Emergency visit, high (level 4) at Banner Payson Medical Center. CPT 99284.
What Banner Payson Medical Center publishes for this service, straight from its standard-charges file, last updated September 22, 2026.
Outpatient / ER
$1,191cash price (self-pay)
$594list price
$244–$1,910range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Banner Health | Medicare Advantage | $244 |
| Aetna | Medicare Advantage | $244 |
| Arizona Physicians IPA | Medicare Advantage | $244 |
| Banner University Health Plan | Medicare Advantage | $244 |
| Blue Cross Blue Shield of Arizona | Medicare Advantage | $244 |
| Cigna Healthcare of Arizona, Inc. | HMO Medicare Advantage Plan/PPO Me | $244 |
| Gila River Health Care Corporation | Managed Care Program | $244 |
| Health Choice Arizona, Inc. | Medicare Advantage | $244 |
| Health Net | Medicare | $244 |
| Kaiser Foundation Health Plan | Medicare Advantage | $244 |
| Mercy Care | Mercy Care Advantage | $244 |
| TriWest Healthcare Alliance Corp - VA CCN | VA Community Care Network | $244 |
| TriWest Healthcare Alliance Corp - VA CCN | Tricare | $244 |
| United Healthcare | UHC Medicare Advantage | $244 |
| UPMC Health Plan | Medicare Advantage | $244 |
| Carekin | Medicare Advantage | $256 |
| Humana | Medicare Advantage | $258 |
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $267 |
| Plotkin Health | Plotkin Health | $267 |
| Arizona Priority Care | Medicare Advantage | $268 |
| Devoted Health Services | Medicare Advantage | $268 |
| Gold Kidney Health Plan | Medicare Advantage | $268 |
| Aetna | Joint Venture | $309 |
| United Healthcare | UHC Individual Exchange | $350 |
| Health Choice Arizona, Inc. | ACA Health Plan | $365 |
| Health Net | Commerical Exchange Product | $368 |
| Aetna | Medical Rental | $375 |
| Aetna | Broad Network | $387 |
| Oscar Health Plan | Commercial | $402 |
| Quiktrip Corporation | Commercial | $413 |
Inpatient
$1,191cash price (self-pay)
$594list price
$267–$535range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $267 |
| Plotkin Health | Plotkin Health | $267 |
| Aetna | Medical Rental | $375 |
| Quiktrip Corporation | Commercial | $413 |
| Cigna Healthcare of Arizona, Inc. | Commerical/HMO Benefit Plan/Local | $461 |
| Arizona Medical Network | Commercial | $513 |
| Provider Network of America | Commercial | $535 |
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