Supplies, drugs & other prices at Foothills Hospital

Boulder, CO · every code in this section with a posted price and a Medicare benchmark.

70 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $4,809.50 $9,619 5.8×
2d tte w or w/o fol w/con,co (C8923) $4,178 $8,356 5.0×
2d tte w or w/o fol w/con,fu (C8924) $2,048 $4,096 5.5×
Adm tocilizu covid-19 1st (M0249) $830.50 $1,661 1.8×
Adm tocilizu covid-19 2nd (M0250) $830.50 $1,661 1.8×
Admin hepatitis b vaccine (G0010) $67.50 $135 1.4×
Admin influenza virus vac (G0008) $113.50 $227 2.3×
Admin pneumococcal vaccine (G0009) $67.50 $135 1.4×
Alcohol/subs interv 15-30mn (G0396) $31.50 $63 0.8×
Alcohol/subs interv >30 min (G0397) $63.50 $127 0.3×
Arthro/shoul surg; w/spacer (C9781)
likely a partial charge — not the full procedure
$4,057 $8,114 0.3×
Ca screen;pelvic/breast exam (G0101) $27.50 $55 0.3×
Cysto impl 4 or more (C9740)
likely a partial charge — not the full procedure
$1,881.25 $3,762.50 0.2×
Cystoscopy prostatic imp 1-3 (C9739)
unusually low — confirm this is the full procedure
$1,881.25 $3,762.50 0.3×
Direct refer hospital observ (G0379) $817 $1,634 1.3×
Ekg tracing for initial prev (G0404) $13.50 $27 0.4×
Hospital outpt clinic visit (G0463) $214.50 $429 1.5×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $200 $400 4.6×
Initial preventive exam (G0402) $129.50 $259 0.9×
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0410T) $11,595 $23,190 1.3×
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0409T) $32,412.50 $64,825 1.4×
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0411T) $11,595 $23,190 1.3×
Insj/rplc car modulj sys pls gen transvns eltrd (0408T) $45,563 $91,126 1.4×
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 Other… (0027U) $292 $584 2.4×
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0003M) $476 $952 0.9×
Obtaining screen pap smear (Q0091) $34 $68 1.1×
Oral hiv-1/hiv-2 screen (G0435) $16.50 $33 1.4×
Oth resp proc, group (G0239) $37 $74 0.9×
Oth resp proc, indiv (G0238) $37.50 $75 1.2×
Pathogen test for platelets (P9100) $33 $66 0.5×
Pemivibart infusion (M0224) $830.50 $1,661 1.8×
Perc d-e cor revasc chro sin (C9607) $48,773 $97,546 2.5×
Perc d-e cor revasc t cabg s (C9604) $40,884 $81,768 3.3×
Perc d-e cor stent ather s (C9602) $48,046 $96,092 2.5×
Perc drug-el cor stent sing (C9600) $40,884 $81,768 3.3×
Perq sac agmntj bi w/wo balo/mchnl dev 2/> ndls (0201T) $4,515.50 $9,031 0.6×
Perq sac agmntj uni w/wo balo/mchnl dev 1/> ndl (0200T) $4,414.25 $8,828.50 0.6×
Posterior vertebral joint(s) arthroplasty (eg, facet jointºs» replacement), including facetectomy, laminectomy,… (0202T)
likely a partial charge — not the full procedure
$2,276 $4,552 0.2×
Potassium hydroxide preps (Q0112) $10.50 $21 1.8×
Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of… (0804T) $48 $96 1.2×
Psa screening (G0103) $25.50 $51 1.3×
Revasc intra lithotrip-ather (C9766) $25,358.50 $50,717 1.3×
Revasc intra lithotrip-stent (C9765) $25,358.50 $50,717 1.3×
Revasc intravasc lithotripsy (C9764) $15,859.50 $31,719 1.3×
Revasc lith-sten-ath tib/per (C9775) $25,358.50 $50,717 1.3×
Revasc lithotr-ather tib/per (C9774) $25,358.50 $50,717 1.3×
Revasc lithotr-stent tib/per (C9773) $25,358.50 $50,717 1.3×
Revasc lithotrip tibi/perone (C9772) $15,859.50 $31,719 1.3×
Revasc lithotrip-stent-ather (C9767) $25,358.50 $50,717 1.3×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $24,738 $49,476 1.2×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $24,738 $49,476 1.2×
Tcat insj perm dual chamber ldls pm compl sys (0795T) $24,738 $49,476 1.2×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $4,047 $8,094 1.2×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $4,047 $8,094 1.2×
Tcat rmvl perm dual chamber ldls pm compl sys (0798T) $4,047 $8,094 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) $24,738 $49,476 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $24,738 $49,476 1.2×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $24,738 $49,476 1.2×
Tee w or w/o fol w/cont, mon (C8927) $4,458.50 $8,917 5.3×
Tee w or w/o fol w/cont,cong (C8926) $4,809.50 $9,619 5.8×
Therapeutic procd strg endur (G0237) $38 $76 1.2×
Trauma respons w/hosp criti (G0390) $5,461 $10,922 3.8×
Trim nail(s) (G0127) $91.25 $182.50 1.5×
Trluml perip athrc renal art (0234T) $20,380 $40,760 1.7×
Tte w or w/o fol w/con,stres (C8928) $2,210.50 $4,421 2.6×
Tte w or w/o fol w/cont, com (C8921) $4,819 $9,638 5.8×
Tte w or w/o fol w/cont, f/u (C8922) $1,147 $2,294 1.4×
Tte w or wo fol wcon,doppler (C8929) $4,458.50 $8,917 5.3×
Unsched dialysis esrd pt hos (G0257) $2,763 $5,526 3.8×
Wet mounts/ w preparations (Q0111) $16.50 $33 0.9×