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1 Effective January 1, 2021 Exhibit # 2 Base Rates and Cost-To-Charge

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1 Effective January 1, 2021 Exhibit # 2 Base Rates and Cost-To-Charge Exhibit # 2 Base Rates and Cost-to-Charge Ratios Source: Medicare FY 2020 IPPS Impact File - Correction Notice (August 2019) Effective 1/1/2021 Provider Total Individual Hospital Name Number CCR Base Rate 060001 North Colorado Medical Center 0.248 $7,103.15 060003 Longmont United Hospital 0.280 $6,549.94 060004 Platte Valley Medical Center 0.390 $6,442.07 060006 Montrose Memorial Hospital 0.384 $6,421.20 060008 San Luis Valley Health 0.390 $6,421.20 060009 Lutheran Medical Center 0.216 $6,521.51 060010 Poudre Valley Hospital 0.261 $6,682.59 060011 Denver Health Medical Center 0.312 $8,378.88 060012 Centura Health-St Mary Corwin Medical Center 0.237 $7,026.34 060013 Mercy Regional Medical Center 0.268 $8,212.13 060014 Presbyterian St Lukes Medical Center 0.155 $7,045.02 060015 Centura Health-St Anthony Hospital 0.208 $6,574.38 060020 Parkview Medical Center, Inc 0.147 $7,078.44 060022 University Colo Health Memorial Hospital Central 0.209 $6,691.82 060023 St Marys Medical Center 0.273 $7,153.44 060024 University Of Colorado Hospital Authority 0.166 $8,061.20 060027 Foothills Hospital 0.213 $6,405.67 060028 Saint Joseph Hospital 0.189 $7,162.96 060030 Mckee Medical Center 0.360 $6,497.94 060031 Centura Health-Penrose-St Francis Health Services 0.198 $6,490.07 060032 Rose Medical Center 0.125 $6,818.26 060034 Swedish Medical Center 0.104 $6,685.29 060044 Colorado Plains Medical Center 0.242 $6,771.99 060049 Uchealth Yampa Valley Medical Center 0.620 $9,919.44 060054 Community Hospital 0.328 $6,419.70 060064 Centura Health-Porter Adventist Hospital 0.206 $6,427.23 060065 North Suburban Medical Center 0.103 $6,749.63 060071 Delta County Memorial Hospital 0.458 $6,417.04 060075 Valley View Hospital Association 0.410 $8,488.41 060076 Sterling Regional Medcenter 0.471 $8,053.11 060096 Vail Health Hospital 0.531 $12,429.28 060100 Medical Center Of Aurora, The 0.123 $6,645.70 060103 Centura Health-Avista Adventist Hospital 0.267 $6,677.57 060104 St Anthony North Health Campus 0.243 $7,357.97 060107 National Jewish Health 0.218 $6,686.05 060112 Sky Ridge Medical Center 0.105 $6,903.57 1 Effective January 1, 2021 Provider Total Individual Hospital Name Number CCR Base Rate 060113 Centura Health-Littleton Adventist Hospital 0.184 $6,349.28 060114 Parker Adventist Hospital 0.204 $6,368.04 060116 Good Samaritan Medical Center 0.205 $6,327.75 060117 Animas Surgical Hospital, Llc 0.359 $6,247.62 060118 St Anthony Summit Medical Center 0.283 $6,442.07 060119 Medical Center Of The Rockies 0.268 $6,331.19 060124 Orthocolorado Hospital At St Anthony Med Campus 0.179 $6,267.92 060125 Castle Rock Adventist Hospital 0.229 $6,370.38 060126 Banner Fort Collins Medical Center 0.539 $6,421.20 060127 Scl Health Community Hospital- Northglenn 0.997 $6,686.05 060128 Longs Peak Hospital 0.394 $6,737.16 060129 UCHealth Broomfield Hospital 0.949 $6,511.90 060130 UCHealth Grandview Hospital 0.655 $6,490.77 * Critical Access Hospitals 0.531 $12,429.28 069999 Any New Hospital 0.229 $6,370.38 * A list of Critical Access Hospitals is available at www.ruralcenter.org/resource-library/cah-locations. 2 Effective January 1, 2021 3 Effective January 1, 2021 .
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