Banner Payson Medical Center

807 South Ponderosa Drive, Payson, AZ 85541 · (928) 474-3222

Critical Access HospitalsVoluntary non-profit - OtherCMS rating 4/5Payson, AZ metro

Price file

Prices published

File dated 2026-09-22

4,116 price rows for 53 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $20

$20

cash

$8 to $41

55 negotiated rates

$42

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 2 lines · metro median $1,061

$1,061

cash

$242 to $1,887

110 negotiated rates

$2,097

list

CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines · metro median $489

$489

cash

$79 to $868

110 negotiated rates

$964

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines · metro median $817

$817

cash

$129 to $1,453

110 negotiated rates

$1,614

list

Cataract surgery with lens implant

CPT 66984

—

cash

$1,507 to $9,964

12 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788 · metro median $8,119

$8,119

cash

$3,749 to $29,208

7 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 4 lines · metro median $50

$50

cash

$35 to $170

110 negotiated rates

$106

list

Colonoscopy (diagnostic)

CPT 45378

—

cash

$575 to $4,735

12 negotiated rates

—

list

Colonoscopy with biopsy

CPT 45380

—

cash

$752 to $4,309

12 negotiated rates

—

list

Colonoscopy with polyp removal

CPT 45385

—

cash

$752 to $4,309

24 negotiated rates

—

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 4 lines · metro median $12

$12

cash

$8 to $38

110 negotiated rates

$24

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $21

$21

cash

$11 to $51

55 negotiated rates

$44

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 2 lines · metro median $169

$169

cash

$69 to $639

55 negotiated rates

$271

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 4 lines · metro median $168

$168

cash

$55 to $2,885

188 negotiated rates

$340

list

Family psychotherapy with the patient

CPT 90847 · lowest of 2 lines · metro median $147

$147

cash

$97 to $924

108 negotiated rates

$259

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$3,669 to $14,220

12 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 4 lines · metro median $50

$50

cash

$35 to $170

110 negotiated rates

$106

list

Group psychotherapy

CPT 90853 · lowest of 4 lines · metro median $97

$97

cash

$54 to $507

162 negotiated rates

$222

list

Hip or knee replacement, no major complications

MS-DRG 470 · metro median $17,871

$17,871

cash

$3,749 to $97,475

7 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392 · metro median $7,464

$7,464

cash

$3,749 to $26,336

7 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743 · metro median $11,034

$11,034

cash

$3,749 to $40,168

7 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

$2,308 to $6,695

12 negotiated rates

—

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$2,052 to $6,695

12 negotiated rates

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 4 lines · metro median $25

$25

cash

$13 to $71

110 negotiated rates

$54

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $19

$19

cash

$8 to $39

55 negotiated rates

$41

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines · metro median $1,496

$1,496

cash

$267 to $2,640

55 negotiated rates

$2,933

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 2 lines · metro median $934

$934

cash

$167 to $1,695

55 negotiated rates

$1,883

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines · metro median $934

$934

cash

$167 to $1,695

55 negotiated rates

$1,883

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473 · metro median $23,370

$23,370

cash

$3,749 to $80,002

12 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483

—

cash

$596 to $2,475

12 negotiated rates

—

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 4 lines · metro median $134

$134

cash

$55 to $1,989

141 negotiated rates

$270

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 4 lines · metro median $183

$183

cash

$55 to $2,394

141 negotiated rates

$370

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 4 lines · metro median $233

$233

cash

$55 to $3,204

141 negotiated rates

$470

list

PSA test (prostate)

CPT 84153 · lowest of 4 lines · metro median $26

$26

cash

$18 to $89

110 negotiated rates

$56

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 4 lines · metro median $9

cash

$6 to $62

110 negotiated rates

$19

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines · metro median $361

$361

cash

$79 to $527

110 negotiated rates

$586

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 4 lines · metro median $25

$25

cash

$4 to $57

110 negotiated rates

$51

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 2 lines · metro median $111

$111

cash

$97 to $507

108 negotiated rates

$256

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $126

$126

cash

$97 to $607

108 negotiated rates

$291

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $143

$143

cash

$97 to $916

108 negotiated rates

$329

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $191

$191

cash

$62 to $528

54 negotiated rates

$244

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$2,003 to $4,299

12 negotiated rates

—

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 4 lines · metro median $3,204

$3,204

cash

$667 to $6,750

110 negotiated rates

$6,000

list

Spinal injection, lower back, with imaging guidance

CPT 62323

—

cash

$460 to $1,384

12 negotiated rates

—

list

TSH test (thyroid)

CPT 84443 · lowest of 4 lines · metro median $24

$24

cash

$17 to $81

110 negotiated rates

$51

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$3,687 to $5,421

12 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · lowest of 2 lines · metro median $280

$280

cash

$79 to $410

110 negotiated rates

$455

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $410

$410

cash

$79 to $599

110 negotiated rates

$666

list

Upper endoscopy (EGD)

CPT 43235

—

cash

$587 to $3,536

12 negotiated rates

—

list

Upper endoscopy with biopsy

CPT 43239

—

cash

$587 to $4,735

24 negotiated rates

—

list

Urinalysis with microscope

CPT 81001 · lowest of 2 lines · metro median $5

cash

$3 to $15

55 negotiated rates

$10

list

Vaginal delivery hospital stay, no complications

MS-DRG 807 · metro median $6,210

$6,210

cash

$3,749 to $14,060

7 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $276

$276

cash

$79 to $468

110 negotiated rates

$520

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://images.pricetransparency.healthcare/public-mrfs/banner/450233470_banner-payson-medical-center_standardcharges.csv
Banner Payson Medical Center · parsed · tall v3.0.0 · file dated 2026-09-22 · 78.1 MB · 4116 price rows read · read Nov 2026