| Procedure | Mountain View Hospital | Lone Peak Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $92 | $97 | $51 |
| Abdominal ultrasound | $1,283 | $1,330 | $100 |
| Abdominal ultrasound (complete) | $1,548 | $1,513 | $114 |
| Abdominal ultrasound (limited) | $1,017 | $1,147 | $86 |
| Albumin blood test | $180 | $99 | $5 |
| Aldosterone test | $547 | $315 | $41 |
| Alkaline phosphatase test | $184 | $162 | $5 |
| Alpha-fetoprotein (AFP) test | $393 | $191 | $17 |
| ALT liver enzyme test | $219 | $162 | $5 |
| Ammonia blood test | $283 | $350 | $15 |
| Amylase test | $268 | $162 | $6 |
| Antinuclear antibody (ANA) test | $194 | $169 | $12 |
| Arterial blood gas (ABG) | $488 | $445 | $26 |
| AST liver enzyme test | $219 | $162 | $5 |
| Barium swallow study | $865 | $1,010 | $107 |
| Basic metabolic panel | $428 | $64 | $8 |
| Bilirubin blood test | $188 | $162 | $5 |
| Blood clotting test (PT/INR) | $184 | $47 | $4 |
| Blood glucose test | $198 | $172 | $5 |
| Blood transfusion | $2,998 | $4,250 | $47 |
| Blood type and screen | $298 | $29 | $10 |
| Blood type test | $144 | $22 | $3 |
| Blood type test (ABO group) | $206 | $22 | $3 |
| Blood type test (Rh/D antigen) | $82 | $22 | $3 |
| BNP (heart failure) test | $516 | $80 | $39 |
| Bone density scan (DEXA) | $1,023 | $574 | $39 |
| Bone scan (nuclear) | $2,714 | $4,462 | $259 |
| Breast MRI | $5,746 | $4,393 | $216 |
| Breast MRI without contrast | $5,317 | $4,022 | $216 |
| Breast ultrasound | $651 | $641 | $92 |
| Breast ultrasound (complete) | $651 | $641 | $100 |
| Breast ultrasound (limited) | $553 | $641 | $84 |
| C-reactive protein (CRP) | $188 | $182 | $5 |
| CA 19-9 tumor marker test | $371 | $297 | $21 |
| CA-125 ovarian marker test | $402 | $342 | $21 |
| Calcium blood test | $172 | $162 | $5 |
| Cardiac stress test | $2,050 | $1,800 | $39 |
| Cardioversion | $4,771 | $4,614 | $155 |
| Carotid artery ultrasound | $2,155 | $2,549 | $156 |
| CEA tumor marker test | $493 | $335 | $19 |
| Celiac disease test | $342 | $148 | $12 |
| Chest X-ray | $593 | $734 | $37 |
| Chest X-ray (1 view) | $390 | $566 | $25 |
| Chest X-ray (2 views) | $562 | $676 | $33 |
| CK-MB heart enzyme test | $664 | $217 | $12 |
| Clotting time test (PTT) | $219 | $185 | $6 |
| Complete blood count (CBC) | $237 | $45 | $7 |
| Comprehensive metabolic panel | $547 | $79 | $11 |
| Copper blood test | $262 | $406 | $12 |
| Coronary CT angiography | $3,581 | $1,169 | $326 |
| Cortisol test | $436 | $335 | $16 |
| CPAP titration study | $1,991 | $1,201 | $69 |
| Creatine kinase (CK) test | $246 | $49 | $7 |
| CT angiography of the chest | $4,915 | $5,805 | $281 |
| CT angiography of the head | $5,659 | $5,805 | $274 |
| CT scan of the abdomen | $4,339 | $4,517 | $230 |
| CT scan of the abdomen and pelvis | $8,680 | $8,489 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $9,343 | $10,182 | $338 |
| CT scan of the abdomen and pelvis with contrast | $8,680 | $8,489 | $300 |
| CT scan of the abdomen and pelvis without contrast | $7,743 | $7,906 | $183 |
| CT scan of the abdomen with and without contrast | $4,651 | $4,967 | $259 |
| CT scan of the abdomen with contrast | $4,339 | $4,517 | $230 |
| CT scan of the abdomen without contrast | $3,915 | $4,220 | $136 |
| CT scan of the arm | $3,204 | $3,602 | $199 |
| CT scan of the arm with contrast | $3,204 | $3,602 | $199 |
| CT scan of the arm without contrast | $2,828 | $3,317 | $161 |
| CT scan of the chest | $4,081 | $3,975 | $167 |
| CT scan of the chest with contrast | $4,334 | $3,975 | $167 |
| CT scan of the chest without contrast | $3,829 | $3,686 | $133 |
| CT scan of the head | $4,300 | $4,287 | $148 |
| CT scan of the head with and without contrast | $4,745 | $4,569 | $173 |
| CT scan of the head without contrast | $3,856 | $3,428 | $107 |
| CT scan of the leg | $3,874 | $3,602 | $166 |
| CT scan of the leg with contrast | $3,874 | $3,602 | $166 |
| CT scan of the leg without contrast | $3,529 | $3,317 | $130 |
| CT scan of the lower back (lumbar spine) | $4,522 | $3,701 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $4,971 | $2,662 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $4,522 | $4,193 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $4,164 | $3,701 | $130 |
| CT scan of the neck | $4,339 | $3,606 | $183 |
| CT scan of the neck (cervical spine) | $4,374 | $4,135 | $168 |
| CT scan of the neck (cervical spine) with contrast | $4,529 | $4,135 | $168 |
| CT scan of the neck (cervical spine) without contrast | $4,219 | $3,701 | $131 |
| CT scan of the neck with and without contrast | $4,745 | $4,840 | $220 |
| CT scan of the neck with contrast | $4,339 | $3,606 | $183 |
| CT scan of the neck without contrast | $3,864 | $3,163 | $150 |
| CT scan of the pelvis | $4,339 | $3,830 | $226 |
| CT scan of the pelvis with contrast | $4,339 | $3,974 | $226 |
| CT scan of the pelvis without contrast | $3,829 | $3,686 | $133 |
| CT scan of the sinuses | $3,864 | $3,758 | $152 |
| CT scan of the sinuses with and without contrast | $4,184 | $4,614 | $184 |
| CT scan of the sinuses with contrast | $3,864 | $3,758 | $152 |
| CT scan of the sinuses without contrast | $3,465 | $1,891 | $128 |
| D-dimer test | $843 | $74 | $10 |
| DHEA-sulfate test | $571 | $288 | $22 |
| Diagnostic mammogram | $689 | $886 | $140 |
| Drug screen (urine) | $390 | $144 | $17 |
| Echocardiogram | $3,061 | $3,949 | $138 |
| Echocardiogram with and without contrast | $1,113 | $1,739 | $101 |
| EKG / ECG (tracing only) | $677 | $674 | $7 |
| Electrocardiogram (EKG) | $677 | $674 | $8 |
| Electrolyte panel | $353 | $244 | $7 |
| Emergency department visit | $2,769 | $2,400 | $69 |
| Emergency department visit (level 1) | $329 | $676 | $11 |
| Emergency department visit (level 2) | $1,291 | $1,457 | $40 |
| Emergency department visit (level 3) | $2,769 | $2,400 | $69 |
| Emergency department visit (level 4) | $3,813 | $3,998 | $118 |
| Emergency department visit (level 5) | $7,541 | $5,209 | $171 |
| Estradiol (estrogen) test | $490 | $296 | $28 |
| Fallopian tube X-ray (HSG) | $1,294 | $1,521 | $164 |
| Fecal occult blood (stool) test | $137 | $94 | $10 |
| Ferritin (iron) test | $134 | $68 | $14 |
| Fibrinogen test | $252 | $477 | $10 |
| Flu vaccine | $92 | $71 | — |
| Folate (folic acid) test | $298 | $74 | $15 |
| Free T4 thyroid test | $607 | $68 | $9 |
| FSH hormone test | $124 | $335 | $19 |
| Gallbladder scan (HIDA) | $3,214 | $2,627 | $334 |
| GGT liver test | $184 | $162 | $7 |
| Glucose tolerance test | $182 | $258 | $8 |
| H. pylori test | $402 | $402 | $67 |
| HDL cholesterol test | $285 | $217 | $8 |
| Hematocrit test | $107 | $135 | $2 |
| Hemodialysis | $2,758 | $2,144 | $75 |
| Hemoglobin A1c (diabetes test) | $283 | $73 | $10 |
| Hepatitis B test | $335 | $48 | $10 |
| Hepatitis B vaccine | $314 | $480 | — |
| Hepatitis C test | $379 | $147 | $14 |
| HIV test | $635 | $103 | $19 |
| HIV test (antibody) | $635 | $103 | $14 |
| IV infusion therapy | $325 | $1,238 | $44 |
| IV infusion therapy (each additional) | $220 | $727 | $21 |
| IV infusion therapy (initial) | $440 | $2,049 | $67 |
| Kidney scan (nuclear) | $2,812 | $1,571 | $172 |
| Kidney ultrasound | $793 | $1,067 | $84 |
| Lactate test | $97 | $263 | $12 |
| LDH test | $198 | $162 | $6 |
| Leg vein ultrasound (Doppler) | $2,025 | $2,140 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $1,579 | $2,140 | $116 |
| LH hormone test | $441 | $335 | $19 |
| Lipase test | $360 | $211 | $7 |
| Lipid (cholesterol) panel | $412 | $78 | $13 |
| Liver function panel | $451 | $59 | $8 |
| Lung function test (PFT) | $602 | $772 | $37 |
| Lung scan (V/Q) | $4,287 | $5,225 | $291 |
| Magnesium blood test | $260 | $49 | $7 |
| MMR vaccine | $348 | $469 | — |
| MRA of the brain | $7,137 | $5,693 | $226 |
| MRA of the neck | $2,440 | $5,129 | $245 |
| MRA of the neck without contrast | $2,440 | $6,046 | $343 |
| MRI of the abdomen | $5,095 | $5,652 | $300 |
| MRI of the abdomen without contrast | $4,122 | $5,258 | $194 |
| MRI of the ankle | $6,200 | $5,258 | $261 |
| MRI of the ankle without contrast | $4,803 | $5,258 | $222 |
| MRI of the brain | $5,881 | $5,258 | $269 |
| MRI of the brain with contrast | $5,881 | $5,258 | $269 |
| MRI of the brain without contrast | $5,366 | $5,258 | $195 |
| MRI of the chest | $5,313 | $5,558 | $371 |
| MRI of the knee | $6,200 | $5,258 | $315 |
| MRI of the knee with contrast | $6,200 | $5,258 | $315 |
| MRI of the knee without contrast | $6,200 | $3,073 | $204 |
| MRI of the lower back (lumbar spine) | $5,880 | $4,908 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $5,366 | $3,957 | $192 |
| MRI of the mid-back (thoracic spine) | $5,881 | $4,908 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $6,394 | $5,858 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $5,366 | $3,957 | $190 |
| MRI of the neck (cervical spine) | $5,881 | $5,558 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $6,394 | $5,858 | $318 |
| MRI of the neck (cervical spine) without contrast | $5,366 | $5,258 | $191 |
| MRI of the pelvis | $4,498 | $5,558 | $268 |
| MRI of the pelvis without contrast | $3,293 | $5,258 | $227 |
| MRI of the shoulder | $4,803 | $5,258 | $313 |
| MRI of the shoulder with contrast | $6,200 | $5,258 | $313 |
| MRI of the shoulder without contrast | $4,803 | $5,258 | $205 |
| MRI of the wrist | $4,803 | $5,258 | $330 |
| MRI of the wrist without contrast | $4,803 | $5,258 | $303 |
| Nebulizer breathing treatment | $268 | $213 | $9 |
| Nuclear cardiac stress test | $6,021 | $6,227 | $428 |
| Occupational therapy evaluation | $146 | $414 | $101 |
| Occupational therapy evaluation (high complexity) | $146 | $414 | $101 |
| Occupational therapy evaluation (low complexity) | $146 | $414 | $101 |
| Occupational therapy evaluation (moderate complexity) | $146 | $414 | $101 |
| Office visit (new patient) | $454 | $390 | $177 |
| Office visit, new patient (level 3) | $345 | $390 | $118 |
| Pap smear (cervical screening) | $284 | $315 | $20 |
| Parathyroid hormone (PTH) test | $790 | $362 | $41 |
| Pelvic ultrasound | $1,419 | $1,218 | $78 |
| Pelvic ultrasound (complete) | $1,419 | $1,513 | $105 |
| Phosphorus blood test | $230 | $162 | $5 |
| Physical therapy evaluation | $193 | $426 | $98 |
| Physical therapy evaluation (high complexity) | $193 | $426 | $98 |
| Physical therapy evaluation (moderate complexity) | $193 | $426 | $98 |
| Platelet count | $168 | $185 | $4 |
| Pneumonia vaccine | $339 | $350 | — |
| Pregnancy blood test (hCG) | $88 | $105 | $8 |
| Pregnancy ultrasound | $1,197 | $841 | $126 |
| Pregnancy ultrasound (first trimester) | $1,318 | $584 | $117 |
| Pregnancy ultrasound (second or third trimester) | $1,076 | $1,098 | $136 |
| Prolactin test | $206 | $97 | $19 |
| Prostate test (PSA) | $405 | $92 | $18 |
| Psychotherapy session | $613 | $886 | $140 |
| Rheumatoid factor test | $131 | $178 | $6 |
| Scoliosis spine X-ray | $480 | $435 | $58 |
| Scoliosis spine X-ray (3 views) | $480 | $543 | $72 |
| Screening mammogram | $782 | $941 | $126 |
| Scrotal ultrasound | $1,001 | $1,211 | $99 |
| Sedimentation rate (ESR) test | $145 | $27 | $3 |
| Sex hormone binding globulin test | $293 | $118 | $22 |
| Soft tissue ultrasound | $694 | $1,058 | $64 |
| Speech therapy | $149 | $188 | $76 |
| Spirometry (lung function test) | $542 | $543 | $30 |
| Spirometry with bronchodilator | $661 | $1,000 | $43 |
| Stress echocardiogram | $4,018 | $6,442 | $209 |
| Stress echocardiogram (complete) | $4,018 | $6,442 | $233 |
| Swallow study | $96 | $601 | $85 |
| T3 thyroid test | $379 | $106 | $14 |
| Tdap (tetanus) vaccine | $285 | $372 | — |
| Testosterone test | $377 | $83 | $26 |
| Thyroid test (TSH) | $318 | $84 | $17 |
| Thyroid ultrasound | $1,085 | $1,102 | $109 |
| Thyroid uptake scan | $3,361 | $3,225 | $145 |
| Total IgE allergy test | $268 | $215 | $16 |
| Total protein test | $172 | $86 | $4 |
| Transvaginal ultrasound | $619 | $923 | $118 |
| Triglycerides test | $233 | $162 | $6 |
| Troponin (heart) test | $871 | $71 | $12 |
| Upper GI series (barium) | $1,055 | $1,258 | $128 |
| Uric acid (gout) test | $198 | $103 | $5 |
| Urinalysis | $141 | $22 | $3 |
| Urine microalbumin test | $386 | $43 | $5 |
| Urine pregnancy test | $88 | $108 | $9 |
| Vaccine administration | $232 | $276 | $19 |
| Vaccine administration (each additional) | $232 | $114 | $16 |
| Vitamin B12 test | $139 | $76 | $15 |
| Vitamin D test | $257 | $49 | $30 |
| X-ray of the abdomen | $572 | $711 | $36 |
| X-ray of the ankle | $524 | $719 | $37 |
| X-ray of the collarbone | $475 | $579 | $33 |
| X-ray of the elbow | $524 | $719 | $33 |
| X-ray of the facial bones | $720 | $922 | $39 |
| X-ray of the foot | $524 | $719 | $34 |
| X-ray of the forearm | $413 | $579 | $29 |
| X-ray of the hand | $524 | $653 | $38 |
| X-ray of the hip | $290 | $328 | $49 |
| X-ray of the hip (1 view) | $290 | $328 | $34 |
| X-ray of the hip (3 views) | $290 | $328 | $49 |
| X-ray of the knee | $745 | $757 | $42 |
| X-ray of the knee (2 views) | $469 | $653 | $34 |
| X-ray of the knee (3 views) | $873 | $757 | $42 |
| X-ray of the knee (4+ views) | $617 | $828 | $49 |
| X-ray of the lower back (lumbar spine) | $687 | $1,019 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $532 | $862 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $841 | $1,176 | $53 |
| X-ray of the lower leg | $524 | $689 | $31 |
| X-ray of the mid-back (thoracic spine) | $543 | $939 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $516 | $885 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $570 | $993 | $39 |
| X-ray of the neck (cervical spine) | $541 | $1,029 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $459 | $564 | $40 |
| X-ray of the pelvis | $413 | $764 | $36 |
| X-ray of the pelvis (1 view) | $413 | $621 | $28 |
| X-ray of the ribs | $669 | $1,027 | $42 |
| X-ray of the ribs (2 views) | $562 | $883 | $36 |
| X-ray of the ribs (3 views) | $669 | $1,027 | $42 |
| X-ray of the shoulder | $562 | $764 | $36 |
| X-ray of the skull | $727 | $1,002 | $40 |
| X-ray of the upper arm | $538 | $579 | $32 |
| X-ray of the wrist | $524 | $653 | $43 |
| Zinc blood test | $200 | $150 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
