CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Banner Payson Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $729
  • Cash Discount Price: $849
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Banner Payson Medical Center is $729. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $849. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.99x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$849

Average discount available for prompt cash payment at this facility.

Insurance Median
$729

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $849 (348%)
Insurance Median: $729 (299%)
Cash: $849 (348% of Medicare)
Ins. Median: $729 (299% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Arizona Physicians Ipa $167 - $688 69%
Banner University Health Plan $167 - $688 69%
Health Choice Arizona, Inc. $167 - $981 69%
Health Net $167 - $1,018 69%
Mercy Care $167 - $688 69%
Aetna $341 - $1,110 140%
Blue Cross Blue Shield $585 - $781 240%
Banner Health $688 282%
Care 1St $688 282%
Cigna $688 - $1,335 282%
Gila River Health Care Corporation $688 282%
Kaiser Foundation Health Plan $688 282%
Triwest Healthcare Alliance Corp - Va Ccn $688 282%
UnitedHealthcare $688 - $1,124 282%
Upmc Health Plan $688 282%
Wellpoint $688 282%
Carelon $722 296%
Humana $729 299%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $755 310%
Plotkin Health $755 310%
Arizona Priority Care $756 310%
Devoted Health Services $756 310%
Gold Kidney Health Plan $756 310%
Oscar Health Plan $1,134 465%
Quiktrip Corporation $1,174 482%
Arizona Medical Network $1,509 619%
Provider Network Of America $1,509 619%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals