Supplies, drugs & other prices at Teton Valley Hospital
Driggs, ID · every code in this section with a posted price and a Medicare benchmark.
27 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $20.60 | $25.75 | 0.4× |
| Colon ca scrn not hi rsk ind (G0121) | $337.60 | $422 | 0.4× |
| Colorectal scrn; hi risk ind (G0105) | $336.80 | $421 | 0.4× |
| Diab manage trn ind/group (G0109) range across 3 matching MRF lines |
$44–$85.64 | $55–$107.05 | varies |
| Direct refer hospital observ (G0379) | $596 | $745 | 1.0× |
| Drug test def 1-7 classes (G0480) range across 6 matching MRF lines |
$88–$226.40 | $110–$283 | varies |
| Drug test def 22+ classes (G0483) range across 2 matching MRF lines |
$352.80–$664 | $441–$830 | varies |
| Drug test def 8-14 classes (G0481) range across 2 matching MRF lines |
$150.40–$258.40 | $188–$323 | varies |
| Ekg tracing for initial prev (G0404) | $74.40 | $93 | 2.6× |
| Elec stim other than wound (G0283) range across 2 matching MRF lines |
$56.54–$1,193.60 | $70.67–$1,492 | varies |
| Electromagntic tx for ulcers (G0329) | $28.80 | $36 | 2.7× |
| Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie,… (0184T) likely a partial charge, not the full procedure |
$1,497.60 | $1,872 | 0.2× |
| Fecal blood scrn immunoassay (G0328) | $27.20 | $34 | 1.5× |
| Hospital outpt clinic visit (G0463) | $148.80 | $186 | 1.1× |
| Inj for sacroiliac jt anesth (G0260) range across 2 matching MRF lines |
$350.16–$404 | $437.70–$505 | varies |
| Njx platelet plasma (0232T) range across 2 matching MRF lines |
$60.80–$979.20 | $76–$1,224 | varies |
| Perq Sacral Augmt Bilat Inj (0201T) | $7,200 | $9,000 | 1.0× |
| Perq Sacral Augmt Unilat Inj (0200T) | $7,200 | $9,000 | 1.0× |
| Psa screening (G0103) | $92 | $115 | 4.8× |
| Scr c/v cyto,thinlayer,rescr (G0145) | $96.80 | $121 | 3.7× |
| Tomosynthesis, mammo (G0279) | $249.04 | $311.30 | 19.6× |
| Trauma respons w/hosp criti (G0390) range across 2 matching MRF lines |
$958.40–$996 | $1,198–$1,245 | varies |
| Tte w or w/o contr, cont ecg (C8930) | $1,695.64 | $2,119.55 | 2.2× |
| Tte w or wo fol wcon,doppler (C8929) | $1,546.86 | $1,933.58 | 2.0× |
| Unsched dialysis esrd pt hos (G0257) | $500 | $625 | 0.7× |
| Visit esketamine 56m or less (G2082) range across 2 matching MRF lines |
$65.60–$828 | $82–$1,035 | varies |
| Visit esketamine, > 56m (G2083) | $1,209.60 | $1,512 | 0.8× |
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.