Primary Children's Hospital
100 North Mario Capecchi Drive, Salt Lake City, UT 84113 · 127 Priced Procedures
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Primary Children's Hospital prices routine shoppable procedures near 2.7× Medicare (p50 0.89×) while skewing captive emergency, lab, and upper-quartile codes to 5.9× Medicare (p75 1.45×, +63% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.57× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 50% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (71.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Captive ER (1.2×) & laboratory (1.3×) services average 2.19× higher multiples than routine shoppable care (2.7×)
- Upper-quartile procedures (Q75 1.45×) jump +63% above the median procedure ratio (Q50 0.89×)
- Unnegotiated chargemaster list prices average 6.8× Medicare (30¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Primary Children's Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 127 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | — | — |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | — | — |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | — | — |
| Trauma team activation HCPCS Code: G0390 | $9,070 | unverified |
| Behavioral health residential care HCPCS Code: H0011 | $4,375 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,155 | unverified |
| C-section delivery (full package) CPT Code: 59510 | $2,572 | 0.9× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,327 | 0.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,071 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,698 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $1,691 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,673 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,465 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,315 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $1,305 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,216 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $941 | unverified |
| Total hip replacement CPT Code: 27130 | $860 | 0.1× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $871 | unverified |
| CT scan, pelvis CPT Code: 72192 | $853 | unverified |
| Injection procedure for pain management HCPCS Code: G0260 | $856 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $779 | 0.3× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $791 | 0.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $814 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $769 | unverified |
Audit a Bill or Quote at Primary Children's Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $168
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (71.2% of gross = $168).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Primary Children's Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,432).
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (71.2% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Primary Children's Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-08-27·administrative_or_closure
Closure Notice
Recorded - 2025-08-13·warning_notice
Warning Notice
Recorded - 2024-06-11·administrative_or_closure
Closure Notice
Recorded - 2024-03-08·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Primary Children's Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.