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Charges and Fees For Common Healthcare Services

Senate Bill (SB) 17-065: Transparency in Direct Pay Health Care Prices requires healthcare facilities, physicians, and providers to post prices for their most common healthcare services. Patients with health insurance are strongly encouraged to consult with their health insurer to determine accurate information about their financial responsibility for a particular health care service at one of our facilities.

If you are not covered by health insurance, you are strongly encouraged to contact Colorado Mountain Medical at (970) 926-6350 to discuss payment options prior to receiving services (learn more about possible enrollment support). Because of these factors, posted health care prices may not reflect the actual amount of your financial responsibility.

Below is a list estimating the cost of Colorado Mountain Medical’s most commonly billed services.

CPT      Price    Description     
99202    $193    Outpatient Office Visit; New Patient; Straightforward    
99203    $299    Outpatient Office Visit; New Patient; Low Complexity     
99204    $443    Outpatient Office Visit; New Patient; Moderate Complexity    
99212    $151    Outpatient Office Visit; Established Patient; Straightforward  
99213    $240    Outpatient Office Visit; Established Patient; Low Complexity    
99214    $340    Outpatient Office Visit; Established Patient; Moderate Complexity   
99392    $278    Preventive Visit; Age 1-4; Established Patient  
99393    $277    Preventive Visit; Age 5-11; Established Patient 
99394    $302    Preventive Visit, Age 12-17, Established Patient    
99395    $309    Preventive Visit, Age 18-39, Established Patient  
99396    $328    Preventive Visit, Age 40-64, Established Patient  
99397    $354    Preventive Visit, Age 65 & over, Established Patient    
PNCK    NS       Prenatal Check (fee included in comprehensive pregnancy care)  
80050    $82      General Health Panel (GHP) (lab work) 
80053    $42      Comprehensive Metabolic Panel (CMP) (lab work) 
80061    $46      Lipid Panel (lab work)   
81003    $7        Urinalysis (dipstick)     
84153    $73      Prostate-Specific Antigen (PSA), total (lab work)  
84443    $68      Thyroid Stimulating Hormone (TSH) (lab work)    
85025    $28      Complete Blood Count (CBC, auto with auto diff.) (lab work)     
87651    $57      Strep A (Swab)  

No Surprise Act & Good Faith

The Good Faith Estimate & No Surprise Act may be helpful to our our patients while understanding their billing statements.

Patients have the right to receive a “Good Faith Estimate” explaining how much health care will cost. Under the law,
health care providers need to give patients who don’t have certain types of health care coverage or who are not
using certain types of health care coverage an estimate of their bill for health care items and services before those
items or services are provided.

This notice applies only to Vail Health Hospital, Colorado Mountain Medical, Shaw Cancer Center in Edwards, and Sonnenalp Breast Center in Edwards.

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment,
coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit
a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan.
Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and
the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs
for the same service and might not count toward your annual out-of-pocket limit. “Surprise billing” is an unexpected
balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency
or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory
surgical center, you are protected from surprise billing or balance billing.