Hospital - Outpatient Direct Pay Prices
Dear health care consumer:
This site has been created as a resource for potential decisions you may make regarding health care services provided by Banner Health facilities in Arizona.
The price information on this site primarily applies to patients who do not have insurance. As more people become insured we anticipate that this price information will not be as relevant.
The majority of uninsured patients that will use this pricing information will relate to the self-pay discounted prices that are part of Banner’s financial assistance program. This program is designed to provide uninsured patients rates similar to those who have insurance.
If you have questions, you can contact Banner Patient Financial Services at
(480) 684-7409. Thank you.
This site lists Direct Pay Prices and approximate price or range of discounted uninsured self-pay prices for the most common inpatient and most common outpatient diagnoses/services provided by the specified Banner Health hospital. The Direct Pay Price is the maximum price that a patient would pay for the standard treatments for the specified diagnoses/services regardless of insurance status, if paid directly by the patient or the patient’s employer. The Direct Pay Price is based upon the upper end of the usual and customary charges that would be incurred for the treatments, excluding complications and exceptional treatments. The usual and customary charges are those that are filed quarterly with the Arizona Department of Health Services.
The actual charges incurred will vary based on a variety of factors, such as severity of illness, selected medical devices, and length of stay. If the actual charges incurred for a patient’s care are less than the Direct Pay Price, the patient will only be responsible to Banner Health for the actual charges. The Direct Pay Price does not include the charges for care related to complications or exceptional treatment. The Direct Pay Price also does not include fees charged by physicians working in the hospital, such as surgeons, radiologists, pathologists, hospitalists and anesthesiologists.
In most instances, Medicare, AHCCCS and commercial insurers pay an amount that is substantially less than the Direct Pay Price. Patients with insurance are encouraged to contact their insurance carrier to determine the specific amount that must be paid based on insurance plan coverage. Reduced self-pay package pricing is also available for certain services. Prompt pay discounts may also be available.
The site also lists the approximate price or range of discounted prices that would be charged to uninsured patients who qualify for Banner’s Basic Financial Assistance program for the listed inpatient and outpatient hospital diagnoses/services. Unlike the Direct Pay Prices, these prices are based upon the average usual and customary charges typically incurred for the listed inpatient and outpatient diagnoses/services, discounted based upon the average of the amounts generally paid to the specific Banner hospital for such diagnoses/services by Medicare and commercial insurers. These are not guaranteed prices, and will vary among Banner hospitals and based upon the level of services actually provided to a specific eligible uninsured patient. Patients without insurance may contact Banner Patient Financial Services at (480) 684-7409 to determine their eligibility for financial assistance under the Banner Health policy for Financial Assistance Programs for Uninsured Hospital Patients.You may also view the policy and a plain language summary of the policy on our Financial Assistance Programs webpage.