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North Suburban Northwest ER top charges

In compliance with federal law, please view pricing information for certain procedures and services at North Suburban Northwest ER .

NOTICE REGARDING HEALTH CARE PLAN COVERAGE

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

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

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

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

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

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

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

North Suburban Northwest ER

25 Most Common Health Services Provided at the Freestanding Emergency Room
CPT Code Charge Description Charge Price
99283 LVL 3 FREE STD EMER DEPT $7,697
99284 LVL 4 FREE STD EMER DEPT $12,898
85027 COMPLETE CBC AUTOMATED $748
80053 COMPREHEN METABOLIC PANEL $1,943
96374 THER/PROPH/DIAG INJ IV PUSH $695
87400 INFLUENZA A/B EACH AG IA $36
87426 SARSCOV CORONAVIRUS AG IA $68
93005 ELECTROCARDIOGRAM TRACING $2,302
81003 URINALYSIS AUTO W/O SCOPE $443
71045 X-RAY EXAM CHEST 1 VIEW $1,049
96361 HYDRATE IV INFUSION ADD-ON $356
84484 ASSAY OF TROPONIN QUANT $1,200
96375 TX/PRO/DX INJ NEW DRUG ADDON $695
74177 CT ABD & PELV W/CONTRAST $22,971
99282 LVL 2 FREE STD EMER DEPT $3,389
84703 CHORIONIC GONADOTROPIN ASSAY $876
80047 METABOLIC PANEL IONIZED CA $1,184
87880 STREP A ASSAY W/OPTIC $178
87081 CULTURE SCREEN ONLY $516
85379 FIBRIN DEGRADATION QUANT $1,146
99281 LVL 1 FREE STD EMER DEPT $1,394
96372 THER/PROPH/DIAG INJ SC/IM $728
70450 CT HEAD/BRAIN W/O DYE $13,041
83605 ASSAY OF LACTIC ACID $828
96360 IV HYDRAT INIT UP TO 1HR $1,072
Freestanding Emergency Facility Fees
CPT Code Charge Description Charge Price
99281 LVL 1 FREE STD EMER DEPT $1,106
99282 LVL 2 FREE STD EMER DEPT $2,690
99283 LVL 3 FREE STD EMER DEPT $6,110
99284 LVL 4 FREE STD EMER DEPT $10,238
99285 LVL 5 FREE STD EMER DEPT $17,184

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