Holy Cross Hospital-jordan Valley — procedure prices

Published prices for 397 procedures at Holy Cross Hospital-jordan Valley (West Jordan, UT), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $54 $134 $81 $51
Abdominal fluid drain (paracentesis) $860 $2,149 $1,136 $284
Abdominal ultrasound $653 $1,633 $736 $100
Abscess incision and drainage $208 $519 $283 $174
Achilles tendon repair $616 $624
ACL knee reconstruction $1,021 $889
Acupuncture $26 $38
Adenoid removal (adenoidectomy) $230 $204
Albumin blood test $69 $173 $74 $5
Aldosterone test $176 $440 $205 $41
Alkaline phosphatase test $69 $173 $74 $5
Allergy patch testing $4 $5
Allergy shots $13 $11
Allergy testing $3 $4
Alpha-fetoprotein (AFP) test $108 $270 $126 $17
ALT liver enzyme test $74 $185 $79 $5
Ammonia blood test $99 $247 $115 $15
Amniocentesis $868 $2,170 $1,147 $120
Amylase test $67 $167 $71 $6
Anal fistula repair $447 $541
Ankle fracture repair $679 $608
Ankle replacement $895 $885
Annual physical (established patient) $133
Annual physical (new patient) $160
Anoscopy $38 $129
Antinuclear antibody (ANA) test $89 $222 $103 $12
Aortic aneurysm repair (AAA) $1,361 $1,345
Aortic valve replacement $1,793 $1,603
Appendix removal (appendectomy) $23,359 $592
Arterial blood gas (ABG) $229 $573 $267 $26
AST liver enzyme test $73 $184 $78 $5
Barium swallow study $349 $871 $395 $107
Bartholin cyst removal $101 $182
Basic metabolic panel $93 $232 $99 $8
Benign skin lesion removal $130 $171
Bilirubin blood test $58 $144 $62 $5
Bladder function test (urodynamics) $210 $345
Bladder scope (cystoscopy) $74 $216
Bladder tumor removal (TURBT) $264 $236
Blood clotting test (PT/INR) $65 $163 $70 $4
Blood crossmatch $238 $594 $302
Blood glucose test $84 $210 $9 $5
Blood transfusion $701 $1,753 $892 $47
Blood type and screen $63 $157 $80 $10
Blood type test $114 $284 $81 $3
BNP (heart failure) test $244 $611 $261 $39
Bone density scan (DEXA) $337 $843 $399 $39
Bone marrow biopsy $2,830 $7,075 $3,707 $172
Bone scan (nuclear) $1,147 $2,868 $1,357 $259
Botox for migraine $114 $157
Brain shunt (VP shunt) $964 $1,023
Breast biopsy $1,812 $4,531 $2,402 $478
Breast MRI $1,234 $3,085 $1,118 $216
Breast reconstruction $1,300 $1,227
Breast reduction $1,014 $980
Breast ultrasound $302 $755 $310 $92
Breathing tube insertion (intubation) $1,946 $4,866 $2,540 $133
Bronchoscopy $1,323 $3,308 $2,147 $303
Bunion surgery (bunionectomy) $559 $883
Burn treatment $319 $797 $430 $129
C-reactive protein (CRP) $63 $159 $74 $5
CA 19-9 tumor marker test $80 $200 $93 $21
CA-125 ovarian marker test $83 $208 $97 $21
Calcium blood test $59 $148 $63 $5
Capsule endoscopy $1,806 $4,516 $2,364 $802
Cardiac ablation $19,210 $48,026 $22,629 $759
Cardiac catheterization $8,136 $20,339 $10,378 $1,049
Cardiac event monitor $150 $170
Cardiac MRI $233 $322
Cardiac rehabilitation $101 $251 $134 $26
Cardiac stress test $418 $1,046 $513 $39
Cardioversion $751 $1,878 $971 $155
Carotid artery surgery $1,024 $1,026
Carotid artery ultrasound $445 $1,112 $438 $156
Carpal tunnel release $2,533 $6,333 $3,338 $483
Cataract surgery $664 $547
CEA tumor marker test $123 $306 $143 $19
Celiac disease test $17 $42 $21 $12
Central line placement $1,982 $4,955 $2,830 $238
Cervical cerclage $141 $137
Cervical LEEP procedure $231 $325
Cesarean section (C-section) $12,087 $7,552
Chalazion (eyelid cyst) removal $93 $131
Chemotherapy infusion $345 $861 $428 $81
Chest fluid drain (thoracentesis) $886 $2,214 $1,437 $311
Chest tube insertion $1,965 $4,913 $2,581 $143
Chest X-ray $292 $729 $337 $37
Chickenpox (varicella) vaccine $343 $857 $505
Chiropractic adjustment $37 $38
Circumcision $2,682 $6,705 $3,072 $167
CK-MB heart enzyme test $115 $289 $134 $12
Clotting time test (PTT) $81 $201 $94 $6
Colon resection (colectomy) $1,228 $1,238
Colonoscopy $1,633 $4,082 $1,224 $480
Colostomy $1,110 $1,122
Colposcopy $123 $161
Complete blood count (CBC) $103 $257 $80 $7
Complex wound repair $226 $390
Comprehensive eye exam $86 $138
Comprehensive metabolic panel $153 $382 $163 $11
Contact lens fitting $105
Continuous glucose monitor setup $32 $35
Contraceptive implant (Nexplanon) $83 $115
Copper blood test $62 $154 $72 $12
Corneal transplant $1,134 $1,066
Coronary angioplasty / stent (PCI) $42,913 $426
Coronary artery bypass (CABG) $60,596 $36,593
Coronary CT angiography $261 $652 $345 $326
Cortisol test $133 $333 $155 $16
COVID-19 PCR test $113 $282 $129 $51
CPAP titration study $522 $1,305 $659 $69
Craniotomy (brain surgery) $2,058 $2,161
Creatine kinase (CK) test $70 $175 $75 $7
CT angiography of the chest $1,593 $3,983 $1,792 $281
CT angiography of the head $1,037 $2,593 $1,207 $274
CT colonography (virtual colonoscopy) $659 $835
CT scan of the abdomen $1,467 $3,667 $1,693 $230
CT scan of the abdomen and pelvis $2,724 $6,809 $3,125 $300
CT scan of the arm $1,681 $4,203 $1,554 $199
CT scan of the chest $1,308 $3,271 $1,622 $167
CT scan of the head $1,345 $3,362 $1,466 $148
CT scan of the leg $1,172 $2,930 $1,554 $166
CT scan of the lower back (lumbar spine) $1,315 $3,288 $1,526 $169
CT scan of the neck $1,226 $3,065 $1,360 $183
CT scan of the neck (cervical spine) $1,400 $3,499 $1,578 $168
CT scan of the pelvis $1,257 $3,143 $1,487 $226
CT scan of the sinuses $1,201 $3,002 $1,407 $152
D-dimer test $131 $328 $153 $10
Defibrillator (ICD) implant $51,997 $129,993 $65,712 $798
Developmental screening (child) $13
DHEA-sulfate test $106 $265 $123 $22
Diagnostic mammogram $264 $659 $320 $140
Dialysis fistula creation $599 $601
Dilation and curettage (D&C) $216 $298
Droopy eyelid repair (ptosis) $540 $745
Drug screen (urine) $147 $367 $162 $17
Ear pressure test (tympanometry) $10 $16
Ear tubes (myringotomy) $148 $174
Eardrum repair (tympanoplasty) $809 $799
Echocardiogram $1,016 $2,539 $1,211 $138
Elbow replacement $1,346 $1,301
Electrocardiogram (EKG) $175 $437 $136 $8
Electroencephalogram (EEG) $486 $1,214 $636 $448
Electrolyte panel $85 $214 $91 $7
Electromyography (EMG) $226 $564 $278 $141
Emergency department visit $470 $1,175 $511 $69
Endometrial biopsy $58 $98
Epidural steroid injection $939 $2,348 $1,248 $275
ERCP (bile duct endoscopy) $332 $311
Esophageal dilation $80 $522
Esophageal variceal banding $128 $126
Estradiol (estrogen) test $150 $374 $174 $28
Eye refraction (glasses prescription) $19
Eyelid surgery (blepharoplasty) $492 $552
Facet joint injection (spine) $572 $1,429 $1,072 $99
Fallopian tube X-ray (HSG) $326 $815 $369 $164
Family therapy session $225 $563 $287 $110
Fecal occult blood (stool) test $41 $103 $31 $10
Feeding tube (PEG) placement $183 $178
Femoral hernia repair $634 $584
Ferritin (iron) test $92 $230 $107 $14
Fibrinogen test $80 $200 $93 $10
Fibroid removal (myomectomy) $927 $914
Flexible sigmoidoscopy $75 $323
Flu test $25 $62 $27 $17
Flu vaccine $44 $110 $101
Folate (folic acid) test $67 $166 $77 $15
Foreign body removal (skin) $205 $511 $277 $157
Free T4 thyroid test $94 $235 $109 $9
FSH hormone test $215 $539 $230 $19
Gallbladder removal (laparoscopic) $864 $658
Gallbladder scan (HIDA) $721 $1,804 $918 $334
Ganglion cyst removal $308 $321
GGT liver test $66 $164 $70 $7
Glaucoma surgery $1,080 $984
Glucose tolerance test $158 $396 $96 $8
Group therapy session $132 $331 $168 $30
H. pylori test $175 $437 $203 $67
Hammertoe repair $363 $548
HDL cholesterol test $69 $172 $73 $8
Hearing test (audiometry) $29 $36
Hematocrit test $54 $134 $57 $2
Hemodialysis $928 $2,321 $1,109 $75
Hemoglobin A1c (diabetes test) $77 $192 $82 $10
Hemorrhoid removal $294 $338
Hepatitis A vaccine $197 $493 $260
Hepatitis B test $72 $180 $84 $10
Hepatitis B vaccine $165 $412 $195
Hepatitis C test $115 $287 $123 $14
Hip arthroscopy $1,054 $931
Hip fracture repair $1,141 $1,120
Hip replacement $1,193 $1,162
HIV test $75 $188 $84 $19
Holter heart monitor $169 $423 $199 $26
Home sleep apnea test $351 $878 $375 $123
HPV vaccine $688 $1,721 $927
Hydrocele repair $315 $315
Hysterectomy $944 $933
Hysteroscopy $214 $1,270
Ileostomy $962 $968
Incisional hernia repair $5,971
Inguinal hernia repair $580 $538
Iron blood test $55 $137 $64 $6
IUD insertion $110
IUD removal $61 $112
IV infusion therapy $206 $515 $272 $44
IVC filter placement $6,888 $17,219 $8,489 $1,885
Joint aspiration (small/intermediate) $365 $914 $482 $57
Kidney biopsy $2,977 $7,442 $3,317 $492
Kidney removal (nephrectomy) $1,181 $1,164
Kidney scan (nuclear) $929 $2,322 $1,098 $172
Kidney stone shock-wave (lithotripsy) $6,357 $15,893 $8,144 $760
Kidney ultrasound $427 $1,067 $416 $84
Knee arthroscopy $581 $524
Knee joint injection $433 $1,084 $479 $69
Knee replacement $30,458 $18,054
Lactate test $61 $152 $65 $12
Laminectomy (spine) $1,440 $1,157
Laryngoscopy $255 $638 $325 $189
LDH test $82 $205 $95 $6
LDL cholesterol test $74 $185 $79 $11
Leg artery angiogram $2,658 $6,645 $3,502 $149
Leg artery angioplasty $11,234 $28,084 $12,355
Leg vein ultrasound (Doppler) $588 $1,469 $539 $150
LH hormone test $112 $279 $119 $19
Lipase test $76 $191 $89 $7
Lipid (cholesterol) panel $80 $200 $85 $13
Liver biopsy $2,260 $5,650 $2,978 $288
Liver function panel $127 $317 $148 $8
Lower back (lumbar) spinal fusion $67,359 $1,511
Lumbar discectomy $1,104 $898
Lumpectomy (breast) $828 $750
Lung function test (PFT) $268 $671 $238 $37
Lung scan (V/Q) $777 $1,943 $959 $291
Magnesium blood test $81 $202 $94 $7
Mastectomy $1,094 $1,021
Mastoidectomy $864 $840
Meniscus repair (knee) $795 $714
MMR vaccine $217 $541 $287
Mohs skin cancer surgery $283 $535
MRA of the brain $1,474 $3,686 $1,697 $226
MRA of the neck $1,431 $3,578 $1,764 $245
MRI of the abdomen $2,008 $5,021 $2,259 $300
MRI of the ankle $4,157 $10,391 $3,320 $261
MRI of the brain $2,097 $5,242 $2,331 $269
MRI of the chest $1,339 $3,347 $1,573 $371
MRI of the knee $3,001 $7,502 $2,724 $315
MRI of the lower back (lumbar spine) $2,222 $5,556 $2,709 $270
MRI of the mid-back (thoracic spine) $2,154 $5,385 $2,669 $271
MRI of the neck (cervical spine) $2,033 $5,081 $2,560 $274
MRI of the pelvis $2,723 $6,807 $3,121 $268
MRI of the shoulder $2,440 $6,099 $2,742 $313
MRI of the wrist $2,520 $6,299 $1,358 $330
Nebulizer breathing treatment $314 $786 $397 $9
Neck (cervical) spinal fusion $1,572 $1,410
Nerve conduction study $476 $1,191 $376 $118
Newborn hospital care $74 $58
Nuchal translucency ultrasound $105 $116
Nuclear cardiac stress test $2,440 $6,101 $2,886 $428
Occupational therapy evaluation $111 $278 $147 $101
Office visit (established patient) $78 $115
Office visit (new patient) $124 $177
Orthopedic hardware removal $391 $632
Ovarian cyst removal $713 $698
Ovary removal (oophorectomy) $966 $822
Pacemaker insertion $27,553 $15,506
Pap smear (cervical screening) $62 $156 $52 $20
Parathyroid hormone (PTH) test $170 $426 $198 $41
Parathyroid removal $900 $891
Pelvic ultrasound $384 $960 $452 $78
PET scan $3,214 $8,036 $3,742
Phosphorus blood test $58 $146 $68 $5
Physical therapy evaluation $153 $383 $184 $98
Pilonidal cyst removal $367 $541
Platelet count $53 $132 $61 $4
Pneumonia vaccine $281 $702 $353
Pregnancy blood test (hCG) $59 $147 $63 $8
Pregnancy ultrasound $521 $1,303 $613 $126
Procalcitonin test $201 $502 $234 $27
Prolactin test $120 $299 $139 $19
Prostate biopsy $119
Prostate removal (prostatectomy) $1,094 $1,063
Prostate surgery (TURP) $674 $526
Prostate test (PSA) $137 $343 $160 $18
Psychiatric evaluation $311 $776 $349 $188
Psychotherapy session $242 $605 $308 $140
Pterygium removal (eye) $345 $540
Pulmonary rehabilitation $80 $201 $105 $87
Radiofrequency nerve ablation $3,992 $9,980 $4,473 $462
Retina scan (OCT) $13 $33
Retinal (fundus) photography $14 $37
Retinal detachment repair $1,077 $966
Rheumatoid factor test $75 $188 $87 $6
Rotator cuff repair $993 $792
Routine eye exam $46 $88
Sacroiliac joint injection $1,687 $4,217 $1,965 $176
Scoliosis spine X-ray $220 $551 $270 $58
Screening colonoscopy $218 $378
Screening mammogram $257 $643 $322 $126
Scrotal ultrasound $375 $939 $438 $99
Sedimentation rate (ESR) test $59 $147 $68 $3
Semen analysis $95 $239 $89 $12
Septoplasty (deviated septum) $613 $613
Sex hormone binding globulin test $58 $144 $67 $22
Shoulder arthroscopy $1,096 $962
Shoulder replacement $1,340 $1,300
Simple wound stitches $245 $613 $346 $127
Sinus surgery (endoscopic) $302 $224
Skin biopsy $353 $883 $486 $121
Skin cancer lesion removal $178 $240
Skin graft $662 $898
Skin lesion freezing (cryotherapy) $44 $36
Skin tag removal $248 $619 $327 $92
Sleep study (polysomnography) $1,984 $4,961 $2,386 $691
Small bowel resection $1,132 $1,136
Soft tissue ultrasound $922 $2,304 $812 $64
Speech therapy $160 $401 $204 $76
Spinal cord stimulator $9,798 $24,495 $12,076 $2,388
Spinal tap (lumbar puncture) $773 $1,933 $1,022 $165
Spine fracture repair (kyphoplasty) $10,988 $27,471 $13,543 $5,803
Spleen removal (splenectomy) $1,024 $1,036
Stomach removal (gastrectomy) $1,591 $1,595
Strabismus (eye muscle) surgery $577 $475
Strep throat test $86 $215 $92 $17
Stress echocardiogram $844 $2,109 $919 $209
Swallow study $181 $454 $231 $85
T3 thyroid test $92 $230 $107 $14
Tdap (tetanus) vaccine $109 $272 $161
Testicle removal (orchiectomy) $305 $306
Testosterone test $184 $460 $214 $26
Thyroid removal (thyroidectomy) $1,175 $1,004
Thyroid test (TSH) $135 $338 $144 $17
Thyroid ultrasound $389 $974 $453 $109
Thyroid uptake scan $684 $1,710 $793 $145
Tilt table test $723 $1,807 $920 $168
Tonsillectomy $283 $252
Total IgE allergy test $55 $139 $65 $16
Total protein test $56 $141 $60 $4
Tracheostomy $280 $273
Transesophageal echocardiogram (TEE) $1,153 $2,882 $1,405 $239
Transvaginal ultrasound $379 $947 $441 $118
Trigger finger release $276 $630
Trigger point injection $442 $1,105 $606 $56
Triglycerides test $81 $203 $87 $6
Troponin (heart) test $118 $296 $138 $12
Tubal ligation $388 $333
Turbinate reduction $165 $294
Turning a breech baby (version) $3,932 $9,829 $5,055 $94
Ulnar nerve surgery (elbow) $565 $575
Umbilical hernia repair $5,971
Upper GI endoscopy (EGD) $126 $371
Upper GI series (barium) $412 $1,031 $488 $128
Ureteral stent placement $143 $373
Ureteroscopy (stone removal) $381 $365
Uric acid (gout) test $67 $167 $71 $5
Urinalysis $54 $134 $29 $3
Urine microalbumin test $79 $197 $83 $5
Urine pregnancy test $58 $144 $67 $9
UV light therapy (skin) $91 $106
Vaccine administration $54 $136 $71 $19
Vaginal delivery $8,797 $5,487
Varicocele repair $328 $327
Varicose vein ablation $253 $1,018
Vasectomy $214 $347
Visual field test $33 $64
Vitamin B12 test $78 $194 $90 $15
Vitamin D test $189 $472 $220 $30
Vitrectomy (eye) $937 $814
Vocal cord injection $229 $211
Wart removal $77 $121
Weight-loss (bariatric) surgery $19,161 $11,645
Well-child visit $112
Whipple procedure (pancreas) $2,878 $2,871
Wound debridement $384 $960 $598 $186
Wrist fracture repair $777 $735
X-ray of the abdomen $243 $607 $287 $36
X-ray of the ankle $580 $1,451 $511 $37
X-ray of the collarbone $265 $663 $291 $33
X-ray of the elbow $461 $1,154 $488 $33
X-ray of the facial bones $303 $758 $361 $39
X-ray of the foot $521 $1,304 $551 $34
X-ray of the forearm $296 $741 $271 $29
X-ray of the hand $482 $1,205 $509 $38
X-ray of the hip $213 $534 $257 $49
X-ray of the knee $355 $888 $355 $42
X-ray of the lower back (lumbar spine) $359 $897 $426 $47
X-ray of the lower leg $353 $881 $322 $31
X-ray of the mid-back (thoracic spine) $358 $894 $369 $36
X-ray of the neck (cervical spine) $375 $938 $311 $47
X-ray of the pelvis $233 $584 $281 $36
X-ray of the ribs $285 $713 $337 $42
X-ray of the shoulder $241 $602 $330 $36
X-ray of the skull $282 $706 $297 $40
X-ray of the upper arm $183 $457 $216 $32
X-ray of the wrist $357 $891 $471 $43
YAG laser capsulotomy (eye) $281 $335
Zinc blood test $59 $147 $68 $11

Source: this hospital’s machine-readable price file (45 CFR §180). Medicare from CMS fee schedules. Estimates — confirm with the hospital. Report an incorrect price.