Supplies, drugs & other prices at Longs Peak Hospital

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

118 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) $934.50 $2,670 1.1×
2d tte w or w/o fol w/con,fu (C8924) $941.85 $2,691 2.5×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T)
unusually low — confirm this is the full procedure
$3,351.25 $9,575 0.4×
Admin hepatitis b vaccine (G0010) $50.75 $145 1.0×
Admin influenza virus vac (G0008) $50.75 $145 1.0×
Admin pneumococcal vaccine (G0009) $50.75 $145 1.0×
Blind/nonblind trans atrial (C9792) $8,662.85 $24,751 0.9×
Ca screen;flexi sigmoidscope (G0104) $640.50 $1,830 0.6×
Catheterize for urine spec (P9612) $16.45 $47 1.8×
Chemo extend iv infus w/pump (G0498) $518 $1,480 1.5×
Colon ca scrn not hi rsk ind (G0121) $1,851.85 $5,291 1.9×
Colorectal scrn; hi risk ind (G0105) $1,851.85 $5,291 1.9×
Comprehensive full body computer-based markerless 3D kinematic and kinetic motion analysis and report (0693T) $365.40 $1,044 1.0×
Covid-19 lab test non-cdc (U0002) $37.10 $106 0.7×
Direct refer hospital observ (G0379) $544.25 $1,555 0.9×
Drug test def 1-7 classes (G0480) $109.75 $313.56 1.0×
Drug test def 8-14 classes (G0481) $29.85 $85.27 0.2×
Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only (0904T) $253.75 $725 4.0×
Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician… (0912T) $80.85 $231 0.8×
Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or… (0911T) $63 $180 1.0×
Elisa hiv-1/hiv-2 screen (G0433) $93.45 $267 5.1×
Ephys eval ccm-d ld 1st impl (0930T) $236.25 $675 0.2×
Ephys eval ccm-d ld separate (0931T) $236.25 $675 0.2×
Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon (0813T) $801.85 $2,291 0.8×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $15,939.35 $45,541 1.3×
Fecal microbiota prep instil (G0455) $454.30 $1,298 0.5×
Fern test (Q0114) $80.85 $231 8.3×
FLT3 (fms-related tyrosine kinase 3) (eg, acute lyeloid leukemia) internal tandem duplication (ITD) variants,… (0046U) $2,336.25 $6,675 5.7×
Hbot, full body chamber, 30m (G0277) $368.90 $1,054 2.5×
Hep c screen high risk/other (G0472) $113.40 $324 2.4×
Hiv combination assay (G0475) $58.80 $168 2.4×
Home sleep test/type 3 porta (G0399) $377.30 $1,078 1.6×
Hospital outpt clinic visit (G0463) $213.50 $610 1.5×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $125.82 $359.46 2.9×
Impltj ant sgm io nbiodegradable rx eluting sys (0660T) $2,622.20 $7,492 0.6×
Inj for sacroiliac jt anesth (G0260) $1,622.60 $4,636 2.2×
Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and… (0671T)
unusually low — confirm this is the full procedure
$2,362.85 $6,751 0.4×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $9,217.60 $26,336 0.8×
Insj wcs lv compl sys (0515T) $27,384 $78,240 1.2×
Insj wcs lv eltrd only (0516T) $9,217.60 $26,336 0.8×
Insj/rplcmt icds w/substernal electrode (0571T) $22,555.05 $64,443 0.7×
Interrog dev eval impl ccm-d system in person (0927T) $200.55 $573 5.0×
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 Other… (0027U) $410.74 $1,173.52 3.4×
Lev 1 hosp type b ed visit (G0380) $131.95 $377 1.7×
Lev 2 hosp type b ed visit (G0381) $157.85 $451 1.6×
Lev 3 hosp type b ed visit (G0382) $239.22 $683.50 1.3×
Lev 4 hosp type b ed visit (G0383) $348.42 $995.50 1.2×
Lev 5 hosp type b ed visit (G0384) $444.15 $1,269 1.0×
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0003M) $562.49 $1,607.10 1.1×
Mra w/cont, abd (C8900) $2,644.25 $7,555 7.1×
Mra w/cont, chest (C8909) $1,862 $5,320 5.0×
Mra w/o cont, abd (C8901) $2,415.70 $6,902 9.5×
Mra w/o cont, chest (C8910) $1,697.15 $4,849 6.7×
Mra w/o cont, lwr ext (C8913) $2,324.35 $6,641 9.1×
Mra w/o cont, pelvis (C8919) $2,511.60 $7,176 9.9×
Mra w/o fol w/cont, abd (C8902) $3,102.40 $8,864 8.3×
Mra w/o fol w/cont, chest (C8911) $2,110.50 $6,030 5.7×
Mra w/o fol w/cont, lwr ext (C8914) $3,628.10 $10,366 9.8×
Mra w/o fol w/cont, pelvis (C8920) $3,527.65 $10,079 9.5×
Mra, w/o dye, upper extr (C8935) $2,080.40 $5,944 8.2×
Mra, w/o&w/dye, upper extr (C8936) $2,907.10 $8,306 7.8×
Mri w/cont, breast, bi (C8906) $728.70 $2,082 2.0×
Mri w/o fol w/cont, breast, (C8908) $2,634.10 $7,526 7.1×
Mri w/o fol w/cont, brst, un (C8905) $1,913.45 $5,467 5.1×
Neuro csf prion prtn qual (0035U) $868.39 $2,481.09 1.6×
Njx pltlt plasma w/img harvest/preparation (0232T) $201.95 $577 0.4×
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T… (0058U) $206.64 $590.40 0.6×
Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed (0908T) $42,378 $121,080 1.3×
Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation,… (0857T) $98.70 $282 0.9×
Oth resp proc, group (G0239) $109.90 $314 2.8×
Oth resp proc, indiv (G0238) $47.60 $136 1.5×
Pathogen test for platelets (P9100) $42.35 $121 0.7×
Perc d-e cor revasc chro sin (C9607) $18,363.10 $52,466 0.9×
Perc d-e cor revasc t cabg s (C9604) $13,248.55 $37,853 1.1×
Perc d-e cor stent ather s (C9602) $16,516.50 $47,190 0.8×
Perc drug-el cor stent sing (C9600) $19,861.45 $56,747 1.6×
Perq sac agmntj bi w/wo balo/mchnl dev 2/> ndls (0201T) $4,523.40 $12,924 0.6×
Perq sac agmntj uni w/wo balo/mchnl dev 1/> ndl (0200T) $4,243.75 $12,125 0.5×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T)
likely a partial charge — not the full procedure
$2,830.80 $8,088 0.2×
Pinworm examinations (Q0113) $75.25 $215 17.6×
Programming device eval impl ccm-d sys in person (0926T) $248.50 $710 6.2×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (0826T) $33.95 $97 0.9×
Prolonged iv inf, req pump (C8957) $233.45 $667 1.0×
Prostate biopsy, any mthd (G0416) $370.65 $1,059 1.0×
Psa screening (G0103) $126.70 $362 6.6×
QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device (0902T) $491.40 $1,404 3.5×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $281.75 $805 0.3×
Quan mr tis wo MRI 1orgn (0648T) $990.50 $2,830 1.0×
Quan us tiss charac i&r w/o dx us same anat (0689T) $246.40 $704 2.7×
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)… (0865T) $220.15 $629 0.9×
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)… (0866T) $220.15 $629 0.9×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $175 $500 4.4×
Removal and reimplantation of anterior segment intraocular nonbiodegradable drug-eluting implant (0661T) $2,622.20 $7,492 0.6×
Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including… (0519T)
unusually low — confirm this is the full procedure
$3,897.25 $11,135 0.3×
Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including… (0520T) $27,384 $78,240 2.5×
Removal of integrated neurostimulation system, vagus nerve (0910T) $3,056.20 $8,732 0.8×
Removal of pulse generator components of wireless heart stimulator system for pacing of lower left chamber of heart (0518T) $3,897.25 $11,135 1.0×
Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed (0909T) $42,379.05 $121,083 1.3×
Revasc intra lithotrip-stent (C9765) $11,110.75 $31,745 0.6×
Revasc intravasc lithotripsy (C9764) $6,950.65 $19,859 0.6×
Revasc lithotrip tibi/perone (C9772) $10,159.45 $29,027 0.8×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $17,494.75 $49,985 0.9×
Tee w or w/o fol w/cont, mon (C8927) $672.35 $1,921 0.8×
Therapeutic procd strg endur (G0237) $91 $260 2.9×
Therapeutic ultrafiltration (0692T) $570.15 $1,629 0.3×
Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging… (0825T) $17,502.10 $50,006 0.9×
Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg,… (0824T) $2,863 $8,180 0.9×
Trauma respons w/hosp criti (G0390) $1,719.38 $4,912.50 1.2×
Trluml perip athrc abd aorta (0236T) $6,688.50 $19,110 0.5×
Trluml perip athrc brchiocph (0237T) $9,029.30 $25,798 0.7×
Trluml perip athrc iliac art (0238T)
unusually low — confirm this is the full procedure
$9,189.25 $26,255 0.5×
Trluml perip athrc renal art (0234T) $6,688.50 $19,110 0.5×
Tte w or w/o contr, cont ecg (C8930) $2,159.85 $6,171 2.6×
Tte w or w/o fol w/con,stres (C8928) $1,927.80 $5,508 2.3×
Tte w or w/o fol w/cont, com (C8921) $1,081.85 $3,091 1.3×
Tte w or wo fol wcon,doppler (C8929) $3,202.50 $9,150 3.8×
Unsched dialysis esrd pt hos (G0257) $1,324.75 $3,785 1.8×
Wet mounts/ w preparations (Q0111) $72.10 $206 3.9×