Intermountain Health Primary Children's Hospital
Salt Lake City, UT · Children's hospital
Posts prices for 43 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-05.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Diagnostic colonoscopy (45378) | $1,793.98 | $2,391.97 | 1.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) | $716.20 | $954.94 | 0.8× |
| After-cataract laser surgery (YAG capsulotomy) (66821) | $984.13 | $1,312.17 | 1.8× |
| CT head/brain without contrast (70450) | $669.68 | $892.91 | 6.3× |
| MRI brain without contrast (70551) range across 2 matching MRF lines |
$1,510.11–$2,187.38 | $2,013.48–$2,916.51 | varies |
| MRI brain with contrast (70552) range across 2 matching MRF lines |
$1,703.58–$1,760.19 | $2,271.44–$2,346.92 | varies |
| MRI brain without and with contrast (70553) | $2,187.38 | $2,916.51 | 6.2× |
| X-ray lower spine, 4+ views (72110) | $231.75 | $309 | 2.2× |
| MRI lumbar spine without contrast (72148) | $1,547.48 | $2,063.30 | 6.4× |
| CT pelvis with contrast (72193) | $1,164.52 | $1,552.69 | 6.6× |
| MRI lower-extremity joint without contrast (73721) | $1,284.49 | $1,712.65 | 5.3× |
| CT abdomen and pelvis with contrast (74177) | $1,767.08 | $2,356.10 | 5.0× |
| Ultrasound, abdomen complete (76700) | $410 | $546.67 | 3.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $377.12 | $502.82 | 3.6× |
| Ultrasound, transvaginal (76830) | $338.52 | $451.36 | 3.2× |
| Mammography, one breast (diagnostic) (77065) | $286.38 | $381.84 | 3.3× |
| Mammography, both breasts (diagnostic) (77066) | $344.78 | $459.70 | 3.1× |
| Mammography, screening (bilateral) (77067) range across 2 matching MRF lines |
$271.30–$542.60 | $361.74–$723.47 | varies |
| Basic metabolic panel (80048) | $33.98 | $45.31 | 4.0× |
| Comprehensive metabolic panel (80053) | $50.30 | $67.07 | 4.8× |
| Obstetric panel (80055) | $169.26 | $225.68 | 3.5× |
| Lipid panel (80061) | $49.65 | $66.20 | 3.7× |
| Renal function panel (80069) | $35.47 | $47.29 | 4.1× |
| Hepatic function panel (80076) | $33.02 | $44.02 | 4.0× |
| Urinalysis, non-automated, without microscopy (81002) | $14.68 | $19.57 | 4.2× |
| PSA, total (84153) | $67.28 | $89.70 | 3.7× |
| Thyroid stimulating hormone (TSH) (84443) | $61.70 | $82.26 | 3.7× |
| CBC with automated differential (85025) | $48.02 | $64.02 | 6.2× |
| CBC, automated (85027) | $36.05 | $48.07 | 5.6× |
| Prothrombin time (PT) (85610) range across 2 matching MRF lines |
$16.10–$61.80 | $21.46–$82.40 | varies |
| Partial thromboplastin time (PTT) (85730) | $16.10 | $21.46 | 2.7× |
| Psychotherapy, 30 minutes (90832) | $138.65 | $184.86 | 0.8× |
| Psychotherapy, 45 minutes (90834) | $325.30 | $433.74 | 1.8× |
| Family psychotherapy, without patient (50 min) (90846) | $152.38 | $203.18 | 0.8× |
| Group psychotherapy (90853) | $93.62 | $124.82 | 0.9× |
| Electrocardiogram (ECG), complete (93000) | $35.74 | $47.65 | 0.6× |
| Left heart catheterization (93452) | $5,986.68 | $7,982.24 | 1.8× |
| Sleep study (attended polysomnography) (95810) | $3,333.11 | $4,444.15 | 3.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 3 matching MRF lines |
$92.36–$100.03 | $123.15–$133.37 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) | $294.54 | $392.72 | 2.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) | $294.54 | $392.72 | 2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) | $320.33 | $427.11 | 2.4× |
| Preventive visit, new patient (age 18–39) (99385) | $157.63 | $210.17 | — |
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.
Children's hospital — Medicare is an adult program, so the Medicare benchmarks on this page are a general yardstick, not rates this hospital typically bills.
More prices at this hospital
- Imaging: 380 codes with posted prices and Medicare benchmarks
- Lab & pathology: 922 codes with posted prices and Medicare benchmarks
- Visits & medical services: 332 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 700 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 49 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (ZIP, 5.4 MB) ↓ — captured 2026-09-05
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.