CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Banner Payson Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $225
  • Cash Discount Price: $1,164
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Banner Payson Medical Center is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,164. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.66x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$1,164

Average discount available for prompt cash payment at this facility.

Insurance Median
$225

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $1,164 (858%)
Insurance Median: $225 (166%)
Cash: $1,164 (858% of Medicare)
Ins. Median: $225 (166% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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 $55 - $933 41%
Banner University Health Plan $55 - $933 41%
Health Choice Arizona, Inc. $55 - $1,331 41%
Health Net $55 - $1,380 41%
Mercy Care $55 - $933 41%
Aetna $102 - $1,463 75%
Banner Health $102 - $933 75%
Blue Cross Blue Shield $102 - $933 75%
Care 1St $102 - $933 75%
Cigna $102 - $1,811 75%
Gila River Health Care Corporation $102 - $933 75%
Kaiser Foundation Health Plan $102 - $933 75%
Triwest Healthcare Alliance Corp - Va Ccn $102 - $933 75%
UnitedHealthcare $102 - $1,524 75%
Upmc Health Plan $102 - $933 75%
Wellpoint $102 - $933 75%
Carelon $108 - $979 80%
Humana $109 - $989 80%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $112 - $1,024 83%
Plotkin Health $112 - $1,024 83%
Arizona Priority Care $113 - $1,026 83%
Devoted Health Services $113 - $1,026 83%
Gold Kidney Health Plan $113 - $1,026 83%
Oscar Health Plan $169 - $1,539 125%
Quiktrip Corporation $175 - $1,592 129%
Arizona Medical Network $225 - $2,048 166%
Provider Network Of America $225 - $2,048 166%

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