Post-Screening Disclosure – UCHealth Emergency Room – Harmony Campus (Freestanding)
Patient Information
Thank you for choosing UCHealth. Below are the non-discounted chargemaster prices for the most common services and facility fees at this location at the time of publication. This information is updated every six months; prices may change without notice. Chargemaster prices are the maximum charges that any patient might be billed for the service. The actual charge for any services rendered may be lower depending on applicable health insurance benefits and the availability of discounts or financial assistance.
| Billing Code | Description of Services | Charge |
| CPT 99281 | Level 1 Emergency Dept visit | $427 |
| CPT 99282 | Level 2 Emergency Dept visit | $737 |
| CPT 99283 | Level 3 Emergency Dept visit | $1,261 |
| CPT 99284 | Level 4 Emergency Dept visit | $1,819 |
| CPT 99285 | Level 5 Emergency Dept visit | $3,553 |
| CPT 99291 | Evaluation and care of critically ill patient for the first 30–74 minutes | $7,804 |
| CPT 99292 | Evaluation and care of critically ill patient after first 30–74 minutes; Billed for each 30-minute block of time | $4,864 |
| CPT 80047 | CAT scan of belly and hip area using IV dye | $177 |
| CPT 85027 | Complete blood count by machine | $154 |
| CPT 96375 | Another dose of a medicine given before by IV into a vein | $230 |
| CPT 96374 | Single dose or first dose of medicine by IV into a vein | $320 |
| CPT 81003 | Urine test by machine without microscope | $83 |
| CPT 93005 | Electrocardiogram (EKG) Heart tracing | $334 |
| CPT 96361 | IV drip for additional hour | $267 |
| CPT 82040 | This test measures the amount of albumin in serum, plasma, or whole blood. Often used to decide nutritional status, renal disease, and other chronic diseases, mostly those involving the kidneys or liver. | $171 |
| CPT 82247 | Measure of the amount of bilirubin in the blood. Bilirubin is made when hemoglobin is broken down by the body. Hemoglobin carries oxygen in the blood. | $346 |
| CPT 84075 | Blood test to measure the amount of alkaline phosphatase in the blood. ALP is an enzyme that shows liver cell damage or to check for cystic fibrosis in an unborn baby. | $117 |
| CPT 84155 | Blood test to measure nutritional status or how well nourished someone is | $102 |
| CPT 84450 | Blood test to check the level of an enzyme that is found mainly in the heart and liver. Level is usually low unless there has been damage such as after a heart attack or liver disease. | $191 |
| CPT 82150 | Serum amylase (protein that helps digest food) is high when there is a problem with the pancreas. A common test when belly pain, tenderness, nausea, and vomiting are present. | $561 |
| CPT 82977 | Blood test to measure the amount of an enzyme that may show liver disease in children or as a screening test for alcoholism | $128 |
| CPT 84460 | Blood test to measure an enzyme that is found mostly in the liver may mean liver disease if level is high | $128 |
| CPT 84484 | Blood test to measure troponin level to check for heart muscle damage as with a heart attack | $259 |
| CPT 87637 | Lab test to look for severe acute respiratory syndrome (SARS), influenza (flu) A, influenza B, respiratory syncytial virus (RSV) all viruses | $401 |
| CPT 81025 | Urine pregnancy test | $156 |
| CPT 71045 | Chest X-Ray with 1 view from the front | $541 |
| CPT 74177 | CAT scan of belly and hip area using IV dye | $6,648 |
| CPT 96372 | Medicine or substance given into skin or into muscle as a shot | $186 |
| CPT 70450 | CAT scan of the head or brain without using dye | $2,821 |
| CPT 87651 | A test for strep throat | $560 |
| CPT 87086 | Urine test for bacteria with number of cells counted | $100 |
| CPT G0378 | Observation of patient by providers, cost by hour | $122 |
The physician providing health care services here may bill separately from the emergency department for the health care services provided. Physician charges are not listed above.
4630 Snow Mesa Drive
Fort Collins, CO 80528
970.237.8100
