Intermountain Health Riverton Hospital — price list

← Hospital overviewVerified from Intermountain Health Riverton 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.

95 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Angio intracranial withstent Inpatient	61635 CPT	$3,058	$2,294	$110 – $2,752	—
Appl on-body injector for timed subq injection Inpatient	96377 CPT	$157	$118	$5.66 – $142	—
Application of long leg cast bilateral Inpatient	29355 CPT	$484	$363	$17.41 – $435	—
Apply forearm splint static Inpatient	29125 CPT	$435	$326	$15.67 – $392	—
Avlsion nail plate partl/compl sgl Inpatient	11730 CPT	$484	$363	$17.41 – $435	—
Car seat/bd airway testing withinterp 60 min inft-12 mo Inpatient	94780 CPT	$192	$144	$6.90 – $173	—
Cardiac spect w wall motion ef Inpatient	78494 CPT	$155	$116	$5.57 – $139	—
Chemo inj via sq reservoir Inpatient	96542 CPT	$524	$393	$18.87 – $472	—
Chemo IV push initial Inpatient	96409 CPT	$684	$513	$24.62 – $616	—
Closed rx mc-p disloc Inpatient	26700 CPT	$484	$363	$17.41 – $435	—
Closed tx calcaneal fracture without manipulation Inpatient	28400 CPT	$484	$363	$17.41 – $435	—
Closed tx mandibular fx withinterdental fixation Inpatient	21453 CPT	$484	$363	$17.41 – $435	—
Closed tx monteggia fx dislocation elbow withmanj unilateral Inpatient	24620 CPT	$1,341	$1,006	$48.29 – $1,207	—
Closed tx ulnar fracture proximal end withmanj unilateral Inpatient	24675 CPT	$1,341	$1,006	$48.29 – $1,207	—
Clsd tx pelvic ring fx Inpatient	27198 CPT	$484	$363	$17.41 – $435	—
Cltx acromclav dislc withmnpj unilateral Inpatient	23545 CPT	$484	$363	$17.41 – $435	—
Cltx fem fx dstl end medial/lat condyle withmanj bilateral Inpatient	27510 CPT	$1,341	$1,006	$48.29 – $1,207	—
Cltx hip dislocation traumatic req anesthesia unilateral Inpatient	27252 CPT	$1,341	$1,006	$48.29 – $1,207	—
Cltx hip dislocation traumatic without anesthesia unilateral Inpatient	27250 CPT	$484	$363	$17.41 – $435	—
Cltx humeral condylar fx medial/lateral withmanj unilateral Inpatient	24577 CPT	$3,120	$2,340	$112 – $2,808	—
Cltx proximal humeral fracture without manipulation Inpatient	23600 CPT	$484	$363	$17.41 – $435	—
Cltx rdcrpl/intercarpl dislc 1/> bones withmanj bilateral Inpatient	25660 CPT	$484	$363	$17.41 – $435	—
Cmplx rpr trunk addl 5cm/< Inpatient	13102 CPT	$751	$563	$27.04 – $676	—
Continuous neb med each addl hr Inpatient	94645 CPT	$176	$132	$6.33 – $158	—
Debride nail any mehod 1to 5 Inpatient	11720 CPT	$543	$407	$19.55 – $489	—
Dialysis central vn stent Inpatient	36908 CPT	$24,349	$18,262	$877 – $21,914	—
Doppler withspectral complete Inpatient	93320 CPT	$614	$460	$22.09 – $552	—
Drainage of forearm bursa bilateral Inpatient	25031 CPT	$485	$364	$17.47 – $437	—
Ecmo/ecls rmvl of central cannula 6 yrs & older Inpatient	33986 CPT	$27,075	$20,306	$975 – $24,368	—
Emergency room - level 3 withmod Inpatient	99283 CPT	$1,844	$1,383	$66.38 – $1,660	—