Skip to Content

HCA HealthONE Northwest ER top charges

In compliance with federal law, please view pricing information for certain procedures and services at HCA HealthONE Northwest ER, A part of Mountain Ridge Hospital .

NOTICE REGARDING HEALTH CARE PLAN COVERAGE

This freestanding emergency department (Northwest Emergency Department ) accepts patients enrolled in the following programs: Colorado Medicaid (Articles 4, 5 and 6 of Title 25.5); Medicare (Title XVIII of the Federal Social Security Act, as amended); the CHIP program (Article 8 of Title 25.5) and a military health plan (10 U.S.C. Section 1071).

The prices listed on this facility’s chargemaster or fee schedule for any given health care service is the maximum charge that any patient will be billed for the service. The actual price for the health care service may be lower depending on your health insurance benefits and the availability of discounts or financial assistance.

This Facility will charge a facility fee. In addition to facility fees, you will be charged for any testing, supplies, or other services you receive. All physicians providing health care services will bill separately from the Facility for services they provided to you.

The health care provider networks and carriers that this Facility participates with are listed here.

This Facility and/or a physician providing health care services may not be a participating provider in your health insurance provider network.

If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided at this Facility. If you are not covered by health insurance, you are strongly encouraged to contact (866) 475-2403 to discuss payment options and the availability of financial assistance prior to receiving a health care service from this Facility.

The average fee schedule price for the twenty-five most common health care services provided by this Facility are listed below. The prices listed for each health care service is the average charge that you may be billed for the particular service. The actual price for the health care service may be lower depending on your insurance coverage and the availability of discounts or financial assistance.

North Suburban Northwest ER

25 Most Common Health Services Provided at the Freestanding Emergency Room
CPT Code Charge Description Charge Price
99283 LVL 3 FREE STD EMER DEPT $8,452
99284 LVL 4 FREE STD EMER DEPT $14,162
85027 COMPLETE CBC AUTOMATED $823
80053 COMPREHEN METABOLIC PANEL $2,137
96374 THER/PROPH/DIAG INJ IV PUSH $763
93005 ELECTROCARDIOGRAM TRACING $2,532
71045 X-RAY EXAM CHEST 1 VIEW $1,154
81003 URINALYSIS AUTO W/O SCOPE $487
96361 HYDRATE IV INFUSION ADD-ON $391
84484 ASSAY OF TROPONIN QUANT $1,320
96375 TX/PRO/DX INJ NEW DRUG ADDON $763
87400 INFLUENZA A/B EACH AG IA $40
87426 SARSCOV CORONAVIRUS AG IA $74
99282 LVL 2 FREE STD EMER DEPT $3,721
84703 CHORIONIC GONADOTROPIN ASSAY $963
74177 CT ABD & PELV W/CONTRAST $25,497
80047 METABOLIC PANEL IONIZED CA $1,302
87880 STREP A ASSAY W/OPTIC $196
85379 FIBRIN DEGRADATION QUANT $1,260
99281 LVL 1 FREE STD EMER DEPT $1,530
83605 ASSAY OF LACTIC ACID $911
87081 CULTURE SCREEN ONLY $567
96372 THER/PROPH/DIAG INJ SC/IM $800
70450 CT HEAD/BRAIN W/O DYE $14,476
81025 URINE PREGNANCY TEST $963
Freestanding Emergency Facility Fees
CPT Code Charge Description Charge Price
99281 LVL 1 FREE STD EMER DEPT $1,260
99282 LVL 2 FREE STD EMER DEPT $3,721
99283 LVL 3 FREE STD EMER DEPT $8,452
99284 LVL 4 FREE STD EMER DEPT $14,162
99285 LVL 5 FREE STD EMER DEPT $16,933

View Insurance Options

CPT® copyright 2023 American Medical Association