Intermountain Health Delta Community Hospital — price list

← Hospital overviewVerified from Intermountain Health Delta Community 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.

94 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Injection aa&/strd pudendal nerve Inpatient	64430 CPT	$676	$507	$507 – $642	—
Ablate pulm tumor perq rf Inpatient	32998 CPT	$12,054	$9,041	$9,041 – $11,452	—
Biophysical profile withnst each additional Inpatient	76818 CPT	$511	$383	$383 – $486	—
Bronch diagnostic addtl procedure Inpatient	31622 CPT	$1,188	$891	$891 – $1,129	—
Carotid approach TAVR Inpatient	33999 CPT	$54,338	$40,754	$40,754 – $51,621	—
Cath placement 3rd order abd bilateral Inpatient	36247 CPT	$4,286	$3,215	$3,215 – $4,072	—
Cath plcmnt 2nd order venous bilateral Inpatient	36012 CPT	$2,543	$1,907	$1,907 – $2,416	—
Cath umbcl artry nb dx/ther Inpatient	36660 CPT	$440	$330	$330 – $418	—
Chemo sq or IM non-hormonal Inpatient	96401 CPT	$368	$276	$276 – $349	—
Chemotherapy into cns Inpatient	96450 CPT	$1,228	$921	$921 – $1,166	—
Cisternogram Inpatient	78630 CPT	$1,989	$1,492	$1,492 – $1,890	—
Closed tx carpal scaphoid fracture withmanj unilateral Inpatient	25624 CPT	$1,188	$891	$891 – $1,129	—
Closed tx mandibular fracture without manipulation Inpatient	21450 CPT	$797	$598	$598 – $758	—
Closed tx septal&nose fx Inpatient	21337 CPT	$1,188	$891	$891 – $1,129	—
Closed tx talus fracture withmanipulation bilateral Inpatient	28435 CPT	$1,188	$891	$891 – $1,129	—
Closed tx tarsometatarsal dislocation without anes Inpatient	28600 CPT	$589	$442	$442 – $559	—
Cltx fx grt toe phlx/phlg withmanj Inpatient	28495 CPT	$589	$442	$442 – $559	—
Cltx gr hmrl tbrs fx withmnpj bilateral Inpatient	23625 CPT	$1,188	$891	$891 – $1,129	—
Cltx inter/peri/subtrochanteric fem fx without manj bilateral Inpatient	27238 CPT	$1,188	$891	$891 – $1,129	—
Cltx interphalangeal joint dislocation without anes Inpatient	28660 CPT	$589	$442	$442 – $559	—
Cltx prox fibula/shft fx without manj Inpatient	27780 CPT	$589	$442	$442 – $559	—
Cltx scap fx withmnpj +-tractj unilateral Inpatient	23575 CPT	$1,188	$891	$891 – $1,129	—
Cltx sho dslc fx gr hmrl tbr bilateral Inpatient	23665 CPT	$1,188	$891	$891 – $1,129	—
Cltx sprcndylr/trnscndylr fem fx withmanj bilateral Inpatient	27503 CPT	$1,188	$891	$891 – $1,129	—
Cltx strnclav dislc withmnpj bilateral Inpatient	23525 CPT	$589	$442	$442 – $559	—
Compression wrap lwr leg unilateral Inpatient	29581 CPT	$341	$256	$256 – $324	—
Control nasal hemorrhage, anterior, complex Inpatient	30903 CPT	$589	$442	$442 – $559	—
Ctrl nsl hemrrg pst nasal packs&/cautery 1st Inpatient	30905 CPT	$1,188	$891	$891 – $1,129	—
Drainage of forearm lesion bilateral Inpatient	25028 CPT	$1,108	$831	$831 – $1,053	—
Emergency room-level 3 Inpatient	99283 CPT	$1,660	$1,245	$1,245 – $1,577	—