Intermountain Health Orem Community Hospital — price list

← Hospital overviewVerified from Intermountain Health Orem 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.

91 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Aep neurodiagnostic interpretation and report Inpatient	92653 CPT	$1,336	$1,002	$32.06 – $1,269	—
After cataract laser surgery Inpatient	66821 CPT	$1,458	$1,093	$34.99 – $1,385	—
Application of long leg cast bilateral Inpatient	29355 CPT	$484	$363	$11.61 – $459	—
Av fist withmech/lytic thromb w periph stenting Inpatient	36906 CPT	$38,288	$28,716	$919 – $36,373	—
Biliary dilation withstent Inpatient	47556 CPT	$4,150	$3,113	$99.60 – $3,943	—
Biopsy bone percutan deep Inpatient	20225 CPT	$2,096	$1,572	$50.30 – $1,991	—
Bronch w/ trach stent insert Inpatient	3611015397 CDM	$13,360	$10,020	$321 – $12,692	—
Bx breast add lesion US guide Inpatient	19084 CPT	$2,861	$2,145	$68.65 – $2,718	—
Cath plcmnt 2nd order venous bilateral Inpatient	36012 CPT	$2,992	$2,244	$71.80 – $2,842	—
Chemo IV infusion concurrent Inpatient	96549 CPT	$646	$484	$15.50 – $614	—
Closed tx bimalleolar ankle fracture withmanj Inpatient	27810 CPT	$1,252	$939	$30.05 – $1,189	—
Closed tx femoral shaft fx without manipulation Inpatient	27500 CPT	$484	$363	$11.61 – $459	—
Closed tx radial shaft fracture withmanipulation Inpatient	25505 CPT	$1,252	$939	$30.05 – $1,189	—
Closed tx talotarsal joint dislc without anes unilateral Inpatient	28575 CPT	$1,252	$939	$30.05 – $1,189	—
Clsd tx clavicular fracture without manipulation Inpatient	23500 CPT	$484	$363	$11.61 – $459	—
Cltx clavicular fx withmnpj bilateral Inpatient	23505 CPT	$1,252	$939	$30.05 – $1,189	—
Cltx hip dislocation traumatic without anesthesia unilateral Inpatient	27250 CPT	$484	$363	$11.61 – $459	—
Cltx prox tibfib jt dislc without anes bilateral Inpatient	27830 CPT	$484	$363	$11.61 – $459	—
Cltx sprcndylr/transcndylr humeral fx withmanj unilateral Inpatient	24535 CPT	$1,252	$939	$30.05 – $1,189	—
Cltx strnclav dislc without mnpj unilateral Inpatient	23520 CPT	$1,252	$939	$30.05 – $1,189	—
Cmplx rpr trunk 2.6-7.5 cm Inpatient	13101 CPT	$751	$563	$18.02 – $713	—
Continuing medical physics Inpatient	77336 CPT	$596	$447	$14.30 – $566	—
Contrast inj abscess assmt Inpatient	49424 CPT	$463	$348	$11.12 – $440	—
CT facet rhizotomy c or t spine single level each addl unilateral level Inpatient	64634 CPT	$2,603	$1,952	$62.47 – $2,473	—
CT facet rhizotomy l or sacral spine unilateral single level Inpatient	64635 CPT	$3,783	$2,837	$90.79 – $3,594	—
Cystography injection Inpatient	51600 CPT	$510	$382	$12.23 – $484	—
Drainage of forearm bursa bilateral Inpatient	25301 CPT	$485	$364	$11.65 – $461	—
Drainage of forearm lesion unilateral Inpatient	25208 CPT	$1,174	$881	$28.18 – $1,116	—
Esophageal pacing Inpatient	93616 CPT	$2,454	$1,840	$58.89 – $2,331	—
Extremity venogram inj unilateral Inpatient	36005 CPT	$814	$610	$19.53 – $773	—