Visits & medical services prices at Mountain West Medical Center
Tooele, UT · every code in this section with a posted price and a Medicare benchmark.
112 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Airway Inhalation Treatment (94640) range across 6 matching MRF lines |
$153.26–$258.04 | $255.43–$430.07 | varies |
| Airway resistance by oscillometry (94728) | $399.53 | $665.88 | 3.1× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) range across 2 matching MRF lines |
$82.78–$86.09 | $137.97–$143.49 | varies |
| Behavral qualit analys voice (92524) | $303.01 | $505.01 | 2.8× |
| Biofeedback training any modality (90901) | $23.77 | $39.61 | 0.6× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $1,052.58 | $1,754.30 | 2.8× |
| Canalith repositioning proc (95992) | $27.88 | $46.46 | 0.7× |
| Car seat/bed test 60 min (94780) | $40.09 | $66.81 | 1.1× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,658.32 | $2,763.86 | 7.6× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$1,982.70–$2,098.09 | $3,304.50–$3,496.82 | varies |
| Cardioversion (92960) | $2,087.17 | $3,478.62 | 3.1× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $18,790.48 | $31,317.46 | 5.7× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $17,445.33 | $29,075.55 | 5.3× |
| Cbt 1st hour (94644) | $462.82 | $771.37 | 3.4× |
| Chemo IV infusion addl hr (96415) | $93.08 | $155.14 | 1.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $488.67 | $814.45 | 1.5× |
| Chest Wall Manipulation (94668) | $98.30 | $163.83 | 0.7× |
| Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) | $272.68 | $454.46 | 0.7× |
| Color/duplex Doppler, complete (93975) | $417.02 | $695.04 | 1.7× |
| Color/duplex Doppler, limited (93976) | $259.55 | $432.58 | 2.5× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) range across 2 matching MRF lines |
$22.43–$23.33 | $37.38–$38.88 | varies |
| Continuous Pulse Ox (94762) | $169.67 | $282.78 | 1.3× |
| Coronary Art/Grft Angio S&I (93455) | $8,799.85 | $14,666.42 | 2.7× |
| Coronary Artery Angio S&I (93454) | $7,983.80 | $13,306.34 | 2.4× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $887.24 | $1,478.74 | 4.0× |
| Cpt initial (94667) | $331.24 | $552.07 | 2.5× |
| Critical care first hour (99291) | $4,358.17 | $7,263.61 | 5.2× |
| Debridement Open Wound 20 Sq Cm< (97597) | $412.18 | $686.97 | 2.0× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $617.54 | $1,029.23 | 2.6× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $480.16 | $800.26 | 4.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,134.53 | $1,890.89 | 4.7× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$312.06–$1,060.72 | $520.10–$1,767.87 | varies |
| Duplex up extrem art bilat (93930) | $615.47 | $1,025.78 | 2.5× |
| Duplex up extrem art unilat/ltd (93931) | $435.18 | $725.30 | 4.1× |
| ECG/monitoring and analysis (93271) | $1,303.48 | $2,172.46 | 13.5× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$361.54–$722.50 | $602.56–$1,204.16 | varies |
| Echo transesophageal (93312) | $1,264.79 | $2,107.99 | 2.3× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) range across 2 matching MRF lines |
$1,166.46–$1,524.38 | $1,944.10–$2,540.64 | varies |
| Electrocardiogram Tracing (93005) range across 3 matching MRF lines |
$358.29–$483.04 | $597.15–$805.06 | varies |
| Emergency Dept Visit Level 2 (99282) | $554 | $923.34 | 3.6× |
| Emergency Dept Visit Level 3 (99283) | $879.02 | $1,465.04 | 3.2× |
| Emergency Dept Visit Level 4 (99284) | $1,314.83 | $2,191.39 | 3.1× |
| Er level 1 (99281) | $316.15 | $526.92 | 3.7× |
| Er level v (99285) | $1,839.28 | $3,065.46 | 3.1× |
| Evaluate Speech Production (92522) | $303.01 | $505.01 | 2.7× |
| Evaluate Swallowing Function (92610) | $270.97 | $451.61 | 3.2× |
| Evaluation of speech fluency (92521) | $303.01 | $505.01 | 2.3× |
| External ECG rec>48hr<7d recording (93242) | $163.51 | $272.52 | 4.3× |
| External ECG rec>7d<15d recording (93246) | $268.97 | $448.29 | 7.1× |
| External Ecg Scanning Analysis Report (93226) | $984.92 | $1,641.53 | 16.5× |
| Extracranial Bilat Study (93880) | $1,482.73 | $2,471.22 | 6.1× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) | $2,312.08 | $3,853.47 | 2.7× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $19,606.70 | $32,677.84 | 6.0× |
| Holter monitor recording (93225) | $1,049.16 | $1,748.60 | 7.8× |
| Immunization administration (90471) range across 4 matching MRF lines |
$34.49–$62.95 | $57.49–$104.91 | varies |
| Insert/Place Heart Catheter (93503) | $2,343.19 | $3,905.32 | 1.5× |
| Iontophoresis 15 min (97033) range across 2 matching MRF lines |
$76.58–$79.64 | $127.63–$132.74 | varies |
| Irrig Drug Delivery Device (96523) | $97.74 | $162.90 | 1.6× |
| IV infusion hydration each additional hour (96361) range across 3 matching MRF lines |
$64.74–$171.98 | $107.90–$286.63 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 3 matching MRF lines |
$155.75–$519.70 | $259.58–$866.16 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 3 matching MRF lines |
$97.58–$171.98 | $162.64–$286.63 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 3 matching MRF lines |
$75.37–$171.98 | $125.61–$286.63 | varies |
| IV push initial (96374) range across 3 matching MRF lines |
$97.58–$212.31 | $162.64–$353.85 | varies |
| L Hrt Art/Grft Angio (93459) | $18,263.05 | $30,438.42 | 5.6× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $612.38 | $1,020.63 | 2.8× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $50.40 | $84 | 1.6× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) range across 2 matching MRF lines |
$31.75–$58.80 | $52.92–$98 | varies |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $19.15 | $31.91 | 1.1× |
| Motion Fluoroscopy/Swallow (92611) | $330 | $550 | 3.6× |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$63.46–$65.99 | $105.76–$109.99 | varies |
| Newborn resuscitation (99465) | $657.06 | $1,095.10 | 1.0× |
| Oral Function Therapy (92526) | $204 | $340 | 2.4× |
| Ot eval high complexity (97167) range across 2 matching MRF lines |
$313.60–$326.15 | $522.67–$543.58 | varies |
| Ot Eval Low Complex (97165) range across 2 matching MRF lines |
$313.60–$326.15 | $522.67–$543.58 | varies |
| Ot Eval Moderate Complexity (97166) range across 2 matching MRF lines |
$313.60–$326.15 | $522.67–$543.58 | varies |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$82.78–$86.09 | $137.97–$143.49 | varies |
| Ot paraffin bath (97018) range across 2 matching MRF lines |
$94.27–$98.03 | $157.11–$163.39 | varies |
| Ot Re-Eval Est Plan Care (97168) range across 2 matching MRF lines |
$173.65–$180.59 | $289.41–$300.99 | varies |
| Phlebotomy therapeutic (99195) | $119.08 | $198.46 | 0.9× |
| Plethysmography (94726) | $399.53 | $665.88 | 1.1× |
| Pt Eval High Complex (97163) range across 2 matching MRF lines |
$129.54–$134.72 | $215.90–$224.54 | varies |
| Pt eval low complex 20 min (97161) range across 2 matching MRF lines |
$129.54–$134.72 | $215.90–$224.54 | varies |
| Pt Eval Mod Complex (97162) range across 2 matching MRF lines |
$129.54–$134.72 | $215.90–$224.54 | varies |
| Pt gait training 15 min (97116) range across 2 matching MRF lines |
$76.58–$79.64 | $127.63–$132.74 | varies |
| Pt Re-Eval Est Plan Care (97164) range across 2 matching MRF lines |
$78.04–$81.16 | $130.06–$135.26 | varies |
| Pulm function test by gas (94727) | $399.53 | $665.88 | 1.8× |
| Pulmonary Stress Testing (94618) | $180.32 | $300.54 | 1.3× |
| R Hrt Art/Grft Angio (93457) | $9,267.56 | $15,445.94 | 2.8× |
| R hrt coronary artery angio (93456) | $8,450.59 | $14,084.31 | 2.6× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $15,481.83 | $25,803.05 | 4.7× |
| Remote 30 Day Ecg Rev/Report (93270) | $997 | $1,661.67 | 26.4× |
| Respiratory flow volume loop (94375) | $295.62 | $492.70 | 1.4× |
| Right Heart Cath (93451) | $467.54 | $779.24 | 0.1× |
| Self Care Mngment Training (97535) range across 4 matching MRF lines |
$25.53–$98.03 | $42.55–$163.39 | varies |
| Sensory Integration Ea 15 Min (97533) range across 2 matching MRF lines |
$61.99–$64.47 | $103.32–$107.45 | varies |
| Speech sound lang comprehen (92523) | $303.01 | $505.01 | 1.3× |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$691.45–$903.34 | $1,152.42–$1,505.56 | varies |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $347.29 | $578.81 | 1.6× |
| Temp transcutaneous pacing (92953) | $237.31 | $395.51 | 0.4× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) range across 2 matching MRF lines |
$32.09–$33.38 | $53.49–$55.63 | varies |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 3 matching MRF lines |
$47.54–$75.13 | $79.23–$125.22 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 3 matching MRF lines |
$188.41–$519.70 | $314.01–$866.16 | varies |
| Therapeutic Activities (97530) range across 3 matching MRF lines |
$65.64–$68.27 | $109.40–$113.78 | varies |
| Tte w/doppler, complete (93306) | $3,296.53 | $5,494.22 | 6.0× |
| Tte W/O Doppler Complete (93307) | $2,288.35 | $3,813.92 | 9.5× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $291 | $485 | 3.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 3 matching MRF lines |
$75.37–$206.78 | $125.61–$344.63 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $259.23 | $432.05 | 1.9× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $323.15 | $538.58 | 1.5× |
| Vent Mgmt Inpat Init Day (94002) | $2,882.23 | $4,803.71 | 4.6× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $1,106.71 | $1,844.52 | 1.8× |
| Wheelchair Mgmt Ea 15 Min (97542) range across 2 matching MRF lines |
$79.67–$82.86 | $132.79–$138.10 | varies |
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.