BEAR LAKE MEMORIAL HOSPITAL (Montpelier, ID) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J9218	LUPRON DEPOT 30MG IM KIT	$9,326	$7,927	—	—	6
78815	NM PET IMAGE W/CT SKULL-THIGH	$6,363	$5,409	—	—	5
23472	ARTHROPLASTY SHOULDER	$5,492	$4,668	—	—	6
58661	LAPROSCOPY W RMVL ADNEXA STRUCTURES	$5,423	$4,610	—	—	6
27447	REPLACEMENT KNEE TOTAL	$5,286	$4,493	—	—	6
27130	TOTAL HIP ARTHOPLASTY	$5,283	$4,490	—	—	6
27245	OPEN TX TROCH FEM FX W/IMPLANT	$4,537	$3,856	—	—	6
23474	REVIS SHLDR ARTHPLST HUM GLEN COMP W ALL	$4,451	$3,783	—	—	6
47563	LAP; CHOLE W/CHOLANIGIOGRAPHY	$4,445	$3,778	—	—	12
23473	REVIS SHLDR ARTHRPLSTY HUM GLEN COMP	$4,437	$3,771	—	—	6
43770	LAPAROSCOPY GASTRIC RSTRC PRO, PLACEMENT	$4,394	$3,735	—	—	6
28496	TX BIG TOE FX	$4,179	$3,552	—	—	6
274	DEVISE GYNECARE TVT 810041	$3,833	$3,258	—	—	5
58572	LAPAROSCOPY SURG W/ TOTAL HYSTERECTOMY	$3,807	$3,236	—	—	6
47562	LAPAROSCOPY; CHOLECYSTECTOMY	$3,801	$3,230	—	—	12
95811	RT SLEEP STUDY CPAP	$3,753	$3,190	—	—	6
27724	REPAIR NON-MALUNION, TIBIA; W/ILIAC	$3,697	$3,142	—	—	6
27759	OPEN TX TIB FX W/IMPLA W/WO SCREWS	$3,642	$3,096	—	—	6
58544	LAP SUPRACERVICAL HYST UTERUS > 250 G	$3,552	$3,019	—	—	6
81201	ADENOMATOUS POLYPOSIS COLI GENE MUTATION	$3,548	$3,016	—	—	6
36561	INSERTION OF TUNNELED CENTRALLY INSERT	$3,510	$2,983	—	—	6
15273	APPLY SKIN GRAFT TO TRUNK 100 SQ CM	$3,469	$2,949	—	—	6
51715	ENDOSCOPIC INJ OF IMPLANT	$3,449	$2,932	—	—	6
74178	CT ABD PELVIS W/WO CONTRAST	$3,440	$2,924	—	—	6
78452	NM MYOCARDIAL PERFUSION SPECT (CHEMICAL	$3,416	$2,904	—	—	6
95810	RT SLEEP STUDY BASELINE	$3,414	$2,901	—	—	6
49000	EXPLORATORY LAPAROTOMY CELIOTOMY	$3,360	$2,856	—	—	6
77074	X RAY BONE SURVEY LIMITED	$3,346	$2,844	—	—	6
21337	CLOSE TX NASAL SEPTAL FX W OR WO STABLZT	$3,324	$2,825	—	—	6
27535	OPEN TREATMENT OF TIBIAL FRACTURE, PROXI	$3,323	$2,825	—	—	6
29828	ARTHROSCOPY, SHLDR, BICEPS TENODESIS	$3,319	$2,821	—	—	6
81432	VISTASEQ BREAST AND GYN CANCER PANEL	$3,300	$2,805	—	—	5
58543	LAPROSCOPY SUPRACERVICAL HYSTERECTOMY	$3,285	$2,792	—	—	6
23465	CAPSUL-RECUR.DISLOC,POST,W/WO BLOCK	$3,259	$2,770	—	—	6
27758	OP TX TIBIAL SHFT FX W/PLA/SCR W/WO CERC	$3,218	$2,735	—	—	6
74177	CT ABD PELVIS W/ CONTRAST	$3,184	$2,706	—	—	6
23460	CAPSUL-RECUR.DISLOC,ANY;BONE BLOCK	$3,169	$2,694	—	—	6
24430	REPAIR NON/MALUNION HUMERUS	$3,147	$2,675	—	—	6
25609	ORIF DISTAL RADIUS	$3,141	$2,669	—	—	6
29827	ARTHROSCOPY, SHLDR, W/ ROTATOR CUFF	$3,117	$2,649	—	—	6
J3424	CYANOKIT STARTING DOSE	$3,079	$2,617	—	—	5
58570	LAPAROSCOPY SURG W/ TOTAL HYSTERECTOMY	$3,079	$2,617	—	—	6
70553	MR BRAIN W/WO CONTRAST	$3,060	$2,601	—	—	6
27822	OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRA	$3,050	$2,592	—	—	6
72157	MR SPINE THORACIC W/WO CONTRAST	$3,049	$2,591	—	—	6
72158	MR SPINE LUMBAR W/WO CONTRAST	$3,049	$2,591	—	—	6
29807	ARTHOSCOPY SHLDR SURG RPR SLAP LESION	$3,002	$2,552	—	—	6
58571	LAP SURG W/ TOTAL HYST UTERUS 250G OR <	$2,981	$2,533	—	—	6
24586	OPEN PERIARTIC FRACT/DIS	$2,954	$2,511	—	—	6
57410	PELVIC EXAM UNDER ANESTHESIA	$2,942	$2,500	—	—	6

Showing top 50 of 2,053 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.