Boulder Community Health
4747 Arapahoe Avenue, Boulder, CO 80304 · 142 Priced Procedures · 80% Patient Recommendation
Typical commercial prices here are 4% below the fair benchmark (0.96×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.96× fair market pricing.
Aligned Regional Benchmark Peer
Boulder Community Health prices shoppable and inpatient services (0.9× to 1.2× Medicare, divergence 1.33×) in alignment with regional hospital peers (0.96× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 4% below peer Fair BaseRate (0.96×)
- Self-pay cash beats commercial insurance on 51% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 80% patient recommendation (75/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.96× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Captive ER (0.8×) & laboratory (1.1×) services average 1.33× higher multiples than routine shoppable care (0.9×)
- Even at low-cost facilities (0.96× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Unnegotiated chargemaster list prices average 15.6× Medicare (14¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Boulder Community Health
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 142 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $50,473 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $30,738 | 1.6× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $30,529 | 1.6× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $27,987 | 1.6× |
| Total knee replacement CPT Code: 27447 | $13,588 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $12,917 | 1.6× |
| Trauma team activation HCPCS Code: G0390 | $3,009 | 2.1× |
| C-section delivery (full package) CPT Code: 59510 | $2,914 | 1.0× |
| Behavioral health counseling (per session) HCPCS Code: H0008 | $2,725 | unverified |
| Vaginal delivery (full package) CPT Code: 59400 | $2,653 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $1,534 | 0.5× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,427 | 1.7× |
| Bunion correction surgery CPT Code: 28296 | $1,312 | 0.4× |
| Total hip replacement CPT Code: 27130 | $1,274 | 0.1× |
| Cataract surgery with lens implant CPT Code: 66984 | $1,066 | 0.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $894 | 0.7× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $853 | 0.8× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $652 | 0.1× |
| Inguinal hernia repair CPT Code: 49505 | $519 | 0.1× |
| Blood transfusion CPT Code: 36430 | $471 | 0.9× |
| Upper endoscopy with biopsy CPT Code: 43239 | $400 | 0.4× |
| Breast lump removal CPT Code: 19120 | $417 | 0.1× |
| Behavioral health residential care HCPCS Code: H0011 | $358 | 1.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $380 | 0.7× |
| Behavioral health day treatment HCPCS Code: H0010 | $311 | 0.9× |
Audit a Bill or Quote at Boulder Community Health (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $28,224
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.3% of gross = $28,224).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Boulder Community Health's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($121,135) is $90,360 above the denoised Fair BaseRate ($30,775) and 5.2× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (23.3% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (1,073 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Boulder Community Health.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.