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 CITYINPATIENTVAGINAL DELIVERY W/O STERILIZATION/D&C W/O CC/MCCDRG 807$5,961 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCCDRG 470$40,110 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W STERILIZATION W/O CC/MCCDRG 785$11,423 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W/O STERILIZATION W/O CC/MCCDRG 788$11,423 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W STERILIZATION W MCCDRG 783$12,806 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W STERILIZATION W CCDRG 784$12,806 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W/O STERILIZATION W MCCDRG 786$12,806 PER CASE
PUEBLO & CANON CITYINPATIENTCESAREAN SECTION W/O STERILIZATION W CCDRG 787$12,806 PER CASE
PUEBLO & CANON CITYINPATIENTSPINAL FUSION EXCEPT CERVICAL W/O MCCDRG 460$86,828 PER CASE
PUEBLO & CANON CITYINPATIENTSEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCCDRG 871$22,250 PER CASE
PUEBLO & CANON CITYINPATIENTVAGINAL DELIVERY W/O STERILIZATION/D&C W MCCDRG 805$7,274 PER CASE
PUEBLO & CANON CITYINPATIENTVAGINAL DELIVERY W/O STERILIZATION/D&C W CCDRG 806$7,274 PER CASE
PUEBLO & CANON CITYINPATIENTPERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCCDRG 247$42,623 PER CASE
PUEBLO & CANON CITYINPATIENTESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCCDRG 392$9,651 PER CASE
PUEBLO & CANON CITYINPATIENTSEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCCDRG 872$18,268 PER CASE
PUEBLO & CANON CITYINPATIENTCERVICAL SPINAL FUSION W/O CC/MCCDRG 473N/APER CASE
PUEBLO & CANON CITYINPATIENTO.R. PROCEDURES FOR OBESITY W/O CC/MCCDRG 621$27,005 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR SMALL LARGE BOWEL PROCEDURES W CCDRG 330$38,013 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCCDRG 331$24,530 PER CASE
PUEBLO & CANON CITYINPATIENTLOWER EXTREM HUMER PROC EXCEPT HIPFOOTFEMUR W/O CC/MCCDRG 494$23,169 PER CASE
PUEBLO & CANON CITYINPATIENTCELLULITIS W/O MCCDRG 603$5,579 PER CASE
PUEBLO & CANON CITYINPATIENTUTERINE ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCCDRG 743$17,991 PER CASE
PUEBLO & CANON CITYINPATIENTVAGINAL DELIVERY W STERILIZATION/D&C W MCCDRG 796$6,329 PER CASE
PUEBLO & CANON CITYINPATIENTVAGINAL DELIVERY W STERILIZATION/D&C W CCDRG 797$6,329 PER CASE
PUEBLO & CANON CITYINPATIENTVAGINAL DELIVERY W STERILIZATION/D&C WO CC/MCCDRG 798$6,329 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIESDRG 483$55,635 PER CASE
PUEBLO & CANON CITYINPATIENTDISORDERS OF PANCREAS EXCEPT MALIGNANCY W CCDRG 439$12,275 PER CASE
PUEBLO & CANON CITYINPATIENTPULMONARY EDEMA RESPIRATORY FAILUREDRG 189$20,180 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR MALE PELVIC PROCEDURES W/O CC/MCCDRG 708N/APER CASE
PUEBLO & CANON CITYINPATIENTNEUROSES EXCEPT DEPRESSIVEDRG 882N/APER CASE
PUEBLO & CANON CITYINPATIENTINFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCCDRG 853$63,339 PER CASE
PUEBLO & CANON CITYINPATIENTDIABETES W CCDRG 638$8,423 PER CASE
PUEBLO & CANON CITYINPATIENTG.I. OBSTRUCTION W/O CC/MCCDRG 390$9,822 PER CASE
PUEBLO & CANON CITYINPATIENTNORMAL NEWBORNDRG 795$1,907 PER CASE
PUEBLO & CANON CITYINPATIENTALCOHOL/DRUG ABUSE/DEPEND W/O REHAB W/O MCCDRG 897$14,178 PER CASE
PUEBLO & CANON CITYINPATIENTREVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCCDRG 468$47,197 PER CASE
PUEBLO & CANON CITYINPATIENTSHOULDER, ELBOW, OR FOREARM PROC, EXC MAJOR JOINT W/O CC/MCCDRG 512$28,549 PER CASE
PUEBLO & CANON CITYINPATIENTNEONATE W OTHER SIGNIFICANT PROBLEMSDRG 794$2,862 PER CASE
PUEBLO & CANON CITYINPATIENTPSYCHOSESDRG 885N/APER CASE
PUEBLO & CANON CITYINPATIENTFULL TERM NEONATE W MAJOR PROBLEMSDRG 793$5,951 PER CASE
PUEBLO & CANON CITYINPATIENTPREMATURITY W/O MAJOR PROBLEMSDRG 792$18,426 PER CASE
PUEBLO & CANON CITYINPATIENTPOISONING TOXIC EFFECTS OF DRUGS W MCCDRG 917$16,790 PER CASE
PUEBLO & CANON CITYINPATIENTEXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATEDRG 790$26,521 PER CASE
PUEBLO & CANON CITYINPATIENTPREMATURITY W MAJOR PROBLEMSDRG 791$17,610 PER CASE
PUEBLO & CANON CITYINPATIENTPOISONING TOXIC EFFECTS OF DRUGS W/O MCCDRG 918$6,976 PER CASE
PUEBLO & CANON CITYINPATIENTINTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRSDRG 065$7,093 PER CASE
PUEBLO & CANON CITYINPATIENTPERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTSDRG 246$60,039 PER CASE
PUEBLO & CANON CITYINPATIENTMISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W/O MCCDRG 641$5,916 PER CASE
PUEBLO & CANON CITYINPATIENTOTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCCDRG 817$5,390 PER CASE
PUEBLO & CANON CITYINPATIENTOTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W CCDRG 818$5,390 PER CASE
PUEBLO & CANON CITYINPATIENTOTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W MCCDRG 831$5,390 PER CASE
PUEBLO & CANON CITYINPATIENTOTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CCDRG 832$5,390 PER CASE
PUEBLO & CANON CITYINPATIENTLAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCCDRG 419$14,522 PER CASE
PUEBLO & CANON CITYINPATIENTPULMONARY EMBOLISM W/O MCCDRG 176$16,331 PER CASE
PUEBLO & CANON CITYINPATIENTBRONCHITIS ASTHMA W/O CC/MCCDRG 203$8,602 PER CASE
PUEBLO & CANON CITYINPATIENTBILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCCDRG 462$63,314 PER CASE
PUEBLO & CANON CITYINPATIENTSIMPLE PNEUMONIA PLEURISY W MCCDRG 193$13,191 PER CASE
PUEBLO & CANON CITYINPATIENTSIMPLE PNEUMONIA PLEURISY W CCDRG 194$14,959 PER CASE
PUEBLO & CANON CITYINPATIENTG.I. HEMORRHAGE W CCDRG 378$13,272 PER CASE
PUEBLO & CANON CITYINPATIENTHIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCCDRG 482$39,174 PER CASE
PUEBLO & CANON CITYINPATIENTRENAL FAILURE W CCDRG 683$9,710 PER CASE
PUEBLO & CANON CITYINPATIENTCERVICAL SPINAL FUSION W CCDRG 472N/APER CASE
PUEBLO & CANON CITYINPATIENTCIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCCDRG 287$11,922 PER CASE
PUEBLO & CANON CITYINPATIENTDISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCCDRG 440$7,208 PER CASE
PUEBLO & CANON CITYINPATIENTPULMONARY EMBOLISM W MCCDRG 175$37,813 PER CASE
PUEBLO & CANON CITYINPATIENTBRONCHITIS ASTHMA W CC/MCCDRG 202$9,660 PER CASE
PUEBLO & CANON CITYINPATIENTMAJOR SMALL LARGE BOWEL PROCEDURES W MCCDRG 329$63,595 PER CASE
PUEBLO & CANON CITYINPATIENTKIDNEY URINARY TRACT INFECTIONS W/O MCCDRG 690$8,008 PER CASE
PUEBLO & CANON CITYINPATIENTDEPRESSIVE NEUROSESDRG 881N/APER CASE
PUEBLO & CANON CITYINPATIENTINFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CCDRG 854$20,202 PER CASE
PUEBLO & CANON CITYINPATIENTLAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CCDRG 418$18,861 PER CASE
PUEBLO & CANON CITYINPATIENTINTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCCDRG 064$26,717 PER CASE
PUEBLO & CANON CITYINPATIENTMEDICAL BACK PROBLEMS W/O MCCDRG 552$16,535 PER CASE
PUEBLO & CANON CITYINPATIENTCOMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CCDRG 454N/APER CASE
PUEBLO & CANON CITYINPATIENTG.I. OBSTRUCTION W CCDRG 389$10,769 PER CASE
PUEBLO & CANON CITYINPATIENTCOMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCCDRG 455N/APER CASE
PUEBLO & CANON CITYINPATIENTDEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCCDRG 057$12,242 PER CASE
PUEBLO & CANON CITYINPATIENTLOWER EXTREM HUMER PROC EXCEPT HIPFOOTFEMUR W CCDRG 493$33,698 PER CASE
PUEBLO & CANON CITYINPATIENTSIMPLE PNEUMONIA PLEURISY W/O CC/MCCDRG 195$9,378 PER CASE
PUEBLO & CANON CITYOUTPATIENTCARDIAC DIAGNOSTIC - ELECTROCARDIOGRAM TRACINGCPT 93005$333 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTCARDIAC DIAGNOSTIC - CARDIOVASCULAR STRESS TESTCPT 93017$1,619 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTCARDIAC DIAGNOSTIC - ECHOCARDIOGRAM, TTE W/DOPPLER COMPLETECPT 93306$1,707 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - COLONOSCOPY AND BIOPSYCPT 45380$2,910 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - DIAGNOSTIC COLONOSCOPYCPT 45378$1,742 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - EGD BIOPSY SINGLE/MULTIPLECPT 43239$3,046 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - LAPAROSCOPIC CHOLECYSTECTOMYCPT 47562$10,017 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - COLONOSCOPY W/LESION REMOVALCPT 45385$3,409 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - HYSTEROSCOPY BIOPSYCPT 58558$6,362 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - LAP ING HERNIA REPAIR INITCPT 49650$10,902 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - LOW BACK DISK SURGERYCPT 63030N/APER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - PRP I/HERN INIT REDUC >5 YRCPT 49505$8,621 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - KNEE ARTHROSCOPY/SURGERYCPT 29881$8,213 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - LAP CHOLECYSTECTOMY/GRAPHCPT 47563$10,638 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - CARE OF MISCARRIAGECPT 59820$3,672 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - TLH W/T/O 250 G OR LESSCPT 58571$8,070 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - CYSTO/URETERO W/LITHOTRIPSYCPT 52356$9,200 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - EGD DIAGNOSTIC BRUSH WASHCPT 43235$2,250 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTSURGERY - INSERT TUNNELED CV CATHCPT 36561$6,906 PER CASE, SINGLE PROCEDURE
PUEBLO & CANON CITYOUTPATIENTIMAGING - COMPUTED TOMOGRAPHY SCAN - CALCIUM SCORINGCPT 75571$99 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - COMPUTED TOMOGRAPHY SCAN - LUNG SCREENINGCPT G0297$385 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - COMPUTED TOMOGRAPHY SCAN - ALL OTHERCPT 70010-76499$761 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - MAGNETIC RESONANCE IMAGING - MRICPT 70010-76499$916 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - DIAGNOSTIC X-RAYCPT 70010-76499$239 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - MAMMOGRAPHYCPT 77053-77067$269 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - BREAST TOMOSYNTHESISCPT 77061-77063, G0279, 0159T$40 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - POSITRON EMMISSION TOMOGRAHY - PETCPT 78491-78815$3,089 PER SCAN
PUEBLO & CANON CITYOUTPATIENTIMAGING - ULTRASOUNDCPT 76506-76999$389 PER SCAN
PUEBLO & CANON CITYOUTPATIENTLAB - ASSAY THYROID STIM HORMONECPT 84443N/APER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTLAB - COMPREHEN METABOLIC PANELCPT 80053N/APER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTLAB - URINALYSIS AUTO W/O SCOPECPT 81003$60 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTLAB - COMPLETE CBC W/AUTO DIFF WBCCPT 85025N/APER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTLAB - METABOLIC PANEL TOTAL CACPT 80048$39 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTLAB - VENIPUNCTURECPT 36415$3 PER PROCEDURE
PUEBLO & CANON CITYOUTPATIENTANCILLARY - SLEEP STUDY FACILITYCPT 95805, 95807-95811$1,522 PER VISIT
PUEBLO & CANON CITYOUTPATIENTANCILLARY - PHYSICAL THERAPYREV 420-429$453 PER VISIT
PUEBLO & CANON CITYOUTPATIENTANCILLARY - OCCUPATIONAL THERAPYREV 430-439$287 PER VISIT
PUEBLO & CANON CITYOUTPATIENTANCILLARY - SPEECH THERAPYREV 440-449$438 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.