CMS Price Transparency Data

Culture, blood

Facility: Banner Payson Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $14
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Banner Payson Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.36x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $15 (145%)
Insurance Median: $14 (136%)
Cash: $15 (145% of Medicare)
Ins. Median: $14 (136% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.32 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.

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 $10 - $13 97%
Banner University Health Plan $10 - $13 97%
Health Choice Arizona, Inc. $10 - $18 97%
Health Net $10 - $19 97%
Mercy Care $10 - $13 97%
Aetna $13 - $21 126%
Banner Health $13 126%
Blue Cross Blue Shield $13 - $49 126%
Care 1St $13 126%
Carelon $13 126%
Cigna $13 - $25 126%
Gila River Health Care Corporation $13 126%
Humana $13 126%
Kaiser Foundation Health Plan $13 126%
Triwest Healthcare Alliance Corp - Va Ccn $13 126%
UnitedHealthcare $13 - $21 126%
Upmc Health Plan $13 126%
Wellpoint $13 126%
Arizona Priority Care $14 136%
Devoted Health Services $14 136%
Gold Kidney Health Plan $14 136%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $14 136%
Plotkin Health $14 136%
Oscar Health Plan $21 203%
Quiktrip Corporation $22 213%
Arizona Medical Network $28 271%
Provider Network Of America $28 271%

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