INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
0434	Occupational Therapy - Evaluation or Reevaluation	—	—	$100	$100	31
97165	Ot eval low complex 30 min	—	—	—	—	30
97166	Ot eval mod complex 45 min	—	—	—	—	30
97167	Ot eval high complex 60 min	—	—	—	—	27
97168	Ot re-eval est plan care	—	—	—	—	27
0430	Occupational Therapy - General Classification	—	—	$39	$90	32
97110	Therapeutic exercises	—	—	—	—	30
97116	Gait training therapy	—	—	—	—	30
97530	Therapeutic activities	—	—	—	—	30
97535	Self care mngment training	—	—	—	—	30
97537	Community/work reintegration	—	—	—	—	27
0424	Physical Therapy - Evaluation or Re-evaluation	—	—	$100	$100	31
97161	Pt eval low complex 20 min	—	—	—	—	30
97162	Pt eval mod complex 30 min	—	—	—	—	30
97163	Pt eval high complex 45 min	—	—	—	—	30
97164	Pt re-eval est plan care	—	—	—	—	30
0420	Physical Therapy - General Classification	—	—	$39	$90	32
97032	Appl modality 1+estim ea 15	—	—	—	—	27
97112	Neuromuscular reeducation	—	—	—	—	30
97113	Aquatic therapy/exercises	—	—	$60	$90	27
97124	Massage therapy	—	—	$60	$90	27
97129	Ther ivntj 1st 15 min	—	—	—	—	27
97140	Manual therapy 1/> regions	—	—	$60	$90	27
0300	Laboratory - General Classification	—	—	—	—	30
0301	Laboratory - Chemistry	—	—	—	—	30
0410	Respiratory Services - General Classification	—	—	—	—	30
0421	Physical Therapy - Visit Charge	—	—	$65	$75	31
97130	Ther ivntj ea addl 15 min	—	—	—	—	27
90935	Hemodialysis one evaluation	—	—	—	—	30
99199	Unlisted special svc px/rprt	—	—	—	—	30
92610	Evaluate swallowing function	—	—	—	—	30
96125	Cognitive test by hc pro	—	—	—	—	27
82945	Glucose other fluid	—	—	—	—	30
11721	Debride nail 6 or more	—	—	—	—	27
97035	App mdlty 1+ultrasound ea 15	—	—	—	—	27
82962	Glucose blood test	—	—	—	—	27
97750	Physical performance test	—	—	—	—	27
71045	X-ray exam chest 1 view	—	—	—	—	30
92609	Use of speech device service	—	—	—	—	27
97542	Wheelchair mngment training	—	—	—	—	27
92612	Endoscopy swallow (fees) vid	—	—	—	—	27
94003	Vent mgmt inpat subq day	—	—	—	—	30
97760	Orthotic mgmt&traing 1st enc	—	—	—	—	27
97014	Electric stimulation therapy	—	—	—	—	27
97763	Orthc/prostc mgmt sbsq enc	—	—	—	—	27
85025	Complete cbc w/auto diff wbc	—	—	—	—	30
95992	Canalith repositioning proc	—	—	—	—	27
80053	Comprehen metabolic panel	—	—	—	—	30
97533	Sensory integration	—	—	—	—	27
80048	Metabolic panel total ca	—	—	—	—	30

Showing top 50 of 5,633 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.