Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
INTRO NON GD/EP/LASER LVL 04
Payson, AZ
See all hospitals reporting HCPCS C1894 →Price type
Banner Payson Medical Center’s median price of $664 is 239% above the median hospital's median price ($196), higher than 90% of the 1,666 hospitals reporting HCPCS C1894. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Bcbs Az bxbsaz neighborhood facility · fee schedule · outpatient | $182.60 | $182.60 | $182.60 – $182.60 |
| 2 | Bcbs Az bcbsaz alliance/blue hpn facility · fee schedule · outpatient | $194.77 | $194.77 | $194.77 – $194.77 |
| 3 | Bcbs Az bxbsaz alliance chs facility · fee schedule · outpatient | $204.51 | $204.51 | $204.51 – $204.51 |
| 4 | Bcbs Az bcbsaz medicare facility · fee schedule · outpatient | $232.54 | $232.54 | $232.54 – $232.54 |
| 5 | Bcbs Az bcbsaz workers comp facility · fee schedule · outpatient | $243.46 | $243.46 | $243.46 – $243.46 |
| 6 | Bcbs Az commercial facility · fee schedule · outpatient | $243.46 | $243.46 | $243.46 – $243.46 |
| 7 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $877.90 | $1,152 | $39.07 – $3,206 |
| 8 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $884.37 | $1,161 | $39.36 – $3,229 |
| 9 | Bcbs Az medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $884.37 | $1,161 | $39.36 – $3,229 |
| 10 | Cigna hmo medicare advantage plan/ppo medicare advantage plan facility · percent of total billed charges · outpatientfrom % of charges | $884.37 | $1,161 | $39.36 – $3,229 |
| 11 | Kaiser medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $884.37 | $1,161 | $39.36 – $3,229 |
| 12 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $884.37 | $1,161 | $39.36 – $3,229 |
| 13 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $937.44 | $1,230 | $41.72 – $3,423 |
| 14 | Devoted medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $972.81 | $1,277 | $43.30 – $3,552 |
| 15 | Aetna joint venture facility · percent of total billed charges · outpatientfrom % of charges | $1,143 | $1,501 | $50.88 – $4,174 |
| 16 | Aetna aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $1,204 | $1,580 | $53.57 – $4,395 |
| 17 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $1,387 | $1,820 | $61.73 – $5,064 |
| 18 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $1,387 | $1,820 | $61.73 – $5,064 |
| 19 | Aetna broad network facility · percent of total billed charges · outpatientfrom % of charges | $1,428 | $1,874 | $63.55 – $5,214 |
| 20 | UnitedHealthcare uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $1,445 | $1,897 | $64.32 – $5,277 |
| 21 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $1,459 | $1,915 | $64.94 – $5,328 |
| 22 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · inpatientfrom % of charges | $1,717 | $2,254 | $76.42 – $6,269 |
| 23 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · outpatientfrom % of charges | $1,717 | $2,254 | $76.42 – $6,269 |
Last updated: Mar 2, 2026
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