CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Banner Payson Medical Center

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 71250
  • Insurance Median: $444
  • Cash Discount Price: $499
  • vs. Medicare Baseline: 4.16x Medicare
The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Banner Payson Medical Center is $444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.16x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$499

Average discount available for prompt cash payment at this facility.

Insurance Median
$444

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $499 (467%)
Insurance Median: $444 (416%)
Cash: $499 (467% of Medicare)
Ins. Median: $444 (416% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 416% of the Medicare baseline (a markup of 316%). 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 $79 - $405 74%
Banner University Health Plan $79 - $405 74%
Health Choice Arizona, Inc. $79 - $577 74%
Health Net $79 - $599 74%
Mercy Care $79 - $405 74%
Aetna $341 - $653 319%
Banner Health $405 379%
Blue Cross Blue Shield $405 - $629 379%
Care 1St $405 379%
Cigna $405 - $786 379%
Gila River Health Care Corporation $405 379%
Kaiser Foundation Health Plan $405 379%
Triwest Healthcare Alliance Corp - Va Ccn $405 379%
UnitedHealthcare $405 - $661 379%
Upmc Health Plan $405 379%
Wellpoint $405 379%
Carelon $425 398%
Humana $429 402%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $444 416%
Plotkin Health $444 416%
Arizona Priority Care $445 417%
Devoted Health Services $445 417%
Gold Kidney Health Plan $445 417%
Oscar Health Plan $668 625%
Quiktrip Corporation $691 647%
Arizona Medical Network $888 831%
Provider Network Of America $888 831%

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