Grand River Medical Center
Grand River Medical Center in Rifle, CO publishes cash prices for 210 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Colorado median for 189 of 205 procedures and above it for 16. Click a procedure to compare it with other hospitals nearby.
501 Airport Rd,Rifle,CO,81650 Collected Sep 29, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Colorado | Off list |
|---|---|---|---|---|---|
| Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY | $380.50 | $761.00 | $171.40–$903.22 | 91% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM | $1,268.00 | $2,536.00 | $284.49–$903.22 | 71% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $1,331.50 | $2,663.00 | $284.49–$903.22 | 70% below | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER) | $2,710.00 | $5,420.00 | $703.82–$934.38 | 61% below | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM | $2,845.50 | $5,691.00 | $703.82–$934.38 | 59% below | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER) | $2,585.00 | $5,170.00 | $680.86–$934.38 | 25% below | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM | $2,714.50 | $5,429.00 | $680.86–$934.38 | 21% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $173.50 | $347.00 | $84.85–$903.22 | 72% below | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Colorado | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $60.00 | $120.00 | $5.30 | 43% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $62.50 | $125.00 | $5.30 | 41% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $60.00 | $120.00 | $5.18 | 71% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $62.50 | $125.00 | $5.18 | 70% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $142.00 | $284.00 | $47.63 | 81% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $26.50 | $53.00 | $5.22 | 35% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $389.50 | $779.00 | $5.22 | 858% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $108.00 | $216.00 | $12.95 | 51% below | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $112.50 | $225.00 | $12.95 | 49% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $77.50 | $155.00 | $12.09 | 27% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $94.00 | $188.00 | $12.09 | 11% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $151.50 | $303.00 | $39.26 | 74% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $395.00 | $790.00 | $39.26 | 32% below | 50% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $20.50 | $41.00 | $8.46 | 93% below | 50% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $140.50 | $281.00 | $8.46 | 50% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $200.00 | $400.00 | $64.80–$903.22 | 67% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $556.50 | $1,113.00 | $64.80–$903.22 | 9% below | 50% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $143.50 | $287.00 | $10.32 | 57% below | 50% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $149.00 | $298.00 | $10.32 | 55% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $20.00 | $40.00 | $2.94–$8.57 | 66% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $21.00 | $42.00 | $2.94–$8.57 | 65% below | 50% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $60.00 | $120.00 | $3.93 | 66% below | 50% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $62.50 | $125.00 | $3.93 | 64% below | 50% |
| Blood lead test CPT 83655 LEAD LEVEL | $27.00 | $54.00 | $12.11 | 90% below | 50% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $38.00 | $76.00 | $12.11 | 86% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $71.00 | $142.00 | $7.52 | 63% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $74.00 | $148.00 | $7.52 | 61% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $67.50 | $135.00 | $2.99 | 51% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $130.00 | $260.00 | $2.99 | 6% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $52.50 | $105.00 | $5.18 | 81% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $89.00 | $178.00 | $5.18 | 68% below | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $116.00 | $232.00 | $20.81 | 65% below | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $120.50 | $241.00 | $20.81 | 64% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $116.00 | $232.00 | $20.81 | 65% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $120.50 | $241.00 | $20.81 | 64% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $76.50 | $153.00 | $51.31 | 41% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $64.50 | $129.00 | $35.09 | 87% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $83.00 | $166.00 | $35.09 | 83% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $36.50 | $73.00 | $13.39 | 80% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $116.00 | $232.00 | $13.39 | 37% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $59.50 | $119.00 | $7.77 | 39% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $62.00 | $124.00 | $7.77 | 36% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $50.00 | $100.00 | $6.47 | 74% below | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $100.00 | $200.00 | $10.56 | 68% below | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $200.50 | $401.00 | $10.56 | 36% below | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $113.50 | $227.00 | $10.18 | 73% below | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $119.00 | $238.00 | $10.18 | 72% below | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $25.00 | $50.00 | $22.23 | 96% below | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $26.50 | $53.00 | $22.23 | 96% below | 50% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $25.00 | $50.00 | $27.94 | 94% below | 50% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $26.50 | $53.00 | $27.94 | 94% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $90.00 | $180.00 | $18.58 | 70% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $116.00 | $232.00 | $18.58 | 61% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $180.00 | $360.00 | $19.63 | 47% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $187.00 | $374.00 | $19.63 | 45% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $72.50 | $145.00 | $13.63 | 66% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $126.50 | $253.00 | $13.63 | 41% below | 50% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $75.00 | $150.00 | $14.70 | 68% below | 50% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $117.50 | $235.00 | $14.70 | 50% below | 50% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $25.00 | $50.00 | $16.94 | 93% below | 50% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $26.50 | $53.00 | $16.94 | 93% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $25.00 | $50.00 | $9.02 | 84% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $120.50 | $241.00 | $9.02 | 24% below | 50% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $25.00 | $50.00 | $25.47 | 96% below | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE | $26.50 | $53.00 | $25.47 | 96% below | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $65.00 | $130.00 | $4.75 | 67% below | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $67.50 | $135.00 | $4.75 | 66% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS | $79.50 | $159.00 | $12.87 | 42% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $154.00 | $308.00 | $12.87 | 12% above | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $64.50 | $129.00 | $35.09 | 81% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $88.50 | $177.00 | $35.09 | 74% below | 50% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $89.50 | $179.00 | $16.85 | 62% below | 50% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $169.50 | $339.00 | $14.38 | 50% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION | $162.50 | $325.00 | $85.10 | 80% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $169.00 | $338.00 | $85.10 | 79% below | 50% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $57.50 | $115.00 | $13.71 | 82% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $101.50 | $203.00 | $24.08 | 44% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $105.50 | $211.00 | $24.08 | 42% below | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $95.00 | $190.00 | $35.09 | 30% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $20.50 | $41.00 | $9.71 | 87% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $115.50 | $231.00 | $9.71 | 26% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $33.50 | $67.00 | $10.74 | 81% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $79.50 | $159.00 | $10.74 | 54% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $67.50 | $135.00 | $10.33 | 58% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $74.00 | $148.00 | $10.33 | 54% below | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $33.50 | $67.00 | $14.27 | 84% below | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT | $58.50 | $117.00 | $14.27 | 71% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $220.50 | $441.00 | $42.84 | 16% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $459.50 | $919.00 | $42.84 | 74% above | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $78.50 | $157.00 | $13.19 | 27% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $79.00 | $158.00 | $13.19 | 27% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $24.50 | $49.00 | $19.35 | 81% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $78.50 | $157.00 | $19.35 | 40% below | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $52.00 | $104.00 | $12.95 | 75% below | 50% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $56.50 | $113.00 | $17.92 | 79% below | 50% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $59.00 | $118.00 | $17.92 | 78% below | 50% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $54.00 | $108.00 | $11.43 | 71% below | 50% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $87.50 | $175.00 | $11.43 | 52% below | 50% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $60.00 | $120.00 | $6.47 | 72% below | 50% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $62.50 | $125.00 | $6.47 | 71% below | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $40.00 | $80.00 | $8.74 | 79% below | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $93.50 | $187.00 | $8.74 | 51% below | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $97.50 | $195.00 | $8.68 | 74% below | 50% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $154.50 | $309.00 | $8.68 | 59% below | 50% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $116.00 | $232.00 | $18.52 | 61% below | 50% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $120.50 | $241.00 | $18.52 | 59% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $84.50 | $169.00 | $6.89 | 61% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $88.00 | $176.00 | $6.89 | 59% below | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $75.00 | $150.00 | $8.17 | 73% below | 50% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $129.00 | $258.00 | $8.17 | 54% below | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $239.50 | $479.00 | $17.03 | 7% above | 50% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $35.50 | $71.00 | $6.70 | 67% below | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $82.50 | $165.00 | $6.70 | 23% below | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $47.00 | $94.00 | $12.88 | 65% below | 50% |
| Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) | $50.00 | $100.00 | $12.88 | 63% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $58.50 | $117.00 | $5.18 | 84% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $59.00 | $118.00 | $5.18 | 84% below | 50% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $180.00 | $360.00 | $47.81 | 71% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $86.00 | $172.00 | $18.39 | 71% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $89.50 | $179.00 | $18.39 | 70% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $75.00 | $150.00 | $18.39 | 73% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $130.00 | $260.00 | $18.39 | 54% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $67.00 | $134.00 | $41.28 | 88% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $178.00 | $356.00 | $41.28 | 68% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $57.00 | $114.00 | $6.01 | 77% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $59.50 | $119.00 | $6.01 | 76% below | 50% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY | $1,811.00 | $3,622.00 | $759.05 | 114% above | 50% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $25.00 | $50.00 | $20.86 | 90% below | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $26.50 | $53.00 | $20.86 | 89% below | 50% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $111.50 | $223.00 | $19.38 | 64% below | 50% |
| Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL | $116.00 | $232.00 | $19.38 | 63% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $33.00 | $66.00 | $4.29 | 72% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $36.50 | $73.00 | $4.29 | 69% below | 50% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $32.50 | $65.00 | $12.60 | 85% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS | $12.50 | $25.00 | $16.55 | 88% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $13.00 | $26.00 | $16.55 | 87% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR STREPTOCOCCUS; GROUP A (STREP) | $12.50 | $25.00 | $16.53 | 92% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $75.00 | $150.00 | $16.53 | 51% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $53.00 | $106.00 | $5.67 | 36% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $55.00 | $110.00 | $5.67 | 33% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $24.50 | $49.00 | $14.39 | 89% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) | $50.00 | $100.00 | $14.39 | 78% below | 50% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VOL/COUNT/MOT | $151.50 | $303.00 | $12.31 | 21% below | 50% |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $99.50 | $199.00 | $8.90 | 72% below | 50% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $103.50 | $207.00 | $8.90 | 71% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS | $35.00 | $70.00 | $4.38 | 39% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $36.50 | $73.00 | $4.38 | 36% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $92.00 | $184.00 | $15.92 | 12% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $56.00 | $112.00 | $4.27 | 56% below | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $73.00 | $146.00 | $4.27 | 42% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON | $191.50 | $383.00 | $61.98 | 55% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $199.00 | $398.00 | $61.98 | 54% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $25.00 | $50.00 | $25.81 | 94% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $26.50 | $53.00 | $25.81 | 93% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $71.00 | $142.00 | $14.55 | 60% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $77.50 | $155.00 | $14.55 | 56% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $25.00 | $50.00 | $16.80 | 91% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $123.50 | $247.00 | $16.80 | 54% below | 50% |
| Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE | $195.50 | $391.00 | $35.09 | 167% above | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $203.50 | $407.00 | $35.09 | 178% above | 50% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $60.00 | $120.00 | $4.52 | 43% below | 50% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $62.50 | $125.00 | $4.52 | 41% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $8.50 | $17.00 | $3.17 | 96% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $25.00 | $50.00 | $2.25 | 74% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $35.00 | $70.00 | $2.25 | 64% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $42.00 | $84.00 | $3.48 | 53% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $71.00 | $142.00 | $8.61 | 30% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $117.50 | $235.00 | $15.08 | 51% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $122.00 | $244.00 | $15.08 | 49% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $110.50 | $221.00 | $29.60 | 44% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $115.00 | $230.00 | $29.60 | 42% below | 50% |
| Zinc blood test CPT 84630 ZINC LEVEL | $91.00 | $182.00 | $11.39 | 35% below | 50% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $166.50 | $333.00 | $11.39 | 18% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $101.00 | $202.00 | $15.05 | 71% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $140.50 | $281.00 | $15.05 | 60% below | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Colorado | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) | $3,441.00 | $6,882.00 | $112.29–$2,845.03 | 59% below | 50% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 REPAIR OF ANTERIOR CRUCIATE LIGAMENT OF KNEE USING AN ENDOSCOPE | $12,218.00 | $24,436.00 | $636.27–$6,614.63 | 4% below | 50% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE | $10,653.50 | $21,307.00 | $817.82–$6,614.63 | 5% above | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH | $2,662.50 | $5,325.00 | $581.62–$1,499.55 | 73% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC | $2,795.50 | $5,591.00 | $581.62–$1,499.55 | 72% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $741.50 | $1,483.00 | $87.96–$903.22 | 81% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $778.50 | $1,557.00 | $87.96–$903.22 | 80% below | 50% |
| Carpal tunnel release, open surgery CPT 64721 RELEASE AND/OR RELOCATION OF HAND NERVE | $1,998.00 | $3,996.00 | $299.42–$1,797.52 | 62% below | 50% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $1,287.50 | $2,575.00 | $310.66–$1,082.91 | 46% below | 50% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $1,287.50 | $2,575.00 | $254.51–$1,082.91 | 49% below | 50% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $1,287.50 | $2,575.00 | $243.29–$903.22 | 35% below | 50% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $64.50 | $129.00 | $51.66–$903.22 | 72% below | 50% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA | $1,332.00 | $2,664.00 | $149.72–$1,388.14 | 14% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX | $64.50 | $129.00 | $22.46–$903.22 | 58% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $67.50 | $135.00 | $22.46–$903.22 | 56% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF LINING OF UTERUS | $1,498.50 | $2,997.00 | $29.95–$903.22 | 370% above | 50% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 EXPLORATION OF NASAL SINUS USING AN ENDOSCOPE | $4,063.50 | $8,127.00 | $510.51–$6,187.08 | — | 50% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 REMOVAL OF NASAL SINUS TISSUE USING AN ENDOSCOPE | $4,902.00 | $9,804.00 | $324.12–$6,187.08 | 52% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL | $740.50 | $1,481.00 | $96.93–$903.22 | 76% below | 50% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE | $10,771.50 | $21,543.00 | $470.65–$3,541.93 | 16% above | 50% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $5,998.50 | $11,997.00 | $281.32–$3,541.93 | 24% below | 50% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $4,991.50 | $9,983.00 | $567.03–$5,212.15 | 67% below | 50% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $5,066.00 | $10,132.00 | $610.08–$5,212.15 | 67% below | 50% |
| Hammertoe correction surgery CPT 28285 CORRECTION OF TOE JOINT DEFORMITY | $9,997.50 | $19,995.00 | $179.64–$2,976.66 | 15% above | 50% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING | $2,442.00 | $4,884.00 | $48.66–$903.22 | 8% above | 50% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP | $2,941.50 | $5,883.00 | $299.42–$2,569.47 | 13% below | 50% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP REPLACEMENT AFTER PREVIOUS HIP SURGERY | $23,797.50 | $47,595.00 | $903.22–$1,497.13 | — | 50% |
| Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE | $5,439.00 | $10,878.00 | $305.42–$4,635.11 | 60% below | 50% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $2,331.00 | $4,662.00 | $230.93–$2,827.44 | 72% below | 50% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION | $1,165.50 | $2,331.00 | $56.60–$903.22 | 26% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $162.00 | $324.00 | $28.08–$903.22 | 43% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $170.00 | $340.00 | $28.08–$903.22 | 40% below | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) | $9,481.50 | $18,963.00 | $318.15–$3,541.93 | 8% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $212.50 | $425.00 | $54.64–$903.22 | 68% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $443.00 | $886.00 | $54.64–$903.22 | 33% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $444.50 | $889.00 | $45.30–$903.22 | 33% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $466.50 | $933.00 | $45.30–$903.22 | 30% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $466.50 | $933.00 | $41.54–$903.22 | 9% below | 50% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 REPAIR OF INSIDE OR OUTSIDE KNEE JOINT CARTILAGE USING AN ENDOSCOPE | $2,967.00 | $5,934.00 | $291.93–$2,976.66 | 53% below | 50% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $4,917.00 | $9,834.00 | $427.79–$5,212.15 | 6% below | 50% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS | $18,997.50 | $37,995.00 | $739.01–$9,087.30 | 28% below | 50% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE | $4,023.00 | $8,046.00 | $546.08–$5,212.15 | 74% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $269.50 | $539.00 | $44.92–$903.22 | 43% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $283.00 | $566.00 | $44.92–$903.22 | 40% below | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $740.50 | $1,481.00 | $103.04–$903.22 | 53% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL | $740.50 | $1,481.00 | $166.92–$903.22 | 74% below | 50% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER | $2,386.50 | $4,773.00 | $293.82–$2,827.44 | 40% below | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $1,279.00 | $2,558.00 | $79.35–$903.22 | 144% above | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $130.50 | $261.00 | $37.43–$903.22 | 86% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $313.00 | $626.00 | $29.95–$903.22 | 23% above | 50% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $405.00 | $810.00 | $267.60–$903.22 | 74% below | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $425.50 | $851.00 | $267.60–$903.22 | 72% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $424.50 | $849.00 | $89.84–$903.22 | 20% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $269.50 | $539.00 | $29.95–$903.22 | 12% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $3,483.00 | $6,966.00 | $29.95–$903.22 | 1032% above | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $1,287.50 | $2,575.00 | $126.90–$903.22 | 36% below | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $1,287.50 | $2,575.00 | $20.59–$903.22 | 36% below | 50% |
| Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE | $11,416.50 | $22,833.00 | $411.71–$2,845.03 | 213% above | 50% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $198.50 | $397.00 | $62.13–$903.22 | 49% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $180.50 | $361.00 | $18.70–$903.22 | 58% below | 50% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $142.00 | $284.00 | $22.46–$903.22 | 38% below | 50% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PARTIAL REMOVAL OF COLLAR BONE AT SHOULDER USING AN ENDOSCOPE | $5,066.00 | $10,132.00 | $502.28–$2,976.66 | 21% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $169.00 | $338.00 | $37.43–$903.22 | 56% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $177.50 | $355.00 | $37.43–$903.22 | 54% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $179.50 | $359.00 | $59.69–$903.22 | 59% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $188.50 | $377.00 | $59.69–$903.22 | 57% below | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $539.50 | $1,079.00 | $37.43–$903.22 | 51% below | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $566.50 | $1,133.00 | $37.43–$903.22 | 49% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $202.50 | $405.00 | $52.42–$903.22 | 49% below | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $212.50 | $425.00 | $52.42–$903.22 | 47% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $169.00 | $338.00 | $44.92–$903.22 | 47% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $177.50 | $355.00 | $44.92–$903.22 | 44% below | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $114.00 | $228.00 | $59.69–$903.22 | 74% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $425.50 | $851.00 | $565.90–$903.22 | 80% below | 50% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER) | $3,999.00 | $7,998.00 | $224.58–$2,845.03 | 52% below | 50% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) | $2,257.50 | $4,515.00 | $205.86–$5,339.67 | 85% below | 50% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER) | $3,031.50 | $6,063.00 | $224.58–$2,845.03 | 63% below | 50% |
| Total hip replacement CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS | $10,688.00 | $21,376.00 | $1,122.85–$13,048.08 | 17% below | 50% |
| Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $10,688.00 | $21,376.00 | $1,497.13–$13,048.08 | 5% below | 50% |
| Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER | $12,441.50 | $24,883.00 | $1,309.98–$13,048.08 | 26% below | 50% |
| Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER | $2,275.50 | $4,551.00 | $187.13–$1,434.52 | 46% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $466.50 | $933.00 | $50.90–$903.22 | 3% below | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM | $1,231.50 | $2,463.00 | $169.56–$1,741.59 | 57% below | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $1,231.50 | $2,463.00 | $179.64–$903.22 | 36% below | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $1,231.50 | $2,463.00 | $157.21–$903.22 | 36% below | 50% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE | $4,440.00 | $8,880.00 | $359.69–$4,702.18 | — | 50% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT | $5,676.00 | $11,352.00 | $149.72–$1,854.88 | 5% above | 50% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN | $4,957.50 | $9,915.00 | $1,764.36–$2,978.97 | 77% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $378.50 | $757.00 | $56.14–$903.22 | 18% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $397.50 | $795.00 | $56.14–$903.22 | 14% below | 50% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREATMENT OF BROKEN FOREARM BONE ON THUMB SIDE OF WRIST; ABOVE WRIST; WITH PLACEMENT OF STABILIZING DEVICE | $7,301.00 | $14,602.00 | $505.67–$6,614.63 | 62% below | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Colorado | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $605.00 | $1,210.00 | $14.99–$903.22 | 64% below | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $672.50 | $1,345.00 | $14.99–$903.22 | 60% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $77.50 | $155.00 | $4,539.00–$7,043.16 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $214.00 | $428.00 | $4,539.00–$7,043.16 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS | $550.00 | $1,100.00 | $127.32–$903.22 | 57% below | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $577.50 | $1,155.00 | $127.32–$903.22 | 55% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $1,860.00 | $3,720.00 | $236.60–$767.72 | 89% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,953.00 | $3,906.00 | $236.60–$767.72 | 89% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $133.00 | $266.00 | $6.42–$903.22 | 77% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $139.50 | $279.00 | $6.42–$903.22 | 76% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $191.00 | $382.00 | $11.73–$75.09 | 51% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP | $200.50 | $401.00 | $11.73–$75.09 | 49% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $272.50 | $545.00 | $34.35–$139.69 | 85% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $286.00 | $572.00 | $34.35–$139.69 | 84% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $498.50 | $997.00 | $57.45–$245.03 | 84% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $523.50 | $1,047.00 | $57.45–$245.03 | 83% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $794.50 | $1,589.00 | $102.11–$381.61 | 90% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $834.00 | $1,668.00 | $102.11–$381.61 | 89% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $1,192.50 | $2,385.00 | $152.23–$548.11 | 92% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $1,252.00 | $2,504.00 | $152.23–$548.11 | 91% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $205.50 | $411.00 | $44.67–$903.22 | 78% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $216.00 | $432.00 | $44.67–$903.22 | 77% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $103.00 | $206.00 | $54.53–$903.22 | 84% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $108.00 | $216.00 | $54.53–$903.22 | 83% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $24.00 | $48.00 | $14.60–$903.22 | 88% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $156.50 | $313.00 | $14.60–$903.22 | 23% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION | $470.50 | $941.00 | $32.89–$903.22 | 276% above | 50% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $207.50 | $415.00 | $100.85 | 16% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $315.00 | $630.00 | $134.25 | 14% below | 50% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN | $396.50 | $793.00 | $182.37 | 23% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $143.50 | $287.00 | $48.42 | 54% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN | $36.00 | $72.00 | $32.32–$903.22 | 57% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES | $138.00 | $276.00 | $32.32–$903.22 | 64% above | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $597.00 | $1,194.00 | $31.51–$903.22 | 372% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $28.50 | $57.00 | $12.58–$903.22 | 56% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN | $176.50 | $353.00 | $146.36 | 54% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES | $205.50 | $411.00 | $146.36 | 47% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $133.00 | $266.00 | $74.02 | 49% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN | $143.00 | $286.00 | $74.02 | 45% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN | $154.00 | $308.00 | $104.58 | 49% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $196.00 | $392.00 | $104.58 | 35% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $74.00 | $148.00 | $46.56 | 66% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $77.50 | $155.00 | $46.56 | 64% below | 50% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $144.00 | $288.00 | $33.18–$903.22 | 79% below | 50% |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $151.00 | $302.00 | $33.18–$903.22 | 78% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $289.50 | $579.00 | $42.21–$903.22 | 46% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $304.00 | $608.00 | $42.21–$903.22 | 43% below | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $496.50 | $993.00 | $34.28–$903.22 | 373% above | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM | $133.50 | $267.00 | $82.14–$903.22 | 85% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $139.00 | $278.00 | $82.14–$903.22 | 85% below | 50% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) WITH SUPERVISION AND REVIEW BY PHYSICIAN | $514.00 | $1,028.00 | $73.23–$903.22 | — | 50% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST | $539.50 | $1,079.00 | $73.23–$903.22 | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Colorado | Off list |
|---|---|---|---|---|---|
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM | $132.50 | $265.00 | $903.22 | 92% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $10.84 | $21.68 | $17.39–$903.22 | 90% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $36.50 | $73.00 | $17.39–$903.22 | 67% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $10.84 | $21.68 | $903.22 | 87% below | 50% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/f73a5211c3c0ff9dedca389bbfa031d7/charges/mrf