Supplies, drugs & other prices at Mount San Rafael Hospital
Trinidad, CO · every code in this section with a posted price and a Medicare benchmark.
26 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | — | $130.50 | — |
| Admin influenza virus vac (G0008) | — | $42.50 | — |
| Ca screen;flexi sigmoidscope (G0104) | — | $546 | — |
| Ca screen;pelvic/breast exam (G0101) | — | $108.50 | — |
| Chemo extend iv infus w/pump (G0498) | — | $94 | — |
| Colon ca scrn not hi rsk ind (G0121) range across 6 matching MRF lines |
— | $759–$3,300.50 | — |
| Colorectal scrn; hi risk ind (G0105) range across 4 matching MRF lines |
— | $759–$1,332 | — |
| Diab manage trn per indiv (G0108) | — | $49.50 | — |
| Diab manage trn ind/group (G0109) | — | $13.50 | — |
| Drug test def 1-7 classes (G0480) range across 6 matching MRF lines |
— | $220.50–$262 | — |
| Elec stim other than wound (G0283) | $41.65 | $59.50 | 3.3× |
| Fecal blood scrn immunoassay (G0328) | — | $32 | — |
| Hospital outpt clinic visit (G0463) | — | $94 | — |
| Initial preventive exam (G0402) range across 4 matching MRF lines |
— | $356–$371 | — |
| Mnt subs tx for change dx (G0270) range across 4 matching MRF lines |
— | $48–$64 | — |
| Mra w/cont, abd (C8900) | — | $4,383 | — |
| Obtaining screen pap smear (Q0091) | — | $75 | — |
| Oth resp proc, indiv (G0238) range across 4 matching MRF lines |
— | $116.50–$228.50 | — |
| Ppps, initial visit (G0438) range across 4 matching MRF lines |
— | $247.50–$349.50 | — |
| Ppps, subseq visit (G0439) range across 4 matching MRF lines |
— | $165.50–$230.50 | — |
| Prolonged iv inf, req pump (C8957) | — | $101 | — |
| Psa screening (G0103) | — | $174.50 | — |
| Therapeutic procd strg endur (G0237) | — | $228.50 | — |
| Tomosynthesis, mammo (G0279) | — | $121.50 | — |
| Trauma respons w/hosp criti (G0390) | — | $3,149.50 | — |
| Wet mounts/ w preparations (Q0111) | — | $25.50 | — |
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.