Banner Ironwood Medical Center
37000 North Gantzel Road, San Tan Valley, AZ · Banner Health · · NPI 1124341672
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 |
|---|---|---|---|---|
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $2,052.04 – $3,741.03 | 6 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $3,741.03 – $4,542.09 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | $660.26 | $3,569.00 | $266.89 – $2,676.75 | 17 |
| Knee MRI (with contrast) CPT 73722 | $550.19 | $2,974.00 | $487.00 – $3,070.63 | 17 |
| Knee MRI (without contrast) CPT 73721 | $440.12 | $2,379.00 | $166.84 – $1,784.25 | 17 |
| Knee X-ray CPT 73564 | $105.28 | $448.00 | $79.00 – $467.28 | 17 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $79.90 | $340.00 | $58.65 – $347.17 | 17 |
| Knee X-ray (3 views, both knees) CPT 73562 | $94.00 | $400.00 | $58.65 – $347.17 | 17 |
| Knee X-ray (standing, both knees) CPT 73565 | $93.06 | $396.00 | $58.65 – $297.00 | 28 |
| Kras gene addl variants CPT 81276 | $142.10 | $580.00 | $193.25 – $435.00 | 28 |
| Kras gene variants exon 2 CPT 81275 | $228.34 | $932.00 | $193.25 – $699.00 | 28 |
| Lactate dehydrogenase (ldh) CPT 83615 | $28.89 | $167.00 | $6.04 – $14.25 | 28 |
| Lactic acid CPT 83605 | $26.47 | $153.00 | $11.57 – $26.25 | 28 |
| Lactoferrin fecal qualitative CPT 83630 | $16.95 | $98.00 | $19.70 – $54.75 | 28 |
| Lactoferrin fecal quant CPT 83631 | $35.29 | $204.00 | $19.63 – $153.00 | 28 |
| Lam facetc/frmt arthrd lum 1 CPT 63052 | not published | not published | $3,646.44 – $3,646.44 | 1 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $4,542.09 – $15,138.00 | 7 |
| Laparo-asst vag hysterectomy CPT 58550 | not published | not published | $3,668.82 – $9,813.71 | 6 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $3,668.82 – $15,138.00 | 7 |
| Laparo-myomectomy complex CPT 58546 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparo partial colectomy 44204 CPT 44204 | not published | not published | $2,311.23 – $9,813.71 | 2 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | not published | not published | $3,668.82 – $3,741.03 | 6 |
| Laparoscopic myomectomy CPT 58545 | not published | not published | $3,668.82 – $9,813.71 | 6 |
| Laparoscopy aspiration CPT 49322 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Laparoscopy biopsy CPT 49321 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparoscopy fundoplasty CPT 43280 | not published | not published | $5,254.47 – $6,458.05 | 6 |
| Laparoscopy lymphadenectomy CPT 38571 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparoscopy lysis CPT 58660 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparoscopy pyeloplasty CPT 50544 | not published | not published | $6,458.05 – $7,292.89 | 6 |
| Laparoscopy remove adnexa CPT 58661 | not published | not published | $3,668.82 – $5,254.47 | 6 |
| Laparo-vag hyst incl t/o CPT 58552 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laparo-vag hyst w/t/o compl CPT 58554 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Lap enterolysis CPT 44180 | not published | not published | $3,668.82 – $9,813.71 | 6 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $3,668.82 – $4,620.72 | 6 |
| Lap ing hernia repair recur CPT 49651 | not published | not published | $3,668.82 – $7,292.89 | 6 |
| Lap paraesophag hern repair CPT 43281 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Laps surg prst8ect rpbic rad CPT 55866 | not published | not published | $6,458.05 – $9,813.71 | 6 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $360.14 | $933.00 | $124.40 – $4,018.00 | 17 |
| Laser surgery of prostate CPT 52648 | not published | not published | $3,200.08 – $9,813.71 | 6 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $8,309.94 | $30,664.00 | $539.00 – $6,221.80 | 17 |
| Lead capillary CPT 83655 | $13.67 | $79.00 | $12.11 – $27.75 | 28 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $8,309.94 | $30,664.00 | $539.00 – $2,021.25 | 17 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,342.49 | $19,714.00 | $539.00 – $7,475.97 | 17 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $375.21 | $2,073.00 | $166.84 – $1,554.75 | 28 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $369.24 | $2,040.00 | $129.45 – $1,530.00 | 17 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $295.39 | $1,632.00 | $79.00 – $1,224.00 | 17 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $376.48 | $2,080.00 | $166.84 – $1,560.00 | 28 |
| Leishmania antibody CPT 86717 | $7.70 | $37.00 | $12.25 – $27.75 | 28 |
| Lens, intraocular (new tech) HCPCS C1780 | $428.17 | $1,413.00 | $282.60 – $1,806.05 | 17 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $653.61 | $2,157.00 | $118.80 – $445.50 | 16 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $653.61 | $2,157.00 | $118.80 – $445.50 | 16 |
| Levetiracetam therapeutic drug level CPT 80177 | $10.90 | $63.00 | $13.25 – $30.00 | 28 |
| Liberta rc ipg HCPCS C1820 | $29,675.58 | $109,504.00 | $977.00 – $79,219.12 | 17 |
| Lidocaine therapeutic drug level CPT 80176 | $7.78 | $45.00 | $14.69 – $33.75 | 28 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $1,139,204.90 | $3,759,504.00 | $4.73 – $2,819,628.00 | 13 |
| Lipase CPT 83690 | $43.08 | $249.00 | $6.89 – $39.00 | 28 |
| Lipoprotein blood high res frac & quant CPT 83701 | $17.65 | $102.00 | $33.86 – $76.50 | 28 |
| Lipoprotein blood quant CPT 83704 | $17.82 | $103.00 | $34.19 – $77.25 | 28 |
| Lipoprotein direct measurement hdl CPT 83718 | $21.28 | $123.00 | $8.19 – $18.75 | 28 |
| Lipoprotein direct measurement ldl CPT 83721 | $16.26 | $94.00 | $10.50 – $24.00 | 28 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $17.82 | $103.00 | $34.19 – $77.25 | 28 |
| Lithium therapeutic drug level CPT 80178 | $9.00 | $52.00 | $6.61 – $39.00 | 28 |
| Liver Function Test CPT 80076 | $49.65 | $287.00 | $8.17 – $215.25 | 28 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $2,052.04 – $3,741.03 | 6 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.68 | $2.24 | $0.45 – $6.95 | 17 |
| Low back disk surgery CPT 63030 | not published | not published | $4,542.09 – $15,138.00 | 7 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $84.53 | $467.00 | $79.00 – $350.25 | 28 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $704.09 | $3,890.00 | $129.45 – $2,917.50 | 28 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $586.80 | $3,242.00 | $266.89 – $2,431.50 | 28 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $469.33 | $2,593.00 | $79.00 – $1,944.75 | 28 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $424.24 | $3,626.00 | $266.89 – $2,719.50 | 28 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $353.57 | $3,022.00 | $266.89 – $2,266.50 | 28 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $282.79 | $2,417.00 | $166.84 – $1,812.75 | 28 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $103.63 | $441.00 | $79.00 – $330.75 | 28 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $118.20 | $503.00 | $79.00 – $377.25 | 28 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $140.06 | $596.00 | $79.00 – $447.00 | 28 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $74.26 | $316.00 | $58.65 – $347.17 | 17 |
| Low frequency non-thermal Ultrasound CPT 97610 | $26.52 | $298.00 | $42.94 – $241.00 | 15 |
| Lumbar diskogram s&i CPT 72295 | $844.12 | $3,592.00 | $290.34 – $3,121.95 | 28 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $7,292.89 – $11,504.39 | 6 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $77.68 | $642.00 | $191.73 – $497.85 | 28 |
| Lung function test (mbc/mvv) CPT 94200 | $27.35 | $226.00 | $40.35 – $169.50 | 28 |
| Lung Function Test (Spirometry) CPT 94010 | $61.47 | $508.00 | $101.17 – $381.00 | 28 |
| Lymphocyte transformation mitogen CPT 86353 | $30.78 | $148.00 | $49.03 – $111.00 | 28 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $1,901.83 – $2,440.42 | 6 |
| Macroscopic exam arthropod CPT 87168 | $3.48 | $13.00 | $4.27 – $9.75 | 28 |
| Macroscopic exam parasite CPT 87169 | $15.54 | $58.00 | $4.31 – $43.50 | 28 |
| Magnesium CPT 83735 | $22.84 | $132.00 | $6.70 – $15.75 | 28 |
| Magnetic image bone marrow CPT 77084 | $336.33 | $1,818.00 | $166.84 – $1,363.50 | 28 |
| Mammosite ced HCPCS C1728 | $3,765.54 | $13,895.00 | $282.60 – $1,059.75 | 17 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $0.29 | $10.90 | $2.18 – $13.01 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $909.20 | $3,355.00 | $62.60 – $612.42 | 17 |
| Mastoids complete CPT 70130 | $196.46 | $836.00 | $79.00 – $627.00 | 17 |
| M.avium-intra dna amp prob CPT 87561 | $28.41 | $106.00 | $35.09 – $79.50 | 28 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $10.90 | $63.00 | $14.46 – $47.25 | 28 |
| Mayo aathr protein s free CPT 85306 | $14.92 | $66.00 | $15.32 – $45.00 | 28 |
| Mayo activated protein c resistance assay CPT 85307 | $14.92 | $66.00 | $15.32 – $49.50 | 28 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $51.90 | $300.00 | $38.57 – $225.00 | 28 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $27.33 | $158.00 | $22.00 – $82.50 | 16 |
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.