Transparency in Health Care Prices Act
Senate Bill 17-065
Effective January 1, 2018
If you have health insurance coverage, 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 by a health care provider at this office. If you do not have health insurance coverage, you are strongly encouraged to contact our business office personnel at (720) 979-0010 to discuss payment options and/or financial resources prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility. Actual services provided during a surgical procedure may vary from the scheduled procedure and price quote, including but not limited to the medically necessary use of high cost drugs, implants, supplies and any procedures other than the original quote based on individual circumstances for each patient case.
| Billed CPT Code | Billed CPT Name | Standard Fee | Self Pay Rate |
|---|---|---|---|
| 15823 | REMOVAL OF EXCESSIVE SKIN AND FAT OF UPPER EYELID | $10,110.00 | $1,189.00 |
| 65855 | LASER REPAIR TO IMPROVE EYE FLUID FLOW | $18,051.00 | $158.00 |
| 66180 | CREATION OF SHUNT TO IMPROVE EYE FLUID FLOW USING TISSUE GRAFT | $23,401.00 | $4,148.00 |
| 66761 | CREATION OF EYELID FLUID DRAINAGE TRACTS IN IRIS USING A LASER, PER SESSION | $19,638.00 | $218.00 |
| 66821 | REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER | $9,433.00 | $357.00 |
| 66982 | COMPLEX REMOVAL OF CATARACT WITH INSERTION OF PROSTHETIC LENS | $17,608.00 | $1,471.00 |
| 66984 | REMOVAL OF CATARACT W/ INSERTION OF PROSTHETIC LENS | $17,608.00 | $1,471.00 |
| 66985 | INSERTION OF PROSTHETIC LENS | $8,255.00 | $1,471.00 |
| 66986 | EXCHANGE OF PROSTHETIC LENS | $17,608.00 | $1,471.00 |
| 67036 | REMOVAL OF EYE FLUID (VITREOUS) BETWEEN LENS AND RETINA | $36,459.00 | $2,538.00 |
| 67040 | DESTRUCTION OF EYE LID (VITREOUS) BETWEEN LENS AND RETINA AND ALL OF RETINA USING A LASER | $36,459.00 | $2,538.00 |
| 67042 | REMOVAL OF MEMBRANE OF RETINA WITH REMOVAL OF INTERNAL LIMITING MEMBRANE OF RETINA | $36,459.00 | $2,538.00 |
| 67108 | REPAIR OF DETACHED RETINA WITH DRAINAGE AND REMOVAL OF INTERNAL LIMITING MEMBRANE OF RETINA | $36,459.00 | $2,538.00 |
| 67113 | COMPLEX REPAIR OF DETACHED RETNIA AND DRAINAGE OF EYE FLUID BETWEEN LENS AND RETINA | $36,459.00 | $3,184.00 |
| 67917 | EXTENSIVE REPAIR OF TURNING-OUTWARD EYELID DEFECT | $20,910.00 | $1,243.00 |