Banner Payson Medical Center
Banner Payson Medical Center in Payson, AZ publishes cash prices for 36 common procedures listed here, from its own machine-readable price file updated Mar 2, 2026. Click a procedure to compare it with other hospitals nearby.
807 South Ponderosa Street, Payson, AZ 85541 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN&PELVIS W CNT | $1,061.08 | $2,097.00 | 49% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN&PELVIS W CNT | $1,061.08 | $2,097.00 | 49% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CNT | $488.75 | $964.00 | 49% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CNT | $488.75 | $964.00 | 49% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CNT | $816.68 | $1,614.00 | 49% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CNT | $816.68 | $1,614.00 | 49% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX W/WO CAD BI | $149.52 | $240.00 | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX W/WO CAD BI | $149.52 | $240.00 | 38% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CNT | $867.00 | $1,700.00 | 49% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CNT | $867.00 | $1,700.00 | 49% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CNT | $1,300.50 | $2,550.00 | 49% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W&WO CNT | $1,300.50 | $2,550.00 | 49% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CNT | $811.95 | $1,637.00 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CNT | $811.95 | $1,637.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US UTERUS PREG 14+WK GEST SGL | $313.54 | $509.00 | 38% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US UTERUS PREG 14+WK GEST SGL | $313.54 | $509.00 | 38% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCRN W/WO CAD 2 VW BI | $165.57 | $212.00 | 22% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCRN W/WO CAD 2 VW BI | $165.57 | $212.00 | 22% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG W 4+ PARAM 6+YRS | $2,613.93 | $4,895.00 | 47% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG W 4+ PARAM 6+YRS PEDS | $3,267.55 | $6,119.00 | 47% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG W 4+ PARAM 6+YRS | $2,613.93 | $4,895.00 | 47% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG W 4+ PARAM 6+YRS PEDS | $3,267.55 | $6,119.00 | 47% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $243.32 | $395.00 | 38% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $243.32 | $395.00 | 38% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMP | $356.66 | $579.00 | 38% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN CMP | $356.66 | $579.00 | 38% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LS 4+ VW | $239.56 | $452.00 | 47% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LS 4+ VW | $239.56 | $452.00 | 47% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 LAB PANEL METAB BASIC W CA TOTAL | $21.62 | $46.00 | 53% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LAB PANEL METAB BASIC W CA TOTAL | $21.62 | $46.00 | 53% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LAB PANEL LIPID NS | $23.97 | $51.00 | 53% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LAB PANEL LIPID | $25.38 | $54.00 | 53% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LAB PANEL LIPID NS | $23.97 | $51.00 | 53% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LAB PANEL LIPID | $25.38 | $54.00 | 53% |
| Complete blood count (CBC) with differential CPT 85025 LAB HEMO PLT AUTO W AUTO SCAN | $11.86 | $24.00 | 51% |
| Complete blood count (CBC) with differential CPT 85025 LAB CBC AUTO W AUTO DIFF | $22.23 | $45.00 | 51% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LAB HEMO PLT AUTO W AUTO SCAN | $11.86 | $24.00 | 51% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LAB CBC AUTO W AUTO DIFF | $22.23 | $45.00 | 51% |
| Complete blood count (CBC), no differential CPT 85027 LAB CBC AUTO WO DIFF | $9.88 | $20.00 | 51% |
| Complete blood count (CBC), no differential inpatient CPT 85027 LAB CBC AUTO WO DIFF | $9.88 | $20.00 | 51% |
| Comprehensive metabolic panel (blood test) CPT 80053 LAB PANEL METAB COMP | $22.56 | $48.00 | 53% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LAB PANEL METAB COMP | $22.56 | $48.00 | 53% |
| Kidney function blood test panel CPT 80069 LAB PANEL FUNCTION RENAL | $21.62 | $46.00 | 53% |
| Kidney function blood test panel inpatient CPT 80069 LAB PANEL FUNCTION RENAL | $21.62 | $46.00 | 53% |
| Liver function blood test panel CPT 80076 LAB PANEL FUNCTION HEPATIC | $21.15 | $45.00 | 53% |
| Liver function blood test panel inpatient CPT 80076 LAB PANEL FUNCTION HEPATIC | $21.15 | $45.00 | 53% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 LAB PSA FREE | $26.32 | $56.00 | 53% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 LAB PSA FREE | $26.32 | $56.00 | 53% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LAB SCR PSA | $26.32 | $56.00 | 53% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LAB PSA TOTAL | $26.32 | $56.00 | 53% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LAB SCR PSA | $26.32 | $56.00 | 53% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LAB PSA TOTAL | $26.32 | $56.00 | 53% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LAB PTT PLASMA/BLD WHL | $9.39 | $19.00 | 51% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LAB PTT PLASMA/BLD WHL | $9.39 | $19.00 | 51% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LAB PROTHROMBIN TIME | $25.19 | $51.00 | 51% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LAB PROTHROMBIN TIME | $25.19 | $51.00 | 51% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LAB THYROID STIMULATING HORMONE NS | $23.97 | $51.00 | 53% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LAB THYROID STIMULATING HORMONE | $25.38 | $54.00 | 53% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LAB THYROID STIMULATING HORMONE NS | $23.97 | $51.00 | 53% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LAB THYROID STIMULATING HORMONE | $25.38 | $54.00 | 53% |
| Urinalysis with microscope exam, automated CPT 81001 LAB UA AUTO W MICRO | $5.28 | $10.00 | 47% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LAB UA AUTO W MICRO | $5.28 | $10.00 | 47% |
| Urinalysis without microscope exam, automated CPT 81003 LAB UA AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated CPT 81003 LAB UA PH AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated CPT 81003 LAB UA KETONES AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated CPT 81003 LAB UA GRAVITY SPCFC AUTO WO MICRO | $27.98 | $53.00 | 47% |
| Urinalysis without microscope exam, automated CPT 81003 POC UA AUTO WO MICRO | $56.50 | $107.00 | 47% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LAB UA AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LAB UA KETONES AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LAB UA PH AUTO WO MICRO | $3.70 | $7.00 | 47% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LAB UA GRAVITY SPCFC AUTO WO MICRO | $27.98 | $53.00 | 47% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC UA AUTO WO MICRO | $56.50 | $107.00 | 47% |
| Urinalysis without microscope exam, manual CPT 81002 LAB UA REDUCING SUBSTANCE | $5.81 | $11.00 | 47% |
| Urinalysis without microscope exam, manual CPT 81002 POC UA NONAUTO WO MICRO DIPSTICK | $5.81 | $11.00 | 47% |
| Urinalysis without microscope exam, manual CPT 81002 LAB UA NONAUTO WO MICRO | $5.81 | $11.00 | 47% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 LAB UA NONAUTO WO MICRO | $5.81 | $11.00 | 47% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC UA NONAUTO WO MICRO DIPSTICK | $5.81 | $11.00 | 47% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 LAB UA REDUCING SUBSTANCE | $5.81 | $11.00 | 47% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 PSYCHOTX FAMILY W PT 50MIN | $186.68 | $330.00 | 43% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PSYCHOTX FAMILY W PT 50MIN | $186.68 | $330.00 | 43% |
| Group psychotherapy session CPT 90853 PSYCHOTX GRP NOT FAMILY | $96.57 | $222.00 | 57% |
| Group psychotherapy session CPT 90853 PSYCHOTX GRP IOP PSYCH ADUL 3H | $205.76 | $473.00 | 56% |
| Group psychotherapy session inpatient CPT 90853 PSYCHOTX GRP NOT FAMILY | $96.57 | $222.00 | 57% |
| Group psychotherapy session inpatient CPT 90853 PSYCHOTX GRP IOP PSYCH ADUL 3H | $205.76 | $473.00 | 56% |
| New patient office visit, about 30 minutes CPT 99203 VISIT NEW LEVEL 3 | $103.95 | $210.00 | 51% |
| New patient office visit, about 30 minutes CPT 99203 VISIT OB TRIAGE NEW LEVEL 3 | $2,141.49 | $2,210.00 | 3% |
| New patient office visit, about 30 minutes inpatient CPT 99203 VISIT NEW LEVEL 3 | $103.95 | $210.00 | 51% |
| New patient office visit, about 30 minutes inpatient CPT 99203 VISIT OB TRIAGE NEW LEVEL 3 | $2,141.49 | $2,210.00 | 3% |
| New patient office visit, about 45 minutes CPT 99204 VISIT NEW LEVEL 4 | $141.07 | $285.00 | 51% |
| New patient office visit, about 45 minutes CPT 99204 VISIT OB TRIAGE NEW LEVEL 4 | $2,577.54 | $2,660.00 | 3% |
| New patient office visit, about 45 minutes inpatient CPT 99204 VISIT NEW LEVEL 4 | $141.07 | $285.00 | 51% |
| New patient office visit, about 45 minutes inpatient CPT 99204 VISIT OB TRIAGE NEW LEVEL 4 | $2,577.54 | $2,660.00 | 3% |
| New patient office visit, about 60 minutes CPT 99205 VISIT NEW LEVEL 5 | $160.88 | $325.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 VISIT OB TRIAGE NEW LEVEL 5 | $3,449.64 | $3,560.00 | 3% |
| New patient office visit, about 60 minutes inpatient CPT 99205 VISIT NEW LEVEL 5 | $160.88 | $325.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 VISIT OB TRIAGE NEW LEVEL 5 | $3,449.64 | $3,560.00 | 3% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTX PT 30MIN | $96.35 | $222.00 | 57% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTX PT 30MIN | $96.35 | $222.00 | 57% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTX PT 45MIN | $109.80 | $253.00 | 57% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTX PT 45MIN | $109.80 | $253.00 | 57% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTX PT 60MIN | $124.12 | $286.00 | 57% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTX PT 60MIN | $124.12 | $286.00 | 57% |