Banner Desert Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 47 procedure codes: 99285 at 6.0× median, 99284 at 4.7× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $510.09 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 6.0× the national median of $85.65.
Bills $326.77 per claim for 99284 (Emergency dept visit, high complexity) — 4.7× the national median of $69.51.
Bills $282.43 per claim for 99283 (Emergency dept visit, moderate complexity) — 6.6× the national median of $42.48.
Billing in the top 1% nationally for 4 procedure codes: 99291, 70496, 92552.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $199.6M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$199.6M
$199,618,075
Total Claims
3.9M
Beneficiaries
3.0M
1.3 claims/patient
Avg Cost/Claim
$52
#460 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Banner Desert Medical Center is a General Acute Care Hospital provider based in Mesa, AZ. From the 2018–2024 period, this provider received $199.6M in Medicaid payments across 3.9M claims.
Why This Matters
This provider received $199.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,952 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 23% of total spending.
$46.6M
91K claims
$510.09
$85.65
Emergency dept visit, high/urgent complexity
$46.6M
91K claims · 23.3%
$42.0M
128K claims
$326.77
$69.51
Emergency dept visit, high complexity
$42.0M
128K claims · 21.0%
$28.5M
101K claims
$282.43
$42.48
Emergency dept visit, moderate complexity
$28.5M
101K claims · 14.3%
CT abdomen and pelvis with contrast
$16.4M
21K claims · 8.2%
$6.8M
13K claims
$523.69
$60.19
CT abdomen and pelvis without contrast
$6.8M
13K claims · 3.4%
$6.3M
1,405 claims · 3.1%
CT head/brain without contrast
$5.0M
35K claims · 2.5%
$4.4M
3,232 claims
$1,355.89
$123.40
Anchor or screw for tissue to bone fixation
$4.4M
3,232 claims · 2.2%
$3.9M
945 claims · 2.0%
Emergency dept visit, low complexity
$3.8M
30K claims · 1.9%
CT cervical spine without contrast
$2.6M
12K claims · 1.3%
$2.3M
67K claims
$34.33
$99.39
Hospital observation service, per hour
$2.3M
67K claims · 1.1%
$2.2M
2,174 claims
$1,023.51
$101.24
Critical care, first 30-74 minutes
$2.2M
2,174 claims · 1.1%
$1.6M
2,321 claims
$691.04
$133.68
MRI brain without contrast, then with contrast
$1.6M
2,321 claims · 0.8%
$1.3M
4,593 claims
$277.01
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.3M
4,593 claims · 0.6%
$1.3M
2,290 claims · 0.6%
$1.3M
1,692 claims
$739.84
$233.73
Polysomnography, sleep study, 6+ hours
$1.3M
1,692 claims · 0.6%
$1.2M
1,355 claims · 0.6%
$1.0M
1,017 claims
$1,019.32
$389.88
Prosthetic implant, not otherwise classified
$1.0M
1,017 claims · 0.5%
$932K
3,275 claims
$284.62
$12.63
Pure tone audiometry, air only, each ear
$932K
3,275 claims · 0.5%
$893K
11K claims
$82.27
$35.80
Surgical pathology, gross and microscopic examination
$893K
11K claims · 0.4%
$834K
8,865 claims
$94.11
$92.96
CT angiography, chest, with contrast
$834K
8,865 claims · 0.4%
$830K
355 claims
$2,337.82
$331.68
Tonsillectomy and adenoidectomy, under age 12
$830K
355 claims · 0.4%
Upper GI endoscopy with biopsy
$817K
2,571 claims · 0.4%
$798K
2,170 claims · 0.4%
$789K
290 claims
$2,719.17
$1,587.53
Injection, infliximab, excludes biosimilar, 10 mg
$789K
290 claims · 0.4%
$730K
1,141 claims
$639.95
$255.03
Sleep study with CPAP titration, polysomnography
$730K
1,141 claims · 0.4%
Comprehensive metabolic panel
$714K
178K claims · 0.4%
$700K
5,712 claims
$122.52
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$700K
5,712 claims · 0.4%
$552K
2,511 claims
$219.65
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$552K
2,511 claims · 0.3%
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