Does Keefe Memorial Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Keefe Memorial Hospital. In a medical emergency, call 911.

Where is Keefe Memorial Hospital?

602 N 6th St W, Cheyenne Wells, CO 80810, in Cheyenne County, Colorado.

What is the phone number of Keefe Memorial Hospital?

(719) 767-5661, as listed by Medicare (CMS).

What is the Medicare star rating of Keefe Memorial Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Keefe Memorial Hospital — Cheyenne Wells, CO

Quick answers

Does Keefe Memorial Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Keefe Memorial Hospital. In a medical emergency, call 911.
Where is Keefe Memorial Hospital?: 602 N 6th St W, Cheyenne Wells, CO 80810, in Cheyenne County, Colorado.
What is the phone number of Keefe Memorial Hospital?: (719) 767-5661, as listed by Medicare (CMS).
What is the Medicare star rating of Keefe Memorial Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[5][6][9][10]}

Treatments^{[7][8][10][11][12]}

IV antibiotic infusions
Monoclonal antibody infusions
Port access for IV medications and blood draws
Blood transfusion
Point of care coagulation testing
Drug and alcohol testing (DOT and employer)
Laser light therapy
Balance and fall prevention therapy
Orthopedic and sports rehabilitation
Neurological rehabilitation
Joint replacement therapy

Procedures^[9]

X-ray
Bone density (DEXA) scan
3D mammography
CT scan
Low dose CT lung scan
Ultrasound
Echocardiogram
MRI (mobile unit, limited availability)
Nuclear medicine (mobile unit, limited availability)
EKG

Programs and centers^[10][13]

Emergency care services
Acute care (inpatient)

Emergency care (hospital website)^{[4][5][6][10]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level 4

Visiting and practical information

Patient portal	Patient Portal

Doctors and clinicians (30)

30 doctors and other clinicians list Keefe Memorial Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 6 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Weisbrod Memorial County Hospital33 mi · Eads, CO · Critical Access Hospital
Kit Carson County Memorial Hospital33 mi · Burlington, CO · Critical Access Hospital
Greeley County Health Services39 mi · Tribune, KS · Critical Access Hospital
Goodland Regional Medical Center50 mi · Goodland, KS · Critical Access Hospital
Prowers Medical Center54 mi · Lamar, CO · Critical Access Hospital

Other hospitals nearby

Wichita County Health Center59 mi · Leoti, KS · Critical Access Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Cheyenne Manor0.3 mi · Cheyenne Wells, CO · 5 of 5 stars

All nursing homes in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Clinics and urgent care

Prairie View Clinic3.9 mi · Cheyenne Wells, CO · Rural health clinic

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Keefe Memorial Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Not reported to Medicare

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	144 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Colorado Best hospitals in Colorado

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 46 common services exactly as Keefe Memorial Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: OFFICE VISIT NEW LOW	$166	$166	Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: NH OV NEW LOW	$283	$283	Not listed in the file
New patient office visit (about 30–44 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: OFFICE VISIT NEW MODERATE	$421	$421	Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: NH OV NEW MODERATE	$421	$421	Not listed in the file
New patient office visit (about 45–59 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: OFFICE VISIT NEW HIGH	$556	$556	Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: NH OV NEW HIGH	$556	$556	Not listed in the file
New patient office visit (about 60–74 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: OFFICE VISIT ESTAB LOW	$183	$183	Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: NH OV ESTAB LOW	$183	$183	Not listed in the file
Established patient office visit (about 20–29 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: OFFICE VISIT ESTAB MODER	$267	$267	Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: NH OV ESTAB MOD	$267	$267	Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: OP VISIT ESTAB MODERATE	$224	$224	Not listed in the file
Established patient office visit (about 30–39 minutes): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate) CPT 99243 · Inpatient or outpatient In the file: CONSULT OFFICE LOW	$365	$365	Not listed in the file
Office consultation with a specialist (moderate): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Inpatient or outpatient In the file: CONSULT OFFICE MODERATE	$540	$540	Not listed in the file
Office consultation with a specialist (moderate to high): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 18–39 CPT 99385 · Inpatient or outpatient In the file: PREV MED NEW AGE 18-39	$359	$359	Not listed in the file
Preventive checkup, new patient, age 18–39: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Preventive checkup, new patient, age 40–64 CPT 99386 · Inpatient or outpatient In the file: PREV MED NEW AGE 40-64	$312	$312	Not listed in the file
Preventive checkup, new patient, age 40–64: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: PHYS ER EXANDED MOD/99283	$177	$177	Not listed in the file
Emergency room visit (moderate): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: ER LEVEL III	$830	$830	Not listed in the file
Emergency room visit (moderate): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: PHYS ER DETAILED MOD/99284	$300	$300	Not listed in the file
Emergency room visit (moderately high): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: ER LEVEL IV	$1,147	$917.60	Not listed in the file
Emergency room visit (moderately high): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: PHYS ER HIGH/99285	$435	$435	Not listed in the file
Emergency room visit (high): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: ER LEVEL V	$1,530	$1,224	Not listed in the file
Emergency room visit (high): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: BASIC METABOLIC PANEL	$158	$158	Not listed in the file
Basic metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: CMP (GSO ONLY)	$173	$173	Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: COMP METABOLIC PANEL	$188	$188	Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: DA COMP METABOLIC PANEL	$22	$22	Not listed in the file
Comprehensive metabolic panel (blood test): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: OB PANEL(GSO CHARGE ONLY)	$260.18	$260.18	Not listed in the file
Obstetric blood test panel: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL	$166	$166	Not listed in the file
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL (GSO ONLY)	$151	$151	Not listed in the file
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PANEL (FASTING)	$166	$166	Not listed in the file
Cholesterol panel (lipid panel): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL PANEL	$167	$167	Not listed in the file
Kidney function panel: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HEPATIC FUNCTION PANEL	$167	$167	Not listed in the file
Liver function panel: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA, Total	$171	$171	Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA SCREENING	$152	$152	Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA DIAGNOSTIC, TOTAL	$144	$144	Not listed in the file
PSA (prostate specific antigen) blood test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: Thyroid Stimulating Hormone	$138	$138	Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH	$138	$138	Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH REFLEX T4 FREE	$138	$138	Not listed in the file
Thyroid stimulating hormone (TSH) test: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: **CBC W/AUTO DIFF	$104	$104	Not listed in the file
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: DA CBC W/AUTO DIFF	$6	$6	Not listed in the file
Complete blood count (CBC) with differential: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HEMOGRAM	$74	$74	Not listed in the file
Complete blood count (CBC), automated: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: Prothrombin Time with INR	$71	$71	Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTHROMBIN TIME	$71	$71	Not listed in the file
Blood clotting time test (prothrombin time, PT): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: Partial Thromboplastin Time, Activated	$98	$98	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT	$138	$138	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD OR BRAIN WO	$1,450	$1,160	Not listed in the file
CT scan of the head or brain, without contrast: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W WO	$4,106	$2,874.20	Not listed in the file
MRI of the brain, before and after contrast: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: CHEST 2V PA & LAT	$364	$364	Not listed in the file
Chest X-ray, 2 views: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: SPINE LS MIN 4 VIEWS	$578	$578	Not listed in the file
X-ray of the lower spine, at least 4 views: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI SPINE LUMBAR WO	$3,186	$2,230.20	Not listed in the file
MRI of the lower back (lumbar spine), without contrast: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W	$2,718	$1,902.60	Not listed in the file
CT scan of the pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS W	$4,850	$3,395	Not listed in the file
CT scan of the abdomen and pelvis, with contrast: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN COMPLETE	$935	$935	Not listed in the file
Ultrasound of the abdomen, complete: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: US OB >1ST TRIMESTER	$922	$922	Not listed in the file
Pregnancy ultrasound (after the first trimester): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL	$723	$723	Not listed in the file
Transvaginal ultrasound: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MAMMOGRAPHY BILATERAL DIAGNOSTIC	$484	$484	Not listed in the file
Diagnostic mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MAMMO SCREENING	$358	$358	Not listed in the file
Screening mammogram, both breasts: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: POLYSOMNOGRAPHY 6+	$3,394	$2,375.80	Not listed in the file
Sleep study (overnight, in a sleep lab): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) In the file: PSYCHOTHERAPY 30 MINUTES/90832	$185	$185	Not listed in the file
Psychotherapy, 30 minutes: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: PSYCHOTHERAPY 45 MINUTES/90834	$245	$245	Not listed in the file
Psychotherapy, 45 minutes: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) In the file: PSYCHOTHERAPY 60 MINUTES/90837	$359	$359	Not listed in the file
Psychotherapy, 60 minutes: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: TONSILLEC ADENOID >AGE 12	$1,906	$1,524.80	Not listed in the file
Removal of tonsils and adenoids (under age 12): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: GI ENDO	$2,040	$1,632	Not listed in the file
Upper GI endoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: GI ENDO W BIOPSY	$2,451	$1,960.80	Not listed in the file
Upper GI endoscopy with biopsy: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: COLONOSCOPY	$2,246	$1,796.80	Not listed in the file
Colonoscopy (diagnostic): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: COLONOSCOPY W BIOPSY	$2,657	$1,859.90	Not listed in the file
Colonoscopy with biopsy: 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: COLONOSCOPY BY SNARE	$2,657	$1,859.90	Not listed in the file
Colonoscopy with removal of polyps (snare): 10 of 12 insurance plan rates Aetna — Default: 90% (a percentage in the contract, not a dollar amount) Aetna — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Default: 85.3% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield of CO — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) Cigna — Default: 95% (a percentage in the contract, not a dollar amount) GEHA Multiplan Network — Default: 90% (a percentage in the contract, not a dollar amount) Golden Rule Insurance Company — Default: 90% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Default: 95% (a percentage in the contract, not a dollar amount) Kaiser Foundation Health Plan of Colorado — Medicare Advantage: 76% (a percentage in the contract, not a dollar amount) UMR Wausau/UHIS — Default: 90% (a percentage in the contract, not a dollar amount)

Source: Keefe Memorial Hospital’s standard charges file (keefemh.org, CSV, CMS template 2.0.0; it can be a very large file), last updated by the hospital on June 30, 2025; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	602 N 6th St W, Cheyenne Wells, CO 80810
County	Cheyenne County
State	Colorado
Phone	(719) 767‑5661
Emergency services	Yes
Ownership	Government - Hospital District or Authority
Medicare overall rating	Not rated by CMS
CMS Certification Number	061343
Name in Medicare records	KEEFE MEMORIAL HOSPITAL
Profile level	Medicare data + hospital website
Official website	keefemh.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Keefe Memorial Health Service District — keefemh.org
Keefe Memorial Health Service District - Keefe Memorial Health Service District — keefemh.org
Emergency Care Services - Keefe Memorial Health Service District — keefemh.org
Infusion Services - Keefe Memorial Health Service District — keefemh.org
Laboratory - Keefe Memorial Health Service District — keefemh.org
Radiology - Keefe Memorial Health Service District — keefemh.org
Keefe Memorial Hospital - Keefe Memorial Health Service District — keefemh.org
Physical Therapy - Keefe Memorial Health Service District — keefemh.org
Laser Light Therapy - Keefe Memorial Health Service District — keefemh.org
Acute Care - Keefe Memorial Health Service District — keefemh.org

Keefe Memorial Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas^{[5][6][9][10]}

Treatments^{[7][8][10][11][12]}

Procedures^[9]

Programs and centers^[10][13]

Emergency care (hospital website)^{[4][5][6][10]}

Visiting and practical information

Doctors and clinicians (30)

Main specialties

Doctors with a page on this site (30)

Other emergency rooms nearby

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Community care nearby

Clinics and urgent care

About the Medicare star rating

Medicare quality data

What patients said (patient survey)

Infections caught in the hospital

Complications and deaths

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Hospital information

Sources

From the hospital’s website

Keefe Memorial Hospital

Summary

Profile from official sources

At a glance

Quick answers

Specialties and care areas[5][6][9][10]

Treatments[7][8][10][11][12]

Procedures[9]

Programs and centers[10][13]

Emergency care (hospital website)[4][5][6][10]

Visiting and practical information

Doctors and clinicians (30)

Main specialties

Doctors with a page on this site (30)

Other emergency rooms nearby

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Nursing homes

Community care nearby

Clinics and urgent care

About the Medicare star rating

Medicare quality data

What patients said (patient survey)

Infections caught in the hospital

Complications and deaths

Return visits to the hospital (readmissions)

Emergency room times and sepsis care

ER wait times and Medicare ratings nearby

Prices

Office and emergency visits

Lab tests

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Heart tests and sleep study

Physical therapy and mental health

Procedures and surgery

Hospital information

Sources

From the hospital’s website

Specialties and care areas^{[5][6][9][10]}

Treatments^{[7][8][10][11][12]}

Procedures^[9]

Programs and centers^[10][13]

Emergency care (hospital website)^{[4][5][6][10]}