Visits & medical services prices at San Juan Hospital
Monticello, UT · every code in this section with a posted price and a Medicare benchmark.
124 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Advncd Care Plan 30 Min (99497) | $107.41 | $153.44 | 1.0× |
| Airway Inhalation Treatment (94640) range across 3 matching MRF lines |
$20.74–$25.62 | $29.63–$36.60 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $49.63 | $70.90 | 3.5× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $75.75 | $108.22 | 0.2× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$57.60–$58.52 | $82.29–$83.60 | varies |
| Cardiac Stress Tst,Tracing Only (93017) | $831.13 | $1,187.33 | 3.8× |
| Cardiopulmonary resuscitation (92950) | $1,011.87 | $1,445.53 | 4.6× |
| Cardioversion (92960) range across 2 matching MRF lines |
$288.89–$479.27 | $412.70–$684.67 | varies |
| Chemo Anti-Neopl Sq/Im (96401) range across 2 matching MRF lines |
$103.82–$245.19 | $148.31–$350.27 | varies |
| Chemo Hormon Antineopl Sq/Im (96402) | $245.19 | $350.27 | 3.4× |
| Chemo IV infusion addl hr (96415) | $126.74 | $181.06 | 1.7× |
| Chemo IV push addl drug (96411) | $245.19 | $350.27 | 3.4× |
| Chemother Prolong Infuse W/Pump (96416) range across 2 matching MRF lines |
$173.85–$187.41 | $248.35–$267.73 | varies |
| Chemotherapy Unspecified (96549) | $248.93 | $355.61 | 5.3× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $93.33 | $133.33 | 1.3× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$417.45–$417.55 | $596.35–$596.50 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $245.19 | $350.27 | 0.7× |
| Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Facility (98940) | $44.44 | $63.49 | 2.0× |
| Color/duplex Doppler, complete (93975) | $568.90 | $812.71 | 2.4× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $51.85 | $74.07 | 1.6× |
| Continuous Pulse Ox (94762) range across 2 matching MRF lines |
$36.30–$242.23 | $51.86–$346.04 | varies |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $52.59 | $75.13 | 0.2× |
| Cpt initial (94667) | $59.26 | $84.66 | 0.4× |
| Critical care first hour (99291) range across 3 matching MRF lines |
$2,067.45–$2,814.87 | $2,953.50–$4,021.24 | varies |
| Debridement Open Wound 20 Sq Cm< (97597) range across 5 matching MRF lines |
$71.86–$166.67 | $102.65–$238.10 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $568.81 | $812.59 | 5.4× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $568.16 | $811.65 | 2.4× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $487.42 | $696.32 | 4.6× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $568.90 | $812.71 | 2.4× |
| Dup-scan xtr veins unilateral/limited study (93971) | $487.42 | $696.32 | 4.6× |
| Duplex Scan Hemodialysis Access (93990) | $1,000.76 | $1,429.66 | 9.5× |
| Duplex up extrem art bilat (93930) | $955.39 | $1,364.84 | 4.0× |
| Duplex up extrem art unilat/ltd (93931) | $660.01 | $942.87 | 6.2× |
| Ear and throat examination (92502) | $225.19 | $321.70 | 0.4× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$457.07–$469.64 | $652.96–$670.91 | varies |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $1,853.37 | $2,647.67 | 3.3× |
| Electrical Stimulation Ea 15 Min (97032) | $48.90 | $69.85 | 3.3× |
| Electrocardiogram Tracing (93005) | $31.85 | $45.50 | 0.5× |
| Emergency Dept Visit Level 2 (99282) range across 3 matching MRF lines |
$325.19–$430.38 | $464.56–$614.83 | varies |
| Emergency Dept Visit Level 3 (99283) range across 3 matching MRF lines |
$508.90–$640.01 | $727–$914.30 | varies |
| Emergency Dept Visit Level 4 (99284) range across 3 matching MRF lines |
$768.17–$1,010.18 | $1,097.38–$1,443.12 | varies |
| Er level 1 (99281) range across 3 matching MRF lines |
$211.12–$211.35 | $301.60–$301.93 | varies |
| Er level v (99285) range across 3 matching MRF lines |
$1,141.41–$1,422.25 | $1,630.59–$2,031.79 | varies |
| Evaluate Swallowing Function (92610) | $263.71 | $376.73 | 3.1× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $266.67 | $380.96 | 2.0× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $277.78 | $396.83 | 2.1× |
| External Ecg Scanning Analysis Report (93226) | $189.63 | $270.90 | 3.2× |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$509.64–$627.42 | $728.06–$896.31 | varies |
| Extracranial Uni/Ltd Study (93882) | $627.42 | $896.31 | 5.9× |
| Group Therapeutic Procedures (97150) | $48.90 | $69.85 | 2.7× |
| Holter monitor recording (93225) range across 3 matching MRF lines |
$134.08–$248.15 | $191.54–$354.50 | varies |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $17.78 | $25.40 | 0.2× |
| Immunization administration (90471) range across 2 matching MRF lines |
$19.75–$44.44 | $28.21–$63.49 | varies |
| Inital newborn e/m (99460) | $74.07 | $105.82 | 0.5× |
| Iontophoresis 15 min (97033) | $62.22 | $88.89 | 3.3× |
| Irrig Drug Delivery Device (96523) range across 3 matching MRF lines |
$37.26–$118.52 | $53.23–$169.32 | varies |
| IV infusion hydration each additional hour (96361) range across 4 matching MRF lines |
$96.29–$98.53 | $137.56–$140.75 | varies |
| IV infusion hydration initial 31 min-1 hour (96360) range across 4 matching MRF lines |
$184.45–$189.63 | $263.50–$270.90 | varies |
| IV infusion ther proph addl sequential to 1 hr (96367) range across 5 matching MRF lines |
$62.22–$168.15 | $88.89–$240.21 | varies |
| IV infusion therapy prophylaxis/dx ea hour (96366) range across 4 matching MRF lines |
$118.52–$121.49 | $169.32–$173.55 | varies |
| IV push initial (96374) range across 5 matching MRF lines |
$58.18–$96.29 | $83.11–$137.56 | varies |
| Motor &/sens nrv cndj preconf eltrd array limb (95905) range across 2 matching MRF lines |
$57.78–$76.29 | $82.54–$108.99 | varies |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) | $527 | $752.86 | 1.3× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $498.50 | $712.14 | 1.2× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 3 matching MRF lines |
$62.22–$183.11 | $88.89–$261.59 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $54.08 | $77.25 | 0.1× |
| Nerve Conduction Studies 1-2 Studies (95907) range across 2 matching MRF lines |
$137.04–$214.82 | $195.77–$306.89 | varies |
| Nerve Conduction Studies 11-12 Studies (95912) | $472.60 | $675.14 | 1.3× |
| Nerve conduction studies 13 or more studies (95913) | $505.93 | $722.76 | 1.3× |
| Nerve Conduction Studies 3-4 Studies (95908) range across 2 matching MRF lines |
$254.82–$284.45 | $364.03–$406.36 | varies |
| Nerve conduction studies 5-6 studies (95909) | $185.19 | $264.56 | 0.8× |
| Nerve conduction studies 7-8 studies (95910) range across 2 matching MRF lines |
$358.53–$459.27 | $512.18–$656.10 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 2 matching MRF lines |
$413.34–$465.19 | $590.48–$664.56 | varies |
| Neuromuscular Reeducation (97112) | $80 | $114.29 | 2.4× |
| Newborn resuscitation (99465) | $165.93 | $237.04 | 0.2× |
| Oral Function Therapy (92526) | $205.93 | $294.18 | 2.4× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $42.97 | $61.38 | 2.0× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $56.29 | $80.42 | 2.6× |
| Osteopathic manipulative tx 5-6 body regions (98927) | $74.07 | $105.82 | 3.4× |
| Osteopathic manipulative tx 7-8 body regions (98928) | $91.11 | $130.16 | 4.2× |
| Osteopathic manipulative tx 9-10 body regions (98929) | $110.38 | $157.68 | 5.0× |
| Ot eval high complexity (97167) | $117.78 | $168.25 | 1.2× |
| Ot Eval Low Complex (97165) | $117.78 | $168.25 | 1.2× |
| Ot Eval Moderate Complexity (97166) | $117.78 | $168.25 | 1.2× |
| Ot manual therapy 15 min (97140) range across 7 matching MRF lines |
$45.92–$93.33 | $65.60–$133.33 | varies |
| Ot Re-Eval Est Plan Care (97168) | $117.78 | $168.25 | 1.7× |
| Patient-initiated spirometric recording (94015) | $11.85 | $16.93 | 0.1× |
| Percutaneous tests w/allergenic extracts (95004) | $8.15 | $11.64 | 0.0× |
| Phlebotomy therapeutic (99195) range across 2 matching MRF lines |
$155.63–$345.93 | $222.33–$494.19 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $2,008.19 | $2,868.84 | 2.3× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) range across 2 matching MRF lines |
$17.78–$18.96 | $25.40–$27.08 | varies |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) range across 2 matching MRF lines |
$17.78–$58.52 | $25.40–$83.60 | varies |
| Pt Eval High Complex (97163) | $121.49 | $173.55 | 1.2× |
| Pt eval low complex 20 min (97161) | $121.49 | $173.55 | 1.2× |
| Pt Eval Mod Complex (97162) | $121.49 | $173.55 | 1.2× |
| Pt gait training 15 min (97116) | $57.04 | $81.49 | 2.0× |
| Pt mechanical traction (97012) | $48.90 | $69.85 | 3.4× |
| Pt Re-Eval Est Plan Care (97164) | $121.49 | $173.55 | 1.8× |
| Pulmonary Stress Testing (94618) range across 2 matching MRF lines |
$77.78–$87.65 | $111.12–$125.22 | varies |
| Pure Tone Audiometry Air (92552) range across 2 matching MRF lines |
$17.78–$55.28 | $25.40–$78.97 | varies |
| Refill/Maint Portable Pump (96521) | $208.15 | $297.36 | 1.0× |
| Refill/Maint Pump/Resvr Syst (96522) range across 2 matching MRF lines |
$158–$186.67 | $225.71–$266.67 | varies |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $71.11 | $101.59 | 0.4× |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) | $21.48 | $30.69 | 0.8× |
| Same day nb discharge (99463) | $102.96 | $147.09 | 0.8× |
| Self Care Mngment Training (97535) | $71.86 | $102.65 | 2.2× |
| Sleep study attended (95807) | $671.13 | $958.75 | 1.8× |
| Spirometry (94010) | $44.22 | $63.17 | 0.2× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $62.22 | $88.89 | 1.7× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $49.63 | $70.90 | 1.7× |
| Ther/Proph/Diag Inj Ia (96373) | $27.09 | $38.70 | 0.1× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 4 matching MRF lines |
$16.59–$23.70 | $23.70–$33.86 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) range across 4 matching MRF lines |
$308.15–$317.04 | $440.22–$452.92 | varies |
| Therapeutic Activities (97530) range across 5 matching MRF lines |
$62.97–$65.93 | $89.95–$94.18 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $48.90 | $69.85 | 1.3× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $36.30 | $51.86 | 1.0× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 5 matching MRF lines |
$17.04–$105.18 | $24.34–$150.26 | varies |
| Tympanometry (92567) | $28.15 | $40.21 | 0.7× |
| Unlisted Diagnostic Gastroenterology Procedure (91299) | $171.12 | $244.45 | 1.3× |
| Upr/L Xtremity Art 2 Levels (93922) range across 4 matching MRF lines |
$100–$135.56 | $142.86–$193.65 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $211.12 | $301.60 | 1.0× |
| Vital capacity, total (94150) | $22.22 | $31.74 | 0.2× |
| Wheelchair Mgmt Ea 15 Min (97542) | $34.07 | $48.67 | 1.1× |
| Whirlpool Therapy (97022) | $62.97 | $89.95 | 4.0× |
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.