Does Mt San Rafael Hospital publish its standard charges and chargemaster?

Yes. Mt San Rafael Hospital publishes a machine-readable file with 1,024 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Mt San Rafael Hospital charge for procedures?

Mt San Rafael Hospital (Trinidad, CO) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · CO · CCN 061321

Mt San Rafael Hospital

Trinidad, CO, 81082

25 bedsCritical Access Hospitals2

Compliance grade

93/100

Rates published

1,024

last crawl 2026-05-22

Procedures tracked

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All CO hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://secure.claraprice.net/price-transparency/BQJH-1670278124636/machine-readable/352336501_crane-memorial-hospital_standardcharges.json · JSON

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
emergency
ED visit level 1	CPT	99281	2	$232	$162	$31	$93.5	0.67×	$209
ED visit level 2	CPT	99282	2	$389	$272	$237	$255	1.1×	$350
ED visit level 3	CPT	99283	2	$678	$475	$414	$444.5	1.1×	$610
ED visit level 4	CPT	99284	2	$1,208	$846	$737	$792	1.2×	$1,087
ED visit level 5	CPT	99285	2	$1,726	$1,208	$1,046	$1,128	1.1×	$1,553
Critical care, first hour	CPT	99291	2	$2,475	$1,733	$1,510	$1,623	1.5×	$2,228
imaging
CT head without contrast	CPT	70450	2	$1,610	$1,127	$687	$997	4.8×	$1,449
CT head with contrast	CPT	70460	2	$1,842	$1,289	$787	$1,140.5	4.9×	$1,658
CT head with and without contrast	CPT	70470	2	$2,305	$1,614	$984	$1,427	5.3×	$2,075
CT neck with contrast	CPT	70491	2	$2,012	$1,408	$859	$1,245.5	4.6×	$1,811
Chest X-ray single view	CPT	71045	2	$336	$235	$84	$136	1.4×	$302
Chest X-ray 2 views	CPT	71046	2	$342	$239	$79	$138.5	1.4×	$308
CT chest without contrast	CPT	71250	2	$1,695	$1,187	$724	$1,049.5	4.9×	$1,526
CT chest with contrast	CPT	71260	2	$2,188	$1,532	$934	$1,355	4.8×	$1,969
CT chest with and without contrast	CPT	71270	2	$2,651	$1,856	$1,132	$1,641.5	5.6×	$2,386
Lumbosacral spine X-ray	CPT	72100	2	$249	$174	$64	$120.5	1.2×	$224
CT cervical spine without contrast	CPT	72125	2	$1,957	$1,370	$836	$1,212	6.0×	$1,761
CT thoracic spine without contrast	CPT	72128	2	$1,679	$1,175	$717	$1,039.5	5.2×	$1,511
CT lumbar spine without contrast	CPT	72131	2	$1,737	$1,216	$742	$1,075.5	5.3×	$1,563
CT pelvis without contrast	CPT	72192	2	$1,621	$1,135	$692	$1,003.5	5.0×	$1,459
CT pelvis with contrast	CPT	72193	2	$1,922	$1,345	$821	$1,190	4.2×	$1,730
Shoulder X-ray	CPT	73030	2	$463	$324	$124	$229.5	2.5×	$417
Humerus X-ray	CPT	73060	2	$371	$260	$47	$154.5	1.7×	$334
Hand X-ray 3 views	CPT	73130	2	$343	$240	$91	$169.5	1.8×	$309
Knee X-ray 1-2 views	CPT	73560	2	$445	$312	$51	$182.5	2.0×	$401
Ankle X-ray 3 views	CPT	73610	2	$278	$195	$79	$123.5	1.3×	$250
CT abdomen without contrast	CPT	74150	2	$1,573	$1,101	$672	$974	5.2×	$1,416
CT abdomen with contrast	CPT	74160	2	$1,852	$1,296	$791	$1,147	4.0×	$1,667
CT abdomen with and without contrast	CPT	74170	2	$2,447	$1,713	$1,045	$1,515	4.5×	$2,202
CT abdomen and pelvis without contrast	CPT	74176	2	$3,219	$2,253	$1,375	$1,993	5.5×	$2,897
CT abdomen and pelvis with contrast	CPT	74177	2	$3,936	$2,755	$1,681	$2,437	4.4×	$3,542
CT abdomen and pelvis with and without contrast	CPT	74178	2	$4,267	$2,987	$1,822	$2,642	4.6×	$3,840
Abdominal ultrasound complete	CPT	76700	2	$919	$643	$392	$583	3.9×	$827
Abdominal ultrasound limited	CPT	76705	2	$919	$643	$392	$583	4.0×	$827
Retroperitoneal ultrasound complete	CPT	76770	2	$588	$412	$251	$373	2.6×	$529
Obstetric ultrasound first trimester	CPT	76801	2	$760	$532	$325	$482.5	3.4×	$684
Obstetric ultrasound after first trimester	CPT	76805	2	$760	$532	$325	$482.5	3.2×	$684
Transvaginal ultrasound	CPT	76830	2	$601	$421	$257	$381.5	2.6×	$541
Pelvic ultrasound complete	CPT	76856	2	$919	$643	$392	$583	4.1×	$827
Scrotal ultrasound	CPT	76870	2	$720	$504	$307	$456.5	3.5×	$648
EKG complete	CPT	93000	2	$83	$58	$51	$51.5	2.1×	$75
EKG tracing only	CPT	93005	2	$101	$71	$51	$62	0.53×	$91
lab
Basic metabolic panel (BMP)	CPT	80048	2	$242	$169	$62	$107	3.3×	$218
Electrolyte panel	CPT	80051	2	$204	$143	$52	$90	3.8×	$184
Comprehensive metabolic panel	CPT	80053	2	$326	$228	$84	$144.5	3.3×	$293
Lipid panel	CPT	80061	2	$180	$126	$46	$79.5	2.1×	$162
Renal function panel	CPT	80069	2	$338	$237	$87	$149.5	5.5×	$304
Hepatic function panel	CPT	80076	2	$221	$155	$57	$98	3.7×	$199
Urinalysis automated	CPT	81003	2	$43	$30	$11	$19	1.4×	$39
Glucose quantitative	CPT	82947	2	$48	$34	$4	$12	0.68×	$43
Hemoglobin A1c	CPT	83036	2	$184	$129	$47	$81.5	3.0×	$166
Thyroid stimulating hormone (TSH)	CPT	84443	2	$273	$191	$56	$103	2.2×	$246
Complete blood count with automated differential	CPT	85025	2	$80	$56	$20	$35	1.3×	$72
Complete blood count without differential	CPT	85027	2	$80	$56	$20	$35	1.6×	$72
Urine culture bacterial	CPT	87086	2	$20	$14	$5	$9	0.39×	$18
Tissue exam by pathologist level IV	CPT	88305	2	$185	$130	$47	$92	0.90×	$167
office
Office visit, new patient, 15-29 min	CPT	99202	2	$148	$104	$90	$91.5	1.1×	$133
Office visit, new patient, 30-44 minutes	CPT	99203	2	$254	$178	$155	$157.5	1.3×	$229
Office visit, new patient, 45-59 min	CPT	99204	2	$389	$272	$226	$237	1.4×	$350
Office visit, new patient, 60-74 min	CPT	99205	2	$439	$307	$268	$272	1.2×	$395
Office visit, established patient, 5 min	CPT	99211	2	$101	$71	$28	$38.5	0.60×	$91
Office visit, established patient, 10-19 min	CPT	99212	2	$91	$64	$56	$56.5	0.71×	$82
Office visit, established patient, 20-29 minutes	CPT	99213	2	$242	$169	$84	$123.5	1.1×	$218
Office visit, established patient, 30-39 minutes	CPT	99214	2	$199	$139	$121	$124.5	0.82×	$179
Office visit, established patient, 40-54 min	CPT	99215	2	$254	$178	$155	$157.5	0.84×	$229
preventive
Upper GI endoscopy diagnostic	CPT	43235	2	$2,084	$1,459	$1,271	$1,290	1.4×	$1,876
Upper GI endoscopy with biopsy	CPT	43239	2	$2,200	$1,540	$1,342	$1,362	1.4×	$1,980
Sigmoidoscopy with biopsy	CPT	45331	2	$1,433	$1,003	$874	$887	0.99×	$1,290
Colonoscopy diagnostic	CPT	45378	2	$2,315	$1,621	$1,412	$1,433.5	1.6×	$2,084
Colonoscopy with biopsy	CPT	45380	2	$3,134	$2,194	$1,912	$1,940.5	1.6×	$2,821
Colonoscopy with polyp removal	CPT	45385	2	$2,084	$1,459	$1,271	$1,290	1.1×	$1,876
surgery
Laparoscopic cholecystectomy	CPT	47562	2	$7,687	$5,381	$4,689	$4,759.5	2.7×	$6,918
Umbilical hernia repair age 5+	CPT	49585	2	$4,812	$3,368	$2,672	$2,935	2.2×	$4,331
Lap inguinal hernia repair	CPT	49650	2	$7,625	$5,338	$4,651	$4,721	4.2×	$6,863

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 2)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	74	$245
UnitedHealthcare	74	$164.5

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