Supplies, drugs & other prices at St. Thomas More Hospital

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

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

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,co (C8923) $580.90 $1,452.23 0.7×
2d tte w or w/o fol w/con,fu (C8924) $770.45 $1,926.12 2.1×
Admin hepatitis b vaccine (G0010) $63.15 $157.86 1.3×
Admin influenza virus vac (G0008) $53.53 $133.81 1.1×
Admin pneumococcal vaccine (G0009) $53.53 $133.81 1.1×
Catheterize for urine spec (P9612) $76.90 $192.24 8.2×
Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s) (0637T) $2,075.50 $5,188.73 5.6×
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s) (0636T) $1,320.94 $3,302.34 5.2×
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast… (0638T) $2,075.50 $5,188.73 5.6×
Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s) (0634T) $1,711.82 $4,279.55 9.3×
Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material (0633T) $707.23 $1,768.07 6.4×
Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast… (0635T) $1,711.82 $4,279.55 9.3×
Covid-19 lab test non-cdc (U0002) $41.27 $103.16 0.8×
Direct refer hospital observ (G0379) $309.75 $774.36 0.5×
Drug test def 1-7 classes (G0480) $75.48 $188.68 0.7×
Fecal microbiota prep instil (G0455) $931.73 $2,329.32 0.9×
Home sleep test/type 3 porta (G0399) $661.50 $1,653.75 2.9×
Hospital outpt clinic visit (G0463) $286.17 $715.42 2.0×
Inj for sacroiliac jt anesth (G0260) $1,079.01 $2,697.52 1.4×
Mra w/cont, abd (C8900) $1,935.99 $4,839.96 5.3×
Mra w/cont, chest (C8909) $1,935.99 $4,839.96 5.3×
Mra w/o cont, abd (C8901) $1,629.96 $4,074.89 6.5×
Mra w/o cont, chest (C8910) $1,629.96 $4,074.89 6.5×
Mra w/o cont, pelvis (C8919) $1,568.91 $3,922.27 6.2×
Mra w/o fol w/cont, abd (C8902) $2,797.15 $6,992.86 7.6×
Mra w/o fol w/cont, chest (C8911) $2,797.15 $6,992.86 7.6×
Oth resp proc, group (G0239) $365.66 $914.14 9.3×
Oth resp proc, indiv (G0238) $42.08 $105.18 1.4×
Pathogen test for platelets (P9100) $68.99 $172.47 1.1×
Prolonged iv inf, req pump (C8957) $263.73 $659.32 1.2×
Psa screening (G0103) $111.24 $278.10 5.8×
Screen cerv/vag thin layer (G0123) $113.58 $283.93 5.6×
Screen pap by tech w md supv (P3000) $59.20 $148 3.2×
Therapeutic procd strg endur (G0237) $365.66 $914.14 12.0×
Trauma respons w/hosp criti (G0390) $1,282.46 $3,206.13 0.9×
Trim nail(s) (G0127) $106.45 $266.12 1.7×
Tte w or w/o contr, cont ecg (C8930) $1,430.15 $3,575.37 1.7×
Tte w or w/o fol w/con,stres (C8928) $992.26 $2,480.64 1.2×
Tte w or w/o fol w/cont, com (C8921) $1,835.69 $4,589.21 2.2×
Tte w or w/o fol w/cont, f/u (C8922) $878.13 $2,195.31 1.1×
Tte w or wo fol wcon,doppler (C8929) $1,110.10 $2,775.25 1.3×