Banner Payson Medical Center — procedure prices

Published prices for 271 procedures at Banner Payson Medical Center (Payson, AZ), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $53 $68 $31 $51
Abdominal fluid drain (paracentesis) $344 $616 $311 $284
Abdominal ultrasound $311 $506 $237 $100
Abscess incision and drainage $105 $184 $126 $174
Achilles tendon repair — — $4,542 $624
ACL knee reconstruction — — $4,542 $889
Albumin blood test $20 $42 $26 $5
Aldosterone test $127 $270 $81 $41
Alkaline phosphatase test $20 $42 $23 $5
Alpha-fetoprotein (AFP) test $24 $51 $23 $17
ALT liver enzyme test $20 $43 $24 $5
Ammonia blood test $21 $44 $47 $15
Amniocentesis $254 $529 $267 $120
Amylase test $9 $20 $23 $6
Ankle fracture repair — — $4,542 $608
Antinuclear antibody (ANA) test $19 $53 $24 $12
Arterial blood gas (ABG) $37 $79 $36 $26
AST liver enzyme test $20 $42 $27 $5
Barium swallow study $151 $285 $129 $107
Basic metabolic panel $22 $46 $21 $8
Bilirubin blood test $20 $42 $24 $5
Bladder scope (cystoscopy) — — $1,301 $216
Bladder tumor removal (TURBT) — — $3,485 $236
Blood clotting test (PT/INR) $25 $51 $21 $4
Blood crossmatch $167 $365 $158 —
Blood glucose test $7 $15 $7 $5
Blood transfusion $265 $561 $345 $47
Blood type and screen $52 $114 $49 $10
Blood type test $82 $180 $76 $3
BNP (heart failure) test $55 $118 $53 $39
Bone density scan (DEXA) $219 $414 $179 $39
Bone marrow biopsy — — $2,519 $172
Bone scan (nuclear) $615 $1,165 $524 $259
Breast biopsy $851 $1,770 $893 $478
Breast MRI $831 $1,471 $657 $216
Breast ultrasound $289 $469 $173 $92
Breathing tube insertion (intubation) $228 $462 $208 $133
Bunion surgery (bunionectomy) — — $4,542 $883
Burn treatment $82 $144 $79 $129
C-reactive protein (CRP) $6 $16 $7 $5
CA 19-9 tumor marker test $23 $63 $28 $21
CA-125 ovarian marker test $23 $63 $28 $21
Calcium blood test $20 $42 $24 $5
Capsule endoscopy $1,144 $1,990 $896 $802
Cardiac rehabilitation $158 $288 $130 $26
Cardiac stress test $466 $929 $418 $39
Cardioversion $419 $872 $400 $155
Carotid artery ultrasound $324 $673 $336 $156
Carpal tunnel release — — $3,373 $483
Cataract surgery — — $7,097 $547
CEA tumor marker test $27 $57 $40 $19
Celiac disease test $13 $35 $24 $12
Central line placement $440 $915 $462 $238
Cervical LEEP procedure — — $3,373 $325
Cesarean section (C-section) $9,102 — $19,774 $7,552
Chest fluid drain (thoracentesis) $473 $983 $403 $311
Chest X-ray $123 $240 $113 $37
Circumcision $150 $266 $120 $167
CK-MB heart enzyme test $31 $66 $30 $12
Clotting time test (PTT) $9 $19 $9 $6
Colon resection (colectomy) — — $12,121 $1,238
Colonoscopy — — $3,373 $480
Complete blood count (CBC) $16 $33 $14 $7
Comprehensive metabolic panel $23 $48 $22 $11
Contraceptive implant (Nexplanon) — — $208 $115
Copper blood test $30 $63 $42 $12
Coronary artery bypass (CABG) $47,110 — $127,061 $36,593
Cortisol test $27 $58 $58 $16
COVID-19 PCR test $73 $154 $69 $51
CPAP titration study $216 $439 $198 $69
Creatine kinase (CK) test $9 $20 $22 $7
CT angiography of the chest $787 $1,556 $700 $281
CT angiography of the head $770 $1,519 $684 $274
CT scan of the abdomen $778 $1,538 $756 $230
CT scan of the abdomen and pelvis $1,061 $2,097 $1,018 $300
CT scan of the arm $557 $1,100 $541 $199
CT scan of the chest $624 $1,234 $607 $167
CT scan of the head $611 $1,205 $589 $148
CT scan of the leg $497 $982 $483 $166
CT scan of the lower back (lumbar spine) $547 $1,082 $532 $169
CT scan of the neck $601 $1,185 $583 $183
CT scan of the neck (cervical spine) $817 $1,614 $690 $168
CT scan of the pelvis $817 $1,614 $794 $226
CT scan of the sinuses $549 $1,082 $532 $152
D-dimer test $15 $31 $14 $10
DHEA-sulfate test $31 $67 $30 $22
Diagnostic mammogram $124 $200 $98 $140
Drug screen (urine) $30 $64 $81 $17
Echocardiogram $473 $904 $510 $138
Electrocardiogram (EKG) $117 $232 $100 $8
Electroencephalogram (EEG) $214 $402 $192 $448
Electrolyte panel $21 $45 $20 $7
Emergency department visit $497 $445 $232 $69
Epidural steroid injection — — $1,002 $275
Estradiol (estrogen) test $39 $84 $38 $28
Eyelid surgery (blepharoplasty) — — $4,917 $552
Facet joint injection (spine) — — $682 $99
Fallopian tube X-ray (HSG) $194 $382 $177 $164
Family therapy session $187 $330 $149 $110
Fecal occult blood (stool) test $18 $38 $25 $10
Femoral hernia repair — — $5,604 $584
Ferritin (iron) test $28 $60 $27 $14
Fibrinogen test $15 $30 $14 $10
Flexible sigmoidoscopy — — $2,519 $323
Flu test $24 $50 $23 $17
Folate (folic acid) test $21 $45 $20 $15
Free T4 thyroid test $13 $28 $27 $9
FSH hormone test $26 $56 $25 $19
Gallbladder removal (laparoscopic) — — $10,128 $658
Gallbladder scan (HIDA) $568 $1,077 $514 $334
Ganglion cyst removal — — $3,861 $321
GGT liver test $10 $22 $25 $7
Glucose tolerance test $12 $26 $14 $8
Group therapy session $97 $222 $149 $30
H. pylori test $95 $203 $91 $67
Hammertoe repair — — $3,861 $548
HDL cholesterol test $21 $45 $18 $8
Hematocrit test $4 $8 $4 $2
Hemoglobin A1c (diabetes test) $14 $30 $14 $10
Hemorrhoid removal — — $2,519 $338
Hepatitis B test $23 $48 $41 $10
Hepatitis C test $19 $51 $23 $14
Hip fracture repair — — $10,128 $1,120
Hip replacement — — $20,256 $1,162
HIV test $28 $65 $36 $19
Home sleep apnea test $498 $625 $281 $123
Hydrocele repair — — $3,861 $315
Hysterectomy — — $5,825 $933
Hysteroscopy — — $3,861 $1,270
Inguinal hernia repair — — $4,928 $538
Iron blood test $9 $20 $23 $6
IUD insertion — — $3,014 —
IUD removal $172 $355 $193 $112
IV infusion therapy $76 $160 $104 $44
IVC filter placement $2,144 $4,458 $2,249 $1,885
Joint aspiration (small/intermediate) $159 $330 $142 $57
Kidney biopsy $815 $1,695 $727 $492
Kidney scan (nuclear) $347 $657 $322 $172
Kidney stone shock-wave (lithotripsy) — — $11,049 $760
Kidney ultrasound $248 $403 $216 $84
Knee arthroscopy — — $4,769 $524
Knee joint injection $291 $606 $248 $69
Knee replacement $24,747 — $66,958 $18,054
Lactate test $16 $35 $20 $12
Laryngoscopy $215 $447 $201 $189
LDH test $9 $19 $21 $6
LDL cholesterol test $15 $32 $37 $11
Leg artery angiogram $471 $833 $375 $149
Leg vein ultrasound (Doppler) $342 $709 $311 $150
LH hormone test $27 $58 $26 $19
Lipase test $10 $21 $23 $7
Lipid (cholesterol) panel $25 $54 $23 $13
Liver biopsy $337 $701 $354 $288
Liver function panel $21 $45 $20 $8
Lumpectomy (breast) — — $3,861 $750
Lung function test (PFT) $165 $319 $168 $37
Lung scan (V/Q) $465 $881 $396 $291
Magnesium blood test $10 $21 $21 $7
Mastectomy — — $4,769 $1,021
Meniscus repair (knee) — — $3,861 $714
MRA of the brain $597 $1,183 $582 $226
MRA of the neck $645 $1,278 $629 $245
MRI of the abdomen $819 $1,450 $713 $300
MRI of the ankle $497 $879 $433 $261
MRI of the brain $1,084 $2,125 $1,046 $269
MRI of the chest $555 $983 $483 $371
MRI of the knee $757 $1,339 $659 $315
MRI of the lower back (lumbar spine) $1,015 $2,047 $1,007 $270
MRI of the mid-back (thoracic spine) $1,015 $2,047 $1,007 $271
MRI of the neck (cervical spine) $1,015 $2,047 $1,007 $274
MRI of the pelvis $973 $1,722 $836 $268
MRI of the shoulder $747 $1,323 $651 $313
MRI of the wrist $628 $1,112 $547 $330
Nuchal translucency ultrasound $211 $343 $154 $116
Nuclear cardiac stress test $1,699 $3,217 $1,448 $428
Office visit (new patient) $2,578 $2,660 $147 $177
Orthopedic hardware removal — — $3,861 $632
Pacemaker insertion $21,632 — $70,606 $15,506
Pap smear (cervical screening) $35 $71 $33 $20
Parathyroid hormone (PTH) test $58 $124 $56 $41
Pelvic ultrasound $301 $488 $210 $78
PET scan $2,173 $4,974 $2,218 —
Phosphorus blood test $20 $42 $19 $5
Physical therapy evaluation $35 $172 $89 $98
Pilonidal cyst removal — — $3,861 $541
Platelet count $7 $14 $6 $4
Pregnancy blood test (hCG) $11 $23 $10 $8
Pregnancy ultrasound $293 $476 $209 $126
Procalcitonin test $39 $82 $37 $27
Prolactin test $28 $59 $27 $19
Prostate surgery (TURP) — — $4,769 $526
Prostate test (PSA) $26 $56 $25 $18
Psychiatric evaluation $188 $333 $143 $188
Psychotherapy session $117 $270 $117 $140
Pterygium removal (eye) — — $3,373 $540
Pulmonary rehabilitation $114 $242 $99 $87
Radiofrequency nerve ablation — — $2,141 $462
Rheumatoid factor test $26 $70 $29 $6
Rotator cuff repair — — $5,423 $792
Sacroiliac joint injection — — $578 $176
Scoliosis spine X-ray $142 $268 $149 $58
Screening mammogram $166 $212 $95 $126
Scrotal ultrasound $293 $475 $214 $99
Sedimentation rate (ESR) test $5 $11 $5 $3
Semen analysis $17 $37 $17 $12
Sex hormone binding globulin test $31 $66 $30 $22
Shoulder replacement — — $10,641 $1,300
Simple wound stitches — — $423 $127
Skin biopsy $130 $228 $109 $121
Sleep study (polysomnography) $3,344 $6,262 $2,626 $691
Soft tissue ultrasound $174 $283 $127 $64
Speech therapy $91 $185 $83 $76
Spinal cord stimulator — — $7,527 $2,388
Spinal tap (lumbar puncture) $242 $504 $247 $165
Strabismus (eye muscle) surgery — — $3,861 $475
Strep throat test $24 $50 $23 $17
Stress echocardiogram $557 $1,065 $479 $209
Swallow study $162 $251 $113 $85
T3 thyroid test $20 $43 $19 $14
Testosterone test $37 $78 $35 $26
Thyroid test (TSH) $25 $54 $23 $17
Thyroid ultrasound $278 $451 $203 $109
Thyroid uptake scan $289 $547 $260 $145
Tilt table test $665 $1,383 $584 $168
Total IgE allergy test $27 $58 $26 $16
Total protein test $26 $56 $23 $4
Transesophageal echocardiogram (TEE) $797 $1,524 $654 $239
Transvaginal ultrasound $243 $395 $178 $118
Trigger finger release — — $3,373 $630
Trigger point injection $87 $181 $91 $56
Triglycerides test $20 $43 $18 $6
Troponin (heart) test $23 $48 $20 $12
Turning a breech baby (version) $552 $470 $231 $94
Ulnar nerve surgery (elbow) — — $3,373 $575
Upper GI endoscopy (EGD) — — $2,519 $371
Upper GI series (barium) $439 $829 $362 $128
Ureteral stent placement — — $3,485 $373
Ureteroscopy (stone removal) — — $5,496 $365
Uric acid (gout) test $7 $14 $6 $5
Urinalysis $4 $9 $5 $3
Urine microalbumin test $17 $36 $21 $5
Urine pregnancy test $31 $58 $24 $9
Vaccine administration $16 $45 $25 $19
Vaginal delivery $7,094 — $10,170 $5,487
Vasectomy — — $3,373 $347
Vitamin B12 test $25 $54 $24 $15
Vitamin D test $42 $89 $40 $30
Weight-loss (bariatric) surgery $15,403 — $51,098 $11,645
Wound debridement $493 $864 $675 $186
Wrist fracture repair — — $5,423 $735
X-ray of the abdomen $121 $229 $103 $36
X-ray of the ankle $103 $194 $87 $37
X-ray of the collarbone $113 $214 $96 $33
X-ray of the elbow $120 $227 $102 $33
X-ray of the facial bones $104 $197 $95 $39
X-ray of the foot $116 $218 $98 $34
X-ray of the forearm $103 $195 $88 $29
X-ray of the hand $122 $230 $104 $38
X-ray of the hip $133 $251 $107 $49
X-ray of the knee $135 $255 $116 $42
X-ray of the lower back (lumbar spine) $206 $388 $185 $47
X-ray of the lower leg $116 $218 $98 $31
X-ray of the mid-back (thoracic spine) $154 $290 $127 $36
X-ray of the neck (cervical spine) $143 $271 $128 $47
X-ray of the pelvis $112 $212 $91 $36
X-ray of the ribs $144 $271 $116 $42
X-ray of the shoulder $131 $248 $112 $36
X-ray of the skull $113 $214 $93 $40
X-ray of the upper arm $126 $237 $107 $32
X-ray of the wrist $114 $216 $97 $43
Zinc blood test $16 $35 $40 $11

Source: this hospital’s machine-readable price file (45 CFR §180). Medicare from CMS fee schedules. Estimates — confirm with the hospital. Report an incorrect price.