Supplies, drugs & other prices at UCHealth Pikes Peak Regional Hospital

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

38 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,fu (C8924) $1,575.20 $1,969 4.3×
Admin influenza virus vac (G0008) $116 $145 2.3×
Admin pneumococcal vaccine (G0009) $116 $145 2.3×
Ca screen;flexi sigmoidscope (G0104) $756 $945 0.8×
Chemo extend iv infus w/pump (G0498) $1,021.60 $1,277 2.9×
Colon ca scrn not hi rsk ind (G0121) $1,472 $1,840 1.5×
Colorectal scrn; hi risk ind (G0105) $1,472 $1,840 1.5×
Covid-19 lab test non-cdc (U0002) $94 $117.50 1.8×
Direct refer hospital observ (G0379) $1,444 $1,805 2.3×
Drug test def 1-7 classes (G0480) $216.98 $271.22 1.9×
Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only (0904T) $401.60 $502 6.5×
Ephys eval ccm-d ld 1st impl (0930T) $400 $500 0.3×
Ephys eval ccm-d ld separate (0931T) $400 $500 0.3×
Hospital outpt clinic visit (G0463) $462.80 $578.50 3.3×
Inj for sacroiliac jt anesth (G0260) $1,880 $2,350 2.5×
Interrog dev eval impl ccm-d system in person (0927T) $451.20 $564 11.5×
Mra w/cont, abd (C8900) $1,757.60 $2,197 4.8×
Mra w/o fol w/cont, abd (C8902) $2,628 $3,285 7.1×
Mra w/o fol w/cont, chest (C8911) $2,628 $3,285 7.1×
Mra w/o fol w/cont, pelvis (C8920) $2,553.60 $3,192 6.9×
Mra, w/o&w/dye, upper extr (C8936) $2,553.60 $3,192 6.9×
Oth resp proc, group (G0239) $732.80 $916 18.6×
Oth resp proc, indiv (G0238) $164.80 $206 5.4×
Programming device eval impl ccm-d sys in person (0926T) $558.40 $698 14.2×
Prolonged iv inf, req pump (C8957) $1,071.20 $1,339 4.8×
Psa screening (G0103) $152 $190 7.9×
QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device (0902T) $876 $1,095 6.2×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $516.80 $646 0.5×
Quan mr tis wo MRI 1orgn (0648T) $1,357.60 $1,697 1.4×
Quan us tiss charac i&r w/o dx us same anat (0689T) $215.20 $269 2.3×
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)… (0866T) $764.80 $956 3.0×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $400 $500 10.2×
Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and… (0818T) $835.20 $1,044 0.2×
Therapeutic procd strg endur (G0237) $144.80 $181 4.7×
Trauma respons w/hosp criti (G0390) $3,364 $4,205 2.4×
Tte w or w/o contr, cont ecg (C8930) $2,707.20 $3,384 3.3×
Tte w or w/o fol w/con,stres (C8928) $2,708 $3,385 3.3×
Tte w or wo fol wcon,doppler (C8929) $3,753.60 $4,692 4.5×