Supplies, drugs & other prices at Orem Community Hospital

Orem, UT · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Antibody treponema pallidum total & rpr ia qual (0064U) $51.70 $68.94 1.7×
Catheterize for urine spec (P9612) $18.46 $24.62 2.0×
Colon ca scrn not hi rsk ind (G0121) $2,393.66 $3,191.55 2.5×
Colorectal scrn; hi risk ind (G0105) $1,904.45 $2,539.27 2.0×
Covid-19 lab test non-cdc (U0002) $159.92 $213.23 3.1×
Diab manage trn per indiv (G0108) $109.76 $146.35 2.0×
Direct refer hospital observ (G0379) $728.01 $970.68 1.2×
Drug test def 1-7 classes (G0480) $100.45 $133.93 0.9×
Drug test def 15-21 classes (G0482) $200.30 $267.07 1.0×
Drug test def 22+ classes (G0483) $242.86 $323.82 1.0×
Drug test def 8-14 classes (G0481) $391.03 $521.37 2.5×
Eia hiv-1/hiv-2 screen (G0432) $123.85 $165.13 6.3×
Elec stim other than wound (G0283) $82.04 $109.39 6.5×
Elec stim unattend for press (G0281) $107.42 $143.23 9.2×
Esophag muc integ w/eso egd (C9777) $13,390.98 $17,854.64 3.4×
Extracorporeal shock wave muscskel sys nos (0101T) $81.98 $109.30 0.3×
Fecal microbiota prep instil (G0455) $3,315.12 $4,420.16 3.5×
Hbot, full body chamber, 30m (G0277) $503.33 $671.11 3.6×
Hospital outpt clinic visit (G0463)
range across 2 matching MRF lines
$273.23–$894.22 $364.30–$1,192.30 varies
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $34,528.28 $46,037.70 1.1×
Neuro csf prion prtn qual (0035U) $1,098.56 $1,464.74 2.0×
Njx platelet plasma (0232T) $437.42 $583.22 1.0×
Oth resp proc, group (G0239) $137.31 $183.08 3.6×
Oth resp proc, indiv (G0238) $59.99 $79.99 2.0×
Pathogen test for platelets (P9100) $604.86 $806.48 10.1×
Perc d-e cor revasc chro sin (C9607) $28,132.88 $37,510.50 1.5×
Perq Sacral Augmt Bilat Inj (0201T) $7,137.28 $9,516.38 1.0×
Perq Sacral Augmt Unilat Inj (0200T)
unusually low: confirm this is the full procedure
$2,888.08 $3,850.77 0.4×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $14,249.05 $18,998.73 1.2×
Place device/marker, non pro (C9728) $2,141.40 $2,855.20 1.5×
Prostate biopsy, any mthd (G0416) $2,527.39 $3,369.85 7.0×
Psa screening (G0103) $96.10 $128.14 5.0×
Revasc intra lithotrip-ather (C9766) $30,348.39 $40,464.52 1.6×
Revasc intra lithotrip-stent (C9765) $26,037.94 $34,717.25 1.4×
Revasc intravasc lithotripsy (C9764) $19,650.86 $26,201.15 1.7×
Revasc lith-sten-ath tib/per (C9775) $37,420.52 $49,894.02 2.0×
Revasc lithotr-ather tib/per (C9774) $26,135.17 $34,846.89 1.4×
Revasc lithotr-stent tib/per (C9773) $20,908.13 $27,877.51 1.1×
Revasc lithotrip tibi/perone (C9772) $15,779.39 $21,039.19 1.3×
Revasc lithotrip-stent-ather (C9767) $37,420.52 $49,894.02 2.0×
Screen cerv/vag thin layer (G0123) $296.42 $395.23 14.6×
Syphilis tst non-treponemal antibody ia qual rpr (0065U) $29.86 $39.81 1.7×
Tee w or w/o fol w/cont, mon (C8927) $4,816.32 $6,421.76 6.1×
Therapeutic ultrafiltration (0692T)
range across 2 matching MRF lines
$1,300.79–$2,179.40 $1,734.38–$2,905.86 varies
Unsched dialysis esrd pt hos (G0257) $2,108.96 $2,811.94 3.0×

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.