Mount San Rafael Hospital
Trinidad, CO · Critical Access Hospital
Posts prices for 50 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-15.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) range across 6 matching MRF lines |
— | $1,560.50–$4,280 | — |
| Shoulder arthroscopy with decompression (29826) | — | $729.50 | — |
| Knee arthroscopy with meniscectomy (29881) | — | $3,615.50 | — |
| Upper GI endoscopy (EGD), diagnostic (43235) range across 10 matching MRF lines |
— | $483.50–$1,515 | — |
| Upper GI endoscopy (EGD) with biopsy (43239) range across 6 matching MRF lines |
— | $596–$3,300.50 | — |
| Diagnostic colonoscopy (45378) range across 5 matching MRF lines |
— | $759–$3,300.50 | — |
| Colonoscopy with biopsy (45380) range across 4 matching MRF lines |
— | $918–$4,035 | — |
| Colonoscopy with lesion removal (45385) range across 7 matching MRF lines |
— | $1,098–$4,768.50 | — |
| Colonoscopy with endoscopic ultrasound (45391) | — | $1,132 | — |
| Laparoscopic gallbladder removal (47562) | — | $7,676 | — |
| Inguinal hernia repair (age 5+) (49505) | — | $4,096.50 | — |
| Epidural injection, lumbar/sacral (with imaging) (62322) range across 6 matching MRF lines |
— | $173.50–$1,215 | — |
| Transforaminal epidural injection, lumbar/sacral (64483) | — | $437 | — |
| Cataract removal with lens insertion (66984) | — | $3,668 | — |
| CT head/brain without contrast (70450) | — | $2,575.50 | — |
| MRI brain without contrast (70551) | — | $3,441 | — |
| MRI brain with contrast (70552) | — | $3,398 | — |
| MRI brain without and with contrast (70553) | — | $5,143.50 | — |
| X-ray lower spine, 4+ views (72110) | — | $800.50 | — |
| MRI lumbar spine without contrast (72148) | — | $2,754.50 | — |
| CT pelvis with contrast (72193) | — | $3,654.50 | — |
| MRI lower-extremity joint without contrast (73721) | — | $3,289.50 | — |
| CT abdomen and pelvis with contrast (74177) | — | $5,027 | — |
| Ultrasound, abdomen complete (76700) | — | $1,402.50 | — |
| Ultrasound, transvaginal (76830) | — | $816 | — |
| Mammography, one breast (diagnostic) (77065) | — | $447.50 | — |
| Mammography, both breasts (diagnostic) (77066) range across 4 matching MRF lines |
— | $72–$437 | — |
| Mammography, screening (bilateral) (77067) range across 8 matching MRF lines |
— | $64–$462.50 | — |
| Basic metabolic panel (80048) range across 4 matching MRF lines |
— | $186.50–$196 | — |
| Comprehensive metabolic panel (80053) range across 4 matching MRF lines |
— | $17.50–$275 | — |
| Lipid panel (80061) range across 7 matching MRF lines |
— | $39.50–$198 | — |
| Renal function panel (80069) | — | $248.50 | — |
| Hepatic function panel (80076) range across 8 matching MRF lines |
— | $72–$192 | — |
| Urinalysis, non-automated, with microscopy (81000) | — | $85.50 | — |
| Urinalysis, non-automated, without microscopy (81002) range across 7 matching MRF lines |
— | $28–$66 | — |
| PSA, total (84153) range across 10 matching MRF lines |
— | $35.50–$172.50 | — |
| Thyroid stimulating hormone (TSH) (84443) range across 6 matching MRF lines |
— | $25–$172.50 | — |
| CBC with automated differential (85025) | — | $126 | — |
| CBC, automated (85027) | — | $60 | — |
| Prothrombin time (PT) (85610) range across 6 matching MRF lines |
— | $27–$77 | — |
| Partial thromboplastin time (PTT) (85730) range across 4 matching MRF lines |
— | $151.50–$909 | — |
| Sleep study (attended polysomnography) (95810) | — | $4,773.50 | — |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 9 matching MRF lines |
$84.35–$137.90 | $120.50–$197 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 9 matching MRF lines |
— | $237.50–$285.50 | — |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 9 matching MRF lines |
— | $290–$498 | — |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 9 matching MRF lines |
— | $495.50–$623.50 | — |
| Office consultation (low complexity, ~30 min) (99243) | — | $306 | — |
| Office consultation (moderate complexity, ~40 min) (99244) | — | $338 | — |
| Preventive visit, new patient (age 18–39) (99385) range across 6 matching MRF lines |
— | $183.50–$348.50 | — |
| Preventive visit, new patient (age 40–64) (99386) range across 4 matching MRF lines |
— | $351.50–$373 | — |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
More prices at this hospital
- Imaging: 211 codes with posted prices and Medicare benchmarks
- Lab & pathology: 627 codes with posted prices and Medicare benchmarks
- Visits & medical services: 152 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 991 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 26 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 1.8 GB) ↓ — captured 2026-08-15
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.