North Suburban Northeast ER top charges
NOTICE REGARDING HEALTH CARE PLAN COVERAGE
This freestanding emergency department (Northeast Emergency Department ) accepts patients enrolled in the following programs: Colorado Medicaid (Articles 4, 5 and 6 of Title 25.5); Medicare (Title XVIII of the Federal Social Security Act, as amended); the CHIP program (Article 8 of Title 25.5) and a military health plan (10 U.S.C. Section 1071).
The prices listed on this facility’s chargemaster or fee schedule for any given health care service is the maximum charge that any patient will be billed for the service. The actual price for the health care service may be lower depending on your health insurance benefits and the availability of discounts or financial assistance.
This Facility will charge a facility fee. In addition to facility fees, you will be charged for any testing, supplies, or other services you receive. All physicians providing health care services will bill separately from the Facility for services they provided to you.
The health care provider networks and carriers that this Facility participates with are listed here.
This Facility and/or a physician providing health care services may not be a participating provider in your health insurance provider network.
If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided at this Facility. If you are not covered by health insurance, you are strongly encouraged to contact (866) 475-2403 to discuss payment options and the availability of financial assistance prior to receiving a health care service from this Facility.
The average fee schedule price for the twenty-five most common health care services provided by this Facility are listed below. The prices listed for each health care service is the average charge that you may be billed for the particular service. The actual price for the health care service may be lower depending on your insurance coverage and the availability of discounts or financial assistance.
Northeast Emergency Department
Updated April 4, 2023
CPT Code | Charge Description | Average Charge per Account |
---|---|---|
99283 | LVL 3 FREE STD EMER DEPT | $6,872 |
99284 | LVL 4 FREE STD EMER DEPT | $11,516 |
85027 | COMPLETE CBC AUTOMATED | $693 |
96374 | THER/PROPH/DIAG INJ IV PUSH | $621 |
80053 | COMPREHEN METABOLIC PANEL | $1,799 |
81003 | URINALYSIS AUTO W/O SCOPE | $410 |
71045 | X-RAY EXAM CHEST 1 VIEW | $962 |
93005 | ELECTROCARDIOGRAM TRACING | $2,093 |
99282 | EMERGENCY DEPT VISIT SF MDM | $3,026 |
84703 | CHORIONIC GONADOTROPIN ASSAY | $811 |
96375 | TX/PRO/DX INJ NEW DRUG ADDON | $621 |
80047 | METABOLIC PANEL IONIZED CA | $1,096 |
85014 | HEMATOCRIT | $242 |
84484 | ASSAY OF TROPONIN QUANT | $1,111 |
87426 | SARSCOV CORONAVIRUS AG IA | $63 |
96361 | HYDRATE IV INFUSION ADD-ON | $318 |
87400 | INFLUENZA A/B EACH AG IA | $33 |
87081 | CULTURE SCREEN ONLY | $478 |
74177 | CT ABD & PELV W/CONTRAST | $21,074 |
96372 | THER/PROPH/DIAG INJ SC/IM | $650 |
99281 | EMR DPT VST MAYX REQ PHY/QHP | $1,244 |
87880 | STREP A ASSAY W/OPTIC | $165 |
87635 | SARS-COV-2 COVID-19 AMP PRB | $92 |
83605 | ASSAY OF LACTIC ACID | $767 |
94640 | AIRWAY INHALATION TREATMENT | $250 |
CPT Code | Charge Description | Average Charge per Account |
---|---|---|
99281 | LVL 1 FREE STD EMER DEPT | $1,244 |
99282 | LVL 2 FREE STD EMER DEPT | $3,026 |
99283 | LVL 3 FREE STD EMER DEPT | $6,872 |
99284 | LVL 4 FREE STD EMER DEPT | $11,516 |
99285 | LVL 5 FREE STD EMER DEPT | $13,769 |
CPT® copyright 2024 American Medical Association