Supplies, drugs & other prices at Keefe Memorial Hospital
Cheyenne Wells, CO · every code in this section with a posted price and a Medicare benchmark.
11 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Adm of soc dtr assess 5-15 m (G0136) | $57 | $57 | 1.4× |
| Admin influenza virus vac (G0008) | $52 | $52 | 1.1× |
| Ca screen;flexi sigmoidscope (G0104) | $363 | $363 | 0.4× |
| Ca screen;pelvic/breast exam (G0101) | $100 | $100 | 0.9× |
| Colorectal scrn; hi risk ind (G0105) | $1,796.80 | $2,246 | 1.8× |
| Depression screen annual (G0444) | $12 | $12 | 0.3× |
| Direct refer hospital observ (G0379) | $579 | $579 | 0.9× |
| Drug test def 1-7 classes (G0480) | $493.50 | $493.50 | 4.3× |
| Initial preventive exam (G0402) | $422 | $422 | 3.0× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $403 | $403 | 0.9× |
| Trauma respons w/hosp criti (G0390) | $1,835.40 | $2,622 | 1.3× |