Intermountain Health Garfield Memorial Hospital — price list

← Hospital overviewVerified from Intermountain Health Garfield Memorial 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.

78 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Abdomen 1st order cath place unilateral Inpatient	36245 CPT	$2,105	$1,579	$1,084 – $2,000	—
Admin pneumococcal vaccine Inpatient	90471 CPT	$18.72	$14.04	$9.64 – $17.78	—
Angio pelvic selective Inpatient	75736 CPT	$3,338	$2,503	$1,719 – $3,171	—
Apply splint finger (dynamic) Inpatient	29131 CPT	$122	$91.52	$62.85 – $116	—
Bronch including fluor guide; ebus invnt peripheral lesions Inpatient	3611014597 CDM	$10,300	$7,725	$5,306 – $9,785	—
Bronch withtransbronch bx single lobe Inpatient	3611016597 CDM	$7,216	$5,412	$3,717 – $6,855	—
Cerebral vascular flow only Inpatient	78610 CPT	$1,963	$1,473	$1,011 – $1,865	—
Cisternogram Inpatient	78630 CPT	$1,989	$1,492	$1,025 – $1,890	—
Closed rx shldr disloc,anesthesia unilateral Inpatient	23655 CPT	$1,207	$905	$622 – $1,147	—
Closed tx talus fracture without manipulation bilateral Inpatient	28430 CPT	$435	$326	$224 – $414	—
Cltx fem fx dstl end medial/lat condyle withmanj bilateral Inpatient	27510 CPT	$1,207	$905	$622 – $1,147	—
Cltx prx hmrl fx mnpj+-tract bilateral Inpatient	23605 CPT	$1,207	$905	$622 – $1,147	—
Cltx tibial shaft fx withmanj withwithout skel tracj Inpatient	27752 CPT	$1,207	$905	$622 – $1,147	—
Cmplx rpr e/n/e/l addl 5cm/< Inpatient	13153 CPT	$676	$507	$348 – $642	—
Cmplx rpr trunk 1.1-2.5 cm Inpatient	13100 CPT	$676	$507	$348 – $642	—
Continuous glucose mntr hosp eqp >72 hrs Inpatient	95250 CPT	$419	$314	$216 – $398	—
Continuous ieop daily Inpatient	94645 CPT	$5,110	$3,833	$2,632 – $4,855	—
CT facet rhizotomy l or sacral spine unilateral single level Inpatient	64635 CPT	$3,215	$2,412	$1,656 – $3,055	—
Ctrl nsl hemrrg pst nasal packs&/cautery 1st Inpatient	30905 CPT	$1,207	$905	$622 – $1,147	—
Dietitian medicaid consult 30 min Inpatient	S9470 CPT	$79.33	$59.50	$40.86 – $75.36	—
Dran extrnl auditry canal absc Inpatient	69020 CPT	$437	$328	$225 – $415	—
Duod/jejuno tube replacement Inpatient	49451 CPT	$2,086	$1,565	$1,075 – $1,982	—
Endoscopic mucosal resection Inpatient	7501060597 CDM	$7,431	$5,573	$3,828 – $7,060	—
Exch perc nephrostomy cath including dx nephro/uretrgrm w img bilateral Inpatient	50435 CPT	$13,144	$9,858	$6,770 – $12,487	—
Extremity venogram inj bilateral Inpatient	36005 CPT	$1,383	$1,038	$713 – $1,314	—
Fetal contraction stress test Inpatient	59020 CPT	$149	$112	$76.76 – $142	—
Hh/hspc home visit est patient 25 min Inpatient	99348 CPT	$239	$179	$123 – $227	—
Holter epatch 48hr to 7 day hookup Inpatient	93242 CPT	$413	$309	$213 – $392	—
I&d upr a/e dp absc/hmtma unilateral Inpatient	23930 CPT	$5,579	$4,184	$2,874 – $5,300	—
Inc & rem fb, sq; compl Inpatient	10121 CPT	$5,185	$3,889	$2,671 – $4,926	—