Does Lakeview Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Lakeview Hospital. In a medical emergency, call 911.

Where is Lakeview Hospital?

630 East Medical Drive, Bountiful, UT 84010, in Davis County, Utah.

What is the phone number of Lakeview Hospital?

(801) 299-2200, as listed by Medicare (CMS).

What is the Medicare star rating of Lakeview Hospital?

5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Lakeview Hospital — Bountiful, UT

Quick answers

Does Lakeview Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Lakeview Hospital. In a medical emergency, call 911.
Where is Lakeview Hospital?: 630 East Medical Drive, Bountiful, UT 84010, in Davis County, Utah.
What is the phone number of Lakeview Hospital?: (801) 299-2200, as listed by Medicare (CMS).
What is the Medicare star rating of Lakeview Hospital?: 5 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^{[5][6][7][17][18][19]}

Cardiology
Diabetes
Ear, nose and throat
Emergency care
Gastroenterology
Intensive care (ICU)
Imaging services
Mental health and wellness
Neurological care
NICU
Nutrition services
Oncology
Orthopedic care
Pain management
Physical therapy and rehabilitation
Spine care
Surgery
Urology
Women's care
Wound care
Trauma care
Behavioral health
Diagnostics and laboratory
Midwifery
Neonatal intensive care (NICU)

Conditions treated^{[5][7][13][17][18]}

Stroke
Breast cancer
Vascular disease
Atrial fibrillation
Coronary artery disease
Heart attack
Heart failure
Chest pain
Trauma injuries
Acute respiratory failure
Diabetic ketoacidosis
Sepsis
Gastrointestinal bleeding
Depression
Dementia
Infertility
Gynecologic infections
Urinary incontinence
Pelvic organ prolapse

Treatments^{[5][8][9][13][15][17][19]}

Cardiac rehabilitation
Electroconvulsive therapy
Inpatient mental health care
Outpatient mental health care
Addiction treatment
Cardiac catheterization
Coronary stent placement
Percutaneous transluminal coronary angioplasty
Intra-aortic balloon pump placement
Pacemaker implantation and replacement
Electrocardiogram
Stress testing
Echocardiography
CT scan
DEXA bone density scan
Mammography
Ultrasound
Nuclear medicine
X-ray
Total hip replacement
Total knee replacement
Total shoulder replacement
Robot-assisted hip and knee replacement
Robotic spine surgery
Spinal fusion
Pelvic floor physical therapy
Blood bank and transfusion services
Colonoscopy
Upper GI endoscopy
Lung biopsy
Robot-assisted gynecologic surgery

Procedures^[5][9]

Heart and vascular surgery
Hip replacement
Knee replacement
Shoulder replacement
Minimally invasive surgery
Appendectomy
Bowel resection
Laparoscopic cholecystectomy
Laparoscopic colon resection
Mastectomy
Hernia surgery
Breast biopsy

Programs and centers^{[5][6][7][13][15][18]}

Labor and delivery
Midwifery
Structural heart
Chest Pain Center
Trauma center (Level III)
Pediatric emergency care
Cardiac rehabilitation program
Inpatient adult behavioral health unit
Intensive outpatient program
Electroconvulsive therapy program
Medicare Comprehensive Care for Joint Replacement (CJR) program
5-week childbirth education series
NICU

Emergency care (hospital website)^{[4][5][6][7][12]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level III
Stroke designation	Certified as a Stroke Receiving Facility by the Utah Department of Health

Recognition^[7][12][13]

Chest Pain Center accreditation (American College of Cardiology)
Advanced Certification in Total Hip and Total Knee Replacement (The Joint Commission)

Doctors and clinicians (212)

212 doctors and other clinicians list Lakeview Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 188 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

LDS Hospital7.5 mi · Salt Lake City, UT · Acute Care Hospital
Holy Cross Hospital - Salt Lake8.1 mi · Salt Lake City, UT · Acute Care Hospital
University of Utah Hospital and Clinics8.3 mi · Salt Lake City, UT · Acute Care Hospital
Primary Children's Hospital8.8 mi · Salt Lake City, UT · Children's Hospital
VA Salt Lake City Healthcare - George E. Wahlen VA Medical Center9.2 mi · Salt Lake City, UT · Federal/VA Acute Care Hospital

Other hospitals nearby

Western Peaks Specialty Hospital0.2 mi · Bountiful, UT · Acute Care Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

South Davis Specialty Care0.2 mi · Bountiful, UT · 5 of 5 stars
Monument Healthcare Stonecreek0.9 mi · Bountiful, UT · 3 of 5 stars
Monument Healthcare Bountiful2.1 mi · Bountiful, UT · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Ovation Hospice of Salt Lake2.0 mi · Bountiful, UT
Rocky Mountain Hospice - Utah2.0 mi · Woods Cross, UT · 2 of 5 stars
Symbii Davis Hospice2.0 mi · Bountiful, UT

All hospice providers in the state →

Home health agencies

Rocky Mountain Home Health - Utah2.0 mi · Woods Cross, UT
Symbii Davis Home Health2.0 mi · Bountiful, UT · 5 of 5 stars
Utah Home Health - North2.0 mi · Bountiful, UT · 5 of 5 stars

All home health agencies in the state →

Dialysis facilities

462538 Liberty Dialysis - Woodscross (FMC)2.0 mi · Bountiful, UT · 4 of 5 stars
DaVita Bountiful Dialysis2.0 mi · Bountiful, UT · 5 of 5 stars
462320 Primary Children's Dialysis Center8.8 mi · Salt Lake City, UT

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Lakeview Endoscopy Center2.0 mi · Bountiful, UT
Mountain West Surgical Center2.0 mi · Bountiful, UT
Oculus Surgery Center, LLC2.0 mi · Bountiful, UT

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Stephen Ratcliffe Community Hlth Ctr7.4 mi · Salt Lake City, UT · Community health center
Magnolia Apartments8.4 mi · Salt Lake City, UT · Community health center
WASATCH HOMELESS HEALTH CARE, INC d.b.a Fourth Street Clinic8.9 mi · Salt Lake City, UT · Community health center

Clinics and urgent care

Daud Dme Ltd LLC8.3 mi · Salt Lake City, UT · Urgent care center
American Current Care P.A.11 mi · Salt Lake City, UT · Urgent care center
American Current Care P.A.11 mi · Salt Lake City, UT · Urgent care center

Pharmacies

CFK, Inc.2.0 mi · Bountiful, UT · Community/retail pharmacy
Costco Wholesale Corporation2.0 mi · West Bountiful, UT · Community/retail pharmacy
Mountain West Medicine, Inc.2.0 mi · Bountiful, UT · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Country Home Assisted Living2.0 mi · Bountiful, UT
Creekside Senior Living2.0 mi · Bountiful, UT
Legacy House of Bountiful2.0 mi · Bountiful, UT
Oak Ridge Assisted Living of Bountiful2.0 mi · Bountiful, UT

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Lakeview Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	3 of 5 stars
Would recommend the hospital	3 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	3 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Quiet at night	4 of 5 stars
Rated the hospital 9 or 10 out of 10	71%National average: 72%
Would definitely recommend the hospital	67%National average: 71%
Nurses “always” communicated well	79%National average: 80%
Doctors “always” communicated well	78%National average: 80%
Staff “always” explained medicines before giving them	59%National average: 62%
Were given information about recovery at home	88%National average: 86%
Room and bathroom “always” clean	80%National average: 74%
Area around the room “always” quiet at night	61%National average: 60%
Completed surveys	454Response rate: 26%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	0.203No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Too few cases to report
Deaths within 30 days: heart failure patients	11.1%
Deaths within 30 days: pneumonia patients	13.6%
Deaths within 30 days: COPD patients	Too few cases to report
Deaths within 30 days: stroke patients	10.9%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	0.87No different from the national rate
Complications after hip or knee replacement	6%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.9%
Readmitted within 30 days: heart failure	20%
Readmitted within 30 days: pneumonia	15.7%
Readmitted within 30 days: COPD	Too few cases to report
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	5.7%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	124 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	0%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	88%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Utah Best hospitals in Utah

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Lakeview Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 NP	$919.50	$919.50	$189.33 – $781.58
New patient office visit (about 30–44 minutes): 10 of 23 insurance plan rates Aetna — FirstHealth: $634.46 Bright Health — HIX: $257.46 Cigna UT Overstock — COMM: $367.80 DMBA (Deseret Mutual Benefit Admin) — PPO: $337.09 ELAP — COMM: $189.33 EverNorth BH — COMM: $643.65 Injury Care of Utah — WCOMP: $717.21 Magellan Behavioral Health — TRICARE: $459.75 Magellan BH — COMMBH: $735.60 Public Employees — PrefferedNetwork: $508.48
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 NP	$1,349.76	$1,349.76	$277.92 – $1,147.30
New patient office visit (about 45–59 minutes): 10 of 23 insurance plan rates Aetna — FirstHealth: $931.33 Bright Health — HIX: $377.93 Cigna UT Overstock — COMM: $539.90 DMBA (Deseret Mutual Benefit Admin) — PPO: $494.82 ELAP — COMM: $277.92 EverNorth BH — COMM: $944.83 Injury Care of Utah — WCOMP: $1,052.81 Magellan Behavioral Health — TRICARE: $674.88 Magellan BH — COMMBH: $1,079.81 Public Employees — PrefferedNetwork: $746.42
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 5 NP	$1,721.06	$1,721.06	$354.37 – $1,462.90
New patient office visit (about 60–74 minutes): 10 of 23 insurance plan rates Aetna — FirstHealth: $1,187.53 Bright Health — HIX: $481.90 Cigna UT Overstock — COMM: $688.42 DMBA (Deseret Mutual Benefit Admin) — PPO: $630.94 ELAP — COMM: $354.37 EverNorth BH — COMM: $1,204.74 Injury Care of Utah — WCOMP: $1,342.43 Magellan Behavioral Health — TRICARE: $860.53 Magellan BH — COMMBH: $1,376.85 Public Employees — PrefferedNetwork: $951.75
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 3 EST	$919.50	$919.50	$189.33 – $781.58
Established patient office visit (about 20–29 minutes): 10 of 23 insurance plan rates Aetna — FirstHealth: $634.46 Bright Health — HIX: $257.46 Cigna UT Overstock — COMM: $367.80 DMBA (Deseret Mutual Benefit Admin) — PPO: $337.09 ELAP — COMM: $189.33 EverNorth BH — COMM: $643.65 Injury Care of Utah — WCOMP: $717.21 Magellan Behavioral Health — TRICARE: $459.75 Magellan BH — COMMBH: $735.60 Public Employees — PrefferedNetwork: $508.48
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT LEVEL 4 EST	$1,349.76	$1,349.76	$277.92 – $1,147.30
Established patient office visit (about 30–39 minutes): 10 of 23 insurance plan rates Aetna — FirstHealth: $931.33 Bright Health — HIX: $377.93 Cigna UT Overstock — COMM: $539.90 DMBA (Deseret Mutual Benefit Admin) — PPO: $494.82 ELAP — COMM: $277.92 EverNorth BH — COMM: $944.83 Injury Care of Utah — WCOMP: $1,052.81 Magellan Behavioral Health — TRICARE: $674.88 Magellan BH — COMMBH: $1,079.81 Public Employees — PrefferedNetwork: $746.42
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$141.04 – $156.34
Office consultation with a specialist (moderate): rates for 8 insurance plans Regence — FocalPoint: $156.34 Regence — FocalPointPlus: $141.04 Regence — Individual: $156.34 Regence — Participating: $156.34 Regence — PPO: $156.34 Regence — Preferred: $156.34 Regence — RealValue: $156.34 Regence — Traditional: $156.34
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) In the file: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination	Not listed in the file	Not listed in the file	$200.71 – $222.49
Office consultation with a specialist (moderate to high): rates for 8 insurance plans Regence — FocalPoint: $222.49 Regence — FocalPointPlus: $200.71 Regence — Individual: $222.49 Regence — Participating: $222.49 Regence — PPO: $222.49 Regence — Preferred: $222.49 Regence — RealValue: $222.49 Regence — Traditional: $222.49
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$68.78 – $180.39
Preventive checkup, new patient, age 18–39: rates for 9 insurance plans Regence — FocalPoint: $180.39 Regence — FocalPointPlus: $162.73 Regence — Individual: $180.39 Regence — Participating: $180.39 Regence — PPO: $180.39 Regence — Preferred: $180.39 Regence — RealValue: $180.39 Regence — Traditional: $180.39 Regence TriWest — Tricare: $68.78
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) In the file: Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examin	Not listed in the file	Not listed in the file	$83.58 – $207.69
Preventive checkup, new patient, age 40–64: rates for 9 insurance plans Regence — FocalPoint: $207.69 Regence — FocalPointPlus: $187.36 Regence — Individual: $207.69 Regence — Participating: $207.69 Regence — PPO: $207.69 Regence — Preferred: $207.69 Regence — RealValue: $207.69 Regence — Traditional: $207.69 Regence TriWest — Tricare: $83.58
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$2,423.68	$2,423.68	$1,031 – $3,911
Emergency room visit (moderate): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $2,156 Aetna — PeakPreference: $1,290 Aetna — StandardNetwork: $1,691 Aetna — UtahConnectedNetwork: $2,214 Bright Health — HIX: $958 Cigna — Exclusive: $1,324 Cigna — LocalPlus: $1,019 Cigna — OAPNBN: $1,152 Humana — MCRHMO: $3,615 Humana — MCRPPO: $3,615
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: LVL 3 EMER DEPT	$2,423.68	$2,423.68	$499.04 – $2,060.13
Emergency room visit (moderate): 10 of 19 insurance plan rates Aetna — FirstHealth: $1,672.34 Cigna — NBNPPO: $988.86 Cigna — Non-ExclusivePPO: $1,250.62 Cigna UT Overstock — COMM: $969.47 DMBA (Deseret Mutual Benefit Admin) — PPO: $888.52 ELAP — COMM: $499.04 EverNorth BH — COMM: $1,696.58 Injury Care of Utah — WCOMP: $1,890.47 Magellan Behavioral Health — TRICARE: $1,211.84 Magellan BH — COMMBH: $1,938.94
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$4,033.71	$4,033.71	$992.16 – $6,320
Emergency room visit (moderately high): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $6,156 Aetna — PeakPreference: $3,684 Aetna — StandardNetwork: $4,828 Aetna — UtahConnectedNetwork: $6,320 Bright Health — HIX: $1,596 Cigna — Exclusive: $2,270 Cigna — LocalPlus: $1,748 Cigna — OAPNBN: $1,975 Humana — MCRHMO: $3,615 Humana — MCRPPO: $3,615
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: LVL 4 EMER DEPT	$4,033.71	$4,033.71	$830.54 – $3,428.65
Emergency room visit (moderately high): 10 of 19 insurance plan rates Aetna — FirstHealth: $2,783.26 Cigna — NBNPPO: $1,645.75 Cigna — Non-ExclusivePPO: $2,081.39 Cigna UT Overstock — COMM: $1,613.48 DMBA (Deseret Mutual Benefit Admin) — PPO: $1,478.76 ELAP — COMM: $830.54 EverNorth BH — COMM: $2,823.60 Injury Care of Utah — WCOMP: $3,146.29 Magellan Behavioral Health — TRICARE: $2,016.86 Magellan BH — COMMBH: $3,226.97
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination	$5,831.31	$5,831.31	$4,637 – $6,405
Emergency room visit (high): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $9,387 Aetna — PeakPreference: $5,617 Aetna — StandardNetwork: $7,362 Aetna — UtahConnectedNetwork: $9,637 Bright Health — HIX: $2,660 Cigna — Exclusive: $4,307 Cigna — LocalPlus: $3,316 Cigna — OAPNBN: $3,747 Humana — MCRHMO: $3,615 Humana — MCRPPO: $3,615
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: LVL 5 EMER DEPT	$5,831.31	$5,831.31	$1,200.67 – $4,956.61
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — FirstHealth: $4,023.60 Cigna — NBNPPO: $2,379.17 Cigna — Non-ExclusivePPO: $3,008.96 Cigna UT Overstock — COMM: $2,332.52 DMBA (Deseret Mutual Benefit Admin) — PPO: $2,137.76 ELAP — COMM: $1,200.67 EverNorth BH — COMM: $4,081.92 Injury Care of Utah — WCOMP: $4,548.42 Magellan Behavioral Health — TRICARE: $2,915.66 Magellan BH — COMMBH: $4,665.05

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch	$305.67	$305.67	$27.92 – $34.86
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $73.54 Aetna — PeakPreference: $43.95 Aetna — StandardNetwork: $57.67 Aetna — UtahConnectedNetwork: $75.47 Bright Health — HIX: $16.92 Cigna — Exclusive: $8.69 Cigna — LocalPlus: $6.71 Cigna — OAPNBN: $7.59 Cigna Healthspring — MCR: $8.46 Coventry Altius — MCR: $8.29
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM	$305.67	$305.67	$62.94 – $259.82
Basic metabolic panel (blood test): 10 of 28 insurance plan rates Aetna — FirstHealth: $210.91 Cigna — NBNPPO: $124.71 Cigna — Non-ExclusivePPO: $157.73 Cigna UT Overstock — COMM: $122.27 DMBA (Deseret Mutual Benefit Admin) — PPO: $112.06 ELAP — COMM: $62.94 EverNorth BH — COMM: $213.97 Imagine Health Wise — PPO: $135.47 Injury Care of Utah — WCOMP: $238.42 Magellan Behavioral Health — TRICARE: $152.84
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon	$446.93	$446.93	$34.85 – $43.51
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $91.79 Aetna — PeakPreference: $54.86 Aetna — StandardNetwork: $71.98 Aetna — UtahConnectedNetwork: $94.20 Bright Health — HIX: $21.12 Cigna — Exclusive: $10.84 Cigna — LocalPlus: $8.37 Cigna — OAPNBN: $9.47 Cigna Healthspring — MCR: $10.56 Coventry Altius — MCR: $10.35
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL	$446.93	$446.93	$92.02 – $379.89
Comprehensive metabolic panel (blood test): 10 of 28 insurance plan rates Aetna — FirstHealth: $308.38 Cigna — NBNPPO: $182.35 Cigna — Non-ExclusivePPO: $230.62 Cigna UT Overstock — COMM: $178.77 DMBA (Deseret Mutual Benefit Admin) — PPO: $163.84 ELAP — COMM: $92.02 EverNorth BH — COMM: $312.85 Imagine Health Wise — PPO: $198.08 Injury Care of Utah — WCOMP: $348.61 Magellan Behavioral Health — TRICARE: $223.47
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or	Not listed in the file	Not listed in the file	$47.81 – $196.98
Obstetric blood test panel: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $347.87 Aetna — PeakPreference: $207.91 Aetna — StandardNetwork: $272.82 Aetna — UtahConnectedNetwork: $357 Bright Health — HIX: $95.62 Cigna — Exclusive: $49.11 Cigna — LocalPlus: $37.92 Cigna — OAPNBN: $42.89 Cigna Healthspring — MCR: $47.81 Coventry Altius — MCR: $46.85
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester	$369.88	$369.88	$13.39 – $55.17
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $116.41 Aetna — PeakPreference: $69.58 Aetna — StandardNetwork: $91.30 Aetna — UtahConnectedNetwork: $119.47 Bright Health — HIX: $26.78 Cigna — Exclusive: $13.75 Cigna — LocalPlus: $10.61 Cigna — OAPNBN: $12.01 Cigna Healthspring — MCR: $13.39 Coventry Altius — MCR: $13.12
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL	$369.88	$369.88	$76.16 – $314.40
Cholesterol panel (lipid panel): 10 of 28 insurance plan rates Aetna — FirstHealth: $255.22 Cigna — NBNPPO: $150.91 Cigna — Non-ExclusivePPO: $190.86 Cigna UT Overstock — COMM: $147.95 DMBA (Deseret Mutual Benefit Admin) — PPO: $135.60 ELAP — COMM: $76.16 EverNorth BH — COMM: $258.92 Imagine Health Wise — PPO: $163.93 Injury Care of Utah — WCOMP: $288.51 Magellan Behavioral Health — TRICARE: $184.94
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo	$328.76	$328.76	$8.68 – $35.76
Kidney function panel: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $75.46 Aetna — PeakPreference: $45.10 Aetna — StandardNetwork: $59.18 Aetna — UtahConnectedNetwork: $77.44 Bright Health — HIX: $17.36 Cigna — Exclusive: $8.91 Cigna — LocalPlus: $6.88 Cigna — OAPNBN: $7.78 Cigna Healthspring — MCR: $8.68 Coventry Altius — MCR: $8.51
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL	$328.76	$328.76	$67.69 – $279.45
Kidney function panel: 10 of 28 insurance plan rates Aetna — FirstHealth: $226.84 Cigna — NBNPPO: $134.13 Cigna — Non-ExclusivePPO: $169.64 Cigna UT Overstock — COMM: $131.50 DMBA (Deseret Mutual Benefit Admin) — PPO: $120.52 ELAP — COMM: $67.69 EverNorth BH — COMM: $230.13 Imagine Health Wise — PPO: $145.71 Injury Care of Utah — WCOMP: $256.43 Magellan Behavioral Health — TRICARE: $164.38
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase	$341.62	$341.62	$8.17 – $33.66
Liver function panel: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $70.93 Aetna — PeakPreference: $42.39 Aetna — StandardNetwork: $55.63 Aetna — UtahConnectedNetwork: $72.79 Bright Health — HIX: $16.34 Cigna — Exclusive: $8.39 Cigna — LocalPlus: $6.48 Cigna — OAPNBN: $7.33 Cigna Healthspring — MCR: $8.17 Coventry Altius — MCR: $8.01
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL	$341.62	$341.62	$70.34 – $290.38
Liver function panel: 10 of 28 insurance plan rates Aetna — FirstHealth: $235.72 Cigna — NBNPPO: $139.38 Cigna — Non-ExclusivePPO: $176.28 Cigna UT Overstock — COMM: $136.65 DMBA (Deseret Mutual Benefit Admin) — PPO: $125.24 ELAP — COMM: $70.34 EverNorth BH — COMM: $239.13 Imagine Health Wise — PPO: $151.41 Injury Care of Utah — WCOMP: $266.46 Magellan Behavioral Health — TRICARE: $170.81
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$193.88	$193.88	$3.17 – $13.06
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $27.51 Aetna — PeakPreference: $16.44 Aetna — StandardNetwork: $21.57 Aetna — UtahConnectedNetwork: $28.23 Bright Health — HIX: $6.34 Cigna — Exclusive: $3.25 Cigna — LocalPlus: $2.51 Cigna — OAPNBN: $2.84 Cigna Healthspring — MCR: $3.17 Coventry Altius — MCR: $3.11
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO	$193.88	$193.88	$39.92 – $164.80
Urine test (automated, with microscope): 10 of 28 insurance plan rates Aetna — FirstHealth: $133.78 Cigna — NBNPPO: $79.10 Cigna — Non-ExclusivePPO: $100.04 Cigna UT Overstock — COMM: $77.55 DMBA (Deseret Mutual Benefit Admin) — PPO: $71.08 ELAP — COMM: $39.92 EverNorth BH — COMM: $135.72 Imagine Health Wise — PPO: $85.93 Injury Care of Utah — WCOMP: $151.23 Magellan Behavioral Health — TRICARE: $96.94
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	Not listed in the file	Not listed in the file	$3.48 – $14.34
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $22.23 Aetna — PeakPreference: $13.28 Aetna — StandardNetwork: $17.43 Aetna — UtahConnectedNetwork: $22.81 Bright Health — HIX: $6.96 Cigna — Exclusive: $3.57 Cigna — LocalPlus: $2.76 Cigna — OAPNBN: $3.12 Cigna Healthspring — MCR: $3.48 Coventry Altius — MCR: $3.41
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity,	$128.47	$128.47	$7.42 – $9.27
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $19.48 Aetna — PeakPreference: $11.64 Aetna — StandardNetwork: $15.28 Aetna — UtahConnectedNetwork: $19.99 Bright Health — HIX: $4.50 Cigna — Exclusive: $2.31 Cigna — LocalPlus: $1.78 Cigna — OAPNBN: $2.01 Cigna Healthspring — MCR: $2.25 Coventry Altius — MCR: $2.21
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO	$128.47	$128.47	$26.45 – $109.20
Urine test (automated, without microscope): 10 of 28 insurance plan rates Aetna — FirstHealth: $88.64 Cigna — NBNPPO: $52.42 Cigna — Non-ExclusivePPO: $66.29 Cigna UT Overstock — COMM: $51.39 DMBA (Deseret Mutual Benefit Admin) — PPO: $47.10 ELAP — COMM: $26.45 EverNorth BH — COMM: $89.93 Imagine Health Wise — PPO: $56.94 Injury Care of Utah — WCOMP: $100.21 Magellan Behavioral Health — TRICARE: $64.23
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total	$416.11	$416.11	$14.58 – $164.03
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $159.84 Aetna — PeakPreference: $95.53 Aetna — StandardNetwork: $125.35 Aetna — UtahConnectedNetwork: $164.03 Bright Health — HIX: $36.78 Cigna — Exclusive: $18.88 Cigna — LocalPlus: $14.58 Cigna — OAPNBN: $16.49 Cigna Healthspring — MCR: $18.39 Coventry Altius — MCR: $18.02
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: PROS SPEC AG (PSA) TOTAL	$416.11	$416.11	$85.68 – $353.69
PSA (prostate specific antigen) blood test: 10 of 28 insurance plan rates Aetna — FirstHealth: $287.12 Cigna — NBNPPO: $169.77 Cigna — Non-ExclusivePPO: $214.71 Cigna UT Overstock — COMM: $166.44 DMBA (Deseret Mutual Benefit Admin) — PPO: $152.55 ELAP — COMM: $85.68 EverNorth BH — COMM: $291.28 Imagine Health Wise — PPO: $184.42 Injury Care of Utah — WCOMP: $324.57 Magellan Behavioral Health — TRICARE: $208.06
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH)	$331.36	$331.36	$55.44 – $69.22
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $145.98 Aetna — PeakPreference: $87.25 Aetna — StandardNetwork: $114.49 Aetna — UtahConnectedNetwork: $149.81 Bright Health — HIX: $33.60 Cigna — Exclusive: $17.25 Cigna — LocalPlus: $13.32 Cigna — OAPNBN: $15.07 Cigna Healthspring — MCR: $16.80 Coventry Altius — MCR: $16.46
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH	$331.36	$331.36	$68.23 – $281.66
Thyroid stimulating hormone (TSH) test: 10 of 28 insurance plan rates Aetna — FirstHealth: $228.64 Cigna — NBNPPO: $135.19 Cigna — Non-ExclusivePPO: $170.98 Cigna UT Overstock — COMM: $132.54 DMBA (Deseret Mutual Benefit Admin) — PPO: $121.48 ELAP — COMM: $68.23 EverNorth BH — COMM: $231.95 Imagine Health Wise — PPO: $146.86 Injury Care of Utah — WCOMP: $258.46 Magellan Behavioral Health — TRICARE: $165.68
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	Not listed in the file	Not listed in the file	$25.64 – $32.01
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $45.96 Aetna — PeakPreference: $27.47 Aetna — StandardNetwork: $36.05 Aetna — UtahConnectedNetwork: $47.17 Bright Health — HIX: $15.54 Cigna — Exclusive: $7.98 Cigna — LocalPlus: $6.16 Cigna — OAPNBN: $6.97 Cigna Healthspring — MCR: $7.77 Coventry Altius — MCR: $7.61
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$171.46	$171.46	$6.47 – $26.66
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $49.39 Aetna — PeakPreference: $29.52 Aetna — StandardNetwork: $38.74 Aetna — UtahConnectedNetwork: $50.69 Bright Health — HIX: $12.94 Cigna — Exclusive: $6.65 Cigna — LocalPlus: $5.14 Cigna — OAPNBN: $5.81 Cigna Healthspring — MCR: $6.47 Coventry Altius — MCR: $6.34
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED	$171.46	$171.46	$35.30 – $145.74
Complete blood count (CBC), automated: 10 of 28 insurance plan rates Aetna — FirstHealth: $118.31 Cigna — NBNPPO: $69.96 Cigna — Non-ExclusivePPO: $88.47 Cigna UT Overstock — COMM: $68.58 DMBA (Deseret Mutual Benefit Admin) — PPO: $62.86 ELAP — COMM: $35.30 EverNorth BH — COMM: $120.02 Imagine Health Wise — PPO: $75.99 Injury Care of Utah — WCOMP: $133.74 Magellan Behavioral Health — TRICARE: $85.73
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time;	$148.36	$148.36	$4.29 – $17.67
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $34.16 Aetna — PeakPreference: $20.42 Aetna — StandardNetwork: $26.79 Aetna — UtahConnectedNetwork: $35.06 Bright Health — HIX: $8.58 Cigna — Exclusive: $4.41 Cigna — LocalPlus: $3.40 Cigna — OAPNBN: $3.85 Cigna Healthspring — MCR: $4.29 Coventry Altius — MCR: $4.20
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME	$148.36	$148.36	$30.55 – $126.11
Blood clotting time test (prothrombin time, PT): 10 of 28 insurance plan rates Aetna — FirstHealth: $102.37 Cigna — NBNPPO: $60.53 Cigna — Non-ExclusivePPO: $76.55 Cigna UT Overstock — COMM: $59.34 DMBA (Deseret Mutual Benefit Admin) — PPO: $54.39 ELAP — COMM: $30.55 EverNorth BH — COMM: $103.85 Imagine Health Wise — PPO: $65.75 Injury Care of Utah — WCOMP: $115.72 Magellan Behavioral Health — TRICARE: $74.18
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood	$178.49	$178.49	$4.77 – $51.81
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna — AetnaSignatureAdministrators: $50.49 Aetna — PeakPreference: $30.18 Aetna — StandardNetwork: $39.60 Aetna — UtahConnectedNetwork: $51.81 Bright Health — HIX: $12.02 Cigna — Exclusive: $6.18 Cigna — LocalPlus: $4.77 Cigna — OAPNBN: $5.40 Cigna Healthspring — MCR: $6.01 Coventry Altius — MCR: $5.89
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT	$178.49	$178.49	$36.75 – $151.72
Blood clotting test (partial thromboplastin time, PTT): 10 of 28 insurance plan rates Aetna — FirstHealth: $123.16 Cigna — NBNPPO: $72.82 Cigna — Non-ExclusivePPO: $92.10 Cigna UT Overstock — COMM: $71.40 DMBA (Deseret Mutual Benefit Admin) — PPO: $65.43 ELAP — COMM: $36.75 EverNorth BH — COMM: $124.94 Imagine Health Wise — PPO: $79.11 Injury Care of Utah — WCOMP: $139.22 Magellan Behavioral Health — TRICARE: $89.25

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: CT HEAD/BRAIN W/O CONT	$4,084.77	$4,084.77	$841.05 – $3,472.05
CT scan of the head or brain, without contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $2,818.49 Cigna — NBNPPO: $1,666.59 Cigna — Non-ExclusivePPO: $2,107.74 Cigna UT Overstock — COMM: $1,633.91 DMBA (Deseret Mutual Benefit Admin) — PPO: $1,497.48 ELAP — COMM: $841.05 EverNorth BH — COMM: $2,859.34 Injury Care of Utah — WCOMP: $3,186.12 Magellan Behavioral Health — TRICARE: $2,042.38 Magellan BH — COMMBH: $3,267.82
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material	$4,084.77	$4,084.77	$245.18 – $607
CT scan of the head or brain, without contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $2,805 Aetna — PeakPreference: $1,679 Aetna — StandardNetwork: $2,200 Aetna — UtahConnectedNetwork: $2,880 Cigna — Exclusive: $607 Cigna — LocalPlus: $467 Cigna — OAPNBN: $529 Regence — FocalPoint: $215.87 Regence — FocalPointPlus: $194.60 Regence — Individual: $215.87
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: MRI BRAIN W&WO CONT	$5,962.42	$5,962.42	$1,227.66 – $5,068.06
MRI of the brain, before and after contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $4,114.07 Cigna — NBNPPO: $2,432.67 Cigna — Non-ExclusivePPO: $3,076.61 Cigna UT Overstock — COMM: $2,384.97 DMBA (Deseret Mutual Benefit Admin) — PPO: $2,185.82 ELAP — COMM: $1,227.66 EverNorth BH — COMM: $4,173.69 Injury Care of Utah — WCOMP: $4,650.69 Magellan Behavioral Health — TRICARE: $2,981.21 Magellan BH — COMMBH: $4,769.94
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth	$5,962.42	$5,962.42	$573 – $828.27
MRI of the brain, before and after contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,664 Aetna — PeakPreference: $2,193 Aetna — StandardNetwork: $2,874 Aetna — UtahConnectedNetwork: $3,762 Cigna — Exclusive: $744 Cigna — LocalPlus: $573 Cigna — OAPNBN: $647 Regence — FocalPoint: $724.97 Regence — FocalPointPlus: $653.55 Regence — Individual: $724.97
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V	$318.51	$318.51	$65.58 – $270.73
Chest X-ray, 2 views: 10 of 34 insurance plan rates Aetna — AetnaSignatureAdministrators: $152.88 Aetna — FirstHealth: $219.77 Aetna — PeakPreference: $92.37 Aetna — StandardNetwork: $121.03 Aetna — UtahConnectedNetwork: $159.25 Cigna — NBNPPO: $129.95 Cigna — Non-ExclusivePPO: $164.35 Cigna UT Overstock — COMM: $127.40 DMBA (Deseret Mutual Benefit Admin) — PPO: $116.77 ELAP — COMM: $65.58
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: Radiologic examination, chest; 2 views	$318.51	$318.51	$182.03
Chest X-ray, 2 views: 10 of 12 insurance plan rates Cigna — Exclusive: $82.86 Cigna — LocalPlus: $63.84 Cigna — OAPNBN: $72.22 Regence — FocalPoint: $178.74 Regence — FocalPointPlus: $161.13 Regence — Individual: $178.74 Regence — Participating: $259.75 Regence — PPO: $213.08 Regence — Preferred: $213.08 Regence — RealValue: $178.74
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: XR L-SPINE 4 + VIEWS	$1,122.90	$1,122.90	$231.21 – $954.47
X-ray of the lower spine, at least 4 views: 10 of 34 insurance plan rates Aetna — AetnaSignatureAdministrators: $538.99 Aetna — FirstHealth: $774.80 Aetna — PeakPreference: $325.64 Aetna — StandardNetwork: $426.70 Aetna — UtahConnectedNetwork: $561.45 Cigna — NBNPPO: $458.14 Cigna — Non-ExclusivePPO: $579.42 Cigna UT Overstock — COMM: $449.16 DMBA (Deseret Mutual Benefit Admin) — PPO: $411.66 ELAP — COMM: $231.21
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views	$1,122.90	$1,122.90	$245.18
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates Cigna — Exclusive: $139.70 Cigna — LocalPlus: $107.64 Cigna — OAPNBN: $121.76 Regence — FocalPoint: $215.87 Regence — FocalPointPlus: $194.60 Regence — Individual: $215.87 Regence — Participating: $313.70 Regence — PPO: $257.34 Regence — Preferred: $257.34 Regence — RealValue: $215.87
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: MRI L-SPINE W/O CONT	$4,168.67	$4,168.67	$858.33 – $3,543.37
MRI of the lower back (lumbar spine), without contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $2,876.38 Cigna — NBNPPO: $1,700.82 Cigna — Non-ExclusivePPO: $2,151.03 Cigna UT Overstock — COMM: $1,667.47 DMBA (Deseret Mutual Benefit Admin) — PPO: $1,528.23 ELAP — COMM: $858.33 EverNorth BH — COMM: $2,918.07 Injury Care of Utah — WCOMP: $3,251.56 Magellan Behavioral Health — TRICARE: $2,084.34 Magellan BH — COMMBH: $3,334.94
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$4,168.67	$4,168.67	$517.79 – $744
MRI of the lower back (lumbar spine), without contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,664 Aetna — PeakPreference: $2,193 Aetna — StandardNetwork: $2,874 Aetna — UtahConnectedNetwork: $3,762 Cigna — Exclusive: $744 Cigna — LocalPlus: $573 Cigna — OAPNBN: $647 Regence — FocalPoint: $490.69 Regence — FocalPointPlus: $442.35 Regence — Individual: $490.69
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: CT PELVIS W/CONTRAST	$5,396.03	$5,396.03	$1,111.04 – $4,586.63
CT scan of the pelvis, with contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $3,723.26 Cigna — NBNPPO: $2,201.58 Cigna — Non-ExclusivePPO: $2,784.35 Cigna UT Overstock — COMM: $2,158.41 DMBA (Deseret Mutual Benefit Admin) — PPO: $1,978.18 ELAP — COMM: $1,111.04 EverNorth BH — COMM: $3,777.22 Injury Care of Utah — WCOMP: $4,208.90 Magellan Behavioral Health — TRICARE: $2,698.01 Magellan BH — COMMBH: $4,316.82
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s)	$5,396.03	$5,396.03	$401.74 – $607
CT scan of the pelvis, with contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $2,805 Aetna — PeakPreference: $1,679 Aetna — StandardNetwork: $2,200 Aetna — UtahConnectedNetwork: $2,880 Cigna — Exclusive: $607 Cigna — LocalPlus: $467 Cigna — OAPNBN: $529 Regence — FocalPoint: $361.38 Regence — FocalPointPlus: $325.78 Regence — Individual: $361.38
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material	Not listed in the file	Not listed in the file	$517.79 – $744
MRI of a leg joint (such as the knee), without contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,664 Aetna — PeakPreference: $2,193 Aetna — StandardNetwork: $2,874 Aetna — UtahConnectedNetwork: $3,762 Cigna — Exclusive: $744 Cigna — LocalPlus: $573 Cigna — OAPNBN: $647 Regence — FocalPoint: $490.69 Regence — FocalPointPlus: $442.35 Regence — Individual: $490.69
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier 50 In the file: MRI LW JNT W/O CONT BI	$8,337.29	$8,337.29	$1,716.65 – $7,086.70
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $5,752.73 Cigna — NBNPPO: $3,401.61 Cigna — Non-ExclusivePPO: $4,302.04 Cigna UT Overstock — COMM: $3,334.92 DMBA (Deseret Mutual Benefit Admin) — PPO: $3,056.45 ELAP — COMM: $1,716.65 EverNorth BH — COMM: $5,836.10 Injury Care of Utah — WCOMP: $6,503.09 Magellan Behavioral Health — TRICARE: $4,168.65 Magellan BH — COMMBH: $6,669.83
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · modifier RT In the file: MRI LW JNT W/O CONT RT	$4,168.67	$4,168.67	$858.33 – $3,543.37
MRI of a leg joint (such as the knee), without contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $2,876.38 Cigna — NBNPPO: $1,700.82 Cigna — Non-ExclusivePPO: $2,151.03 Cigna UT Overstock — COMM: $1,667.47 DMBA (Deseret Mutual Benefit Admin) — PPO: $1,528.23 ELAP — COMM: $858.33 EverNorth BH — COMM: $2,918.07 Injury Care of Utah — WCOMP: $3,251.56 Magellan Behavioral Health — TRICARE: $2,084.34 Magellan BH — COMMBH: $3,334.94
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: CT ABD&PELVIS W/CONT	$10,791.97	$10,791.97	$2,222.07 – $9,173.17
CT scan of the abdomen and pelvis, with contrast: 10 of 22 insurance plan rates Aetna — FirstHealth: $7,446.46 Cigna — NBNPPO: $4,403.12 Cigna — Non-ExclusivePPO: $5,568.66 Cigna UT Overstock — COMM: $4,316.79 DMBA (Deseret Mutual Benefit Admin) — PPO: $3,956.34 ELAP — COMM: $2,222.07 EverNorth BH — COMM: $7,554.38 Injury Care of Utah — WCOMP: $8,417.74 Magellan Behavioral Health — TRICARE: $5,395.98 Magellan BH — COMMBH: $8,633.58
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s)	$10,791.97	$10,791.97	$467 – $828.27
CT scan of the abdomen and pelvis, with contrast: 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $2,805 Aetna — PeakPreference: $1,679 Aetna — StandardNetwork: $2,200 Aetna — UtahConnectedNetwork: $2,880 Cigna — Exclusive: $607 Cigna — LocalPlus: $467 Cigna — OAPNBN: $529 Regence — FocalPoint: $724.97 Regence — FocalPointPlus: $653.55 Regence — Individual: $724.97
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE	$1,482.46	$1,482.46	$305.24 – $1,260.09
Ultrasound of the abdomen, complete: 10 of 34 insurance plan rates Aetna — AetnaSignatureAdministrators: $711.58 Aetna — FirstHealth: $1,022.90 Aetna — PeakPreference: $429.91 Aetna — StandardNetwork: $563.33 Aetna — UtahConnectedNetwork: $741.23 Cigna — NBNPPO: $604.84 Cigna — Non-ExclusivePPO: $764.95 Cigna UT Overstock — COMM: $592.98 DMBA (Deseret Mutual Benefit Admin) — PPO: $543.47 ELAP — COMM: $305.24
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: Ultrasound, abdominal, real time with image documentation; complete	$1,482.46	$1,482.46	$194.60 – $313.70
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates Cigna — Exclusive: $274.65 Cigna — LocalPlus: $211.61 Cigna — OAPNBN: $239.38 Regence — FocalPoint: $215.87 Regence — FocalPointPlus: $194.60 Regence — Individual: $215.87 Regence — Participating: $313.70 Regence — PPO: $257.34 Regence — Preferred: $257.34 Regence — RealValue: $215.87
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: US PREG AFTER 1ST TRI	$1,482.46	$1,482.46	$305.24 – $1,260.09
Pregnancy ultrasound (after the first trimester): 10 of 34 insurance plan rates Aetna — AetnaSignatureAdministrators: $711.58 Aetna — FirstHealth: $1,022.90 Aetna — PeakPreference: $429.91 Aetna — StandardNetwork: $563.33 Aetna — UtahConnectedNetwork: $741.23 Cigna — NBNPPO: $604.84 Cigna — Non-ExclusivePPO: $764.95 Cigna UT Overstock — COMM: $592.98 DMBA (Deseret Mutual Benefit Admin) — PPO: $543.47 ELAP — COMM: $305.24
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day	$1,482.46	$1,482.46	$245.18
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates Cigna — Exclusive: $308.98 Cigna — LocalPlus: $238.06 Cigna — OAPNBN: $269.30 Regence — FocalPoint: $215.87 Regence — FocalPointPlus: $194.60 Regence — Individual: $215.87 Regence — Participating: $313.70 Regence — PPO: $257.34 Regence — Preferred: $257.34 Regence — RealValue: $215.87
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: US TRANSVAGINAL	$1,482.46	$1,482.46	$305.24 – $1,260.09
Transvaginal ultrasound: 10 of 34 insurance plan rates Aetna — AetnaSignatureAdministrators: $711.58 Aetna — FirstHealth: $1,022.90 Aetna — PeakPreference: $429.91 Aetna — StandardNetwork: $563.33 Aetna — UtahConnectedNetwork: $741.23 Cigna — NBNPPO: $604.84 Cigna — Non-ExclusivePPO: $764.95 Cigna UT Overstock — COMM: $592.98 DMBA (Deseret Mutual Benefit Admin) — PPO: $543.47 ELAP — COMM: $305.24
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) In the file: Ultrasound, transvaginal	$1,482.46	$1,482.46	$194.60 – $313.70
Transvaginal ultrasound: 10 of 12 insurance plan rates Cigna — Exclusive: $301.88 Cigna — LocalPlus: $232.59 Cigna — OAPNBN: $263.11 Regence — FocalPoint: $215.87 Regence — FocalPointPlus: $194.60 Regence — Individual: $215.87 Regence — Participating: $313.70 Regence — PPO: $257.34 Regence — Preferred: $257.34 Regence — RealValue: $215.87
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral	Not listed in the file	Not listed in the file	$205.70
Diagnostic mammogram, one breast: 10 of 26 insurance plan rates Cigna — Exclusive: $311.36 Cigna — LocalPlus: $239.90 Cigna — OAPNBN: $271.37 Cigna Healthspring — MCR: $80.99 Coventry Altius — MCR: $79.37 Devoted Health — MCR: $80.99 Health Choice — MCD: $80.99 Health Choice — MCR: $80.99 Humana — MCRHMO: $77.75 Humana — MCRPPO: $80.99
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier LT In the file: MAMMO DIAG CAD UNI LT	$1,085.32	$1,085.32	$223.47 – $922.52
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — AetnaSignatureAdministrators: $520.95 Aetna — FirstHealth: $748.87 Aetna — PeakPreference: $314.74 Aetna — StandardNetwork: $412.42 Aetna — UtahConnectedNetwork: $542.66 Cigna — NBNPPO: $442.81 Cigna — Non-ExclusivePPO: $560.03 Cigna UT Overstock — COMM: $434.13 DMBA (Deseret Mutual Benefit Admin) — PPO: $397.88 ELAP — COMM: $223.47
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier RT In the file: MAMMO DIAG CAD UNI RT	$1,085.32	$1,085.32	$223.47 – $922.52
Diagnostic mammogram, one breast: 10 of 29 insurance plan rates Aetna — AetnaSignatureAdministrators: $520.95 Aetna — FirstHealth: $748.87 Aetna — PeakPreference: $314.74 Aetna — StandardNetwork: $412.42 Aetna — UtahConnectedNetwork: $542.66 Cigna — NBNPPO: $442.81 Cigna — Non-ExclusivePPO: $560.03 Cigna UT Overstock — COMM: $434.13 DMBA (Deseret Mutual Benefit Admin) — PPO: $397.88 ELAP — COMM: $223.47
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: MAMMO DIAG CAD BI	$1,322.48	$1,322.48	$272.30 – $1,124.11
Diagnostic mammogram, both breasts: 10 of 29 insurance plan rates Aetna — AetnaSignatureAdministrators: $634.79 Aetna — FirstHealth: $912.51 Aetna — PeakPreference: $383.52 Aetna — StandardNetwork: $502.54 Aetna — UtahConnectedNetwork: $661.24 Cigna — NBNPPO: $539.57 Cigna — Non-ExclusivePPO: $682.40 Cigna UT Overstock — COMM: $528.99 DMBA (Deseret Mutual Benefit Admin) — PPO: $484.82 ELAP — COMM: $272.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,322.48	$1,322.48	$263
Diagnostic mammogram, both breasts: 10 of 26 insurance plan rates Cigna — Exclusive: $396.60 Cigna — LocalPlus: $305.58 Cigna — OAPNBN: $345.67 Cigna Healthspring — MCR: $103.90 Coventry Altius — MCR: $101.82 Devoted Health — MCR: $103.90 Health Choice — MCD: $103.90 Health Choice — MCR: $103.90 Humana — MCRHMO: $99.74 Humana — MCRPPO: $103.90
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCR CAD BI	$1,201.46	$1,201.46	$247.38 – $1,021.24
Screening mammogram, both breasts: 10 of 29 insurance plan rates Aetna — AetnaSignatureAdministrators: $576.70 Aetna — FirstHealth: $829.01 Aetna — PeakPreference: $348.42 Aetna — StandardNetwork: $456.55 Aetna — UtahConnectedNetwork: $600.73 Cigna — NBNPPO: $490.20 Cigna — Non-ExclusivePPO: $619.95 Cigna UT Overstock — COMM: $480.58 DMBA (Deseret Mutual Benefit Admin) — PPO: $440.46 ELAP — COMM: $247.38
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$1,201.46	$1,201.46	$72.84 – $327.94
Screening mammogram, both breasts: 10 of 26 insurance plan rates Cigna — Exclusive: $327.94 Cigna — LocalPlus: $252.67 Cigna — OAPNBN: $285.82 Cigna Healthspring — MCR: $85.70 Coventry Altius — MCR: $83.99 Devoted Health — MCR: $85.70 Health Choice — MCD: $85.70 Health Choice — MCR: $85.70 Humana — MCRHMO: $82.27 Humana — MCRPPO: $85.70

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Not listed in the file	Not listed in the file	$12.54
Electrocardiogram (ECG/EKG) with reading: rates for 1 insurance plan Regence TriWest — Tricare: $12.54
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe	Not listed in the file	Not listed in the file	$12,258
Left heart catheterization (diagnostic): 10 of 22 insurance plan rates Aetna — AetnaSignatureAdministrators: $16,409 Aetna — PeakPreference: $9,820 Aetna — StandardNetwork: $12,870 Aetna — UtahConnectedNetwork: $16,847 Bright Health — HIX: $3,685 Imagine Health Wise — PPO: $29,151 MotivHealth — MotivNet: $26,917 MotivHealth — MotivSelect: $21,894 MotivHealth — TPARental: $27,994 MotivHealth — Wasatch: $21,894
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor	Not listed in the file	Not listed in the file	$33,283
Heart rhythm study (electrophysiology evaluation): 10 of 16 insurance plan rates Aetna — AetnaSignatureAdministrators: $90,443 Aetna — PeakPreference: $54,124 Aetna — StandardNetwork: $70,936 Aetna — UtahConnectedNetwork: $92,855 Bright Health — HIX: $12,580 Regence — FocalPoint: $15,403.84 Regence — FocalPointPlus: $13,886.22 Regence — Individual: $15,403.84 Regence — Participating: $22,384.90 Regence — PPO: $18,363.20
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters,	Not listed in the file	Not listed in the file	$3,280
Heart rhythm study with ablation for atrial fibrillation: 10 of 24 insurance plan rates Aetna — AetnaSignatureAdministrators: $38,089 Aetna — PeakPreference: $22,794 Aetna — StandardNetwork: $29,874 Aetna — UtahConnectedNetwork: $39,105 Bright Health — HIX: $3,280 Imagine Health Wise — PPO: $59,237 MotivHealth — MotivNet: $47,786 MotivHealth — MotivSelect: $38,869 MotivHealth — TPARental: $49,697 MotivHealth — Wasatch: $38,869
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist	Not listed in the file	Not listed in the file	$3,249
Sleep study (overnight, in a sleep lab): rates for 9 insurance plans Regence — FocalPoint: $2,065.30 Regence — FocalPointPlus: $1,861.82 Regence — Individual: $2,065.30 Regence — Participating: $3,001.30 Regence — PPO: $2,462.08 Regence — Preferred: $2,462.08 Regence — RealValue: $2,065.30 Regence — Traditional: $3,001.30 United — AllPayerAppendix: $3,249

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib	Not listed in the file	Not listed in the file	$23.97 – $41.17
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 22 insurance plan rates Cigna Healthspring — MCR: $28.20 Coventry Altius — MCR: $27.64 Devoted Health — MCR: $28.20 Health Choice — MCD: $28.20 Health Choice — MCR: $28.20 Humana — MCRHMO: $27.07 Humana — MCRPPO: $28.20 Molina Healthcare — MGMCD: $23.97 Molina Healthcare — MGMCR: $28.20 Regence — FocalPoint: $41.17
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT	$166.02	$166.02	$34.18 – $141.12
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 35 insurance plan rates Aetna — AetnaSignatureAdministrators: $79.69 Aetna — FirstHealth: $114.55 Aetna — PeakPreference: $48.15 Aetna — StandardNetwork: $63.09 Aetna — UtahConnectedNetwork: $83.01 Bright Health — HIX: $46.49 Cigna — NBNPPO: $67.74 Cigna — Non-ExclusivePPO: $85.67 Cigna UT Overstock — COMM: $66.41 DMBA (Deseret Mutual Benefit Admin) — PPO: $60.86
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: THER EXERCISES 15 MIN OT	$167.29	$167.29	$34.45 – $142.20
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 35 insurance plan rates Aetna — AetnaSignatureAdministrators: $80.30 Aetna — FirstHealth: $115.43 Aetna — PeakPreference: $48.51 Aetna — StandardNetwork: $63.57 Aetna — UtahConnectedNetwork: $83.64 Bright Health — HIX: $46.84 Cigna — NBNPPO: $68.25 Cigna — Non-ExclusivePPO: $86.32 Cigna UT Overstock — COMM: $66.92 DMBA (Deseret Mutual Benefit Admin) — PPO: $61.33
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	Not listed in the file	Not listed in the file	$80.79 – $140.15
Physical therapy evaluation (low complexity): 10 of 22 insurance plan rates Cigna Healthspring — MCR: $95.06 Coventry Altius — MCR: $93.16 Devoted Health — MCR: $95.06 Health Choice — MCD: $95.06 Health Choice — MCR: $95.06 Humana — MCRHMO: $91.26 Humana — MCRPPO: $95.06 Molina Healthcare — MGMCD: $80.79 Molina Healthcare — MGMCR: $95.06 Regence — FocalPoint: $140.15
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX	$367.16	$367.16	$75.60 – $312.09
Physical therapy evaluation (low complexity): 10 of 35 insurance plan rates Aetna — AetnaSignatureAdministrators: $176.24 Aetna — FirstHealth: $253.34 Aetna — PeakPreference: $106.48 Aetna — StandardNetwork: $139.52 Aetna — UtahConnectedNetwork: $183.58 Bright Health — HIX: $102.80 Cigna — NBNPPO: $149.80 Cigna — Non-ExclusivePPO: $189.45 Cigna UT Overstock — COMM: $146.86 DMBA (Deseret Mutual Benefit Admin) — PPO: $134.60
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact	Not listed in the file	Not listed in the file	$71.10 – $85.33
Physical therapy evaluation (low complexity): 10 of 13 insurance plan rates Cigna Healthspring — MCR: $83.65 Coventry Altius — MCR: $81.98 Devoted Health — MCR: $83.65 Health Choice — MCD: $83.65 Health Choice — MCR: $83.65 Humana — MCRHMO: $80.31 Humana — MCRPPO: $83.65 Molina Healthcare — MGMCD: $71.10 Molina Healthcare — MGMCR: $83.65 Regence BCBS — MGMCR: $84.49
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	Not listed in the file	Not listed in the file	$80.79 – $140.15
Physical therapy evaluation (moderate complexity): 10 of 22 insurance plan rates Cigna Healthspring — MCR: $95.06 Coventry Altius — MCR: $93.16 Devoted Health — MCR: $95.06 Health Choice — MCD: $95.06 Health Choice — MCR: $95.06 Humana — MCRHMO: $91.26 Humana — MCRPPO: $95.06 Molina Healthcare — MGMCD: $80.79 Molina Healthcare — MGMCR: $95.06 Regence — FocalPoint: $140.15
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX	$458.95	$458.95	$94.50 – $390.11
Physical therapy evaluation (moderate complexity): 10 of 35 insurance plan rates Aetna — AetnaSignatureAdministrators: $220.30 Aetna — FirstHealth: $316.68 Aetna — PeakPreference: $133.10 Aetna — StandardNetwork: $174.40 Aetna — UtahConnectedNetwork: $229.47 Bright Health — HIX: $128.51 Cigna — NBNPPO: $187.25 Cigna — Non-ExclusivePPO: $236.82 Cigna UT Overstock — COMM: $183.58 DMBA (Deseret Mutual Benefit Admin) — PPO: $168.25
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or	Not listed in the file	Not listed in the file	$71.10 – $85.33
Physical therapy evaluation (moderate complexity): 10 of 13 insurance plan rates Cigna Healthspring — MCR: $83.65 Coventry Altius — MCR: $81.98 Devoted Health — MCR: $83.65 Health Choice — MCD: $83.65 Health Choice — MCR: $83.65 Humana — MCRHMO: $80.31 Humana — MCRPPO: $83.65 Molina Healthcare — MGMCD: $71.10 Molina Healthcare — MGMCR: $83.65 Regence BCBS — MGMCR: $84.49
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	Not listed in the file	Not listed in the file	$80.79 – $140.15
Physical therapy evaluation (high complexity): 10 of 22 insurance plan rates Cigna Healthspring — MCR: $95.06 Coventry Altius — MCR: $93.16 Devoted Health — MCR: $95.06 Health Choice — MCD: $95.06 Health Choice — MCR: $95.06 Humana — MCRHMO: $91.26 Humana — MCRPPO: $95.06 Molina Healthcare — MGMCD: $80.79 Molina Healthcare — MGMCR: $95.06 Regence — FocalPoint: $140.15
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX	$550.75	$550.75	$113.40 – $468.14
Physical therapy evaluation (high complexity): 10 of 35 insurance plan rates Aetna — AetnaSignatureAdministrators: $264.36 Aetna — FirstHealth: $380.02 Aetna — PeakPreference: $159.72 Aetna — StandardNetwork: $209.28 Aetna — UtahConnectedNetwork: $275.38 Bright Health — HIX: $154.21 Cigna — NBNPPO: $224.71 Cigna — Non-ExclusivePPO: $284.19 Cigna UT Overstock — COMM: $220.30 DMBA (Deseret Mutual Benefit Admin) — PPO: $201.90
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP\|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o	Not listed in the file	Not listed in the file	$71.10 – $85.33
Physical therapy evaluation (high complexity): 10 of 13 insurance plan rates Cigna Healthspring — MCR: $83.65 Coventry Altius — MCR: $81.98 Devoted Health — MCR: $83.65 Health Choice — MCD: $83.65 Health Choice — MCR: $83.65 Humana — MCRHMO: $80.31 Humana — MCRPPO: $83.65 Molina Healthcare — MGMCD: $71.10 Molina Healthcare — MGMCR: $83.65 Regence BCBS — MGMCR: $84.49
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: Psychotherapy, 30 minutes with patient	Not listed in the file	Not listed in the file	$294.03 – $473.98
Psychotherapy, 30 minutes: rates for 8 insurance plans Regence — FocalPoint: $326.16 Regence — FocalPointPlus: $294.03 Regence — Individual: $326.16 Regence — Participating: $473.98 Regence — PPO: $388.82 Regence — Preferred: $388.82 Regence — RealValue: $326.16 Regence — Traditional: $473.98
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: Psychotherapy, 45 minutes with patient	Not listed in the file	Not listed in the file	$294.03 – $473.98
Psychotherapy, 45 minutes: rates for 8 insurance plans Regence — FocalPoint: $326.16 Regence — FocalPointPlus: $294.03 Regence — Individual: $326.16 Regence — Participating: $473.98 Regence — PPO: $388.82 Regence — Preferred: $388.82 Regence — RealValue: $326.16 Regence — Traditional: $473.98
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: INDIV SESSION 60MIN	$838.92	$838.92	$172.73 – $713.08
Psychotherapy, 60 minutes: 10 of 24 insurance plan rates Aetna — AetnaSignatureAdministrators: $402.68 Aetna — FirstHealth: $578.85 Aetna — PeakPreference: $243.29 Aetna — StandardNetwork: $318.79 Aetna — UtahConnectedNetwork: $419.46 Bright Health — HIX: $234.90 Cigna — Exclusive: $258.39 Cigna — LocalPlus: $198.82 Cigna — NBNPPO: $342.28 Cigna — Non-ExclusivePPO: $432.88
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: Psychotherapy, 60 minutes with patient	$838.92	$838.92	$294.03 – $473.98
Psychotherapy, 60 minutes: rates for 8 insurance plans Regence — FocalPoint: $326.16 Regence — FocalPointPlus: $294.03 Regence — Individual: $326.16 Regence — Participating: $473.98 Regence — PPO: $388.82 Regence — Preferred: $388.82 Regence — RealValue: $326.16 Regence — Traditional: $473.98
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: FAM WO PT 50 MIN	$747.69	$747.69	$153.95 – $635.54
Family psychotherapy, without the patient: 10 of 34 insurance plan rates Aetna — FirstHealth: $515.91 Bright Health — HIX: $209.35 Cigna — Exclusive: $230.29 Cigna — LocalPlus: $177.20 Cigna — NBNPPO: $305.06 Cigna — Non-ExclusivePPO: $385.81 Cigna — OAPNBN: $200.38 Cigna UT Overstock — COMM: $299.08 DMBA (Deseret Mutual Benefit Admin) — PPO: $274.10 ELAP — COMM: $153.95
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) In the file: Family psychotherapy (without the patient present), 50 minutes	$747.69	$747.69	$294.03 – $473.98
Family psychotherapy, without the patient: rates for 8 insurance plans Regence — FocalPoint: $326.16 Regence — FocalPointPlus: $294.03 Regence — Individual: $326.16 Regence — Participating: $473.98 Regence — PPO: $388.82 Regence — Preferred: $388.82 Regence — RealValue: $326.16 Regence — Traditional: $473.98
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes	Not listed in the file	Not listed in the file	$294.03 – $473.98
Family psychotherapy, with the patient: rates for 8 insurance plans Regence — FocalPoint: $326.16 Regence — FocalPointPlus: $294.03 Regence — Individual: $326.16 Regence — Participating: $473.98 Regence — PPO: $388.82 Regence — Preferred: $388.82 Regence — RealValue: $326.16 Regence — Traditional: $473.98
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP PSY GRP (NOT FAMILY)	$458.15	$458.15	$94.33 – $389.43
Group psychotherapy: 10 of 24 insurance plan rates Aetna — AetnaSignatureAdministrators: $219.91 Aetna — FirstHealth: $316.12 Aetna — PeakPreference: $132.86 Aetna — StandardNetwork: $174.10 Aetna — UtahConnectedNetwork: $229.07 Bright Health — HIX: $128.28 Cigna — Exclusive: $141.11 Cigna — LocalPlus: $108.58 Cigna — NBNPPO: $186.93 Cigna — Non-ExclusivePPO: $236.41
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: Group psychotherapy (other than of a multiple-family group)	$458.15	$458.15	$220 – $377
Group psychotherapy: 10 of 13 insurance plan rates Aetna — AetnaSignatureAdministrators: $367 Aetna — PeakPreference: $220 Aetna — StandardNetwork: $288 Aetna — UtahConnectedNetwork: $377 ELAP — COMM: $287 Regence — FocalPoint: $187.77 Regence — FocalPointPlus: $169.28 Regence — Individual: $187.77 Regence — Participating: $272.88 Regence — PPO: $223.85

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19	Not listed in the file	Not listed in the file	$1,348 – $9,001
Removal of breast growth (open surgery): 10 of 21 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,767 Aetna — PeakPreference: $5,246 Aetna — StandardNetwork: $6,876 Aetna — UtahConnectedNetwork: $9,001 Bright Health — HIX: $1,348 Cigna — Exclusive: $5,944 Cigna — LocalPlus: $4,577 Cigna — OAPNBN: $5,172 Regence — FocalPoint: $7,773.44 Regence — FocalPointPlus: $7,007.58
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft	Not listed in the file	Not listed in the file	$13,389.49 – $47,431
Total hip replacement: 10 of 31 insurance plan rates Aetna — AetnaSignatureAdministrators: $43,697 Aetna — PeakPreference: $26,150 Aetna — StandardNetwork: $34,272 Aetna — UtahConnectedNetwork: $44,862 Bright Health — HIX: $5,740 Cigna — Exclusive: $19,714 Cigna — LocalPlus: $15,179 Cigna — OAPNBN: $17,151 Devoted Health — MCR: $16,249.38 Humana — MCRHMO: $14,000
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)	Not listed in the file	Not listed in the file	$13,389.49 – $47,431
Total knee replacement: 10 of 31 insurance plan rates Aetna — AetnaSignatureAdministrators: $43,697 Aetna — PeakPreference: $26,150 Aetna — StandardNetwork: $34,272 Aetna — UtahConnectedNetwork: $44,862 Bright Health — HIX: $5,740 Cigna — Exclusive: $19,714 Cigna — LocalPlus: $15,179 Cigna — OAPNBN: $17,151 Devoted Health — MCR: $16,249.38 Humana — MCRHMO: $14,000
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele	Not listed in the file	Not listed in the file	$4,000 – $4,250
Shoulder arthroscopy: shaving of shoulder bone: 10 of 12 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,767 Aetna — PeakPreference: $5,246 Aetna — StandardNetwork: $6,876 Aetna — UtahConnectedNetwork: $9,001 Bright Health — HIX: $1,348 Cigna — Exclusive: $5,944 Cigna — LocalPlus: $4,577 Cigna — OAPNBN: $5,172 Sterling Life Insurance — MCR: $4,000 United — AllPayerAppendix: $4,495
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula	Not listed in the file	Not listed in the file	$2,320 – $9,149
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,911 Aetna — PeakPreference: $5,333 Aetna — StandardNetwork: $6,989 Aetna — UtahConnectedNetwork: $9,149 Bright Health — HIX: $2,320 Cigna — Exclusive: $7,697 Cigna — LocalPlus: $5,927 Cigna — OAPNBN: $6,696 Regence — FocalPoint: $6,586.56 Regence — FocalPointPlus: $5,937.64
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12	Not listed in the file	Not listed in the file	$5,246 – $9,001
Removal of tonsils and adenoids (under age 12): 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,767 Aetna — PeakPreference: $5,246 Aetna — StandardNetwork: $6,876 Aetna — UtahConnectedNetwork: $9,001 Bright Health — HIX: $1,348 Cigna — Exclusive: $5,944 Cigna — LocalPlus: $4,577 Cigna — OAPNBN: $5,172 Regence — FocalPoint: $12,008.79 Regence — FocalPointPlus: $10,825.66
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep	Not listed in the file	Not listed in the file	$1,887 – $2,451
Upper GI endoscopy (diagnostic): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,872 Aetna — PeakPreference: $2,317 Aetna — StandardNetwork: $3,037 Aetna — UtahConnectedNetwork: $3,975 Bright Health — HIX: $960 Cigna — Exclusive: $2,451 Cigna — LocalPlus: $1,887 Cigna — OAPNBN: $2,132 Imagine Health Wise — PPO: $6,136 MotivHealth — MotivNet: $5,817
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,184 – $3,733
Upper GI endoscopy with biopsy: 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Imagine Health Wise — PPO: $6,136 MotivHealth — MotivNet: $5,817
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Not listed in the file	Not listed in the file	$969.85 – $4,640
Colonoscopy (diagnostic): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Imagine Health Wise — PPO: $4,306 MotivHealth — MotivNet: $4,082
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple	Not listed in the file	Not listed in the file	$1,184 – $4,640
Colonoscopy with biopsy: 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Imagine Health Wise — PPO: $4,306 MotivHealth — MotivNet: $4,082
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Not listed in the file	Not listed in the file	$2,176 – $3,733
Colonoscopy with removal of polyps (snare): 10 of 28 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Imagine Health Wise — PPO: $4,306 MotivHealth — MotivNet: $4,082
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and	Not listed in the file	Not listed in the file	$1,184 – $3,733
Ultrasound of the lower bowel by endoscope: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Regence — FocalPoint: $2,393.53 Regence — FocalPointPlus: $2,157.72
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Not listed in the file	Not listed in the file	$1,184 – $3,733
Screening colonoscopy (not high risk): 10 of 19 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Public Employees — Summit: $2,753 Public Employees — SummitExclusive: $2,486
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy	Not listed in the file	Not listed in the file	$2,720 – $15,824
Gallbladder removal by laparoscope: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $9,519 Aetna — PeakPreference: $5,697 Aetna — StandardNetwork: $7,466 Aetna — UtahConnectedNetwork: $9,773 Bright Health — HIX: $2,720 Cigna — Exclusive: $10,080 Cigna — LocalPlus: $7,762 Cigna — OAPNBN: $8,769 Regence — FocalPoint: $11,843.75 Regence — FocalPointPlus: $10,676.88
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible	Not listed in the file	Not listed in the file	$5,927 – $7,697
Groin (inguinal) hernia repair, age 5 or older: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,911 Aetna — PeakPreference: $5,333 Aetna — StandardNetwork: $6,989 Aetna — UtahConnectedNetwork: $9,149 Bright Health — HIX: $2,320 Cigna — Exclusive: $7,697 Cigna — LocalPlus: $5,927 Cigna — OAPNBN: $6,696 Regence — FocalPoint: $7,163.99 Regence — FocalPointPlus: $6,458.18
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) In the file: Biopsy, prostate; needle or punch, single or multiple, any approach	Not listed in the file	Not listed in the file	$1,184
Prostate biopsy: rates for 9 insurance plans Bright Health — HIX: $1,184 Regence — FocalPoint: $4,158.48 Regence — FocalPointPlus: $3,748.77 Regence — Individual: $4,158.48 Regence — Participating: $6,043.10 Regence — PPO: $4,957.39 Regence — Preferred: $4,957.39 Regence — RealValue: $4,158.48 Regence — Traditional: $6,043.10
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;	Not listed in the file	Not listed in the file	$5,477 – $7,113
Prostate removal by laparoscope (radical prostatectomy): 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $9,519 Aetna — PeakPreference: $5,697 Aetna — StandardNetwork: $7,466 Aetna — UtahConnectedNetwork: $9,773 Bright Health — HIX: $4,420 Cigna — Exclusive: $7,113 Cigna — LocalPlus: $5,477 Cigna — OAPNBN: $6,189 Regence — FocalPoint: $21,134.78 Regence — FocalPointPlus: $19,052.53
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C	Not listed in the file	Not listed in the file	$5,246 – $9,001
Hysteroscopy with biopsy of the uterus lining: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $8,767 Aetna — PeakPreference: $5,246 Aetna — StandardNetwork: $6,876 Aetna — UtahConnectedNetwork: $9,001 Bright Health — HIX: $1,348 Cigna — Exclusive: $5,944 Cigna — LocalPlus: $4,577 Cigna — OAPNBN: $5,172 Regence — FocalPoint: $6,454.45 Regence — FocalPointPlus: $5,818.54
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur	Not listed in the file	Not listed in the file	$960 – $3,975
Spinal injection, lower back (epidural), with imaging guidance: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,872 Aetna — PeakPreference: $2,317 Aetna — StandardNetwork: $3,037 Aetna — UtahConnectedNetwork: $3,975 Bright Health — HIX: $960 Cigna — Exclusive: $2,451 Cigna — LocalPlus: $1,887 Cigna — OAPNBN: $2,132 Regence — FocalPoint: $1,405.82 Regence — FocalPointPlus: $1,267.31
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing	Not listed in the file	Not listed in the file	$922.42 – $3,975
Nerve root injection, lower back, with imaging guidance: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,872 Aetna — PeakPreference: $2,317 Aetna — StandardNetwork: $3,037 Aetna — UtahConnectedNetwork: $3,975 Bright Health — HIX: $960 Cigna — Exclusive: $2,451 Cigna — LocalPlus: $1,887 Cigna — OAPNBN: $2,132 Regence — FocalPoint: $1,807.29 Regence — FocalPointPlus: $1,629.23
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel	Not listed in the file	Not listed in the file	$1,184 – $7,048
Carpal tunnel release: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Regence — FocalPoint: $3,964.12 Regence — FocalPointPlus: $3,573.57
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or	Not listed in the file	Not listed in the file	$573.59 – $3,733
Laser treatment of clouding after cataract surgery: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $3,636 Aetna — PeakPreference: $2,176 Aetna — StandardNetwork: $2,852 Aetna — UtahConnectedNetwork: $3,733 Bright Health — HIX: $1,184 Cigna — Exclusive: $3,207 Cigna — LocalPlus: $2,470 Cigna — OAPNBN: $2,790 Regence — FocalPoint: $1,113.66 Regence — FocalPointPlus: $1,003.94
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga	Not listed in the file	Not listed in the file	$5,697 – $9,773
Cataract removal with lens implant: 10 of 20 insurance plan rates Aetna — AetnaSignatureAdministrators: $9,519 Aetna — PeakPreference: $5,697 Aetna — StandardNetwork: $7,466 Aetna — UtahConnectedNetwork: $9,773 Bright Health — HIX: $3,280 Cigna — Exclusive: $4,975 Cigna — LocalPlus: $3,831 Cigna — OAPNBN: $4,329 Regence — FocalPoint: $4,629.88 Regence — FocalPointPlus: $4,173.74

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care	Not listed in the file	Not listed in the file	$2,350
Vaginal delivery, with care before and after: rates for 3 insurance plans Sterling Life Insurance — MCR: $2,350 Universal Healthcare — MCR: $2,350 University of UT — MCR: 103% (a percentage in the contract, not a dollar amount)
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, cesarean delivery, and postpartum care	Not listed in the file	Not listed in the file	$2,350
Cesarean delivery (C-section), with care before and after: rates for 3 insurance plans Sterling Life Insurance — MCR: $2,350 Universal Healthcare — MCR: $2,350 University of UT — MCR: 103% (a percentage in the contract, not a dollar amount)
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) In the file: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after p	Not listed in the file	Not listed in the file	$2,350
Vaginal delivery after a previous C-section, with care before and after: rates for 3 insurance plans Sterling Life Insurance — MCR: $2,350 Universal Healthcare — MCR: $2,350 University of UT — MCR: 103% (a percentage in the contract, not a dollar amount)

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA	Not listed in the file	Not listed in the file	$4,323
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 67 insurance plan rates Aetna — AetnaSignatureAdministrators: $123,678 Aetna — FirstHealth: $4,323 Aetna — PeakPreference: $74,013 Aetna — StandardNetwork: $97,002 Aetna — UtahConnectedNetwork: $126,976 Bright Health — HIX: $62,026.57 Cigna — Exclusive: $287,164.31 Cigna — LocalPlus: $219,301.03 Cigna — OAPNBN: $249,833.15 Cigna Healthspring — MCR: $76,400.09
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$23,377.64
Spinal fusion (not neck), without major complications: rates for 8 insurance plans Bright Health — HIX: $23,377.64 Health Choice — MCD: $29,366.66 Health Choice — MCR: $29,366.66 Hosp Uncompensated Care — MCR: $29,366.66 Molina Healthcare — MGMCD: $29,513.49 University of Utah — HealthyOptionsMedicalExcellence: $29,366.66 University of Utah — HealthyU: $29,366.66 University of Utah — HealthyUCHIP: $29,366.66
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT	Not listed in the file	Not listed in the file	$4,323
Hip or knee replacement (major joint of the leg), without major complications: 10 of 67 insurance plan rates Aetna — AetnaSignatureAdministrators: $35,196.64 Aetna — FirstHealth: $4,323 Aetna — PeakPreference: $21,061.66 Aetna — StandardNetwork: $27,604.49 Aetna — UtahConnectedNetwork: $36,134.08 Bright Health — HIX: $12,025.94 Cigna — Exclusive: $56,620.93 Cigna — LocalPlus: $43,240.15 Cigna — OAPNBN: $49,260.25 Cigna Healthspring — MCR: $16,017.52
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,323
Neck (cervical) spinal fusion, without complications: 10 of 67 insurance plan rates Aetna — AetnaSignatureAdministrators: $44,546.40 Aetna — FirstHealth: $4,323 Aetna — PeakPreference: $26,656.55 Aetna — StandardNetwork: $34,937.44 Aetna — UtahConnectedNetwork: $45,732.87 Bright Health — HIX: $15,725.69 Cigna — Exclusive: $71,661.92 Cigna — LocalPlus: $54,726.62 Cigna — OAPNBN: $62,345.92 Cigna Healthspring — MCR: $19,956.97
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$4,323
Uterus and ovary surgery (not for cancer), without complications: 10 of 67 insurance plan rates Aetna — AetnaSignatureAdministrators: $22,639.05 Aetna — FirstHealth: $4,323 Aetna — PeakPreference: $13,547.20 Aetna — StandardNetwork: $17,755.66 Aetna — UtahConnectedNetwork: $23,242.03 Bright Health — HIX: $7,426.34 Cigna — Exclusive: $36,419.51 Cigna — LocalPlus: $27,812.77 Cigna — OAPNBN: $31,685 Cigna Healthspring — MCR: $10,726.48

Source: Lakeview Hospital’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	630 East Medical Drive, Bountiful, UT 84010
County	Davis County
State	Utah
Phone	(801) 299‑2200
Emergency services	Yes
Ownership	Voluntary non-profit - Other
Medicare overall rating	5 of 5 stars
CMS Certification Number	460042
Name in Medicare records	LAKEVIEW HOSPITAL
Profile level	Medicare data + hospital website
Official website	mountainstar.com
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Lakeview Hospital — mountainstar.com
Lakeview Hospital specialties — mountainstar.com
Lakeview Hospital | Lakeview Hospital — mountainstar.com
Emergency Care | Lakeview Hospital — mountainstar.com
Imaging Services | Lakeview Hospital — mountainstar.com
Surgery | Lakeview Hospital — mountainstar.com
Awards & Recognition | Lakeview Hospital — mountainstar.com
Cardiology | Lakeview Hospital — mountainstar.com
Orthopedic Care | Lakeview Hospital — mountainstar.com
Women's Care | Lakeview Hospital — mountainstar.com
Behavioral Health | Lakeview Hospital — mountainstar.com
Diagnostics and Laboratory | Lakeview Hospital — mountainstar.com

Lakeview Hospital

Summary

Profile from official sources

At a glance