Supplies, drugs & other prices at Uintah Basin Medical Center

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

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

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ProcedurePosted cashPosted gross× Medicare
Adm tocilizu covid-19 1st (M0249) $620.10 $689 1.4×
Adm tocilizu covid-19 2nd (M0250) $620.10 $689 1.4×
Admin pneumococcal vaccine (G0009)
range across 2 matching MRF lines
$58.50–$61.43 $65–$68.25 varies
Colon ca scrn not hi rsk ind (G0121) $1,980 $2,200 2.1×
Colorectal scrn; hi risk ind (G0105) $1,980 $2,200 2.1×
Diab manage trn ind/group (G0109) $26.78 $29.75 1.7×
Direct refer hospital observ (G0379)
range across 2 matching MRF lines
$168.75–$177.30 $187.50–$197 varies
Drug test def 1-7 classes (G0480)
range across 5 matching MRF lines
$115.43–$456.75 $128.25–$507.50 varies
Drug test def 15-21 classes (G0482)
range across 2 matching MRF lines
$11.25–$313.20 $12.50–$348 varies
Drug test def 22+ classes (G0483) $313.20 $348 1.3×
Drug test def 8-14 classes (G0481) $57.15 $63.50 0.4×
Elec stim other than wound (G0283)
range across 2 matching MRF lines
$97.20–$102.15 $108–$113.50 varies
Group mnt 2 or more 30 mins (G0271) $29.48 $32.75 1.7×
Hbot, full body chamber, 30m (G0277)
range across 2 matching MRF lines
$495–$880.20 $550–$978 varies
Hospital outpt clinic visit (G0463)
range across 2 matching MRF lines
$213.08–$223.65 $236.75–$248.50 varies
Initial preventive exam (G0402) $214.65 $238.50 1.6×
Inj for sacroiliac jt anesth (G0260)
range across 2 matching MRF lines
$1,045.80–$1,427.40 $1,162–$1,586 varies
Mnt subs tx for change dx (G0270) $56.25 $62.50 1.8×
Prostate biopsy, any mthd (G0416)
range across 2 matching MRF lines
$165.38–$282.38 $183.75–$313.75 varies
Psa screening (G0103) $127.13 $141.25 6.6×
Tomosynthesis, mammo (G0279)
range across 3 matching MRF lines
$98.55–$201.15 $109.50–$223.50 varies
Trauma respons w/hosp criti (G0390)
range across 7 matching MRF lines
$2,022.75–$3,490.43 $2,247.50–$3,878.25 varies
Tte w or w/o fol w/con,stres (C8928) $1,190.70 $1,323 1.5×
Tte w or wo fol wcon,doppler (C8929)
range across 2 matching MRF lines
$1,190.70–$1,312.43 $1,323–$1,458.25 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.