Intermountain Health American Fork Hospital — price list

← Hospital overviewVerified from Intermountain Health American Fork Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

97 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
HC ABDOMEN ADD 2/3 ORDER CATH PLACE Inpatient	36248 CPT	$1,232	$924	$22.18 – $1,109	—
HC ANGIO PELVIC SELECTIVE Inpatient	75736 CPT	$3,927	$2,945	$70.68 – $3,534	—
HC BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT Inpatient	96127 CPT	$162	$122	$2.92 – $146	—
HC BRONCHOSCOPY W DILATION Inpatient	3611018797 CDM	$6,067	$4,550	$109 – $5,460	—
HC BYPASS GRAFT REVASC BMS/PTCA/ATHER INITIAL ART/BRNCH Inpatient	92937 CPT	$35,321	$26,491	$636 – $31,789	—
HC CATH PLACEMENT SEG PUL ART BILATERAL Inpatient	36015 CPT	$3,690	$2,768	$66.43 – $3,321	—
HC CATH UMBCL ARTRY NB DX/THER Inpatient	36660 CPT	$440	$330	$7.91 – $396	—
HC CHANGE G-TUBE TO G-J TUBE PERC Inpatient	49446 CPT	$3,351	$2,514	$60.33 – $3,016	—
HC CLOSE RX DIST FINGER FX, MANIPULATION Inpatient	26755 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ Inpatient	27808 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ Inpatient	25622 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION Inpatient	28470 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ BILAT Inpatient	24620 CPT	$1,279	$960	$23.03 – $1,151	—
HC CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION Inpatient	24650 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ Inpatient	25565 CPT	$1,279	$960	$23.03 – $1,151	—
HC CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION Inpatient	23570 CPT	$484	$363	$8.71 – $435	—
HC CLOSED TX TALUS FRACTURE W/O MANIPULATION BILAT Inpatient	28430 CPT	$484	$363	$8.71 – $435	—
HC CLTX DSTL FIBULAR FX LAT MALLS W/MANJ Inpatient	27788 CPT	$484	$363	$8.71 – $435	—
HC CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ BILAT Inpatient	27232 CPT	$655	$491	$11.79 – $589	—
HC CLTX GR HMRL TBRS FX W/MNPJ BILAT Inpatient	23625 CPT	$1,279	$960	$23.03 – $1,151	—
HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ BILAT Inpatient	24565 CPT	$1,279	$960	$23.03 – $1,151	—
HC CLTX METACARPAL FX W/MANIPULATION EACH BONE Inpatient	26605 CPT	$484	$363	$8.71 – $435	—
HC CLTX PROX FIBULA/SHFT FX W/O MANJ Inpatient	27780 CPT	$484	$363	$8.71 – $435	—
HC CLTX THIGH FX UNILAT Inpatient	27267 CPT	$1,279	$960	$23.03 – $1,151	—
HC CONTINUOUS NEB MED EACH ADDL HR Inpatient	94645 CPT	$176	$132	$3.17 – $158	—
HC DRAIN BLADDER BY TROCAR/CATH Inpatient	51101 CPT	$655	$491	$11.79 – $589	—
HC ELBOW ARTHRO INJECT BILATERAL Inpatient	24220 CPT	$1,269	$952	$22.85 – $1,142	—
HC EMERGENCY ROOM - LEVEL 3 W/MOD Inpatient	99283 CPT	$1,844	$1,383	$33.19 – $1,660	—
HC EMERGENCY ROOM-LEVEL 3 Inpatient	99283 CPT	$1,844	$1,383	$33.19 – $1,660	—
HC ENDOSCOPIC MUCOSAL RESECTION Inpatient	7501060597 CDM	$8,257	$6,193	$149 – $7,431	—