Visits & medical services prices at St. Anthony Summit Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of… (95803) $171.29 $428.21 2.8×
Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord (96450) $1,233.59 $3,083.96 3.5×
Aerosol inhalation pentamidine (94642) $375.82 $939.55 1.6×
Airway inhalation treatment (94640) $113.85 $284.62 0.5×
Appl on-body injector for timed subq injection (96377) $95.83 $239.57 1.9×
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $79.02 $197.55
Assessment of aphasia (96105) $182.87 $457.16
Bipap initial day (94660) $229.28 $573.20 1.0×
Breathing capacity test (94010) $309.71 $774.26 1.4×
Bronchial allergy tests (95070) $290.68 $726.69 0.7×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $309.71 $774.26 0.8×
C motor evoked lwr limbs (95929) $851.15 $2,127.87 2.2×
C motor evoked uppr limbs (95928) $1,007.20 $2,517.99 1.1×
Cardiopulmonary exercise testing (94621) $568.74 $1,421.84 1.4×
Cardiovascular stress test (93017) $629.60 $1,573.99 2.8×
Cardioversion elective external (92960) $1,209.38 $3,023.44 1.7×
Caregiver training 1st 30 min (97550) $45.12 $112.80
Caregiver training ea addl 15 (97551) $20.64 $51.59
Chemo anti-neopl sq/im (96401) $166.18 $415.44 2.2×
Chemo hormon antineopl sq/im (96402) $178.90 $447.25 2.4×
Chemo IV infus each addl seq (96417) $175.72 $439.28 2.3×
Chemo IV infusion addl hr (96415) $165.36 $413.38 2.2×
Chemo IV push addl drug (96411) $329.05 $822.62 4.3×
Chemother prolong infuse w/pump (96416) $516.92 $1,292.28 1.5×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $771.37 $1,928.42 2.2×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $445.63 $1,114.06 1.3×
Chest physiotherapy initial (94667) $110.76 $276.90 0.8×
Color/duplex Doppler, complete (93975) $786.69 $1,966.72 3.1×
Color/duplex Doppler, limited (93976) $691.59 $1,728.97 6.3×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $49.94 $124.86
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $328.91 $822.26 2.3×
Cpr (92950) $414.80 $1,036.98 1.8×
Cptrized oph dx img pst segment uni/bi optic nrv (92133) $84.64 $211.59 1.4×
Cptrized oph dx img pst segment uni/bi retina (92134) $84.64 $211.59 1.4×
Critical care ill/injured patient init 30-74 min (99291) $6,769.70 $16,924.24 7.8×
Ctr motr ep std transcrnl motr stim upr&low limb (95939) $1,140.70 $2,851.72 1.3×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) $691.59 $1,728.97 2.7×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $691.59 $1,728.97 6.3×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $866.48 $2,166.20 3.4×
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $438.91 $1,097.26 4.0×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $603.41 $1,508.51 2.4×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $642.69 $1,606.72 5.8×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $691.59 $1,728.97 2.7×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $691.59 $1,728.97 6.3×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $461.42 $1,153.54 4.2×
Echo transesophageal (93312) $1,135.95 $2,839.87 2.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,307.62 $3,269.05 2.3×
Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording);… (93313) $1,300.84 $3,252.10 2.3×
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed,… (93307) $647.02 $1,617.55 2.6×
EEG extended monitoring 61-119 minutes (95813) $641.12 $1,602.79 2.8×
EKG 12 lead tracing only (93005) $93.62 $234.04 1.5×
EKG rhythm strip (93041) $66.80 $167 1.1×
Electrode stimulation brain (95961) $1,510.80 $3,776.99 1.7×
Emergency department visit high mdm (99285) $6,684.22 $16,710.55 10.6×
Emergency department visit low mdm (99283) $1,482.06 $3,705.14 5.1×
Emergency department visit may not req phys/qhp (99281) $344.45 $861.12 3.9×
Emergency department visit moderate mdm (99284) $3,180.27 $7,950.67 7.2×
Emergency department visit straightforward mdm (99282) $663.31 $1,658.26 4.1×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $133.68 $334.19
Evaluate pt use of inhaler (94664) $112.29 $280.72 0.5×
Evaluation of speech fluency (92521) $69.14 $172.84
Evaluation of speech sound production articulate (92522) $56.12 $140.30
Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic… (94617) $270.18 $675.43 1.9×
Ext ECG>48hr<7d scan a/r (93243) $93.62 $234.04 0.7×
External ECG rec>48hr<7d recording (93242) $82.35 $205.86 2.1×
External ECG rec>7d<15d recording (93246) $93.62 $234.04 2.4×
External ECG rec>7d<15d scanning alys w/report (93247) $90.75 $226.86 0.6×
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $263.06 $657.63 1.2×
Group caregiver training strategies & technique (97552) $19.27 $48.17
Hot/cold pack (97010) $9.18 $22.93
Immunization administration (90471) $50.11 $125.27 0.7×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $231.44 $578.58 4.7×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $231.44 $578.58 1.0×
Io anal gast n-stim subsq (95981) $167.23 $418.07 2.7×
Io ga n-stim subsq w/reprog (95982) $100.87 $252.16 2.6×
Irrigaj implntd venous access drug delivery syst (96523) $99.23 $248.06 1.6×
IV infusion hydration each additional hour (96361) $116.78 $291.94 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $528.08 $1,320.21 2.4×
IV infusion ther proph addl sequential to 1 hr (96367) $116.78 $291.94 1.5×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $528.08 $1,320.21 2.4×
IV tx, each additional hour (96366) $116.78 $291.94 2.4×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $110.76 $276.90 0.8×
Mechanical chest wall oscillation lung function (94669) $309.71 $774.27 1.3×
Methacholine challenge (94070) $917.31 $2,293.27 2.3×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $123.81 $309.52
Multiple sleep latency (95805) $1,161.99 $2,904.96 1.3×
Muscle test 3 limbs (95863) $708.26 $1,770.65 5.2×
Muscle test larynx (95865) $708.26 $1,770.65 5.0×
Ndl EMG 4 xtr w/wo related paraspinal areas (95864) $944.15 $2,360.37 7.0×
Needle electromyography 2 extremities with or without related paraspinal areas 95861 (95861) $304.85 $762.12 2.2×
Needle electromyography cranial nrv muscle uni (95867) $198.73 $496.81 0.9×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $425.92 $1,064.78 3.0×
Needle measurement of electrical activity in muscles on both sides of body (95868) $333.18 $832.94 1.5×
Negative pressure wound therapy dme </= 50 sq cm (97605) $178.04 $445.08 0.8×
Nerve conduction studies 3-4 studies (95908) $915.22 $2,288.05 4.0×
Neuromuscular junction test (95937) $210.94 $527.35 1.6×
Noninvasive ear/pulse oximetry overnight monitor (94762) $334.16 $835.38 2.5×
Occupational therapy eval high complex 60 mins (97167) $205.25 $513.12
Occupational therapy eval low complex 30 mins (97165) $125.06 $312.63
Occupational therapy eval mod complex 45 mins (97166) $137.61 $344.02
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92004) $165.44 $413.60 1.2×
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and… (92014) $165.42 $413.54 1.2×
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and… (92012) $165.42 $413.54 1.2×
Opscpy extnd optic nrv/macula drawing i&r uni/bi (92202) $103.38 $258.44 1.7×
Opscpy extnd rta drawing & scl deprsn i&r uni/bi (92201) $103.38 $258.44 1.7×
Oral function therapy (92526) $93.37 $233.41
Orthc/prostc mgmt sbsq enc (97763) $58.69 $146.72
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $69.66 $174.13
Ot manual therapy ea 15 min (97140) $72.28 $180.70
Ot neuromuscular re-education (97112) $81.82 $204.54
Ot re-evaluation (97168) $96.06 $240.14
OT Therapeutic Activities Charges (97530) $91.77 $229.42
Ot wheelchair management (97542) $104.83 $262.06
Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen extracted (94681) $340.44 $851.10 0.9×
Oxygen uptake, expired gas analysis; rest, indirect (separate procedure) (94690) $51.60 $128.99 0.8×
Phlebotomy therapeutic (99195) $184.09 $460.22 1.3×
Physical therapy evaluation high complex 45 mins (97163) $205.25 $513.12
Physical therapy evaluation low complex 20 mins (97161) $125.06 $312.63
Physical therapy evaluation mod complex 30 mins (97162) $137.61 $344.02
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $3,249.10 $8,122.73 3.6×
Polysom <6 yrs sleep w/cpap/bilvl vent 4/> param (95783) $2,298.50 $5,746.24 2.5×
Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist (95808) $848.19 $2,120.46 0.9×
Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a… (95782) $2,629.71 $6,574.26 2.9×
Pt gait training 15 min (97116) $65.95 $164.87
Pt re-evaluation (97164) $96.06 $240.14
Pulm funct tst plethysmograp (94726) $309.71 $774.26 0.8×
Pulmonary stress testing (94618) $270.18 $675.43 1.9×
Refilling and maintenance of portable pump (96521) $423.42 $1,058.54 1.9×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $69.86 $174.64
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95927) $148.08 $370.19 0.7×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95938) $435.54 $1,088.85 0.5×
Sleep study unattended (95806) $263.36 $658.39 1.2×
Speech sound lang comprehen (92523) $116.59 $291.47
Standardized cognitive performance testing (96125) $123.45 $308.62
Stress tte only (93350) $1,603.35 $4,008.36 2.8×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $213.74 $534.33 4.3×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $229.92 $574.78 1.0×
Surfactant administration (94610) $113.56 $283.90 0.5×
Temp transcutaneous pacing (92953) $587.78 $1,469.45 0.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $84.05 $210.12
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $84 $210
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $70.72 $176.80
Therapeutic prophylactic/dx injection subq/im (96372) $142.41 $356.01 1.9×
Transcranial doppler stdy intracranial art compl (93886) $579.09 $1,447.72 2.3×
Transcranial Doppler study of the intracranial arteries; limited study Age Under 21 (93888) $402.98 $1,007.43 3.7×
Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study Age Under 21 (93304) $489.79 $1,224.47 0.8×
Tte congenital complete (93303) $647.02 $1,617.55 1.1×
Tte f-up or lmtd (93308) $332.36 $830.90 1.3×
Tte w/doppler complete (93306) $1,166 $2,915 2.0×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $112.14 $280.34
Upr/l xtremity art 2 levels (93922) $390.24 $975.60 2.8×
Ventilation ip/obs initial day (94002) $424.55 $1,061.37 0.7×
Ventilator subsequent day (94003) $424.55 $1,061.37 0.7×
Vital capacity total (94150) $190.17 $475.41 1.4×