Intermountain Health Sevier Valley Hospital — price list

← Hospital overviewVerified from Intermountain Health Sevier Valley 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.

89 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Alcohol ablation procedure Inpatient	49999 CPT	$1,395	$1,046	$1,046 – $1,325	—
Angio visceral select Inpatient	75726 CPT	$1,753	$1,315	$1,315 – $1,666	—
Application of long leg cast unilateral Inpatient	29355 CPT	$589	$442	$442 – $559	—
Apply splint finger (dynamic) Inpatient	29131 CPT	$122	$91.52	$91.52 – $116	—
Bone marrow aspiration only unilateral Inpatient	38220 CPT	$380	$285	$285 – $361	—
Bronch withendobronchial bx Inpatient	3611016197 CDM	$5,775	$4,331	$4,331 – $5,486	—
Bronchoscopy withfluoro & 3d navigation Inpatient	31627 CPT	$3,353	$2,514	$2,514 – $3,185	—
Cath 2nd thorac/brachio Inpatient	36216 CPT	$2,992	$2,244	$2,244 – $2,842	—
Cath placement 3rd order abd bilateral Inpatient	36247 CPT	$4,286	$3,215	$3,215 – $4,072	—
Catheter stripping Inpatient	36595 CPT	$1,467	$1,100	$1,100 – $1,394	—
Change g-tube to g-j tube perc Inpatient	49446 CPT	$2,849	$2,137	$2,137 – $2,706	—
Change ureter stent percut unilateral Inpatient	50382 CPT	$3,838	$2,878	$2,878 – $3,646	—
Chemo cns intrathecal withlp Inpatient	96450 CPT	$1,228	$921	$921 – $1,166	—
Close rx dist finger fx, manipulation Inpatient	26755 CPT	$589	$442	$442 – $559	—
Closed rx shldr dislocation bilateral Inpatient	23650 CPT	$589	$442	$442 – $559	—
Closed tx carpal scaphoid fracture withmanj unilateral Inpatient	25624 CPT	$1,049	$787	$787 – $997	—
Closed tx radial&ulnar shaft fractures without man Inpatient	25560 CPT	$589	$442	$442 – $559	—
Closed tx scapular fracture without manipulation Inpatient	23570 CPT	$589	$442	$442 – $559	—
Closed tx talus fracture without manipulation unilateral Inpatient	28430 CPT	$589	$442	$442 – $559	—
Clsd tx trochantric fx without man Inpatient	27246 CPT	$589	$442	$442 – $559	—
Cltx inter/peri/subtrochanteric fem fx without manj unilateral Inpatient	27238 CPT	$1,049	$787	$787 – $997	—
Cltx interphalangeal joint dislocation without anes Inpatient	28660 CPT	$589	$442	$442 – $559	—
Cltx metar fx withmanj Inpatient	28475 CPT	$589	$442	$442 – $559	—
Cltx strnclav dislc withmnpj unilateral Inpatient	23525 CPT	$589	$442	$442 – $559	—
Cltx thigh fx withmnpj bilateral Inpatient	27268 CPT	$1,049	$787	$787 – $997	—
Debr exz/inf skin; 10% bs Inpatient	11000 CPT	$589	$442	$442 – $559	—
Defib transvenous analysis withrpgm Inpatient	93289 CPT	$88.50	$66.38	$66.38 – $84.08	—
Dialysis embo any vein(s) Inpatient	36909 CPT	$24,744	$18,558	$18,558 – $23,507	—
Doppler withspectral limited Inpatient	93321 CPT	$308	$231	$231 – $293	—
Drain finger abscess,complicated Inpatient	26011 CPT	$3,158	$2,369	$2,369 – $3,001	—