373 EAST TENTH STREET, SPRINGFIELD, CO, 81073
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| imaging | ||||||||
| MRI brain without contrast | CPT | 70551 | 6 | $2,017 | $1,614 | $1,892 | $1,977 | $1,977 |
| MRI brain with and without contrast | CPT | 70553 | 6 | $2,143 | $1,714 | $2,010 | $2,100 | $2,100 |
| MRI lumbar spine without contrast | CPT | 72148 | 6 | $2,931 | $2,345 | $2,749 | $2,872 | $2,872 |
| MRI lower extremity joint without contrast | CPT | 73721 | 6 | $2,931 | $2,345 | $2,618 | $2,742 | $2,872 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 6 | $1,879 | $1,503 | $1,762 | $1,841 | $1,841 |
| lab | ||||||||
| Comprehensive metabolic panel | CPT | 80053 | 6 | $263 | $210 | $247 | $258 | $258 |
| Lipid panel | CPT | 80061 | 6 | $214 | $171 | $201 | $210 | $210 |
| Complete blood count with automated differential | CPT | 85025 | 6 | $126 | $101 | $118 | $123 | $123 |
| office | ||||||||
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 6 | $205 | $164 | $192 | $201 | $201 |
| preventive | ||||||||
| Colonoscopy diagnostic | CPT | 45378 | 6 | $2,106 | $1,685 | $351 | $1,171 | $2,064 |
| Colonoscopy with biopsy | CPT | 45380 | 6 | $2,214 | $1,771 | $543 | $1,322 | $2,170 |
| Colonoscopy with polyp removal | CPT | 45385 | 6 | $2,214 | $1,771 | $498 | $1,298.5 | $2,170 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 12 | $1,909 |
| Blue Cross Blue Shield | 12 | $1,909 |
| Cigna | 12 | $1,850.5 |
| Meritain Health | 12 | $1,909 |
| rocky mountain hospital & medical | 12 | $1,909 |
| UnitedHealthcare | 12 | $1,827 |
