Top Charges for Rocky Mountain Spine Clinic
In compliance with federal law, please view pricing information for certain procedures and services performed at our practice.
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 health care facility. If you are not covered by health insurance, you are strongly encouraged to contact Rocky Mountain Spine Clinic at (303) 225-8120 to discuss payment options prior to receiving a health care service from this health care facility since posted health care prices may not reflect the actual amount of your financial responsibility. The health care price for any given health care service is an estimate and the actual charges for the health care service are dependent on the circumstances at the time the service is rendered.
The total health care price for any given health care service is an estimate and the actual charges for the health care service cannot reasonably be known as they are dependent on the circumstances at the time the service is rendered. Factors that may affect pricing include your insurance coverage and related cost sharing, the nature of services actually rendered, and any financial assistance you may be eligible for.
| CPT Code | Description | NonFac Charges |
|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $212 |
| 72100 | X-ray of lower and sacral spine, 2-3 views | $37 |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $388 |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | $43 |
| 22853 | Insertion of cage or mesh device to spine bone and disc space during spine fusion | $904 |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $134 |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $298 |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $262 |
| 63052 | Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back | $906 |
| 22633 | Fusion of spine in lower back with partial removal of spine bone and disc | $6,569 |
| 22842 | Placement of stabilizing device to back, 3-6 spine bone segments | $2,673 |
| 72050 | X-ray of upper spine, 4-5 views | $45 |
| 72040 | X-ray of upper spine, 2-3 views | $37 |
| 63053 | Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back | $677 |
| 22634 | Fusion of additional segment of spine with partial removal of spine bone and disc | $1,740 |