CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Banner Payson Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $16,008
  • Cash Discount Price: $7,464
  • vs. Medicare Baseline: 2.82x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Banner Payson Medical Center is $16,008. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,464. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.82x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$7,464

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,008

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $7,464 (132%)
Insurance Median: $16,008 (282%)
Cash: $7,464 (132% of Medicare)
Ins. Median: $16,008 (282% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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 282% of the Medicare baseline (a markup of 182%). 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
Aetna $3,708 65%
Blue Cross Blue Shield $16,008 - $23,772 282%

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