LABORATORY PROCEDURES IMAGING/RADIOLOGY PROCEDURES THERAPY GVH EMERGENCY DEPARTMENT PROCECURES

Transcription

1 PROCEDURE CHARGES / HOSPITAL may vary depending on circumstances. Prices subject to change. LABORATORY PROCEDURES Basic Metabolic Panel $ Comprehensive Metabolic Panel $ UA Micro $ C-Reactive Protein $ CBC $ Lipid Panel 4 $ Thyroid Stimulating Hormone $ Prothrombin Time $ UA w/o Micro $ LDL $ Urine Culture $ Manual Differential $ Hemogram $ Troponin $ Venipuncture (Lab Draw) $ THERAPY Electrical Stimulation $ Wound Debridement $ Physical Therapy Evaluation Moderate $ Therapeutic Exercise Charge $ Therapeutic Activities Charge $ Neuromuscular Re-education $ Manual Therapy Charge $ PT Gait Training Charges $ Vasopneumatic Devices $ Physical Therapy Evaluation Low $ GVH EMERGENCY DEPARTMENT PROCECURES Level 1 $ Level 2 $ Level 3 $ Level 4 $ Level 5 $1, Hydration First Hour $ Hydration Additional Hour $ IV Injection Initial $ IV Injection Additional $ IV tx, First Hour $ IV tx, Additional Hour $ ER Laceration Repair Simple $ ER Laceration Repair Complex $ ER I&D Abscess $ Foreign Body Removal $ EKG $ Respiratory Treatment $ IMAGING/RADIOLOGY PROCEDURES CT Exams: CT Single Body Part w/o Contrast $1, (i.e. knee, shoulder, spine, brain, abdomen) CT Single Body Part w/ Contrast $1, CT Abdomen/Pelvis w/o Contrast $2, CT Abdomen/Pelvis w/ Contrast $2, MRI Exams: MRI Single Body Part w/o Contrast $1, (i.e. knee, shoulder, spine, brain, abdomen) MRI Single Body Part $1, w/ and w/o Contrast Ultrasound Exams: Ultrasound Abdomen Complete $ Ultrasound Pelvic $ Ultrasound Abdomen Limited $ Ultrasound Breast $ Ultrasound Transvaginal Scan $ Ultrasound Head & Neck $ X-Ray Exams XR Chest 2 Views $ XR Chest Single View $ XR Lumbar Spine $ XR Foot 3 Views $

2 PROCEDURE CHARGES / HOSPITAL may vary depending on circumstances. Prices subject to change. PROCEDURES Home Sleep Study $ Colonoscopy $5, SI Joint Injections $1, Facet Joint Injections First Level $ Facet Joint Injections Additional Level $ Injection Sacroiliac Joint Charge $1, Epidural Steroid Injection Cervical. Thorasic $1, Transforaminal or Selective Nerve Root Block Lumbar $2, Transforaminal Additional Level $1, SURGICAL PROCEDURES Please call and ask for the Admissions Department to obtain an estimate for surgical procedures. The pricing for all surgical procedures, both inpatient and outpatient, are quoted in a cost range. These procedures vary in price dependent on the surgical provider (surgeon) of the service. These prices do not include your physician s fees. Your surgeon and anesthesiologist will bill you separately. Surgeons use different equipment and implants (hip, knee and other replacement joints made by various manufacturers), and take varying amounts of time to perform the same procedure. The amount of time in the operating room may vary due to many factors, including the patient s health condition or the physician s approach to the particular procedure. Please obtain as much information from your surgeon as possible before calling the hospital to obtain an estimate N. TAYLOR STREET GUNNISON, CO 81230

3 GENERAL SURGERY CLINIC PROCEDURE CHARGES / GENERAL SURGERY CLINIC New Patient Office Visit, Level 1 New Patient Office Visit, Level 2 New Patient Office Visit, Level 3 New Patient Office Visit, Level 4 New Patient Office Visit, Level 5 Est Patient Office Visit, Level 1 Est Patient Office Visit, Level 2 Est Patient Office Visit, Level 3 Est Patient Office Visit, Level 4 Est Patient Office Visit, Level 5 Office Consult, Level 2 Office Consult, Level 3 Office Consult, Level 4 ER Level Consult, Level 3 ER Level Consult, Level 4 Excision Benign Lesion Trunk (1.1 CM CM) Excision Benign Lesion Trunk (>4 CM) Excision Benign Lesion Scalp (1.1 CM CM) EGD EGD w/biopsy Laparoscopy, Appendectomy Colonoscopy Colonoscopy w/biopsy Colonoscopy w/snare Anoscopy Laparoscopy, Cholecystectomy Umbilical Hernia Repair Laparoscopy, Inguinal Hernia Repair $ $ $ $ $ $74.00 $ $ $ $ $ $ $ $ $ $1, $1, $1, $1, $2, $2, $1, N. TAYLOR STREET GUNNISON, CO 81230

4 PROCEDURE CHARGES / FAMILY MEDICINE CLINIC New Patient Office Visit, Level I $ New Patient Office Visit, Level II $ New Patient Office Visit, Level III $ New Patient Office Visit, Level IV $ New Patient Office Visit, Level V $ Est Patient Office Visit, Level I $74.00 Est Patient Office Visit, Level II $ Est Patient Office Visit, Level III $ Est Patient Office Visit, Level IV $ Est Patient Office Visit, Level V $ Office Consult, New or Est 15 min Initial Preventative Care, New Pt $ Periodic Preventative Care Ages 1-4 $ Periodic Preventative Care Ages $ Periodic Preventative Care Ages $ Periodic Preventative Care Ages $ Destruction Benign Lesion $ Venipuncture $12.00 Urinalysis $8.00 Pregnancy Test, Urine $20.00 Hemoglobin $14.00 Mononucleosis, Blood $18.00 Influenza Test $40.00 Strep A Test $41.00 Immunization Admin $65.00 Pneumococcal Vaccine $ Flu Vaccine $51.00 EKG (12 Lead) $44.00 Nebulizer Treatment $ N. IOWA STREET GUNNISON, CO 81230

5 MOUNTAIN CLINIC PROCEDURE CHARGES / MOUNTAIN CLINIC AIRWAY INHALATION TREATMENT HYDRATION IV INFUSION ADD ON THERAPEUTIC INJECTION INTRAMUSCULAR THERAPEUTIC INJECTION IV PUSH IV PUSH EACH ADDITIONAL BRACE KNEE ER LEVEL I ER LEVEL II ER LEVEL III ER LEVEL IV ER LEVEL V Urgent Care NEW PT-OFFICE VISIT LEVEL 2 Urgent Care NEW PT-OFFICE VISIT LEVEL 3 Urgent Care NEW PT-OFFICE VISIT LEVEL 4 Urgent Care NEW PT-OFFICE VISIT LEVEL 5 ESTABLISHED PT-OFFICE VISIT LEVEL 1 ESTABLISHED PT-OFFICE VISIT LEVEL 2 ESTABLISHED PT-OFFICE VISIT LEVEL 3 ESTABLISHED PT-OFFICE VISIT LEVEL 4 ESTABLISHED PT-OFFICE VISIT LEVEL 5 ARM SLING APPLICATION SHORT LEG SPLINT APPLICATION LONG LEG SPLINT APPLICATION SHORT ARM SPLINT LACERATION REPAIR CLOSED TREATMENT SHOULDER CLOSED TREATMENT COLLES FRACTURE INTERMEDIATE WOUND REPAIR NERVE BLOCK PERIPHERAL REMOVAL FOREIGN BODY EYE THERAPEUTIC IV INFUSION INITIAL HYDRATION IV INFUSION INITIAL $ $61.00 $81.00 $ $81.00 $ $ $ $ $ $ $ $ $ $ $52.00 $ $ $ $ $19.00 $ $ $ $ $ $ $ $ L A , 12011, SNOWMASS ROAD, AXTEL 100 MT. CRESTED BUTTE, CO 81225