Senate Bill (SB) 17-065: Transparency in Direct Pay Health Care Prices requires healthcare facilities, physicians, and providers to post prices for their most common healthcare services. Patients with health insurance are strongly encouraged to consult with their health insurer to determine accurate information about their financial responsibility for a particular health care service at one of our facilities.
If you are not covered by health insurance, you are strongly encouraged to contact Colorado Mountain Medical at (970) 926-6350 to discuss payment options prior to receiving services (learn more about possible enrollment support). Because of these factors, posted health care prices may not reflect the actual amount of your financial responsibility.
Below is a list estimating the cost of Colorado Mountain Medical’s most commonly billed services.
CPT Price Description
99202 $203 Outpatient Office Visit; New Patient; Straightforward
99203 $314 Outpatient Office Visit; New Patient; Low Complexity
99204 $465 Outpatient Office Visit; New Patient; Moderate Complexity
99212 $159 Outpatient Office Visit; Established Patient; Straightforward
99213 $252 Outpatient Office Visit; Established Patient; Low Complexity
99214 $357 Outpatient Office Visit; Established Patient; Moderate Complexity
99392 $292 Preventive Visit; Age 1-4; Established Patient
99393 $291 Preventive Visit; Age 5-11; Established Patient
99394 $317 Preventive Visit, Age 12-17, Established Patient
99395 $324 Preventive Visit, Age 18-39, Established Patient
99396 $344 Preventive Visit, Age 40-64, Established Patient
99397 $372 Preventive Visit, Age 65 & over, Established Patient
80050 $92 General Health Panel (lab) *
80053 $28 Comprehensive Metabolic Panel (lab) *
80061 $36 Lipid Panel (lab) *
81003 $7 Urinalysis (dipstick)
84153 $48 Prostate-Specific Antigen (lab) *
84443 $44 Thyroid Stimulating Hormone (lab) *
85025 $21 Complete Blood Count (lab) *
87651 $92 Strep A (swab)
* INDICATES LAB DRAW FEE: Cost is $25.
Travel Service Pricing: Physician Consult & Vaccines for Adults
CPT Price Description
99402 $175 Physician Consultation
90690 $151 Typhoid Vaccine (live oral)
90691 $151 Typhoid Vaccine (VI Capsular IM) **
90717 $217 Yellow Fever **
90715 $75 Tdap **
90636 $140 Hepatitis A & B combo **
90750 $212 Shingrix (Shingles) **
** INDICATES INJECTION FEE: Cost is $57 for one vaccine and $29 for each additional vaccine.
NOTE: CMM does not file for Medicare Part D plans. Please contact your insurance provider to request coverage information within your plan.
Obstetric Care Pricing
Below are cost estimates for obstetric procedures performed by Colorado Mountain Medical physicians. Please note that the Family Birth Center at Vail Health Hospital is a separate facility from Colorado Mountain Medical and therefore have additional separate charges from those listed below. Contact Vail Health Hospital at (970) 777-2902 to request minimal estimated pricing for a normal vaginal birth.
- Global prenatal care & vaginal delivery: $6,434
This covers all prenatal office visits, normal vaginal delivery, and postpartum care for the mother, excluding any additional care. The global prenatal charges do not cover the confirmation of pregnancy visit, lab work, and prenatal imaging, such as ultrasounds and fetal stress tests.
- Global prenatal care & C-section delivery: $7,118
This covers all prenatal office visits, normal vaginal delivery, and postpartum care for the mother, excluding any additional care. The global prenatal charges do not cover the confirmation of pregnancy visit, lab work, and prenatal imaging such as ultrasounds and fetal stress tests.
Charges and Fees
Charges and Fees For Common Healthcare Services
No Surprise Act & Good Faith
The Good Faith Estimate & No Surprise Act may be helpful to our our patients while understanding their billing statements.
WHAT IS A “GOOD FAITH ESTIMATE?”
Patients have the right to receive a “Good Faith Estimate” explaining how much health care will cost. Under the law,
health care providers need to give patients who don’t have certain types of health care coverage or who are not
using certain types of health care coverage an estimate of their bill for health care items and services before those
items or services are provided.
This notice applies only to Vail Health Hospital, Colorado Mountain Medical, Shaw Cancer Center in Edwards, and Sonnenalp Breast Center in Edwards.
WHAT IS “BALANCE BILLING” (SOMETIMES CALLED “SURPRISE BILLING”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment,
coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit
a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan.
Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and
the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs
for the same service and might not count toward your annual out-of-pocket limit. “Surprise billing” is an unexpected
balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency
or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
PATIENT RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory
surgical center, you are protected from surprise billing or balance billing.
WHAT IS A “GOOD FAITH ESTIMATE?”
Patients have the right to receive a “Good Faith Estimate” explaining how much health care will cost. Under the law,
health care providers need to give patients who don’t have certain types of health care coverage or who are not
using certain types of health care coverage an estimate of their bill for health care items and services before those
items or services are provided.
This notice applies only to Vail Health Hospital, Colorado Mountain Medical, Shaw Cancer Center in Edwards, and Sonnenalp Breast Center in Edwards.
WHAT IS “BALANCE BILLING” (SOMETIMES CALLED “SURPRISE BILLING”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment,
coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit
a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan.
Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and
the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs
for the same service and might not count toward your annual out-of-pocket limit. “Surprise billing” is an unexpected
balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency
or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
PATIENT RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory
surgical center, you are protected from surprise billing or balance billing.