Pueblo/Canon City Test/Procedure Costs

The following test / procedure costs apply to:

  • St. Mary-Corwin Hospital
  • St. Thomas-More Hospital
Location Service Description Test/Procedure Billing Code Self-Pay Rate Payment Method
PUEBLO & CANON CITY INPATIENT VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES DRG 775 $5,715 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC DRG 470 $38,456 PER CASE
PUEBLO & CANON CITY INPATIENT CESAREAN SECTION W/O CC/MCC DRG 766 $10,952 PER CASE
PUEBLO & CANON CITY INPATIENT CESAREAN SECTION W CC/MCC DRG 765 $12,278 PER CASE
PUEBLO & CANON CITY INPATIENT SPINAL FUSION EXCEPT CERVICAL W/O MCC DRG 460 $83,248 PER CASE
PUEBLO & CANON CITY INPATIENT SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC DRG 871 $21,333 PER CASE
PUEBLO & CANON CITY INPATIENT VAGINAL DELIVERY W COMPLICATING DIAGNOSES DRG 774 $6,974 PER CASE
PUEBLO & CANON CITY INPATIENT PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC DRG 247 $40,866 PER CASE
PUEBLO & CANON CITY INPATIENT ESOPHAGITIS GASTROENT  MISC DIGEST DISORDERS W/O MCC DRG 392 $9,254 PER CASE
PUEBLO & CANON CITY INPATIENT SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC DRG 872 $17,515 PER CASE
PUEBLO & CANON CITY INPATIENT CERVICAL SPINAL FUSION W/O CC/MCC DRG 473 N/A PER CASE
PUEBLO & CANON CITY INPATIENT O.R. PROCEDURES FOR OBESITY W/O CC/MCC DRG 621 $25,892 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W CC DRG 330 $36,446 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W/O CC/MCC DEG 331 $23,519 PER CASE
PUEBLO & CANON CITY INPATIENT LOWER EXTREM  HUMER PROC EXCEPT HIPFOOTFEMUR W/O CC/MCC DEG 494 $22,214 PER CASE
PUEBLO & CANON CITY INPATIENT CELLULITIS W/O MCC DRG 603 $5,349 PER CASE
PUEBLO & CANON CITY INPATIENT UTERINE  ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC DRG 743 $17,249 PER CASE
PUEBLO & CANON CITY INPATIENT VAGINAL DELIVERY W STERILIZATION /OR DC DRG 767 $6,068 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES DRG 483 $53,341 PER CASE
PUEBLO & CANON CITY INPATIENT DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC DRG 439 $11,769 PER CASE
PUEBLO & CANON CITY INPATIENT PULMONARY EDEMA  RESPIRATORY FAILURE DRG 189 $19,348 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR MALE PELVIC PROCEDURES W/O CC/MCC DRG 708 N/A PER CASE
PUEBLO & CANON CITY INPATIENT NEUROSES EXCEPT DEPRESSIVE DRG 882 N/A PER CASE
PUEBLO & CANON CITY INPATIENT INFECTIOUS  PARASITIC DISEASES W O.R. PROCEDURE W MCC DRG 853 $60,728 PER CASE
PUEBLO & CANON CITY INPATIENT DIABETES W CC DRG 638 $8,075 PER CASE
PUEBLO & CANON CITY INPATIENT G.I. OBSTRUCTION W/O CC/MCC DRG 390 $9,417 PER CASE
PUEBLO & CANON CITY INPATIENT NORMAL NEWBORN DRG 795 $1,828 PER CASE
PUEBLO & CANON CITY INPATIENT ALCOHOL/DRGU ABUSE/DEPEND W/O REHAB W/O MCC DRG 897 $13,593 PER CASE
PUEBLO & CANON CITY INPATIENT REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC DRG 468 $45,251 PER CASE
PUEBLO & CANON CITY INPATIENT SHOULDER, ELBOW, OR FOREARM PROC, EXC MAJOR JOINT W/O CC/MCC DRG 512 $27,372 PER CASE
PUEBLO & CANON CITY INPATIENT NEONATE W OTHER SIGNIFICANT PROBLEMS DRG 794 $2,744 PER CASE
PUEBLO & CANON CITY INPATIENT PSYCHOSES DRG 885 N/A PER CASE
PUEBLO & CANON CITY INPATIENT FULL TERM NEONATE W MAJOR PROBLEMS DRG 793 $5,706 PER CASE
PUEBLO & CANON CITY INPATIENT PREMATURITY W/O MAJOR PROBLEMS DRG 792 $17,666 PER CASE
PUEBLO & CANON CITY INPATIENT POISONING  TOXIC EFFECTS OF DRUGS W MCC DRG 917 $16,098 PER CASE
PUEBLO & CANON CITY INPATIENT EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE DRG 790 $25,428 PER CASE
PUEBLO & CANON CITY INPATIENT PREMATURITY W MAJOR PROBLEMS DRG 791 $16,884 PER CASE
PUEBLO & CANON CITY INPATIENT POISONING  TOXIC EFFECTS OF DRUGS W/O MCC DRG 918 $6,689 PER CASE
PUEBLO & CANON CITY INPATIENT INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS DRG 065 $6,801 PER CASE
PUEBLO & CANON CITY INPATIENT PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS DRG 246 $57,564 PER CASE
PUEBLO & CANON CITY INPATIENT MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W/O MCC DRG 641 $5,672 PER CASE
PUEBLO & CANON CITY INPATIENT OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS DRG 781 $5,168 PER CASE
PUEBLO & CANON CITY INPATIENT LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC DRG 419 $13,923 PER CASE
PUEBLO & CANON CITY INPATIENT PULMONARY EMBOLISM W/O MCC DRG 176 $15,658 PER CASE
PUEBLO & CANON CITY INPATIENT BRONCHITIS  ASTHMA W/O CC/MCC DRG 203 $8,248 PER CASE
PUEBLO & CANON CITY INPATIENT BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC DRG 462 $60,704 PER CASE
PUEBLO & CANON CITY INPATIENT SIMPLE PNEUMONIA  PLEURISY W MCC DRG 193 $12,647 PER CASE
PUEBLO & CANON CITY INPATIENT SIMPLE PNEUMONIA  PLEURISY W CC DRG 194 $14,342 PER CASE
PUEBLO & CANON CITY INPATIENT G.I. HEMORRHAGE W CC DRG 378 $12,725 PER CASE
PUEBLO & CANON CITY INPATIENT HIP  FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC DRG 482 $37,559 PER CASE
PUEBLO & CANON CITY INPATIENT RENAL FAILURE W CC DRG 683 $9,309 PER CASE
PUEBLO & CANON CITY INPATIENT CERVICAL SPINAL FUSION W CC DRG 472 N/A PER CASE
PUEBLO & CANON CITY INPATIENT CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC DRG 287 $11,430 PER CASE
PUEBLO & CANON CITY INPATIENT DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC DRG 440 $6,911 PER CASE
PUEBLO & CANON CITY INPATIENT PULMONARY EMBOLISM W MCC DRG 175 $36,254 PER CASE
PUEBLO & CANON CITY INPATIENT BRONCHITIS  ASTHMA W CC/MCC DRG 202 $9,262 PER CASE
PUEBLO & CANON CITY INPATIENT MAJOR SMALL  LARGE BOWEL PROCEDURES W MCC DRG 329 $60,974 PER CASE
PUEBLO & CANON CITY INPATIENT KIDNEY  URINARY TRACT INFECTIONS W/O MCC DRG 690 $7,678 PER CASE
PUEBLO & CANON CITY INPATIENT DEPRESSIVE NEUROSES DRG 881 N/A PER CASE
PUEBLO & CANON CITY INPATIENT INFECTIOUS  PARASITIC DISEASES W O.R. PROCEDURE W CC DRG 854 $19,369 PER CASE
PUEBLO & CANON CITY INPATIENT LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC DRG 418 $18,083 PER CASE
PUEBLO & CANON CITY INPATIENT INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC DRG 064 $25,616 PER CASE
PUEBLO & CANON CITY INPATIENT MEDICAL BACK PROBLEMS W/O MCC DRG 552 $15,853 PER CASE
PUEBLO & CANON CITY INPATIENT COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC DRG 454 N/A PER CASE
PUEBLO & CANON CITY INPATIENT G.I. OBSTRUCTION W CC DRG 389 $10,325 PER CASE
PUEBLO & CANON CITY INPATIENT COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC DRG 455 N/A PER CASE
PUEBLO & CANON CITY INPATIENT DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC DRG 057 $11,737 PER CASE
PUEBLO & CANON CITY INPATIENT LOWER EXTREM  HUMER PROC EXCEPT HIPFOOTFEMUR W CC DRG 493 $32,309 PER CASE
PUEBLO & CANON CITY INPATIENT SIMPLE PNEUMONIA  PLEURISY W/O CC/MCC DRG 195 $8,991 PER CASE
PUEBLO & CANON CITY OUTPATIENT CARDIAC DIAGNOSTIC - ELECTROCARDIOGRAM TRACING CPT 93005 $319 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT CARDIAC DIAGNOSTIC - CARDIOVASCULAR STRESS TEST CPT 93017 $1,552 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT CARDIAC DIAGNOSTIC - ECHOCARDIOGRAM, TTE W/DOPPLER COMPLETE CPT 93306 $1,637 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - COLONOSCOPY AND BIOPSY CPT 45380 $2,790 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - DIAGNOSTIC COLONOSCOPY CPT 45378 $1,671 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - EGD BIOPSY SINGLE/MULTIPLE CPT 43239 $2,920 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - LAPAROSCOPIC CHOLECYSTECTOMY CPT 47562 $9,604 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - COLONOSCOPY W/LESION REMOVAL CPT 45385 $3,269 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - HYSTEROSCOPY BIOPSY CPT 58558 $6,100 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - LAP ING HERNIA REPAIR INIT CPT 49650 $10,453 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - LOW BACK DISK SURGERY CPT 63030 N/A PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - PRP I/HERN INIT REDUC >5 YR CPT 49505 $8,266 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - KNEE ARTHROSCOPY/SURGERY CPT 29881 $7,875 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - LAPARO CHOLECYSTECTOMY/GRAPH CPT 47563 $10,199 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - CARE OF MISCARRIAGE CPT 59820 $3,520 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - TLH W/T/O 250 G OR LESS CPT 58571 $7,737 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - CYSTO/URETERO W/LITHOTRIPSY CPT 52356 $8,821 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - EGD DIAGNOSTIC BRUSH WASH CPT 43235 $2,158 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT SURGERY - INSERT TUNNELED CV CATH CPT 36561 $6,621 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITY OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - CALCIUM SCORING CPT 75571 $99 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - LUNG SCREENING CPT G0297 $385 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - COMPUTED TOMOGRAPHY SCAN - ALL OTHER CPT 70010-76499 $1,161 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - MAGNETIC RESONANCE IMAGING - MRI CPT 70010-76499 $1,196 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - DIAGNOSTIC X-RAY CPT 70010-76499 $453 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - MAMMOGRAPHY CPT 77053-77067 $187 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - POSITRON EMMISSION TOMOGRAHY - PET CPT 78491-78815 $2,504 PER SCAN
PUEBLO & CANON CITY OUTPATIENT IMAGING - ULTRASOUND CPT 76506-76999 $587 PER SCAN
PUEBLO & CANON CITY OUTPATIENT LAB - ASSAY THYROID STIM HORMONE CPT 84443 N/A PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT LAB - COMPREHEN METABOLIC PANEL CPT 80053 N/A PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT LAB - URINALYSIS AUTO W/O SCOPE CPT 81003 $58 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT LAB - COMPLETE CBC W/AUTO DIFF WBC CPT 85025 N/A PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT LAB - METABOLIC PANEL TOTAL CA CPT 80048 $37 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT LAB - VENIPUNCTURE CPT 36415 $3 PER PROCEDURE
PUEBLO & CANON CITY OUTPATIENT ANCILLARY - SLEEP STUDY FACILITY CPT 95805-95811 $1,459 PER VISIT
PUEBLO & CANON CITY OUTPATIENT ANCILLARY - PHYSICAL THERAPY REV 420-429 $435 PER VISIT
PUEBLO & CANON CITY OUTPATIENT ANCILLARY - OCCUPATIONAL THERAPY REV 430-439 $275 PER VISIT
PUEBLO & CANON CITY OUTPATIENT ANCILLARY - SPEECH THERAPY REV 440-449 $420 PER VISIT

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The pricing information provided on this website is intended to give self-pay patients, who have scheduled services, an estimate of the prices and expected payment amounts for commonly provided health care services at Centura Health hospitals. The pricing only covers the specific service listed and provided through the hospital, and does not include complicating factors or professional fees for services such as those provided by a physician, surgeon, pathologist, anesthesiologist, radiologist, nurse practitioner or other independent practitioners. Please contact those offices directly for price information associated with their care and service. The pricing does not include fees associated with implants, high-cost drugs, or second procedures. The pricing is for patients who have pre-scheduled the service and not applicable to patients who receive services in the emergency department.

This pricing does not apply to patients who have health insurance coverage through Medicare, Medicaid, other government insurance programs, or an insurance company. If a patient has health insurance, the patient’s health insurance policy (including deductibles, co-pay, co-insurance and out-of-pocket maximums) will apply and the amount the patient owes for health care services will depend on the patient’s insurance coverage.

The pricing information provided is region specific, and is not transferrable across regions.

The pricing information is not a guarantee of insurance coverage or availability of services.

There are certain chronic conditions or long-term care that Centura Health may not be able to provide customized pricing  for without additional clinical information from your physician.

Centura Health reserves the right to update or change any price at any time.

If you do not see the procedure or service you are looking for, or wish to receive a customized quote on a specific procedure, please request a custom estimate.

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