Shoppable Services at McKay-Dee Hospital

General Disclosure

The two lists of standard charges displayed represent the pricing information for medical items and services required by the federal Hospital Price Transparency Rule. The pricing information does not necessarily reflect your financial responsibility for your hospital visit, for several reasons, including:

  • The listings reflect prices paid by your insurer for services provided during your hospital visit, which may not reflect your share of the costs for these services under the terms of your health plan.
  • The prices for your insurer are only available if your insurer covers the medical items or services under the terms of your health plan.
  • The actual medical items, including medications, and services that are furnished to you during your visit may vary from what is anticipated.
  • You may receive services or supplies from physicians, practitioners or contractors who are not employed by this hospital; the prices for such services or supplies are not listed here.
  • Your insurer may not be contracted with this hospital for all services. The posted prices will not apply to services for which your insurer has not contracted.

These listings do not guarantee pricing, coverage, benefits, or payments. Your financial liability will be based on the medical items and services billed by the hospital, the terms of your insurance policy, and the status of your benefits (i.e., deductibles, out of pocket maximum, co-insurance, and copays) at the time you receive care. Your eligibility and the amounts covered by your insurance are solely determined by your health insurance provider.

We encourage you to contact a Hospital Cost Estimation Specialist at (855) 442-8601 or INTCostEstimate@R1RCM.com or your insurer to obtain more precise information regarding your potential financial liability.

CDM Bill Item Service Code Service Description Payer Plan Name Inpatient Cash Price Inpatient Min Price Inpatient Max Price Inpatient Negotiated Price Outpatient Cash Price Outpatient Min Price Outpatient Max Price Outpatient Negotiated Price Charge Price
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Select $161.75 $56.94 $197.10 $122.72 $161.75 $56.94 $197.10 $122.72 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Provider Networks of America Provider Networks of America (PNOA) $164.25 $56.94 $197.10 $164.25 $164.25 $56.94 $197.10 $164.25 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Provider Networks of America Provider Networks of America (PNOA) $161.75 $56.94 $197.10 $161.75 $161.75 $56.94 $197.10 $161.75 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Provider Networks of America Provider Networks of America (PNOA) $164.25 $56.94 $197.10 $164.25 $164.25 $56.94 $197.10 $164.25 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Prodegi Corporate Benefit Services, LLC Prodegi Corporate Benefit Services, LLC $164.25 $56.94 $197.10 $179.58 $164.25 $56.94 $197.10 $179.58 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Prodegi Corporate Benefit Services, LLC Prodegi Corporate Benefit Services, LLC $164.25 $56.94 $197.10 $179.58 $164.25 $56.94 $197.10 $179.58 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Prodegi Corporate Benefit Services, LLC Prodegi Corporate Benefit Services, LLC $161.75 $56.94 $197.10 $176.85 $161.75 $56.94 $197.10 $176.85 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Petersen, Inc. Petersen, Inc. $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Petersen, Inc. Petersen, Inc. $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Petersen, Inc. Petersen, Inc. $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Care $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Preferred Care $164.25 $56.94 $197.10 $194.91 $164.25 $56.94 $197.10 $194.91 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care State Employees and Advantage Care Exclusive $161.75 $56.94 $197.10 $150.75 $161.75 $56.94 $197.10 $150.75 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care State Employees and Advantage Care Exclusive $164.25 $56.94 $197.10 $153.08 $164.25 $56.94 $197.10 $153.08 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care State Employees and Advantage Care Exclusive $164.25 $56.94 $197.10 $153.08 $164.25 $56.94 $197.10 $153.08 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Care $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Preferred Care $161.75 $56.94 $197.10 $191.95 $161.75 $56.94 $197.10 $191.95 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Care $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Capital Care $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Capital Care $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Capital Care $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Exclusive $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Exclusive $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Summit Exclusive $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Preferred Care $164.25 $56.94 $197.10 $194.91 $164.25 $56.94 $197.10 $194.91 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care - Non State $164.25 $56.94 $197.10 $156.80 $164.25 $56.94 $197.10 $156.80 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care - Non State $161.75 $56.94 $197.10 $154.42 $161.75 $56.94 $197.10 $154.42 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man PEHP PEHP Advantage Care - Non State $164.25 $56.94 $197.10 $156.80 $164.25 $56.94 $197.10 $156.80 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MotivHealth MotivHealth $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MotivHealth MotivHealth $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MotivHealth MotivHealth $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina CHIP $164.25 $56.94 $197.10 $180.68 $164.25 $56.94 $197.10 $180.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina Marketplace $164.25 $56.94 $197.10 $180.68 $164.25 $56.94 $197.10 $180.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina Marketplace $164.25 $56.94 $197.10 $180.68 $164.25 $56.94 $197.10 $180.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina CHIP $164.25 $56.94 $197.10 $180.68 $164.25 $56.94 $197.10 $180.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina CHIP $161.75 $56.94 $197.10 $177.93 $161.75 $56.94 $197.10 $177.93 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Molina Healthcare of Utah Molina Marketplace $161.75 $56.94 $197.10 $177.93 $161.75 $56.94 $197.10 $177.93 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MedCare International, Inc. MedCare International, Inc. $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MedCare International, Inc. MedCare International, Inc. $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man MedCare International, Inc. MedCare International, Inc. $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Management and Training Corporation (MTC) - for Clearfield Job Corps $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Management and Training Corporation (MTC) - for Clearfield Job Corps $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Management and Training Corporation (MTC) - for Clearfield Job Corps $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Managed Care Administrators, Inc. Managed Care Administrators, Inc. $161.75 $56.94 $197.10 $168.22 $161.75 $56.94 $197.10 $168.22 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Managed Care Administrators, Inc. Managed Care Administrators, Inc. $164.25 $56.94 $197.10 $170.82 $164.25 $56.94 $197.10 $170.82 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Managed Care Administrators, Inc. Managed Care Administrators, Inc. $164.25 $56.94 $197.10 $170.82 $164.25 $56.94 $197.10 $170.82 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man LW Miller LW Miller $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man LW Miller LW Miller $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man LW Miller LW Miller $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Juniper Systems Juniper Systems $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Juniper Systems Juniper Systems $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Juniper Systems Juniper Systems $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Inovar Inovar $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Inovar Inovar $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Inovar Inovar $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Injury Care of Nevada Injury Care of Nevada $161.75 $56.94 $197.10 $161.75 $161.75 $56.94 $197.10 $161.75 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Injury Care of Nevada Injury Care of Nevada $164.25 $56.94 $197.10 $164.25 $164.25 $56.94 $197.10 $164.25 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Injury Care of Nevada Injury Care of Nevada $164.25 $56.94 $197.10 $164.25 $164.25 $56.94 $197.10 $164.25 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Icon Health Fitness Icon Health Fitness $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Icon Health Fitness Icon Health Fitness $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Icon Health Fitness Icon Health Fitness $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Hygeia Corporation Hygeia Corporation $164.25 $56.94 $197.10 $197.10 $164.25 $56.94 $197.10 $197.10 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Hygeia Corporation Hygeia Corporation $164.25 $56.94 $197.10 $197.10 $164.25 $56.94 $197.10 $197.10 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Hygeia Corporation Hygeia Corporation $161.75 $56.94 $197.10 $194.10 $161.75 $56.94 $197.10 $194.10 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Humana Humana ChoiceCare $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Humana Humana ChoiceCare $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Humana Humana ChoiceCare $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $164.25 $56.94 $197.10 $170.82 $164.25 $56.94 $197.10 $170.82 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $161.75 $56.94 $197.10 $168.22 $161.75 $56.94 $197.10 $168.22 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man HealthSCOPE Benefits, Inc. HealthSCOPE Benefits, Inc. $164.25 $56.94 $197.10 $170.82 $164.25 $56.94 $197.10 $170.82 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Health Utah Health Utah $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Health Utah Health Utah $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Health Utah Health Utah $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Global Excel Global Excel $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Global Excel Global Excel $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Global Excel Global Excel $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Medical Center Franklin County Medical Center $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Medical Center Franklin County Medical Center $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Medical Center Franklin County Medical Center $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Franklin County $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Franklin County $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Franklin County Franklin County $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Network Care $164.25 $56.94 $197.10 $151.99 $164.25 $56.94 $197.10 $151.99 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Choice $161.75 $56.94 $197.10 $183.32 $161.75 $56.94 $197.10 $183.32 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Choice $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Network Care $161.75 $56.94 $197.10 $149.67 $161.75 $56.94 $197.10 $149.67 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Choice $164.25 $56.94 $197.10 $186.15 $164.25 $56.94 $197.10 $186.15 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health Network Care $164.25 $56.94 $197.10 $151.99 $164.25 $56.94 $197.10 $151.99 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health $161.75 $56.94 $197.10 $144.50 $161.75 $56.94 $197.10 $144.50 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health $164.25 $56.94 $197.10 $146.73 $164.25 $56.94 $197.10 $146.73 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man EMI Health EMI Health $164.25 $56.94 $197.10 $146.73 $164.25 $56.94 $197.10 $146.73 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Dixie State University Dixie State University $161.75 $56.94 $197.10 $155.28 $161.75 $56.94 $197.10 $155.28 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Dixie State University Dixie State University $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Dixie State University Dixie State University $164.25 $56.94 $197.10 $157.68 $164.25 $56.94 $197.10 $157.68 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Select $164.25 $56.94 $197.10 $124.61 $164.25 $56.94 $197.10 $124.61 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Value $164.25 $56.94 $197.10 $136.00 $164.25 $56.94 $197.10 $136.00 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Value $161.75 $56.94 $197.10 $133.93 $161.75 $56.94 $197.10 $133.93 $215.67
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Select $164.25 $56.94 $197.10 $124.61 $164.25 $56.94 $197.10 $124.61 $219.00
99385 1025766 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS / Initial Comp Preventive Med 18 to 39 years New 99385 / Initial comprehensive preventive medicine evaluation and man Deseret Mutual DMBA Deseret Premier $164.25 $56.94 $197.10 $136.00 $164.25 $56.94 $197.10 $136.00 $219.00