Visits & medical services prices at Banner Payson Medical Center
Payson, AZ · every code in this section with a posted price and a Medicare benchmark.
158 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) | $107.48 | $190 | 0.5× |
| Airway resistance by oscillometry (94728) | $99.97 | $193 | 0.7× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 4 matching MRF lines |
$3.14–$17.01 | $73 | varies |
| Application on-body injector (96377) | $41.28 | $80 | 0.8× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $211.86 | $409 | 0.5× |
| Canalith repositioning proc (95992) | $38.91 | $167 | 1.0× |
| Cardiac Stress Tst,Tracing Only (93017) | $466.36 | $929 | 2.0× |
| Cardiopulmonary exercise testing (94621) | $470.86 | $909 | 1.2× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$247.32–$251.92 | $511 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$419.43–$422.05 | $872 | varies |
| Chemo Admin Peritoneal Cavity (96446) | $240.01 | $678 | 0.7× |
| Chemo Anti-Neopl Sq/Im (96401) | $195.41 | $552 | 2.5× |
| Chemo Hormon Antineopl Sq/Im (96402) | $75.76 | $214 | 1.0× |
| Chemo Intralesional Over 7 (96406) | $93.46 | $264 | 0.4× |
| Chemo intralesional up to 7 (96405) | $59.47 | $168 | 0.8× |
| Chemo IV infusion addl hr (96415) | $7.07 | $45 | 0.1× |
| Chemo IV push addl drug (96411) | $42.13 | $119 | 0.5× |
| Chemother Prolong Infuse W/Pump (96416) | $33.13 | $211 | 0.1× |
| Chemotherapy Into Cns (96450) | $236.12 | $667 | 0.7× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $15.54 | $99 | 0.2× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $31.56 | $201 | 0.1× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $67.61 | $191 | 0.2× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) | $153.99 | $435 | 0.4× |
| Chest Wall Manipulation (94668) | $44.86 | $91 | 0.3× |
| Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) | $541.31 | $1,045 | 1.4× |
| Color/duplex Doppler, complete (93975) | $322.46 | $669 | 1.3× |
| Color/duplex Doppler, limited (93976) | $187.98 | $390 | 1.7× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) range across 4 matching MRF lines |
$3.35–$18.17 | $78 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $216.43 | $439 | 0.9× |
| Cpt initial (94667) | $35.50 | $72 | 0.3× |
| Critical care first hour (99291) | $539.66 | $1,115 | 0.6× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$26.33–$64.52 | $113 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $219.31 | $455 | 0.9× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $139.30 | $289 | 1.2× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) | $239.55 | $497 | 2.1× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $373.07 | $774 | 1.5× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $230.88 | $479 | 2.1× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $365.36 | $758 | 1.4× |
| Dup-scan xtr veins unilateral/limited study (93971) | $317.64 | $659 | 2.8× |
| Duplex Scan Hemodialysis Access (93990) | $294.02 | $610 | 2.6× |
| Duplex up extrem art bilat (93930) | $391.38 | $812 | 1.5× |
| Duplex up extrem art unilat/ltd (93931) | $256.91 | $533 | 2.3× |
| Echo Heart Xthoracic,Limited (93308) | $292.36 | $559 | 1.1× |
| Echo transesophag montr cardiac pump functj (93318) | $1,276.64 | $2,441 | 2.2× |
| Echo transesophageal (93312) | $758.87 | $1,451 | 1.3× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $834.71 | $1,596 | 1.4× |
| EEG awake and asleep (95819) | $231.22 | $433 | 1.0× |
| EEG awake drowsy (95816) | $197.58 | $370 | 0.9× |
| Electrical Stimulation Ea 15 Min (97032) range across 4 matching MRF lines |
$2.92–$15.84 | $68 | varies |
| Electrocardiogram Tracing (93005) | $117.39 | $232 | 1.9× |
| Electroconvulsive Therapy (90870) | $445.21 | $787 | 0.5× |
| Emergency Dept Visit Level 2 (99282) | $252.10 | $315 | 1.5× |
| Emergency Dept Visit Level 3 (99283) | $496.79 | $445 | 1.7× |
| Emergency Dept Visit Level 4 (99284) | $1,191.40 | $565 | 2.7× |
| Er level 1 (99281) | $197.65 | $255 | 2.2× |
| Er level v (99285) | $1,496.11 | $775 | 2.4× |
| Evaluate pt use of inhaler (94664) | $55.71 | $113 | 0.2× |
| Evaluate Swallowing Function (92610) | $162.40 | $251 | 1.9× |
| Extracranial Bilat Study (93880) | $395.24 | $820 | 1.6× |
| Extracranial Uni/Ltd Study (93882) | $253.53 | $526 | 2.3× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) | $265.08 | $461 | 0.7× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $695.18 | $1,209 | 0.8× |
| Gi tract capsule endoscopy (91110) | $1,144.25 | $1,990 | 1.2× |
| Group Therapeutic Procedures (97150) | $31.11 | $55 | 1.7× |
| Immunization administration (90471) | $21.06 | $60 | 0.3× |
| Insert/Place Heart Catheter (93503) | $1,256.37 | $2,612 | 0.7× |
| Intracranial Complete Study (93886) | $402.47 | $835 | 1.6× |
| Iontophoresis 15 min (97033) range across 4 matching MRF lines |
$3.27–$17.71 | $76 | varies |
| Irrig Drug Delivery Device (96523) | $68.11 | $132 | 1.1× |
| IV infusion hydration each additional hour (96361) range across 2 matching MRF lines |
$27.61–$28.07 | $58 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 2 matching MRF lines |
$100.44–$102.12 | $211 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 2 matching MRF lines |
$53.31–$54.21 | $112 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 2 matching MRF lines |
$31.42–$31.94 | $66 | varies |
| IV push initial (96374) range across 3 matching MRF lines |
$123.90–$132.10 | $256 | varies |
| Low frequency non-thermal us (97610) range across 5 matching MRF lines |
$7.31–$97.07 | $170 | varies |
| Lung Function Test (Mbc/Mvv) (94200) | $49.21 | $95 | 0.8× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $205.33 | $426 | 0.9× |
| Mechanical chest wall oscillation per session (94669) | $171.56 | $348 | 0.7× |
| Methacholine challenge (94070) | $211.86 | $409 | 0.5× |
| Motility study esophagus (91010) | $427.22 | $743 | 1.1× |
| Motion Fluoroscopy/Swallow (92611) | $190.86 | $295 | 2.1× |
| Multiple Sleep Latency Test (95805) range across 4 matching MRF lines |
$2,776.45–$3,470.56 | $3,488–$4,360 | varies |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $210.13 | $368 | 0.5× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $246.10 | $431 | 0.6× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 3 matching MRF lines |
$23.07–$56.53 | $99 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 3 matching MRF lines |
$45.20–$110.77 | $194 | varies |
| Neuromuscular Reeducation (97112) range across 4 matching MRF lines |
$3.14–$17.01 | $73 | varies |
| Newborn resuscitation (99465) | $290.77 | $514 | 0.4× |
| O2 Uptk Exp Gas Alys W/Co2 Output % O2 Xtrc (94681) | $204.61 | $395 | 0.5× |
| Oral Function Therapy (92526) | $100.45 | $205 | 1.2× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) range across 4 matching MRF lines |
$2.84–$15.38 | $66 | varies |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 4 matching MRF lines |
$2.75–$14.91 | $64 | varies |
| Ot Contrast Bath Ea 15 Min (97034) range across 4 matching MRF lines |
$2.11–$11.42 | $49 | varies |
| Ot eval high complexity (97167) | $29.59 | $216 | 0.3× |
| Ot Eval Low Complex (97165) | $17.67 | $129 | 0.2× |
| Ot Eval Moderate Complexity (97166) | $23.56 | $172 | 0.2× |
| Ot manual therapy 15 min (97140) range across 4 matching MRF lines |
$3.57–$19.34 | $83 | varies |
| Ot paraffin bath (97018) range across 4 matching MRF lines |
$1.46–$7.92 | $34 | varies |
| Ot Prosthetic Training, Each 15 Min (97761) range across 4 matching MRF lines |
$2.58–$13.98 | $60 | varies |
| Ot Re-Eval Est Plan Care (97168) | $17.67 | $129 | 0.3× |
| Ot rom hand (95852) | $15.84 | $68 | 0.7× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $157.82 | $288 | 1.1× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $121.66 | $222 | 0.9× |
| Penile Vascular Study,Ltd or F/U (93981) | $146.53 | $304 | 1.3× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $149.87 | $304 | 0.6× |
| Phlebotomy therapeutic (99195) | $66.05 | $128 | 0.5× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $144.74 | $306 | 2.3× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $114.47 | $242 | 1.8× |
| Physical Performance Test (97750) | $14.68 | $63 | 0.4× |
| Plethysmography (94726) | $113.44 | $219 | 0.3× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) range across 4 matching MRF lines |
$2,735.68–$3,419.74 | $5,123–$6,404 | varies |
| Polysom <6 yrs 4/> paramtrs (95782) | $3,318.81 | $6,215 | 3.6× |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) | $5,224.15 | $6,563 | 5.7× |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) range across 2 matching MRF lines |
$1,301.89–$1,627.63 | $2,438–$3,048 | varies |
| Psych diag eval w/med srvcs (90792) | $197.43 | $349 | 1.0× |
| Psychiatric diagnostic evaluation (90791) | $179.33 | $317 | 0.9× |
| Pt Eval High Complex (97163) | $44.50 | $216 | 0.5× |
| Pt eval low complex 20 min (97161) | $26.57 | $129 | 0.3× |
| Pt Eval Mod Complex (97162) | $35.43 | $172 | 0.4× |
| Pt gait training 15 min (97116) | $16.78 | $72 | 0.6× |
| Pt mechanical traction (97012) | $18.17 | $78 | 1.3× |
| Pt Re-Eval Est Plan Care (97164) | $26.57 | $129 | 0.4× |
| Pulm function test by gas (94727) | $106.19 | $205 | 0.5× |
| Pulmonary Stress Testing (94618) | $134.68 | $260 | 0.9× |
| Refill/Maint Portable Pump (96521) | $78.95 | $153 | 0.3× |
| Refill/Maint Pump/Resvr Syst (96522) | $65.02 | $126 | 0.3× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $55.66 | $110 | 0.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $56.53 | $99 | 0.3× |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) | $15.15 | $65 | 0.6× |
| Self Care Mngment Training (97535) range across 4 matching MRF lines |
$3.57–$19.34 | $83 | varies |
| Sensory Integration Ea 15 Min (97533) range across 4 matching MRF lines |
$2.84–$15.38 | $66 | varies |
| Sleep study attended (95807) range across 4 matching MRF lines |
$1,158.25–$1,448.21 | $2,169–$2,712 | varies |
| Sleep study unattended (95806) range across 4 matching MRF lines |
$462.48–$578.69 | $581–$727 | varies |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) | $497.50 | $625 | 2.2× |
| Speech sound lang comprehen (92523) | $181.30 | $370 | 0.8× |
| Spirometry (94010) | $118.62 | $229 | 0.5× |
| Stress Tte Only (93350) | $557 | $1,065 | 1.0× |
| Surfactant Admin Thru Tube (94610) | $39.37 | $76 | 0.2× |
| Temp transcutaneous pacing (92953) | $261.84 | $541 | 0.4× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $3.74 | $87 | 0.2× |
| Ther Ivntj Ea Addl 15 Min (97130) | $3.57 | $83 | 0.2× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $18.17 | $78 | 0.5× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) range across 4 matching MRF lines |
$2.88–$15.61 | $67 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$36.30–$38.70 | $75 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 2 matching MRF lines |
$120.43–$122.45 | $253 | varies |
| Therapeutic Activities (97530) range across 4 matching MRF lines |
$2.88–$15.61 | $67 | varies |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $665.22 | $1,383 | 1.7× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $233.77 | $485 | 2.1× |
| Tte w/doppler, complete (93306) | $652.70 | $1,248 | 1.1× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $90.65 | $185 | 1.2× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 2 matching MRF lines |
$36.30–$38.70 | $75 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $161.95 | $336 | 1.1× |
| Vasopneumatic device (97016) | $1.63 | $38 | 0.1× |
| Vent Mgmt Inpat Init Day (94002) | $501.38 | $1,017 | 0.8× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $358.90 | $728 | 0.5× |
| Vital capacity, total (94150) | $22.27 | $43 | 0.2× |
| Wheelchair Mgmt Ea 15 Min (97542) | $16.78 | $72 | 0.5× |
| Whirlpool Therapy (97022) | $16.31 | $70 | 1.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.