Supplies, drugs & other prices at St. Elizabeth Hospital

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

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $147.32 $368.28 4.1×
2d tte w or w/o fol w/con,fu (C8924) $1,728.04 $4,320.09 4.7×
Admin hepatitis b vaccine (G0010) $56.82 $142.04 1.2×
Admin influenza virus vac (G0008) $256.57 $641.41 5.2×
Admin pneumococcal vaccine (G0009) $55.64 $139.10 1.1×
Catheterize for urine spec (P9612) $68.70 $171.75 7.4×
Covid-19 lab test non-cdc (U0002) $147.32 $368.28 2.9×
Direct refer hospital observ (G0379) $436.78 $1,091.95 0.7×
Hospital outpt clinic visit (G0463) $396.07 $990.16 2.8×
Inj for sacroiliac jt anesth (G0260) $799.38 $1,998.45 1.1×
Mra w/cont, chest (C8909) $2,095.69 $5,239.22 5.7×
Mra w/cont, pelvis (C8918) $2,508.13 $6,270.32 6.8×
Mra w/o cont, chest (C8910) $1,755.47 $4,388.66 7.0×
Mra w/o fol w/cont, abd (C8902) $2,686.38 $6,715.95 7.3×
Mri w/o fol w/cont, brst, un (C8905) $3,060.70 $7,651.74 8.3×
Oth resp proc, group (G0239) $276.53 $691.32 7.0×
Oth resp proc, indiv (G0238) $69.47 $173.66 2.3×
Prolonged iv inf, req pump (C8957) $252.13 $630.32 1.1×
Psa screening (G0103) $94.62 $236.53 4.9×
Revasc intravasc lithotripsy (C9764)
unusually low — confirm this is the full procedure
$4,829.50 $12,073.73 0.4×
Screen cerv/vag thin layer (G0123) $55.59 $138.97 2.7×
Trauma respons w/hosp criti (G0390) $2,992.38 $7,480.95 2.1×
Tte w or wo fol wcon,doppler (C8929) $1,442.92 $3,607.29 1.7×