CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Banner Payson Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $95
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Banner Payson Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.75x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $166 (131%)
Insurance Median: $95 (75%)
Cash: $166 (131% of Medicare)
Ins. Median: $95 (75% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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 $50 40%
Banner University Health Plan $50 - $87 40%
Health Choice Arizona, Inc. $50 - $124 40%
Health Net $50 - $129 40%
Mercy Care $50 - $87 40%
Aetna $86 - $140 68%
Banner Health $87 69%
Blue Cross Blue Shield $87 - $461 69%
Care 1St $87 69%
Cigna $87 - $169 69%
Gila River Health Care Corporation $87 69%
Kaiser Foundation Health Plan $87 69%
Triwest Healthcare Alliance Corp - Va Ccn $87 69%
Upmc Health Plan $87 69%
Wellpoint $87 69%
Carelon $91 72%
Humana $92 73%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $95 75%
Plotkin Health $95 75%
Arizona Priority Care $96 76%
Devoted Health Services $96 76%
Gold Kidney Health Plan $96 76%
Oscar Health Plan $143 113%
Quiktrip Corporation $148 117%
Arizona Medical Network $191 151%
Provider Network Of America $191 151%

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