CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Banner Payson Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $189
Cash Discount Price: $1,123
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Banner Payson Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,123. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.61x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.

Cash / Self-Pay

$1,123

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)

Cash / Self-Pay: $1,123 (955%)

Insurance Median: $189 (161%)

Cash: $1,123 (955% of Medicare)

Ins. Median: $189 (161% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$55 - $906	47%
Banner University Health Plan	$55 - $906	47%
Health Choice Arizona, Inc.	$55 - $1,293	47%
Health Net	$55 - $1,341	47%
Mercy Care	$55 - $906	47%
Aetna	$86 - $1,421	73%
Banner Health	$86 - $906	73%
Blue Cross Blue Shield	$86 - $906	73%
Care 1St	$86 - $906	73%
Cigna	$86 - $1,759	73%
Gila River Health Care Corporation	$86 - $906	73%
Kaiser Foundation Health Plan	$86 - $906	73%
Triwest Healthcare Alliance Corp - Va Ccn	$86 - $906	73%
UnitedHealthcare	$86 - $1,481	73%
Upmc Health Plan	$86 - $906	73%
Wellpoint	$86 - $906	73%
Carelon	$90 - $951	77%
Humana	$91 - $960	77%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$94 - $994	80%
Plotkin Health	$94 - $994	80%
Arizona Priority Care	$95 - $997	81%
Devoted Health Services	$95 - $997	81%
Gold Kidney Health Plan	$95 - $997	81%
Oscar Health Plan	$142 - $1,495	121%
Quiktrip Corporation	$147 - $1,547	125%
Arizona Medical Network	$189 - $1,989	161%
Provider Network Of America	$189 - $1,989	161%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,123.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Payson Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.