▸ Hospital · ID · CCN 130065
Mountain View Hospital
2325 CORONADO STREET, IDAHO FALLS, ID, 83404-
40 bedsAcute Care Hospitals5
Compliance grade
C
70/100
Procedures tracked
167
of 209 target codes
Payers
9
with negotiated rates
Rates published
3,767
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 9 | $340 | $238 | $255 | $289 | $358.11 |
| Psychotherapy 30 minutes | CPT | 90832 | 9 | $120 | $84 | $90 | $102 | $277.42 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 9 | $205 | $143.5 | $153.75 | $174.25 | $358.11 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 9 | $582 | $407.4 | $300.05 | $494.7 | $529.49 |
| CT head with contrast | CPT | 70460 | 9 | $899 | $629.3 | $602.3 | $755.16 | $809.1 |
| CT head with and without contrast | CPT | 70470 | 9 | $1,003 | $702.1 | $674.28 | $842.52 | $902.7 |
| CT neck with contrast | CPT | 70491 | 9 | $899 | $629.3 | $602.3 | $755.16 | $809.1 |
| MRI brain without contrast | CPT | 70551 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $987.3 |
| MRI brain with contrast | CPT | 70552 | 9 | $1,398 | $978.6 | $1,048.5 | $1,174.32 | $1,258.2 |
| MRI brain with and without contrast | CPT | 70553 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| Chest X-ray single view | CPT | 71045 | 9 | $135 | $94.5 | $66.57 | $114.75 | $121.5 |
| Chest X-ray 2 views | CPT | 71046 | 9 | $240 | $168 | $101.25 | $127.07 | $216 |
| CT chest without contrast | CPT | 71250 | 9 | $582 | $407.4 | $300.05 | $494.7 | $529.49 |
| CT chest with contrast | CPT | 71260 | 9 | $899 | $629.3 | $602.3 | $755.16 | $809.1 |
| CT chest with and without contrast | CPT | 71270 | 9 | $1,003 | $702.1 | $674.28 | $842.52 | $902.7 |
| MRI chest without contrast | CPT | 71550 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $1,071.74 |
| MRI chest with and without contrast | CPT | 71552 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,451.8 | $1,537.2 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $135 | $94.5 | $101.25 | $115.43 | $237.55 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $582 | $407.4 | $300.05 | $494.7 | $529.49 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $720 | $504 | $300.05 | $604.8 | $648 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $582 | $407.4 | $300.05 | $494.7 | $529.49 |
| MRI cervical spine without contrast | CPT | 72141 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $987.3 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $987.3 |
| MRI lumbar spine without contrast | CPT | 72148 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $1,049.99 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 9 | $1,398 | $978.6 | $1,040.15 | $1,174.32 | $1,258.2 |
| MRI cervical spine with and without contrast | CPT | 72156 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| MRI lumbar spine with contrast | CPT | 72158 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| CT pelvis without contrast | CPT | 72192 | 9 | $582 | $407.4 | $300.05 | $488.88 | $523.8 |
| CT pelvis with contrast | CPT | 72193 | 9 | $899 | $629.3 | $594.82 | $755.16 | $809.1 |
| Shoulder X-ray | CPT | 73030 | 9 | $135 | $94.5 | $101.25 | $115.43 | $237.55 |
| Humerus X-ray | CPT | 73060 | 9 | $135 | $94.5 | $101.25 | $115.43 | $148.43 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $135 | $94.5 | $101.25 | $115.43 | $148.43 |
| MRI upper extremity joint without contrast | CPT | 73221 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $987.3 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| Knee X-ray 1-2 views | CPT | 73560 | 9 | $135 | $94.5 | $92.25 | $110.7 | $148.43 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $135 | $94.5 | $90.75 | $108.9 | $237.55 |
| MRI lower extremity joint without contrast | CPT | 73721 | 9 | $1,097 | $767.9 | $716.03 | $852.44 | $1,008.19 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| CT abdomen without contrast | CPT | 74150 | 9 | $582 | $407.4 | $300.05 | $488.88 | $523.8 |
| CT abdomen with contrast | CPT | 74160 | 9 | $899 | $629.3 | $593 | $755.16 | $809.1 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $1,003 | $702.1 | $674.28 | $842.52 | $902.7 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $995 | $696.5 | $592.15 | $835.8 | $895.5 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $1,350 | $945 | $938.93 | $1,147.5 | $1,304.89 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $1,585 | $1,109.5 | $938.93 | $1,331.4 | $1,426.5 |
| MRI abdomen without contrast | CPT | 74181 | 9 | $1,097 | $767.9 | $716.03 | $932.45 | $999.81 |
| MRI abdomen with and without contrast | CPT | 74183 | 9 | $1,708 | $1,195.6 | $1,207.7 | $1,434.72 | $1,537.2 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $347 | $242.9 | $260.25 | $296.69 | $347 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $250 | $175 | $168.75 | $201.25 | $337.13 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $347 | $242.9 | $260.25 | $296.69 | $337.13 |
| Obstetric ultrasound first trimester | CPT | 76801 | 9 | $219 | $153.3 | $161.15 | $186.15 | $337.13 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 9 | $300 | $210 | $225 | $256.5 | $337.13 |
| Transvaginal ultrasound | CPT | 76830 | 9 | $289 | $202.3 | $216.75 | $247.1 | $337.13 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $338 | $236.6 | $197.25 | $236.5 | $337.13 |
| Scrotal ultrasound | CPT | 76870 | 9 | $303 | $212.1 | $201 | $242.4 | $337.13 |
| Diagnostic mammography unilateral | CPT | 77065 | 9 | $223 | $156.1 | $48.75 | $177.65 | $223 |
| Diagnostic mammography bilateral | CPT | 77066 | 9 | $295 | $206.5 | $206.25 | $242.05 | $295 |
| Screening mammography bilateral | CPT | 77067 | 9 | $260 | $182 | $33.75 | $55.25 | $257.08 |
| EKG tracing only | CPT | 93005 | 9 | $187.5 | $131.25 | $48.75 | $90 | $243.26 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $1,320 | $924 | $525 | $990 | $1,310.53 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $1,320 | $924 | $420.65 | $1,122 | $1,310.53 |
| Stress echocardiogram | CPT | 93350 | 9 | $1,836 | $1,285.2 | $420.65 | $1,542.24 | $1,652.4 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 2 | — | — | $21,112 | $21,355 | $21,998 |
| COPD w MCC | MS-DRG | 190 | 2 | — | — | $12,245 | $12,991 | $14,229 |
| COPD w CC | MS-DRG | 191 | 2 | — | — | $8,957.26 | $10,458 | $10,921 |
| COPD w/o CC/MCC | MS-DRG | 192 | 2 | — | — | $7,894.99 | $8,205.19 | $8,653 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 2 | — | — | $9,021.97 | $10,757 | $10,878 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 2 | — | — | $7,080.58 | $7,978.54 | $8,207.26 |
| AMI discharged alive w MCC | MS-DRG | 280 | 2 | — | — | $15,753 | $19,041 | $19,802 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | — | — | $9,379.72 | $11,480 | $11,706 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 2 | — | — | $8,096.45 | $8,478.95 | $8,950.55 |
| Heart failure & shock w MCC | MS-DRG | 291 | 2 | — | — | $16,078 | $16,616 | $16,945 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | — | — | $9,411.47 | $10,891 | $10,992 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 2 | — | — | $7,407.81 | $7,558.91 | $7,953.92 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 2 | — | — | $12,718 | $13,632 | $14,383 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 2 | — | — | $8,463.97 | $8,808.82 | $9,123.83 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | — | — | $5,882.78 | $6,292.18 | $6,719.49 |
| GI hemorrhage w CC | MS-DRG | 378 | 2 | — | — | $8,233.2 | $11,163 | $11,834 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 2 | — | — | $6,455.43 | $7,530.86 | $7,805.74 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 2 | — | — | $7,671.54 | $8,302.8 | $9,027.03 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 2 | — | — | $15,868 | $16,190 | $18,289 |
| Kidney/UTI w MCC | MS-DRG | 689 | 2 | — | — | $12,065 | $12,141 | $13,284 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 2 | — | — | $7,862.02 | $8,783.02 | $9,489.5 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 2 | — | — | $19,806 | $20,113 | $22,184 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 2 | — | — | $9,715.5 | $11,699 | $12,582 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 9 | $32 | $22.4 | $17.27 | $27.2 | $32 |
| General health panel | CPT | 80050 | 9 | $192.5 | $134.75 | $69.53 | $161.71 | $173.25 |
| Electrolyte panel | CPT | 80051 | 9 | $32 | $22.4 | $14.33 | $17.7 | $28.8 |
| Comprehensive metabolic panel | CPT | 80053 | 9 | $73.5 | $51.45 | $21.56 | $35 | $66.15 |
| Lipid panel | CPT | 80061 | 9 | $45 | $31.5 | $23.16 | $33.75 | $40.52 |
| Renal function panel | CPT | 80069 | 9 | $32 | $22.4 | $17.73 | $26.88 | $28.8 |
| Hepatic function panel | CPT | 80076 | 9 | $155.5 | $108.85 | $16.67 | $130.63 | $139.95 |
| Urinalysis non-automated | CPT | 81002 | 9 | $10 | $7 | $5.22 | $8.4 | $9 |
| Urinalysis automated | CPT | 81003 | 9 | $35 | $24.5 | $4.59 | $8.5 | $31.5 |
| Glucose quantitative | CPT | 82947 | 9 | $33.6 | $23.52 | $8.01 | $10.62 | $30.24 |
| Hemoglobin A1c | CPT | 83036 | 9 | $43.05 | $30.14 | $14.28 | $25 | $38.75 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 9 | $62 | $43.4 | $32.12 | $52.7 | $62 |
| Complete blood count with automated differential | CPT | 85025 | 9 | $31.5 | $22.05 | $15.87 | $26.1 | $31.5 |
| Complete blood count without differential | CPT | 85027 | 9 | $20 | $14 | $12.56 | $17 | $20 |
| Urine culture bacterial | CPT | 87086 | 9 | $32 | $22.4 | $16.49 | $27.2 | $29.68 |
| Urine culture identification | CPT | 87088 | 9 | $13 | $9.1 | $9.75 | $11.12 | $16.53 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $100 | $70 | $75 | $85 | $168.27 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 9 | $380 | $266 | $172.21 | $323 | $406.04 |
| C-section delivery only | CPT | 59514 | 9 | $4,239 | $2,967.3 | $3,179.25 | $3,603.15 | $3,815.1 |
| Cesarean section w CC/MCC | MS-DRG | 765 | 1 | — | — | $8,080 | $10,459 | $12,838 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 1 | — | — | $6,060 | $7,409.73 | $8,759.45 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 1 | — | — | $4,545 | $6,485.05 | $8,425.1 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 1 | — | — | $3,687 | $5,133.77 | $6,580.53 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $150 | $105 | $112.5 | $127.5 | $135 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 8 | $225 | $157.5 | $168.75 | $191.25 | $202.5 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $305 | $213.5 | $228.75 | $259.25 | $274.5 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 8 | $400 | $280 | $300 | $340 | $360 |
| Office visit, established patient, 5 min | CPT | 99211 | 9 | $56 | $39.2 | $42 | $47.6 | $56 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 8 | $120 | $84 | $90 | $102 | $108 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 8 | $150 | $105 | $112.5 | $127.5 | $135 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 8 | $225 | $157.5 | $168.75 | $191.25 | $202.5 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 8 | $350 | $245 | $262.5 | $297.5 | $315 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $1,494 | $1,045.8 | $1,120.5 | $1,277.37 | $2,311.36 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | $1,100 | $770 | $825 | $940.5 | $2,311.36 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | $1,082 | $757.4 | $444.35 | $919.7 | $1,530.44 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $803 | $562.1 | $521.72 | $682.55 | $1,530.44 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | $1,225 | $857.5 | $918.75 | $1,047.38 | $2,448.57 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $1,545 | $1,081.5 | $1,158.75 | $1,320.98 | $2,448.57 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | $1,648 | $1,153.6 | $1,236 | $1,409.04 | $2,448.57 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 9 | $7,210 | $5,047 | $5,407.5 | $6,128.5 | $6,489 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 2 | — | — | $32,656 | $36,458 | $38,704 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 2 | — | — | $23,737 | $23,906 | $24,821 |
| Total hip replacement | CPT | 27130 | 9 | $9,641 | $6,748.7 | $5,410.69 | $8,194.85 | $8,676.9 |
| Total knee replacement | CPT | 27447 | 9 | $8,755 | $6,128.5 | $5,777.11 | $7,441.75 | $7,879.5 |
| Knee revision arthroplasty single component | CPT | 27486 | 9 | $5,789 | $4,052.3 | $4,341.75 | $4,920.65 | $5,387.97 |
| Knee revision arthroplasty all components | CPT | 27487 | 9 | $10,300 | $7,210 | $7,070.62 | $8,755 | $9,270 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 9 | $3,619 | $2,533.3 | $2,714.25 | $3,076.15 | $3,257.1 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | $6,180 | $4,326 | $4,635 | $5,283.9 | $13,471 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 9 | $5,150 | $3,605 | $3,862.5 | $4,377.5 | $6,669.87 |
| ACL reconstruction | CPT | 29888 | 9 | $7,210 | $5,047 | $5,407.5 | $6,164.55 | $19,601 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | — | — | $56,896 | $57,251 | $59,663 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 2 | — | — | $24,598 | $28,623 | $30,153 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | — | — | $18,350 | $18,503 | $20,252 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 2 | — | — | $15,702 | $18,607 | $19,887 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | — | — | $13,151 | $14,070 | $15,585 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 2 | — | — | $41,075 | $42,035 | $48,286 |
| Open appendectomy | CPT | 44950 | 9 | $2,524 | $1,766.8 | $1,893 | $2,145.4 | $7,086.32 |
| Laparoscopic appendectomy | CPT | 44970 | 9 | $5,150 | $3,605 | $3,862.5 | $4,403.25 | $11,716 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 2 | — | — | $70,667 | $73,441 | $76,298 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 2 | — | — | $44,562 | $45,450 | $48,248 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | — | — | $32,470 | $36,983 | $37,932 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | — | — | $23,085 | $23,356 | $23,778 |
| Laparoscopic cholecystectomy | CPT | 47562 | 9 | $6,592 | $4,614.4 | $4,944 | $5,636.16 | $11,716 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 9 | $5,356 | $3,749.2 | $4,017 | $4,579.38 | $11,716 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | — | — | $31,940 | $33,649 | $36,213 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | — | — | $22,204 | $22,265 | $24,644 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 2 | — | — | $15,984 | $18,208 | $19,891 |
| Open umbilical hernia repair | CPT | 49560 | 9 | $4,000 | $2,800 | $3,000 | $3,413.67 | $8,293.83 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 9 | $4,326 | $3,028.2 | $3,244.5 | $3,677.1 | $8,293.83 |
| Lap inguinal hernia repair | CPT | 49650 | 9 | $6,798 | $4,758.6 | $4,810.12 | $5,778.3 | $11,716 |
| Lap incisional hernia repair | CPT | 49652 | 9 | $12,270 | $8,589 | $9,202.5 | $10,430 | $16,985 |
| Total abdominal hysterectomy | CPT | 58150 | 9 | $13,390 | $9,373 | $4,809.57 | $11,382 | $12,051 |
| Vaginal hysterectomy | CPT | 58260 | 9 | $5,508 | $3,855.6 | $4,131 | $4,681.8 | $12,335 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 9 | $9,476 | $6,633.2 | $7,107 | $8,062 | $16,985 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 9 | $9,476 | $6,633.2 | $7,107 | $8,096.98 | $11,716 |
| Lap salpingo-oophorectomy | CPT | 58661 | 9 | $6,695 | $4,686.5 | $5,021.25 | $5,724.23 | $11,716 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 2 | — | — | $33,007 | $34,902 | $38,444 |
| OR procedure for obesity w CC | MS-DRG | 620 | 2 | — | — | $20,653 | $21,105 | $21,625 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 2 | — | — | $17,373 | $18,861 | $19,342 |
| Complex cataract surgery | CPT | 66982 | 9 | $2,226 | $1,558.2 | $1,669.5 | $1,892.1 | $5,433.12 |
| Cataract surgery with lens implant | CPT | 66984 | 9 | $722 | $505.4 | $541.5 | $617.31 | $5,433.12 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 2 | — | — | $11,321 | $12,585 | $13,331 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 2 | — | — | $14,659 | $18,907 | $20,199 |
Payer mix (top 9)
| Payer | Codes covered | Median rate |
|---|---|---|
| dmba | 163 | $941.34 |
| Blue Cross Blue Shield | 159 | $1,207.7 |
| first choice | 120 | $422.26 |
| mountain health co-op | 120 | $392.8 |
| Multiplan | 120 | $368.25 |
| three rivers | 120 | $441.9 |
| acpn | 120 | $417.35 |
| UnitedHealthcare | 120 | $407.53 |
| Aetna | 120 | $417.35 |