CMS Price Transparency Data

CT scan, sinuses

Facility: Banner Payson Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $389
  • Cash Discount Price: $439
  • vs. Medicare Baseline: 3.64x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Banner Payson Medical Center is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $439. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.64x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$439

Average discount available for prompt cash payment at this facility.

Insurance Median
$389

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: $439 (411%)
Insurance Median: $389 (364%)
Cash: $439 (411% of Medicare)
Ins. Median: $389 (364% 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 364% of the Medicare baseline (a markup of 264%). 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 - $355 74%
Banner University Health Plan $79 - $355 74%
Health Choice Arizona, Inc. $79 - $506 74%
Health Net $79 - $525 74%
Mercy Care $79 - $355 74%
Aetna $341 - $573 319%
Banner Health $355 332%
Blue Cross Blue Shield $355 - $671 332%
Care 1St $355 332%
Cigna $355 - $689 332%
Gila River Health Care Corporation $355 332%
Kaiser Foundation Health Plan $355 332%
Triwest Healthcare Alliance Corp - Va Ccn $355 332%
UnitedHealthcare $355 - $580 332%
Upmc Health Plan $355 332%
Wellpoint $355 332%
Carelon $372 348%
Humana $376 352%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $389 364%
Plotkin Health $389 364%
Arizona Priority Care $390 365%
Devoted Health Services $390 365%
Gold Kidney Health Plan $390 365%
Oscar Health Plan $585 548%
Quiktrip Corporation $606 567%
Arizona Medical Network $778 728%
Provider Network Of America $778 728%

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