Physician
Physician Assistant
Physician Assistant
WEST JORDAN, UT
HOLY CROSS HOSPITAL-JORDAN VALLEY
mountain.commonspirit.org/location/holy-cross-hospital-jordan-valley
Based on specialty. Actual services may vary — contact the provider's office to confirm.
Based on CMS Medicare Provider Utilization data for 2023. These represent what this physician charged Medicare, not necessarily what you would pay. Compare with other physicians
| Procedure | Avg Charge | Medicare Allowed | Medicare Paid | Services |
|---|---|---|---|---|
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $315 | $106 | $106 | 82 |
99214 Established patient office or other outpatient visit, 30-39 minutes | $201 | $103 | $54 | 56 |
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | $183 | $75 | $75 | 17 |
99213 Established patient office or other outpatient visit, 20-29 minutes | $136 | $71 | $41 | 144 |
99212 Established patient office or other outpatient visit, 10-19 minutes | $81 | $46 | $23 | 13 |
G0008 Administration of influenza virus vaccine | $67 | $25 | $25 | 17 |
G0009 Administration of pneumococcal vaccine | $67 | $25 | $25 | 15 |
81002 Urinalysis, manual test | $11 | $3 | $3 | 24 |
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Physician identity data from the NPPES NPI Registry. Last synced 3/28/2026.