Sky Ridge Primary Care Lone Tree Top Charges
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 Sky Ridge Primary Care - Lone Tree at (303) 792-5200 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 |
|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $298 |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $212 |
| 99396 | Established patient periodic preventive medicine examination (40-64 years) | $293 |
| 96160 | Administration and interpretation of patient-focused health risk assessment | $300 |
| G2211 | Clinical staff time for medical services related to ongoing care for a patient with a serious or complex condition. | $54 |
| G0439 | Office visit for annual wellness exam. | $456 |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $388 |
| 90471 | Administration of vaccine | $60 |
| 99395 | Established patient periodic preventive medicine examination (18-39 years) | $272 |
| 36415 | Insertion of needle into vein for collection of blood sample | $9 |
| G0136 | Assessment to identify social determinants of health (SDOH) that limit the ability to diagnose or treat problems. SDOH may include income, education, language, access to health care, and other factors. | $66 |
| 98928 | Osteopathic manipulative treatment, 7-8 body regions | $248 |
| G0444 | An annual screening to check for depression. | $66 |
| 81003 | Automated urinalysis test | $7 |
| 36416 | Puncture of skin for collection of blood sample | $3 |