Visits & medical services prices at Mountain View Hospital

Idaho Falls, ID · every code in this section with a posted price and a Medicare benchmark.

275 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $108 $108 1.1×
Airway inhalation treatment (94640) $140 $140 0.6×
Analyze neurostim complex (95972) $730 $730 7.8×
Analyze neurostim no prog (95970) $195 $195 1.5×
Analyze neurostim simple (95971) $400 $400 4.3×
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $31 $31 2.2×
Application on-body injector (96377) $200 $200 4.3×
Assessment of aphasia per hr (96105) $314.50 $314.50 3.2×
Basic vestibular evaluation (92540) $95 $95 0.4×
Bedside Swallowing Eval (92610) $281.50 $281.50 3.3×
Behavioral and qualitative analysis of voice and resonance (92524) $314 $314 2.9×
Biofeedback training any modality (90901) $65 $65 1.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $408 $408 1.1×
C motor evoked upr&lwr limbs (95939) $1,210 $1,210 1.4×
Caloric vestibular test w/rec bi bithermal (92537) $29 $29 0.2×
Canalith Repositioning Procedure (95992) $43 $43 1.1×
Car seat/bed test 60 min (94780) $75 $75 2.0×
Cardiac Stress Tst,Tracing Only (93017) $407.50 $407.50 1.9×
Cardiopulmonary resuscitation (92950) $1,011 $1,011 4.7×
Cardioversion (92960) $2,000 $2,000 3.1×
Cardioversion elective internal (92961) $2,396.50 $2,396.50 3.7×
Cath Perc Clos,Cong Interatrial Commun W/Impl (93580) $49,478.56 $49,478.56 2.7×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $14,000 $14,000 4.4×
Cbt 1st hour (94644) $250 $250 1.9×
Chemo Hormon Antineopl Sq/Im (96402) $160 $160 2.2×
Chemo IV push addl drug (96411) $250 $250 3.5×
Chemo prolong 8+ hrs infuse w/pump (96416) $582 $582 1.8×
Chemother, IV infusion, 1 hr (96413) $700 $700 2.1×
Chemother, IV infusion, ea add hr (96415) $300 $300 4.2×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $200 $200 2.8×
Chemotherapy into cns (96450) $850 $850 2.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $500 $500 7.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $500 $500 1.5×
Chronic care management services 1st 20 min (99490) $73 $73 0.7×
Color/duplex Doppler, complete (93975) $657 $657 2.8×
Color/duplex Doppler, limited (93976) $590 $590 5.7×
Comprehensive Hearing Test (92557) $104 $104 0.8×
Cont Gluc Monitoring Patient Provided Equipment (95249) $155 $155 2.7×
Continuous Glucose Monitoring (95250) $212 $212 1.6×
Coronary art/grft angio s&i (93455) $14,000 $14,000 4.4×
Coronary artery angio s&i (93454) $14,000 $14,000 4.4×
Cpap/bipap (94660) $1,200 $1,200 5.5×
Cpt initial (94667) $70 $70 0.5×
Critical care (99291) $3,926 $3,926 4.8×
Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) $845 $845 2.3×
Ctr Motor Ep Std Transcrnl Motor Stimj Upr Limbs (95928) $845 $845 1.0×
Dbrdmt prmlg les w/pdt (96574) $452 $452 2.3×
Debridement Open Wound 20 Sq Cm< (97597) $425 $425 2.1×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $37 $37 0.1×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $590 $590 2.5×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $250 $250 2.4×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $590 $590 2.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $425 $425 4.1×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $590 $590 2.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $425 $425 4.1×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $590 $590 2.5×
Dup-scan xtr veins unilateral/limited study (93971) $425 $425 4.1×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $720 $720 3.1×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $590 $590 5.7×
Duplex scan extracranial art compl bi study (93880) $627.50 $627.50 2.7×
Duplex Scan Hemodialysis Access (93990) $425 $425 4.1×
Ear and throat examination (92502) $876 $876 1.6×
Echo Heart Xthoracic,Limited (93308) $979.50 $979.50 4.2×
Echo transesophag montr cardiac pump functj (93318) $2,700 $2,700 5.0×
Echo transesophageal (93312) $1,750 $1,750 3.2×
Echo Transesophageal - Congenital Tee Complete (93315) $1,724 $1,724 3.2×
Echo Transthoracic - Congenital Tte Complete (93303) $1,400 $1,400 2.6×
Echo Transthoracic - Congenital Tte Limited (93304) $1,320 $1,320 2.4×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,836 $1,836 3.4×
EEG awake and asleep (95819) $700 $700 3.3×
EEG awake drowsy (95816) $850 $850 4.0×
EEG cerebral death evaluation (95824) $266 $266 0.7×
EEG coma or sleep only (95822) $1,350 $1,350 6.3×
EEG cont rec w/video by tech min 8 channels (95700) $606 $606 2.8×
EEG greater than 1 hour (95813) $950 $950 4.5×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $1,810 $1,810 4.9×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $905 $905 4.2×
Elec alys implt brn npgt prgrmg 1st 15 min (95983) $106 $106 1.1×
Elec alys implt cplx cn npgt prgrmg (95977) $267 $267 2.8×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $524.50 $524.50 14.2×
Electrocardiogram Tracing (93005) $243.75 $243.75 4.2×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $1,087.50 $1,087.50 5.1×
EMG one extremity (95860) $870 $870 6.6×
EMG two extremities (95861) $870 $870 6.6×
Endomyocardial biopsy (93505) $5,478.92 $5,478.92 1.8×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $2,721 $2,721 2.3×
Er level 1 (99281) $370 $370 4.4×
Er level ii (99282) $679 $679 4.5×
Er level iii (99283) $1,183 $1,183 4.4×
Er level IV (99284) $1,912 $1,912 4.6×
Er level v (99285) $2,788 $2,788 4.7×
Esoph balloon distension tst (91040) $260 $260 0.7×
Esophgl funcj g-esop rflx impd eltrd prolng (91038) $610 $610 1.7×
Eval speech sound production (92522) $314 $314 2.8×
Eval to use/fit voice prosth (92597) $165 $165 2.3×
Evaluate Pt Use Of Inhaler (94664) $252 $252 1.2×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $387 $387 3.2×
Evaluation of speech fluency (92521) $475 $475 3.6×
External ECG rec>48hr<7d recording (93242) $247 $247 6.7×
External ECG rec>7d<15d recording (93246) $247 $247 6.7×
External Ecg Scanning Analysis Report (93226) $247 $247 4.2×
Eye exam w anesth; complete (92018) $1,545 $1,545 0.7×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $241 $241 1.2×
Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) $700 $700 0.8×
Fundus photography w/interpretation & report (92250) $350 $350 2.7×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $610 $610 1.7×
Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) $260 $260 1.2×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $650 $650 0.8×
Gi tract capsule endoscopy (91110) $2,100 $2,100 2.3×
Group Therapeutic Procedures (97150) $88 $88 4.9×
Hemodialysis (90935) $1,386.50 $1,386.50 2.0×
Holter Monitor (93225) $218.50 $218.50 1.7×
Ilr Device Eval Progr (93285) $60 $60 1.6×
Immune Admin Oral/Nasal (90473) $58 $58 0.8×
Immunization Admin (90471) $48 $48 0.7×
Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) $253 $253 1.9×
Injection intra arterial (96373) $150 $150 0.7×
Ins swan ganz bedside (93503) $5,478.92 $5,478.92 3.5×
Interrog dev eval scrms phys/qhp in person (93291) $55 $55 1.9×
Interrog device eval heart (93289) $75 $75 2.0×
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) $375 $375 6.4×
Intrapulmonary Surfactant Administj Phys/Qhp (94610) $225 $225 1.0×
Iontophoresis 15 min (97033) $71 $71 3.7×
Irrig drug delivery device (96523) $191.50 $191.50 3.3×
IV infusion hydration each additional hour (96361) $208 $208 4.5×
IV infusion hydration initial 31 min-1 hour (96360) $250 $250 1.2×
IV infusion ther proph addl sequential to 1 hr (96367) $276 $276 3.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $350 $350 1.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $175 $175 3.8×
IV push ea addl new drug (96375) $150 $150 3.2×
IV push initial (96374) $250 $250 1.2×
L hrt art/grft angio (93459) $14,000 $14,000 4.4×
Liver Elastography W/O Imag W/I&R (91200) $160 $160 1.3×
Manual therapy 15 min (97140) $133.50 $133.50 4.8×
Massage 15 min (97124) $53 $53 1.8×
Mechanical chest wall oscillation (94669) $225 $225 1.0×
Mechanical traction (97012) $84 $84 5.8×
Methacholine challenge (94070) $695 $695 1.9×
Motility study esophagus (91010) $475 $475 1.3×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $355 $355 3.9×
Multiple Sleep Latency Test (95805) $3,100 $3,100 3.7×
Nasopharyngoscopy (92511) $1,030 $1,030 5.2×
Needle Electromyography Cranial Nrv Muscle Bi (95868) $263 $263 1.2×
Needle Electromyography Cranial Nrv Muscle Uni (95867) $175 $175 0.8×
Neg press wound tx >50 cm (97608) $450 $450 1.1×
Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) $440 $440 1.1×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $275 $275 1.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $457 $457 1.1×
Nerve Conduction Studies 11-12 Studies (95912) $662.50 $662.50 1.8×
Nerve conduction studies 13/> studies (95913) $750 $750 2.0×
Nerve Conduction Studies 3-4 Studies (95908) $369.50 $369.50 1.7×
Nerve Conduction Studies 5-6 Studies (95909) $304.50 $304.50 1.4×
Nerve Conduction Studies 7-8 Studies (95910) $400 $400 1.1×
Nerve Conduction Studies 9-10 Studies (95911) $634.50 $634.50 1.7×
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $150 $150 1.2×
Newborn resuscitation (99465) $683 $683 1.0×
Nitric oxide expired gas determination (95012) $109 $109 3.0×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $315 $315 2.4×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $89.50 $89.50 0.7×
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $112.50 $112.50 2.4×
Osteopathic Manipulative Tx 1-2 Body Regions (98925) $75 $75 3.5×
Osteopathic manipulative tx 3-4 body regions (98926) $106 $106 5.0×
Ot Contrast Bath Ea 15 Min (97034) $66 $66 4.7×
Ot eval high complex 60 min (97167) $243 $243 2.4×
Ot eval low complex 30 min (97165) $243 $243 2.4×
Ot eval mod complex 45 min (97166) $243 $243 2.4×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $77 $77 1.5×
Ot Prosthetic Training, Each 15 Min (97761) $50 $50 1.2×
Ot re-evaluation (97168) $243 $243 3.5×
Ot therapeutic activity 15 min (97530) $178 $178 5.1×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $330 $330 2.6×
Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) $330 $330 2.6×
Paraffin bath pt (97018) $66 $66 11.0×
Patch/Application Test Specify Number Tests (95044) $528 $528 0.6×
Percutaneous tests w/allergenic extracts (95004) $280 $280 0.3×
Peripheral arterial disease rehab per session (93668) $150 $150 2.6×
Peritoneal Dialysis (90945) $2,500 $2,500 6.1×
Perq transcath closure pda (93582) $25,000 $25,000 1.4×
Perq Transcath Cls Mitral (93590) $25,000 $25,000 1.4×
Perq transcath cls paravalvr leak 1 aortic valve (93591) $25,000 $25,000 1.4×
Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) $14,220 $14,220 2.5×
Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) $36,377.82 $36,377.82 3.2×
Phlebotomy therapeutic (99195) $219 $219 1.7×
Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) $200 $200 3.4×
Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) $200 $200 3.4×
Plethysmography (94726) $341 $341 0.9×
Pm device eval in person (93288) $61 $61 1.7×
Pm device progr eval dual (93280) $75 $75 2.0×
Pm device progr eval multi (93281) $87 $87 2.4×
Pm device progr eval sngl (93279) $67 $67 1.8×
Pm/Icd Remote Tech Serv (93296) $109 $109 3.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $3,100 $3,100 3.7×
Polysom <6 yrs 4/> paramtrs (95782) $3,100 $3,100 3.7×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $500 $500 10.8×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $89 $89 2.4×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $23 $23 0.5×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $34 $34 0.7×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) $77 $77 2.1×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) $89 $89 2.4×
Prq balloon valvuloplasty aortic valve (92986) $14,000 $14,000 2.5×
Prq Balloon Valvuloplasty Mitral Valve (92987) $14,000 $14,000 1.2×
Prq Card Stent W/Angio 1 Vsl (92928) $18,000 $18,000 1.6×
Prq Card Stent/Ath/Angio (92933) $24,000 $24,000 1.3×
Prq Revasc Byp Graft 1 Vsl (92937) $36,377.82 $36,377.82 3.2×
Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) $25,000 $25,000 1.4×
Prq tcat plmt ntrac st 2+les (92930) $24,000 $24,000 1.3×
Prq trluml coronary angio/atherect one art/brnch (92924) $24,000 $24,000 2.1×
Pt Aquatic Therapy/Exercises (97113) $215 $215 5.8×
Pt Electrical Stimulation (97032) $62 $62 4.2×
Pt eval high complex 45 min (97163) $234 $234 2.4×
Pt eval low complex 20 min (97161) $234 $234 2.4×
Pt eval mod complex 30 min (97162) $234 $234 2.4×
Pt gait training 15 min (97116) $85 $85 2.9×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $85 $85 2.6×
Pt Physical Performance Test (97750) $93 $93 2.8×
Pt re-evaluation (97164) $234 $234 3.5×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $127.50 $127.50 3.9×
Pt ultraviolet (97028) $24 $24 2.9×
Pt Whirlpool Therapy (97022) $98 $98 6.2×
Pulm Funct Test Oscillometry (94728) $150 $150 1.2×
Pulmonary Service/Procedure (94799) $165 $165 1.3×
Pulmonary stress test simple (94618) $245 $245 1.9×
Pure Tone Audiometry Air Only (92552) $50 $50 0.4×
R & l hrt cath w/njx l ventriculog img s&i (93453) $14,000 $14,000 4.4×
R hrt art/grft angio (93457) $14,000 $14,000 4.4×
R hrt coronary artery angio (93456) $14,000 $14,000 4.4×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $14,000 $14,000 4.4×
R&l hrt art/ventricle angio (93460) $14,000 $14,000 4.4×
Refill/Maint Portable Pump (96521) $400 $400 1.9×
Rem Interrog Scrms <30 D Phys/Qhp (93298) $125 $125 3.4×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $173 $173 4.7×
Remote therapeutic mntr 1st set-up&pt educaj eqp (98975) $246 $246 1.9×
Remote therapeutic monitoring (eg, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily)… (98977) $107 $107 2.9×
Right heart cath (93451) $14,000 $14,000 4.4×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $402 $402 2.0×
Rom meas&reprt hand w/wo comparison normal sid (95852) $72 $72 3.4×
Rt Chest Wall Manipulation,Subsequent (94668) $86 $86 0.7×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $194 $194 4.1×
Sensory Integration Ea 15 Min (97533) $85 $85 1.4×
Short-latency somatosens ep std upr limbs (95925) $425 $425 2.0×
Sleep study attended (95807) $1,157 $1,157 3.1×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $450 $450 2.1×
Smoking cessation > 10 min (99407) $35 $35 0.9×
Somatosensory testing (95938) $870 $870 1.0×
Speech sound lang comprehen (92523) $314 $314 1.4×
Spirometry (94010) $185 $185 0.9×
Ssep lower limbs (95926) $870 $870 4.1×
Standardized Cognitive Performance Testing (96125) $314.50 $314.50 3.1×
Stress echo (93350) $1,836 $1,836 3.4×
Temp transcutaneous pacing (92953) $1,896.50 $1,896.50 2.9×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $210.50 $210.50 9.4×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $85 $85 4.0×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $228 $228 2.2×
Therapeutic prophylactic/dx injection subq/im (96372) $125 $125 1.8×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $35 $35 0.9×
Trans Care Mgmt 14 Day Disch (99495) $150 $150 1.1×
Trans Care Mgmt 7 Day Disch (99496) $150 $150 1.1×
Tte w/doppler, complete (93306) $1,420 $1,420 2.6×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $575 $575 2.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $228 $228 3.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $328 $328 3.9×
Tympanometry (92567) $27 $27 0.7×
Unlisted Cardiovascular Service/Procedure (93799) $805 $805 6.3×
Upr/lxtr art stdy 3+ lvls (93923) $535 $535 2.5×
Valvuloplasty pulmonary valve (92990) $14,000 $14,000 1.2×
Vasc Duplex Scan Extracranial,Limited (93882) $402 $402 3.9×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $720 $720 3.4×
Vasopneumatic device (97016) $80 $80 6.7×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $1,456.75 $1,456.75 4.0×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $2,670 $2,670 3.1×
Vent mgmt inpat init day (94002) $2,500 $2,500 4.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $2,000 $2,000 3.3×
Wheelchair Mgmt Ea 15 Min (97542) $45 $45 1.4×
Xtrnl mobile cv telemetry w/technical support (93229) $721 $721 2.0×
Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) $1,668 $1,668 45.2×