National Jewish Health
1400 Jackson St, Denver, CO 80206 · 83 Priced Procedures
Typical commercial prices here are +5% above the fair benchmark (1.05×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Cash-Arbitrage Bifurcated Pricer
National Jewish Health maintains elevated commercial insurance contracts (1.05× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 53% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.95× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 53% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (64.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.05× 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.
- Commercial insurance median sits at 1.04× Fair BaseRate (1.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.39×) jump +34% above the median procedure ratio (Q50 1.04×)
- Unnegotiated chargemaster list prices average 6.4× Medicare (28¢ 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 National Jewish Health
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 83 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Upper endoscopy with biopsy CPT Code: 43239 | $1,986 | 2.0× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,262 | 1.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,262 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $928 | 0.9× |
| Blood transfusion CPT Code: 36430 | $854 | 1.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $800 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $715 | 1.4× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $576 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $541 | 1.2× |
| MRI, lower back (no contrast) CPT Code: 72148 | $489 | 1.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $489 | 1.4× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $428 | 1.4× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $368 | 2.2× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $368 | 2.2× |
| Neurobehavioral status check CPT Code: 96116 | $228 | 1.0× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $252 | 0.9× |
| CT scan, pelvis CPT Code: 72192 | $200 | 1.2× |
| CT scan, chest (no contrast) CPT Code: 71250 | $200 | 1.2× |
| CT scan, head (no contrast) CPT Code: 70450 | $185 | 1.2× |
| CT scan, sinuses CPT Code: 70486 | $185 | 1.1× |
| CT scan, head (with contrast) CPT Code: 70460 | $185 | 0.8× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $185 | 0.7× |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $155 | unverified |
| X-ray, neck (cervical spine) CPT Code: 72040 | $110 | 1.2× |
| X-ray, hip CPT Code: 73502 | $110 | 1.2× |
Audit a Bill or Quote at National Jewish Health (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,695
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (64.0% of gross = $1,695).
Self-Pay Cash Rate ($1,854) Beats Your Bill
National Jewish Health's published 45 CFR § 180 self-pay cash rate is $1,854 (vs. $1,986 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $987 Fair BaseRate ($927 Medicare)
Your bill ($2,648) is $1,661 above the denoised Fair BaseRate ($987) and 2.9× the $927 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (64.0% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at National Jewish Health. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-07-18·administrative_or_closure
Closure Notice
Recorded - 2025-06-13·cap_corrective_action
CAP Request
Recorded - 2025-03-11·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare. 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 National Jewish Health.
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.