 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $176.09 – $681.68 | 6 |
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.