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.

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ProcedureCash priceGross charge× Medicare
Aep hearing status deter broadband stimuli i&r (92651) $107.48 $190 0.5×
Appl on-body injector for timed subq injection (96377) $41.28 $80 0.8×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $211.86 $409 0.5×
Canalith Repositioning (95992) $38.91 $167 1.0×
Capsule endoscopy (91110) $1,144.25 $1,990 1.2×
Cardiac Stress Tst,Tracing Only (93017) $466.36 $929 2.0×
Cardiopulmonary exercise testing (94621) $470.86 $909 1.2×
Cardiopulmonary resuscitation (92950) $249.62 $511 1.1×
Cardioversion (92960) $420.74 $872 0.6×
Chemo Admin Peritoneal Cavity (96446) $240.01 $678 0.7×
Chemo Hormon Antineopl Sq/Im (96402) $75.76 $214 1.0×
Chemo inj subarach/intravent (96542) $153.99 $435 0.4×
Chemo IV push addl drug (96411) $42.13 $119 0.5×
Chemo Iv Push Sngl Drug (96409) $67.61 $191 0.2×
Chemo prolong 8+ hrs infuse w/pump (96416) $33.13 $211 0.1×
Chemother, IV infusion, 1 hr (96413) $31.56 $201 0.1×
Chemother, IV infusion, ea add hr (96415) $7.07 $45 0.1×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $195.41 $552 2.5×
Chemotx Admn Cns Req Spinal Puncture (96450) $236.12 $667 0.7×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $15.54 $99 0.2×
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×
Cpap initiation and management (94660) $216.43 $439 0.9×
Cpt initial (94667) $35.50 $72 0.3×
Critical care (99291) $539.66 $1,115 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $26.33 $113 0.1×
Demo &/or eval,pt use,aerosol device (94664) $55.71 $113 0.2×
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 artl infl&ven o/f pen vsl f-up/lmtd std (93981) $146.53 $304 1.3×
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 Uxtr Art/Artl Bpgs Compl Bi Study (93930) $391.38 $812 1.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $256.91 $533 2.3×
Dup-scan xtr veins unilateral/limited study (93971) $317.64 $659 2.8×
Duplex hemodialysis access (93990) $294.02 $610 2.6×
Duplex scan extracranial art compl bi study (93880) $395.24 $820 1.6×
Echo Heart Xthoracic,Limited (93308) $292.36 $559 1.1×
Echo transesophageal (93312) $758.87 $1,451 1.3×
Echo Transesophageal - Congenital Tee Complete (93315) $834.71 $1,596 1.4×
EEG awake asleep (95819) $231.22 $433 1.0×
EEG awake drowsy (95816) $197.58 $370 0.9×
EKG (93005) $117.39 $232 1.9×
EKG rhythm strip (93041) $55.66 $110 0.9×
Electroconvulsive Therapy (90870) $445.21 $787 0.5×
Er level 1 (99281) $197.65 $255 2.2×
Er level ii (99282) $252.10 $315 1.5×
Er level iii (99283) $496.79 $445 1.7×
Er level IV (99284) $1,191.40 $565 2.7×
Er level v (99285) $1,496.11 $775 2.4×
Evaluation of swallowing function (92610) $162.40 $251 1.9×
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×
Group Therapeutic Procedures (97150) $31.11 $55 1.7×
Immunization Admin (90471) $21.06 $60 0.3×
Ins swan ganz bedside (93503) $1,256.37 $2,612 0.7×
Intralesional Chemo Admin,8+ Lesn (96406) $93.46 $264 0.4×
Intralesional Chemo Admin,<8 Lesn (96405) $59.47 $168 0.8×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $68.11 $132 1.1×
IV infusion hydration each additional hour (96361) $27.84 $58 0.6×
IV infusion hydration initial 31 min-1 hour (96360) $101.28 $211 0.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $53.76 $112 0.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $121.44 $253 0.5×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $31.68 $66 0.6×
IV push initial (96374) $132.10 $256 0.6×
Low frequency non-thermal us (97610) $39.61 $170 0.2×
Manual therapy 15 min (97140) $11.46 $83 0.4×
Massage 15 min (97124) $9.24 $67 0.3×
Maximum voluntary ventilation (94200) $49.21 $95 0.8×
Mechanical chest wall oscillation (94669) $171.56 $348 0.7×
Mechanical traction (97012) $18.17 $78 1.3×
Methacholine challenge (94070) $211.86 $409 0.5×
Motility study esophagus (91010) $427.22 $743 1.1×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $190.86 $295 2.1×
Multiple sleep latency test (95805) $3,123.50 $3,924 3.4×
Neg press wnd tx </=50 sq cm (97607) $210.13 $368 0.5×
Neg press wound tx >50 cm (97608) $246.10 $431 0.6×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $23.07 $99 0.1×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $45.20 $194 0.1×
Newborn resuscitation (99465) $290.77 $514 0.4×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $161.95 $336 1.1×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $204.61 $395 0.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $8.83 $64 0.2×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $10.76 $78 0.3×
Ot Contrast Bath Ea 15 Min (97034) $6.76 $49 0.5×
Ot eval high complex 60 min (97167) $29.59 $216 0.3×
Ot eval low complex 30 min (97165) $17.67 $129 0.2×
Ot eval mod complex 45 min (97166) $23.56 $172 0.2×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $9.11 $66 0.2×
Ot Prosthetic Training, Each 15 Min (97761) $8.28 $60 0.2×
Ot Range Motion Measure,Each Extrem (95851) $15.15 $65 0.6×
Ot re-eval est plan care (97168) $17.67 $129 0.3×
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×
Paraffin bath (97018) $4.69 $34 0.8×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $149.87 $304 0.6×
Phy/qhp op pulm rhb w/mntr (94626) $144.74 $306 2.3×
Phy/qhp op pulm rhb w/o mntr (94625) $114.47 $242 1.8×
Plethysmography (94726) $113.44 $219 0.3×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,077.71 $5,763.50 3.4×
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) $1,464.76 $2,743 1.6×
Psych diag eval w/med srvcs (90792) $197.43 $349 1.0×
Psychiatric diagnostic evaluation (90791) $179.33 $317 0.9×
Pt Aquatic Therapy/Exercises (97113) $18.17 $78 0.5×
Pt Electric Current Therapy (97033) $10.49 $76 0.6×
Pt Electrical Stimulation (97032) $9.38 $68 0.6×
Pt eval high complex 45 min (97163) $44.50 $216 0.5×
Pt eval low complex 20 min (97161) $26.57 $129 0.3×
Pt Gait Training Therapy (97116) $16.78 $72 0.6×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $10.08 $73 0.3×
Pt Physical Performance Test (97750) $14.68 $63 0.4×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $35.43 $172 0.4×
Pt re-evaluation (97164) $26.57 $129 0.4×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $11.46 $83 0.4×
Pt Ultrasound Therapy (97035) $10.08 $73 0.7×
Pt Whirlpool Therapy (97022) $16.31 $70 1.0×
Pulm Funct Test Oscillometry (94728) $99.97 $193 0.7×
Pulm function test by gas (94727) $106.19 $205 0.5×
Pulmonary stress testing (94618) $134.68 $260 0.9×
Refill/Maint Pump/Resvr Syst (96522) $65.02 $126 0.3×
Refill/maint, portable pump (96521) $78.95 $153 0.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $56.53 $99 0.3×
Rom meas&reprt hand w/wo comparison normal sid (95852) $15.84 $68 0.7×
Rt Chest Wall Manipulation,Subsequent (94668) $44.86 $91 0.3×
Sensory Integration Ea 15 Min (97533) $9.11 $66 0.1×
Sleep study attended (95807) $1,303.23 $2,440.50 3.3×
Sleep study unattended (95806) $520.58 $654 2.3×
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 echo (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 Cog Funcj Cntct Ea Addl 15 Minutes (97130) $3.57 $83 0.2×
Ther/Proph/Diag Inj Sc/Im (96372) $37.50 $75 0.5×
Therapeutic Activities (97530) $9.24 $67 0.3×
Therapeutic phlebotomy (99195) $66.05 $128 0.5×
Tilt Table Eval (93660) $665.22 $1,383 1.7×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $402.47 $835 1.6×
Transcranial Doppler Limited (93888) $233.77 $485 2.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $652.70 $1,248 1.1×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $90.65 $185 1.2×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $100.45 $205 1.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $37.50 $75 0.8×
Ultrasound of heart with probe in esophagus to assess heart pump function (93318) $1,276.64 $2,441 2.2×
Vasc Duplex Extrem Venous,Bilat (93970) $365.36 $758 1.4×
Vasc Duplex Scan Extracranial,Limited (93882) $253.53 $526 2.3×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $205.33 $426 0.9×
Vasopneumatic device (97016) $1.63 $38 0.1×
Ventilation assist & mgmt inpatient 1st 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×