Visits & medical services prices at Teton Valley Hospital
Driggs, ID · every code in this section with a posted price and a Medicare benchmark.
140 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) range across 3 matching MRF lines |
$24.80–$32.80 | $31–$41 | varies |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$14.40–$195.20 | $18–$244 | varies |
| Analyze neurostim complex (95972) range across 2 matching MRF lines |
$74.40–$125.60 | $93–$157 | varies |
| Analyze Neurostim Simple (95971) range across 3 matching MRF lines |
$72–$128.80 | $90–$161 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $43.20 | $54 | 3.0× |
| Assessment of aphasia per hr (96105) | $335.24 | $419.05 | 3.4× |
| Behavral qualit analys voice (92524) | $308.80 | $386 | 2.8× |
| Biofeedback training any modality (90901) | $36 | $45 | 0.9× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $427.20 | $534 | 1.2× |
| Canalith repositioning proc (95992) | $100 | $125 | 2.5× |
| Cardiac Stress Tst,Tracing Only (93017) | $895.20 | $1,119 | 4.2× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$407.20–$719.20 | $509–$899 | varies |
| Cardioversion (92960) range across 2 matching MRF lines |
$240–$1,589.60 | $300–$1,987 | varies |
| Cbt 1st hour (94644) range across 2 matching MRF lines |
$108–$172.80 | $135–$216 | varies |
| Chemo Anti-Neopl Sq/Im (96401) | $104.84 | $131.05 | 1.5× |
| Chemo Hormon Antineopl Sq/Im (96402) | $96.04 | $120.05 | 1.4× |
| Chemo IV infusion addl hr (96415) range across 2 matching MRF lines |
$120.80–$194.40 | $151–$243 | varies |
| Chemo IV push addl drug (96411) | $186.66 | $233.33 | 2.6× |
| Chemother Prolong Infuse W/Pump (96416) | $536.80 | $671 | 1.6× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $192.84 | $241.05 | 2.7× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) range across 2 matching MRF lines |
$490.40–$518.40 | $613–$648 | varies |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $313.77 | $392.21 | 1.0× |
| Color/duplex Doppler, complete (93975) | $900.80 | $1,126 | 3.8× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $63.20 | $79 | 2.0× |
| Cont gluc mntr physician/qhp provided equiptment (95250) | $211.04 | $263.80 | 1.6× |
| Continuous Pulse Ox (94762) | $278.40 | $348 | 2.2× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $482.40 | $603 | 2.2× |
| Critical care first hour (99291) | $476 | $595 | 0.6× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$66.40–$294.40 | $83–$368 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,076 | $1,345 | 4.6× |
| Dup-scan xtr veins unilateral/limited study (93971) range across 2 matching MRF lines |
$408.80–$576 | $511–$720 | varies |
| ECG/monitoring and analysis (93271) | $314.44 | $393.05 | 3.3× |
| Echo Heart Xthoracic,Limited (93308) range across 4 matching MRF lines |
$40–$741.60 | $50–$927 | varies |
| Echo transesophag congen probe plcmt only (93316) | $57.60 | $72 | 0.1× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $1,100 | $1,375 | 2.0× |
| EEG awake and asleep (95819) | $948.48 | $1,185.60 | 4.4× |
| EEG awake drowsy (95816) | $845.95 | $1,057.44 | 4.0× |
| Electrical Stimulation Ea 15 Min (97032) | $24.80 | $31 | 1.7× |
| Electrocardiogram Tracing (93005) | $203.20 | $254 | 3.5× |
| Emergency Dept Visit Level 2 (99282) | $93.60 | $117 | 0.6× |
| Emergency Dept Visit Level 3 (99283) | $158.40 | $198 | 0.6× |
| Emergency Dept Visit Level 4 (99284) | $270.40 | $338 | 0.7× |
| Emg 3 Extremities (95863) range across 2 matching MRF lines |
$184–$716 | $230–$895 | varies |
| Emg 4 Extremities (95864) range across 2 matching MRF lines |
$196–$728 | $245–$910 | varies |
| Er level 1 (99281) | $56 | $70 | 0.7× |
| Er level v (99285) | $392 | $490 | 0.7× |
| Evaluate pt use of inhaler (94664) | $195.20 | $244 | 0.9× |
| Evaluate Speech Production (92522) | $308.80 | $386 | 2.8× |
| Evaluate Swallowing Function (92610) | $232.80 | $291 | 2.7× |
| Evaluation of speech fluency (92521) | $273.60 | $342 | 2.1× |
| External ECG rec>48hr<7d recording (93242) range across 2 matching MRF lines |
$21.60–$61.60 | $27–$77 | varies |
| External ECG rec>7d<15d recording (93246) | $103.20 | $129 | 2.8× |
| External Ecg Scanning Analysis Report (93226) | $249.60 | $312 | 4.3× |
| Extracranial Bilat Study (93880) range across 2 matching MRF lines |
$308–$791.20 | $385–$989 | varies |
| Extracranial Uni/Ltd Study (93882) | $527.20 | $659 | 5.1× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,140 | $1,425 | 2.1× |
| Group Therapeutic Procedures (97150) | $28.80 | $36 | 1.6× |
| Holter monitor recording (93225) | $318.40 | $398 | 2.4× |
| Immunization administration (90471) | $58.40 | $73 | 0.8× |
| Iontophoresis 15 min (97033) | $71.20 | $89 | 3.7× |
| Irrig Drug Delivery Device (96523) | $160.80 | $201 | 2.8× |
| Ischemic limb exercise test (95875) | $109.60 | $137 | 0.9× |
| IV infusion hydration each additional hour (96361) | $158.40 | $198 | 3.4× |
| IV infusion hydration initial 31 min-1 hour (96360) | $376.80 | $471 | 1.8× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $204 | $255 | 2.9× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $153.60 | $192 | 3.3× |
| IV push initial (96374) | $179.20 | $224 | 0.9× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $384 | $480 | 1.8× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $44.80 | $56 | 1.4× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $44.80 | $56 | 1.2× |
| Motion Fluoroscopy/Swallow (92611) | $365.60 | $457 | 4.0× |
| Muscle Test 2 Limbs (95861) range across 2 matching MRF lines |
$151.20–$486.40 | $189–$608 | varies |
| Muscle Test Nonparaspinal (95870) | $36.80 | $46 | 0.3× |
| Muscle Test One Limb (95860) range across 2 matching MRF lines |
$94.40–$264.80 | $118–$331 | varies |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) range across 2 matching MRF lines |
$77.60–$932.80 | $97–$1,166 | varies |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) range across 2 matching MRF lines |
$36.80–$356.80 | $46–$446 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $156.80 | $196 | 0.8× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $323.20 | $404 | 0.8× |
| Nerve Conduction Studies 1-2 Studies (95907) range across 2 matching MRF lines |
$98.40–$164.80 | $123–$206 | varies |
| Nerve Conduction Studies 11-12 Studies (95912) range across 2 matching MRF lines |
$293.60–$651.20 | $367–$814 | varies |
| Nerve conduction studies 13 or more studies (95913) range across 2 matching MRF lines |
$347.20–$783.20 | $434–$979 | varies |
| Nerve Conduction Studies 3-4 Studies (95908) range across 2 matching MRF lines |
$123.20–$255.20 | $154–$319 | varies |
| Nerve conduction studies 5-6 studies (95909) range across 2 matching MRF lines |
$148–$329.60 | $185–$412 | varies |
| Nerve conduction studies 7-8 studies (95910) range across 2 matching MRF lines |
$196.80–$406.40 | $246–$508 | varies |
| Nerve Conduction Studies 9-10 Studies (95911) range across 2 matching MRF lines |
$245.60–$508.80 | $307–$636 | varies |
| Neuromuscular Reeducation (97112) range across 2 matching MRF lines |
$52.80–$72 | $66–$90 | varies |
| Oral Function Therapy (92526) | $215.20 | $269 | 2.6× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $67.20 | $84 | 1.5× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $43.20 | $54 | 2.0× |
| Ot eval high complexity (97167) | $308.80 | $386 | 3.1× |
| Ot Eval Low Complex (97165) | $196 | $245 | 1.9× |
| Ot Eval Moderate Complexity (97166) | $228.80 | $286 | 2.3× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$42.40–$68 | $53–$85 | varies |
| Ot paraffin bath (97018) | $48 | $60 | 8.0× |
| Ot Re-Eval Est Plan Care (97168) | $61.60 | $77 | 0.9× |
| Phlebotomy therapeutic (99195) | $175.20 | $219 | 1.3× |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$38.40–$163.20 | $48–$204 | varies |
| Pm device progr eval dual (93280) range across 2 matching MRF lines |
$69.60–$202.40 | $87–$253 | varies |
| Pm Device Progr Eval Sngl (93279) range across 2 matching MRF lines |
$58.40–$113.96 | $73–$142.45 | varies |
| Pt Eval High Complex (97163) | $181.60 | $227 | 1.9× |
| Pt eval low complex 20 min (97161) | $156.80 | $196 | 1.6× |
| Pt Eval Mod Complex (97162) | $172.80 | $216 | 1.8× |
| Pt gait training 15 min (97116) | $45.60 | $57 | 1.6× |
| Pt Re-Eval Est Plan Care (97164) | $108 | $135 | 1.6× |
| Pulmonary Stress Testing (94618) range across 2 matching MRF lines |
$239.20–$240 | $299–$300 | varies |
| Refill/Maint Portable Pump (96521) range across 2 matching MRF lines |
$217.64–$224 | $272.05–$280 | varies |
| Refill/Maint Pump/Resvr Syst (96522) range across 2 matching MRF lines |
$212.80–$305.52 | $266–$381.90 | varies |
| Remote 30 Day Ecg Rev/Report (93270) | $247.20 | $309 | 6.7× |
| Remote 30 Day Ecg Tech Supp (93229) range across 2 matching MRF lines |
$864–$889.60 | $1,080–$1,112 | varies |
| Respiratory flow volume loop (94375) | $222.40 | $278 | 1.0× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) range across 2 matching MRF lines |
$28–$226.40 | $35–$283 | varies |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) | $428.52 | $535.65 | 3.5× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $209.44 | $261.80 | 4.4× |
| Same day nb discharge (99463) | $190.96 | $238.70 | 1.5× |
| Self Care Mngment Training (97535) | $69.60 | $87 | 2.1× |
| Sensory Integration Ea 15 Min (97533) | $49.60 | $62 | 0.8× |
| Speech sound lang comprehen (92523) | $308.80 | $386 | 1.4× |
| Spin/Brain Pump Refil & Main (95991) range across 2 matching MRF lines |
$73.60–$342.40 | $92–$428 | varies |
| Spirometry (94010) | $256 | $320 | 1.2× |
| Standardized Cognitive Performance Testing (96125) | $280 | $350 | 2.7× |
| Stress Tte Only (93350) range across 2 matching MRF lines |
$164.80–$1,321.60 | $206–$1,652 | varies |
| Temp transcutaneous pacing (92953) | $481.60 | $602 | 0.7× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $71.20 | $89 | 3.2× |
| Ther Ivntj Ea Addl 15 Min (97130) | $35.20 | $44 | 1.7× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $93.60 | $117 | 2.5× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $88.80 | $111 | 3.0× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$26.40–$94.40 | $33–$118 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $490.40 | $613 | 2.3× |
| Therapeutic Activities (97530) range across 2 matching MRF lines |
$56.80–$79.20 | $71–$99 | varies |
| Tobacco Use Cessation Intensive >10 Minutes (99407) range across 2 matching MRF lines |
$23.64–$38.40 | $29.55–$48 | varies |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) range across 2 matching MRF lines |
$18.40–$20.44 | $23–$25.55 | varies |
| Tte w/doppler, complete (93306) range across 3 matching MRF lines |
$116.80–$1,940 | $146–$2,425 | varies |
| Tte W/O Doppler Complete (93307) | $1,127.84 | $1,409.80 | 4.8× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $193.60 | $242 | 2.5× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $179.20 | $224 | 3.9× |
| Upr/L Xtremity Art 2 Levels (93922) | $544.80 | $681 | 4.1× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $250.40 | $313 | 1.2× |
| Vent Mgmt Inpat Init Day (94002) | $1,202.40 | $1,503 | 2.0× |
| Vital capacity, total (94150) | $84.80 | $106 | 0.7× |
| Wheelchair Mgmt Ea 15 Min (97542) | $54.44 | $68.05 | 1.8× |
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.