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 HealthOne Physician Group at (303) 788-6657 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.
| Procedure Code | Description | Self-Pay Price |
|---|---|---|
| 59025 | Fetal Non-Stress Test | $90.35 |
| 76805 | OB Ultrasound 14+ Weeks Single Fetus | $291.20 |
| 76816 | OB Ultrasound Follow Up | $228.15 |
| 76817 | OB Transvaginal Ultrasound | $202.15 |
| 76830 | Non OB Transvaginal Ultrasound | $244.40 |
| 81002 | Labs - Urinalysis | $7.15 |
| 81025 | Urine Pregnancy Test | $17.55 |
| 85014 | Labs - Hematocrit | $6.50 |
| 85018 | Labs - Hemoglobin | $6.50 |
| 90471 | Immunization Administration | $44.85 |
| 90715 | TDAP Vaccine | $80.60 |
| 99213 | Established Patient Office Visits Level 3 | $89.05 |
| 99214 | Established Patient Office Visit Level 4 | $131.95 |
| 99395 | Preventative Visit Established Age 18-39 | $124.15 |
| 99396 | Preventative Visit Established Age 40-64 | $135.20 |
| 0501F | Office - Other Visits | - |
| 0502F | Subsequent Prenatal Care | - |
| 0503F | Postpartum Care Visit | - |
| J1050 | Medroxyprogesterone Acetate | $0.65 |