Supplies, drugs & other prices at Intermountain Health Bear River Valley Hospital
Tremonton, UT · every code in this section with a posted price and a Medicare benchmark.
48 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Antibody treponema pallidum total & rpr ia qual (0064U) | $46.54 | $62.05 | 1.5× |
| Catheterize for urine spec (P9612) | $18.46 | $24.62 | 2.0× |
| Colon ca scrn not hi rsk ind (G0121) | $2,154.30 | $2,872.40 | 2.3× |
| Colorectal scrn; hi risk ind (G0105) | $1,714.01 | $2,285.35 | 1.8× |
| Covid-19 lab test non-cdc (U0002) | $159.92 | $213.23 | 3.1× |
| Diab manage trn per indiv (G0108) | $87.81 | $117.08 | 1.6× |
| Diab manage trn ind/group (G0109) | $46.04 | $61.38 | 2.9× |
| Direct refer hospital observ (G0379) | $673.59 | $898.12 | 1.1× |
| Drug test def 1-7 classes (G0480) | $100.45 | $133.93 | 0.9× |
| Drug test def 15-21 classes (G0482) | $191.69 | $255.59 | 1.0× |
| Drug test def 22+ classes (G0483) | $242.86 | $323.82 | 1.0× |
| Drug test def 8-14 classes (G0481) | $151.08 | $201.44 | 1.0× |
| Eia hiv-1/hiv-2 screen (G0432) | $123.85 | $165.13 | 6.3× |
| Elec stim unattend for press (G0281) | $107.42 | $143.23 | 9.2× |
| Esophag muc integ w/eso egd (C9777) | $12,051.88 | $16,069.17 | 3.1× |
| Extracorporeal shock wave muscskel sys nos (0101T) | $65 | $86.66 | 0.3× |
| Fecal microbiota prep instil (G0455) | $2,652.10 | $3,536.14 | 2.8× |
| Hbot, full body chamber, 30m (G0277) | $503.33 | $671.11 | 3.6× |
| Hospital outpt clinic visit (G0463) range across 2 matching MRF lines |
$218.58–$760.10 | $291.44–$1,013.46 | varies |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $31,075.45 | $41,433.93 | 1.0× |
| Neuro csf prion prtn qual (0035U) | $1,098.56 | $1,464.74 | 2.0× |
| Njx platelet plasma (0232T) | $393.68 | $524.90 | 0.9× |
| Oth resp proc, group (G0239) | $109.84 | $146.46 | 2.9× |
| Pathogen test for platelets (P9100) | $728.94 | $971.92 | 12.2× |
| Perc d-e cor revasc chro sin (C9607) | $28,132.88 | $37,510.50 | 1.5× |
| Perq Sacral Augmt Bilat Inj (0201T) | $6,423.56 | $8,564.74 | 0.9× |
| Perq Sacral Augmt Unilat Inj (0200T) unusually low: confirm this is the full procedure |
$2,599.28 | $3,465.70 | 0.4× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) | $12,824.14 | $17,098.86 | 1.1× |
| Place device/marker, non pro (C9728) | $1,820.19 | $2,426.92 | 1.3× |
| Prolonged iv inf, req pump (C8957) | $499.61 | $666.15 | 2.3× |
| Prostate biopsy, any mthd (G0416) | $2,148.28 | $2,864.37 | 5.9× |
| Psa screening (G0103) | $96.10 | $128.14 | 5.0× |
| Revasc intra lithotrip-stent (C9765) | $20,908.13 | $27,877.51 | 1.1× |
| Revasc intravasc lithotripsy (C9764) range across 2 matching MRF lines |
$15,779.39–$17,685.78 | $21,039.19–$23,581.04 | varies |
| Revasc lith-sten-ath tib/per (C9775) | $33,678.47 | $44,904.63 | 1.8× |
| Revasc lithotr-ather tib/per (C9774) | $23,521.64 | $31,362.19 | 1.3× |
| Revasc lithotr-stent tib/per (C9773) | $18,817.32 | $25,089.76 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $14,201.47 | $18,935.29 | 1.2× |
| Revasc lithotrip-stent-ather (C9767) | $33,678.46 | $44,904.61 | 1.8× |
| Screen cerv/vag thin layer (G0123) | $251.96 | $335.95 | 12.4× |
| Sim ang w/prs cath rad emb (C8004) | $36,794.93 | $49,059.90 | 3.1× |
| Syphilis tst non-treponemal antibody ia qual rpr (0065U) | $26.88 | $35.84 | 1.5× |
| Tee w or w/o fol w/cont, mon (C8927) | $4,093.88 | $5,458.50 | 5.2× |
| Therapeutic procd strg endur (G0237) | $100.92 | $134.56 | 3.4× |
| Therapeutic ultrafiltration (0692T) | $1,113.96 | $1,485.28 | 0.7× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$3,342.16–$3,847.85 | $4,456.22–$5,130.47 | varies |
| Trim nail(s) (G0127) | $93.97 | $125.29 | 1.6× |
| Unsched dialysis esrd pt hos (G0257) | $1,898.06 | $2,530.75 | 2.7× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.