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Mountain West Medical Center

Utah · 1,500 published self-pay prices, from $49.71 to $35,400.

These items are published without a standard CPT or HCPCS code, so they cannot be reliably matched against the same service at another hospital. They are shown exactly as this facility published them, and are excluded from every median, average and comparison elsewhere on this site.

Showing the 300 lowest-priced of 1,500 published items.

ItemCash priceSetting
17-hydroxypregnenolone (hormone) level$98.32Outpatient
2019-NCOV CORONAVIRUS, SARS-COV-2/2019-NCOV (COVID-19), ANY TECHNIQUE, MULTIPLE TYPES OR SUBTYPES (INCLUDES ALL TARGETS), NON-CDC$96.52Outpatient
3D radiographic procedure with computerized image postprocessing$452Outpatient
AA5 D25W-LYTES-CA 2L$133Outpatient
ACETYLCHOL INTR 20MG$91.99Outpatient
ACETYLCHOLINE KIT OP$91.99Outpatient
Activated protein resistance assay$250Outpatient
Acute hepatitis panel$254Outpatient
ACYCLOVIR 5% OINTMENT$76.14Outpatient
Adenosine, 5-monophosphate, cyclic (cyclic AMP) level$208Outpatient
ADH (antidiuretic hormone) level$719Outpatient
ADHESION BARRIER$76.58Outpatient
Administration of chemotherapy into vein, 1 hour or less$489Outpatient
Administration of chemotherapy into vein, each additional hour$93.08Outpatient
Adrenocorticotropic hormone (ACTH) level$132Outpatient
Alcohols levels, 1 or 2$116Outpatient
Aldolase (enzyme) level$287Outpatient
Aldosterone hormone level$102Outpatient
Alkaloids levels$60.00Outpatient
Alpha-1-antitrypsin (protein) blood test, phenotype$60.97Outpatient
Alpha-1-antitrypsin (protein) blood test, total$288Outpatient
Alpha-fetoprotein (AFP) analysis$107Outpatient
Alpha-fetoprotein (AFP) level, amniotic fluid$327Outpatient
Alpha-fetoprotein (AFP) level, serum$60.02Outpatient
Aluminum level$119Outpatient
AMIDATE 20 MG/10 ML VIAL$80.36Outpatient
Amikacin (antibiotic) level$238Outpatient
Amino acid level, 6 or more amino acids, quantitative, each specimen$52.97Outpatient
Aminolevulinic acid (protein) level$121Outpatient
AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE$1,013Outpatient
Amphetamines levels, 1 or 2$234Outpatient
Amphetamines levels, 3 or 4$258Outpatient
Amphetamines levels, 5 or more$105Outpatient
Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen$132Outpatient
Amplifed DNA probe detection of 20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative bacterial target, and 1 pan Candida target in blood culture specimen$223Outpatient
Amplifed DNA probe detection of 20 gram-positive bacterial targets, 6 resistance genes, 1 pan gram-negative bacterial target, and 1 pan Candida target in blood culture specimen$223Outpatient
Amplifed DNA probe detection of fungus in blood culture specimen$223Outpatient
Analysis for antibody (IgM) to Cytomegalovirus (CMV)$252Outpatient
Analysis for antibody (IgM) to Toxoplasma (parasite)$267Outpatient
Analysis for antibody (IgM) to West Nile virus$49.73Outpatient
Analysis for antibody bordetella (respiratory bacteria)$77.55Outpatient
Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)$283Outpatient
Analysis for antibody to aspergillus (fungus)$82.12Outpatient
Analysis for antibody to blastomyces (fungus)$157Outpatient
Analysis for antibody to Brucella (bacteria)$157Outpatient
Analysis for antibody to Coccidioides (bacteria)$151Outpatient
Analysis for antibody to Coxiella burnetii (Q fever bacteria)$407Outpatient
Analysis for antibody to Cytomegalovirus (CMV)$220Outpatient
Analysis for antibody to Diphtheria (bacteria)$174Outpatient
Analysis for antibody to Eastern equine virus (viral encephalitis)$164Outpatient
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen$81.93Outpatient
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen$94.69Outpatient
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid$90.12Outpatient
Analysis for antibody to fungus$72.00Outpatient
Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)$180Outpatient
Analysis for antibody to helminth (intestinal worm)$554Outpatient
Analysis for antibody to Hepatitis D virus$271Outpatient
Analysis for antibody to Herpes simplex virus$220Outpatient
Analysis for antibody to Herpes simplex virus, type 1$272Outpatient
Analysis for antibody to Herpes simplex virus, type 2$284Outpatient
Analysis for antibody to histoplasma (fungus)$113Outpatient
Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)$786Outpatient
Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)$222Outpatient
Analysis for antibody to La crosse (California) virus (encephalitis causing virus)$164Outpatient
Analysis for antibody to Legionella (waterborne bacteria)$252Outpatient
Analysis for antibody to Leptospira$231Outpatient
Analysis for antibody to Listeria monocytogenes (bacteria)$120Outpatient
Analysis for antibody to mumps virus$202Outpatient
Analysis for antibody to Mycoplasma (bacteria)$222Outpatient
Analysis for antibody to protozoa (parasite)$65.67Outpatient
Analysis for antibody to Rickettsia (bacteria)$145Outpatient
Analysis for antibody to St. Louis virus (viral encephalitis)$168Outpatient
Analysis for antibody to tetanus bacteria (Clostridium tetanus)$234Outpatient
Analysis for antibody to Toxoplasma (parasite)$296Outpatient
Analysis for antibody to varicella-zoster virus (chicken pox)$103Outpatient
Analysis for antibody to virus$276Outpatient
Analysis for antibody to West Nile virus$49.73Outpatient
Analysis for antibody to Yersinia (bacteria)$339Outpatient
Analysis for antibody, Treponema pallidum$63.00Outpatient
Analysis for detection of tumor marker$81.35Outpatient
Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report$2,803Outpatient
Analysis of voice and resonance production$303Outpatient
Analysis test by nucleic acid for hepatitis b virus$481Outpatient
Analysis test by nucleic acid for Hepatitis C virus$763Outpatient
Analysis test by nucleic acid for HIV-1 virus, first through 10 drugs tested$435Outpatient
ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE)$63.00Outpatient
Androstanediol glucuronide (hormone) level$90.31Outpatient
Androstenedione (hormone) level$288Outpatient
ANES LV 1 INI 15 MIN$900Outpatient
ANES LV 2 INI 15 MIN$1,349Outpatient
ANES LV 3 INI 15 MIN$1,799Outpatient
ANES LV 4 EA ADD MIN$61.18Outpatient
ANES LV 4 INI 15 MIN$2,251Outpatient
Angiotensin l - converting enzyme (ACE) level$288Outpatient
Antibody identification test for white blood cell antibodies$119Outpatient
Antibody identification test, platelet antibodies$482Outpatient
Antibody identification test, platelet associated immunoglobulin assay$232Outpatient
Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)$304Outpatient
Antidepressants levels, 3-5 (tricyclic and other cyclicals)$335Outpatient
Antidepressants levels, 6 or more (tricyclic and other cyclicals)$402Outpatient
Antithrombin III antigen (clotting inhibitor) activity$129Outpatient
Antithrombin III antigen (clotting inhibitor) level$304Outpatient
Application of hot wax bath$94.27Outpatient
Application of medication using electrical current, each 15 minutes$76.58Outpatient
Application of stress by physician for joint imaging$531Outpatient
Application of ultrasound, each 15 minutes$82.78Outpatient
APRI 28 DAY TABLET$59.23Outpatient
Arsenic level$103Outpatient
Ascorbic acid (Vitamin C) level, blood$288Outpatient
Aspiration and/or injection of fluid from medium joint$172Outpatient
Aspiration and/or injection of fluid from small joint$194Outpatient
Aspiration of fluid from chest cavity using imaging guidance$1,083Outpatient
Assessment of blood clotting function$331Outpatient
ASTIGMATISM CORRECTING FUNCTION OF INTRAOCULAR LENS$298Outpatient
Automated white blood cell count$71.64Outpatient
Bacterial blood culture$211Outpatient
Bacterial culture for aerobic isolates$270Outpatient
Bacterial culture for anaerobic isolates$168Outpatient
Bacterial culture, any other source except urine, blood or stool, aerobic$162Outpatient
Bacterial culture, any source, except blood, anaerobic$203Outpatient
Bacterial urine culture$82.12Outpatient
BARICITINIB 2MG TAB$141Outpatient
BELLADON/OPIUM SUPPO$50.18Outpatient
BENZ14-BUT2-TET2 60G$167Outpatient
Benzodiazepines levels, 1-12$226Outpatient
Benzodiazepines levels, 13 or more$105Outpatient
BETAXOLOL HCL 0.5% EYE DROP$158Outpatient
Bile acids level, total$246Outpatient
Bilirubin level, direct$113Outpatient
Blood chloride level$113Outpatient
Blood clot evaluation, (retraction time)$107Outpatient
Blood count, hemoglobin$69.36Outpatient
Blood creatinine level$96.41Outpatient
Blood gases measurement, with O2 saturation$443Outpatient
Blood glucose (sugar) level after receiving dose of glucose$113Outpatient
Blood glucose (sugar) tolerance test, 3 specimens$174Outpatient
Blood glucose (sugar) tolerance test, each additional beyond 3 specimens$61.36Outpatient
Blood osmolality (concentration) measurement$142Outpatient
Blood pH level$113Outpatient
Blood potassium level$113Outpatient
Blood sodium level$113Outpatient
Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)$86.69Outpatient
Blood test panel for obstetrics ( cbc, differential wbc count, hepatitis b, hiv, rubella, syphilis, antibody screening, rbc, blood typing)$119Outpatient
Blood test, basic group of blood chemicals (Calcium, total)$147Outpatient
Blood test, clotting time, substitution$60.97Outpatient
Blood test, comprehensive group of blood chemicals$70.80Outpatient
Blood typing for paternity testing, each additional antigen system$70.50Outpatient
Blood typing for red blood cell antigens$161Outpatient
Blood typing Rh phenotyping$70.50Outpatient
Blood unit compatibility test, antiglobulin technique$257Outpatient
Blood viscosity measurement$175Outpatient
BLOOD, SPLIT UNIT$207Outpatient
Body fluid cell count$96.03Outpatient
Body fluid cell count with cell identification$106Outpatient
Body fluid pH level$113Outpatient
BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)$805Outpatient
Bone marrow, smear interpretation$495Outpatient
BR-BRST BX LOC CLP 1$1,506Outpatient
BR-BRST BX LOC CLP A$279Outpatient
BR-PLC LOC DVCE 1ST$597Outpatient
BR-PLC LOC DVCE ADD$418Outpatient
BRAIN IMAGING, TOMOGRAPHIC (SPECT)$2,269Outpatient
Breath test analysis for helicobacter pylori$136Outpatient
BRIDION 200 MG/2 ML VIAL$207Outpatient
BRIMONIDIN .1%OS 5ML$190Outpatient
BROMFENAC .09%OS 5ML$199Outpatient
BUPIVACAINE .5% 50ML$51.82Outpatient
BUPIVAVAINE .5% 30ML$51.82Outpatient
Buprenorphine level$93.91Outpatient
C-peptide (protein) level$299Outpatient
Cadmium level$339Outpatient
Calcitonin (hormone) level$252Outpatient
Calcium level, ionized$54.00Outpatient
Calcium level, total$54.00Outpatient
CANDIN SKIN TEST$81.01Outpatient
Carbamazepine level, total$165Outpatient
Carbohydrate (sugar) analysis$234Outpatient
Carbohydrate analysis, single qualitative$113Outpatient
Carbohydrate analysis, single quantitative$60.00Outpatient
Carbon dioxide (bicarbonate) level$113Outpatient
CARBOPROST 250MCG/ML$416Outpatient
Carboxyhemoglobin (protein) level$164Outpatient
Carcinoembryonic antigen (CEA) protein level$268Outpatient
Carnitine level$213Outpatient
Carotene level$288Outpatient
Catecholamines (organic nitrogen) level$377Outpatient
CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)$12,375Outpatient
CATHETER, SUPRAPUBIC/CYSTOSCOPIC$122Outpatient
CATHETER, THROMBECTOMY/EMBOLECTOMY$2,931Outpatient
CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)$308Outpatient
CBC W-MANUAL DIFF$98.32Outpatient
CC-ILIAC ANG W-CATH$141Outpatient
CDC 2019 NOVEL CORONAVIRUS (2019-NCOV) REAL-TIME RT-PCR DIAGNOSTIC PANEL$67.57Outpatient
Cell examination of body fluid, simple filter method$83.26Outpatient
Cell examination of body fluid, smears$372Outpatient
Cell examination of specimen, selective cellular enhancement technique$160Outpatient
Cell-based immunofluorescence (CBA) detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody$120Outpatient
Cell-based immunofluorescence (CBA) detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody$120Outpatient
Cerebrospinal fluid, or amniotic fluid albumin (protein) level$60.00Outpatient
Ceruloplasmin (protein) level$288Outpatient
Cervicovaginal secretion of placenta protein$239Outpatient
CERVIDIL 10 MG VAGINAL INSRT$566Outpatient
Chemical receptor analysis$165Outpatient
Chemical test for genetic disorder$383Outpatient
Chemistry procedures$162Outpatient
Chloramphenicol level$327Outpatient
Chloride level$146Outpatient
Cholinesterase (enzyme) level$177Outpatient
Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease$177Outpatient
Chromosome analysis for genetic defects, analyze 100-300 cells$317Outpatient
Chromosome analysis for genetic defects, count 15-20 cells$240Outpatient
Chromosome analysis for genetic defects, count 45 cells for mosaicism$360Outpatient
CISATRACURIUM 200 MG/20 ML VL$177Outpatient
CLIND 18MG/ML D5W 50$56.06Outpatient
CLINIMIX E 4.25%-5% SOLUTION$122Outpatient
CLINIMIX E 5%-20% SOLUTION$132Outpatient
CLONIDINE-TTS-2 .2MG$93.05Outpatient
CLONIDINE-TTS-3 .3MG$129Outpatient
CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)$907Outpatient
Clotting factor II prothrombin, measurement$112Outpatient
Clotting factor IX (PTC or Christmas) measurement$584Outpatient
Clotting factor V (AcG or proaccelerin) measurement$337Outpatient
Clotting factor VII (proconvertin, stable factor)$392Outpatient
Clotting factor VIII (AHG) measurement$248Outpatient
Clotting factor VIII (von Willebrand factor) measurement$210Outpatient
Clotting factor VIII (VW factor) antigen$316Outpatient
Clotting factor VIII (VW factor) measurement$597Outpatient
Clotting factor X (Stuart-Prower) measurement$119Outpatient
Clotting factor X assessment test, diluted$75.00Outpatient
Clotting factor XI (PTA) measurement$566Outpatient
Clotting factor XII (Hageman) measurement$585Outpatient
Clotting factor XIII (fibrin stabilizing) measurement$136Outpatient
Coagulation assessment blood test, plasma or whole blood$75.00Outpatient
Coagulation assessment blood test, substitution, plasma fractions$75.00Outpatient
Coagulation function analysis, agglutination slide, semiquantitative$223Outpatient
Coagulation function measurement, D-dimer; quantitative$242Outpatient
COBALT CO-57 CYANOCOBALAMIN, ORAL, DIAGNOSTIC, PER STUDY DOSE, UP TO 1 MICROCURIE$501Outpatient
COCAINE 4% 4ML SOLN$344Outpatient
Cocaine level$445Outpatient
COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS$85.55Outpatient
Complete blood cell count (red cells, white blood cell, platelets), automated test$87.83Outpatient
Complete ultrasound of abdomen and pelvis artery and vein blood flow$417Outpatient
Complete ultrasound scan behind abdominal cavity$1,331Outpatient
Complete ultrasound scan of 1 breast$982Outpatient
Complete ultrasound scan of abdomen$1,472Outpatient
Complete ultrasound scan of joint$1,077Outpatient
Complete ultrasound scan of pelvis$556Outpatient
Complete ultrasound study of arm and leg arteries$323Outpatient
Complete X-ray of body bones$531Outpatient
Concentration of specimen for infectious agents$54.49Outpatient
Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria)$60.00Outpatient
Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV$119Outpatient
Confirmation test for Hepatitis C antibody$168Outpatient
CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)$375Outpatient
CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)$300Outpatient
Copper level$288Outpatient
Corticosterone (hormone) level$345Outpatient
Cortisol (hormone) measurement, free$72.41Outpatient
Cortisol (hormone) measurement, total$60.00Outpatient
COVID19 21 TRGTS PRB$223Outpatient
Creatine kinase (cardiac enzyme) level, isoenzymes$234Outpatient
Creatine kinase (cardiac enzyme) level, MB fraction only$339Outpatient
Creatine kinase (cardiac enzyme) level, total$113Outpatient
Creatine measurement$145Outpatient
Creatinine clearance measurement to test for kidney function$234Outpatient
Critical care, each additional 30 minutes$510Both
Critical care, first 30-74 minutes$4,358Both
Cryoglobulin (protein) measurement$243Outpatient
CRYOPRECIPITATE, EACH UNIT$96.98Outpatient
Crystal identification from tissue or body fluid$103Outpatient
CT scan for measuring calcium and other minerals in bone$217Outpatient
CT scan head or brain with contrast$1,868Outpatient
CT scan head or brain without contrast$1,783Outpatient
CT scan of abdomen and pelvis before and after contrast$3,236Outpatient
CT scan of abdomen and pelvis with contrast$3,027Outpatient
CT scan of abdomen and pelvis without contrast$2,918Outpatient
CT scan of abdomen before and after contrast$1,634Outpatient
CT scan of abdomen with contrast$1,528Outpatient
CT scan of abdomen without contrast$1,423Outpatient
CT scan of abdominal aorta and both leg arteries with contrast$863Outpatient
CT scan of arm with contrast$2,030Outpatient
CT scan of arm without contrast$1,849Outpatient
CT scan of blood vessels and grafts of heart with contrast$1,530Outpatient
CT scan of blood vessels of abdomen and pelvis with contrast$1,568Outpatient
CT scan of blood vessels of abdomen with contrast$784Outpatient
CT scan of blood vessels of arm with contrast$559Outpatient
CT scan of blood vessels of chest with contrast$2,204Outpatient
CT scan of blood vessels of head with contrast$784Outpatient
CT scan of blood vessels of lower leg with contrast$492Outpatient
CT scan of blood vessels of neck with contrast$864Outpatient
CT scan of blood vessels of pelvis with contrast$784Outpatient
CT scan of chest before and after contrast$1,899Outpatient
CT scan of chest with contrast$1,785Outpatient
CT scan of chest without contrast$1,899Outpatient
CT scan of congenital heart disease with contrast$900Outpatient
CT scan of cranial cavity before and after contrast$2,252Outpatient
CT scan of cranial cavity with contrast$2,223Outpatient
CT scan of cranial cavity without contrast$1,846Outpatient
CT scan of face before and after contrast$2,522Outpatient
CT scan of face with contrast$1,970Outpatient

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