BANNER PAYSON MEDICAL CENTER
Critical Access Hospitals
Procedure Prices at BANNER PAYSON MEDICAL CENTER
Therapeutic Activities
CPT 97530
$53
LAB CBC AUTO W AUTO DIFF
CPT 85025
$60
Mechanical Traction
CPT 97012
$61
LAB PANEL METAB COMP
CPT 80053
$63
Therapeutic Exercises
CPT 97110
$65
Diagnostic Mammogram (unilateral)
CPT 77065
$134
Chest X-Ray (1 view)
CPT 71045
$153
Screening Mammogram (bilateral)
CPT 77067
$158
EKG Tracing
CPT 93005
$183
Chest X-Ray (2 views)
CPT 71046
$194
Diagnostic Mammogram (bilateral)
CPT 77066
$203
PSYCHOTX PT 60MIN
CPT 90837
$225
Thoracic Spine X-Ray
CPT 72072
$254
VISIT OB TRIAGE ESTABLISHED LEVEL 3
CPT 99213
$334
Abdominal Ultrasound — Limited
CPT 76705
$367
OB Ultrasound
CPT 76805
$433
Retroperitoneal Ultrasound
CPT 76770
$450
Abdominal Ultrasound
CPT 76700
$492
ER Visit — Low-Moderate Complexity
CPT 99283
$506
ER Visit — Moderate Complexity
CPT 99284
$641
ER Visit — High Complexity
CPT 99285
$880
MRI Joint of Lower Extremity
CPT 73721
$911
CT Chest
CPT 71250
$1,172
CT Abdomen & Pelvis
CPT 74177
$1,361
Echocardiogram w/ Doppler
CPT 93306
$1,447
MRI Brain w/o Contrast
CPT 70551
$1,448
MRI Brain w/ Contrast
CPT 70553
$2,389
Compare Prices Nearby
Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.