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Acute Care Hospitals
MountainView Hospital
4.0
Financial Assistance
You May Qualify for Free or Discounted Care
- May qualify for free care with family-of-4 income up to $64,300/yr
- May qualify for discounted care with family-of-4 income up to $128,600/yr
- Processing Time: Typically 14–30 days.
- Required Documents: 6
ProcedureScout is independent — we are not paid by hospitals, financial assistance programs, applications, or referrals. Whether you qualify depends on each hospital's rules and a final review.
All Procedure Prices
Insurance:
| Procedure | CPT | Price |
|---|---|---|
| Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography | 22080 | $10,574 |
| ROD LEGACY 5.5MM X 500MM | 27130 | $23,042 |
| PLATE VARIAX CLAV SUP MIDSHAFT TI STD 10H 122MM RT | 29881 | $5,047 |
| Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene r | 301 | $112 |
| CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | 306 | $321 |
| PR ANES ESOPH THYRD LARYNX TRACH & LYMPH NECK 1YR | 320 | $14,380 |
| Parathyroid planar imaging (including subtraction, when performed); | 341 | $13,270 |
| Lead, pacemaker, transvenous vdd single pass | 35308 | $5,859 |
| Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-em | 38009 | $1,198 |
| Injection, haloperidol decanoate, per 50 mg | 39335 | $218 |
| SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL | 402 | $3,523 |
| Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg | 412269 | $100 |
| Ultrasonic guidance for amniocentesis, imaging supervision and interpretation | 429051 | $3,523 |
| Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative proces | 463064 | $11,447 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 463070 | $11,102 |
| Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years | 510487 | $1,107 |
| Intracavitary radiation source application; simple | 511390 | $827 |
| DEVICE EXCHANGE TRAPPER 97CM X 10MM X 10MM X 0.014IN | 59400 | $5,212 |
| IMPLANT BREAST SMOOTHSILK ROUND MINI 310CC | 59510 | $7,955 |
| Rho(D) immune globulin (RhIgIV), human, for intravenous use | 636 | $106 |
| MRI IAC W/O CONTRAST | 70551 | $988 |
| Injection, glatiramer acetate, 20 mg | 712142 | $4,099 |
| Injection, amiodarone hydrochloride (nexterone), 30 mg | 713324 | $106 |
| Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist | 724010 | $9,418 |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation | 727019 | $14,380 |
| Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella | 736012 | $321 |
| Lacosamide | 736123 | $112 |
| Stem cells (ie, CD34), total count | 736247 | $420 |
| MRI EXT LOW JNT W/O CON RT LTD | 73721 | $823 |
| CT ABD PELVIS W/CON | 74177 | $933 |
| Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube | 754007 | $917 |
| Plethysmography for determination of lung volumes and, when performed, airway resistance | 754020 | $1,988 |
| Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation Facility Cardiovascular Thorac | 75889 | $14,380 |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», w | 763040 | $31,234 |
| Ultrasonic guidance for amniocentesis, imaging supervision and interpretation Facility | 76946 | $3,523 |
| Intracavitary radiation source application; simple | 77761 | $827 |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or ejection fractionºs», w | 78492 | $31,234 |
| Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative proces | 78494 | $11,447 |
| Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), in | 786005 | $1,081 |
| Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography Facility Colon and Rectal Surgery | 78630 | $10,574 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 78800 | $11,102 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 78802 | $13,270 |
| Lacosamide | 80235 | $112 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 83784 | $13,270 |
| Stem cells (ie, CD34), total count | 86367 | $420 |
| Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella | 87507 | $321 |
| Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years | 90732 | $1,107 |
| TTE W/DOPPLER COMPLETE | 93306 | $658 |
| Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube | 94610 | $917 |
| Plethysmography for determination of lung volumes and, when performed, airway resistance | 94726 | $1,988 |
| Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist | 95810 | $9,418 |
| Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), in | 95990 | $1,081 |
| Lead, pacemaker, transvenous vdd single pass | C1779 | $5,859 |
| Injection, amiodarone hydrochloride (nexterone), 30 mg Non-facility Midlevel | J0283 | $106 |
| GLATIRAMER ACETATE 20MG KIT | J1595 | $4,099 |
| HALOPERIDOL DEC (GN) 50MG/1ML | J1631 | $218 |
| Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg | J7614 | $100 |
| Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-em | Q0166 | $1,198 |