BAYLOR UNIVERSITY MEDICAL CENTER
3500 Gaston Ave., Dallas, TX · Baylor Scott & White Health · · NPI 1447250253
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Listeria monocytogenes CPT 86723 | $159.53 | $265.88 | $10.00 – $199.41 | 28 |
| Lithium therapeutic drug level CPT 80178 | $95.88 | $159.80 | $5.55 – $119.85 | 28 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $12,380.88 | $20,634.80 | $3,507.92 – $17,539.58 | 20 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $660.00 | $1,100.00 | $35.00 – $751.09 | 28 |
| Liver elastography 91200 CPT 91200 | $312.00 | $520.00 | $31.93 – $390.00 | 28 |
| Liver Function Test CPT 80076 | $193.52 | $322.54 | $6.86 – $241.91 | 28 |
| Liver image (3d) with flow CPT 78206 | $1,198.66 | $1,997.76 | $133.99 – $669.97 | 21 |
| Liver imaging CPT 78201 | $1,279.10 | $2,131.83 | $175.43 – $1,598.87 | 28 |
| Liver imaging (3d) CPT 78205 | $1,198.66 | $1,997.76 | $339.62 – $1,698.10 | 21 |
| Liver imag w/vasclr flow CPT 78202 | $1,255.15 | $2,091.92 | $194.80 – $1,568.94 | 28 |
| Liver/spleen imag static only CPT 78215 | $1,471.52 | $2,452.54 | $180.10 – $1,839.40 | 28 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $504.82 | $841.37 | $135.99 – $1,021.72 | 28 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $1,088.27 – $8,018.48 | 19 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $161.06 | $268.44 | $1.27 – $228.17 | 22 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $12.92 | $21.53 | $0.19 – $1.83 | 22 |
| Low back disk surgery CPT 63030 | not published | not published | $2,398.52 – $17,722.46 | 19 |
| Low cost skin substitute app HCPCS C5271 | $1,126.12 | $1,876.87 | $319.07 – $1,595.34 | 22 |
| Low cost skin substitute app HCPCS C5273 | $1,584.24 | $2,640.40 | $448.87 – $4,517.58 | 22 |
| Low cost skin substitute app HCPCS C5275 | $1,313.06 | $2,188.44 | $372.03 – $1,860.17 | 22 |
| Low cost skin substitute app HCPCS C5272 | $693.49 | $1,155.81 | $196.49 – $982.44 | 21 |
| Low cost skin substitute app HCPCS C5274 | $769.45 | $1,282.42 | $218.01 – $1,090.06 | 21 |
| Low cost skin substitute app HCPCS C5276 | $2,428.65 | $4,047.75 | $688.12 – $3,440.59 | 21 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $184.05 | $306.75 | $99.77 – $1,841.00 | 28 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,677.35 | $2,795.59 | $167.39 – $2,096.69 | 28 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,381.40 | $3,969.00 | $173.75 – $2,976.75 | 28 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,054.79 | $3,424.65 | $99.77 – $2,568.49 | 28 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,196.33 | $5,327.21 | $329.13 – $3,995.41 | 28 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,181.58 | $3,635.96 | $279.00 – $2,726.97 | 28 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,190.02 | $3,650.03 | $197.14 – $2,737.52 | 28 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $337.54 | $562.56 | $40.10 – $421.92 | 28 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $475.04 | $791.73 | $52.13 – $593.80 | 28 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $535.91 | $893.19 | $61.48 – $669.89 | 28 |
| Lower jaw bone graft CPT 21215 | not published | not published | $2,788.09 – $14,507.25 | 19 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $306.47 | $510.79 | $31.74 – $383.09 | 28 |
| Low frequency non-thermal Ultrasound CPT 97610 | $364.77 | $607.95 | $103.35 – $495.95 | 28 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $3,110.01 – $25,500.18 | 18 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $9,126.00 – $25,500.18 | 18 |
| Lso sagit rigid panel prefab HCPCS L0635 | $1,513.13 | $2,521.88 | $428.72 – $2,017.50 | 20 |
| L/s ratio fetal lung CPT 83661 | $254.12 | $423.53 | $10.00 – $317.65 | 28 |
| Lumbar diskogram s&i CPT 72295 | $2,358.23 | $3,930.39 | $111.60 – $4,783.04 | 28 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $7,038.00 – $46,166.33 | 19 |
| Lumizyme injection HCPCS J0221 | $1,735.97 | $2,893.29 | $187.25 – $1,891.44 | 28 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $628.51 | $1,047.51 | $144.93 – $805.95 | 28 |
| Lung function test (mbc/mvv) CPT 94200 | $214.94 | $358.24 | $56.30 – $268.68 | 28 |
| Lung Function Test (Spirometry) CPT 94010 | $405.67 | $676.12 | $114.94 – $507.09 | 28 |
| Lung perfusion imaging CPT 78580 | $1,348.42 | $2,247.36 | $213.51 – $1,685.52 | 28 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $21,365.20 | $35,608.66 | $38.76 – $8,916.19 | 28 |
| Lvad shower bag heartmate HCPCS Q0501 | $837.59 | $1,395.99 | $90.95 – $596.45 | 21 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $1,247.96 – $17,652.85 | 17 |
| Lymphatics/lymph node imaging CPT 78195 | $1,939.47 | $3,232.45 | $317.76 – $2,424.34 | 28 |
| Lymphocyte transformation mitogen CPT 86353 | $1,239.31 | $2,065.51 | $10.00 – $497.31 | 28 |
| Lymphocytotoxicity assay CPT 86805 | $370.20 | $617.00 | $10.00 – $462.75 | 28 |
| Lymph vessel x-ray arm/leg CPT 75801 | $700.80 | $1,168.00 | $284.65 – $1,556.23 | 22 |
| Lymph vessel x-ray trunk CPT 75805 | $2,694.05 | $4,490.09 | $313.39 – $7,896.23 | 28 |
| Lymph vessel x-ray trunk CPT 75807 | $1,238.59 | $2,064.32 | $146.54 – $7,896.23 | 28 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $187.22 – $4,063.00 | 18 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $1,063.52 – $7,744.80 | 19 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $652.80 – $5,045.72 | 19 |
| Macro exam dissect molec study ea CPT 88387 | $101.29 | $168.82 | $16.71 – $143.50 | 21 |
| Macroscopic exam arthropod CPT 87168 | $45.36 | $75.60 | $3.59 – $56.70 | 28 |
| Macroscopic exam parasite CPT 87169 | $48.74 | $81.24 | $3.62 – $60.93 | 28 |
| Magnesium CPT 83735 | $92.35 | $153.91 | $5.63 – $19.41 | 28 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $58.32 | $97.20 | $0.47 – $8.06 | 22 |
| Magnetic image bone marrow CPT 77084 | $1,349.86 | $2,249.77 | $227.71 – $2,149.00 | 28 |
| Makena, 10 mg HCPCS J1726 | $1,445.40 | $2,409.00 | $18.68 – $2,047.65 | 22 |
| Malaria antibody CPT 86750 | $126.00 | $210.00 | $10.00 – $157.50 | 28 |
| Male sling procedure CPT 53440 | not published | not published | $2,416.00 – $31,800.16 | 19 |
| Mammosite ced HCPCS C1728 | $2,000.16 | $3,333.60 | $0.00 – $0.01 | 19 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $593.04 – $3,981.46 | 18 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $593.04 – $6,093.00 | 18 |
| Manipulation of hip joint CPT 27275 | not published | not published | $593.04 – $4,063.00 | 19 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $17.82 | $29.70 | $5.05 – $25.25 | 21 |
| Man's shoe oxford brace HCPCS L3225 | $175.11 | $291.85 | $49.61 – $233.48 | 20 |
| Manual diff wbc count b-coat CPT 85009 | $44.14 | $73.56 | $4.26 – $55.17 | 28 |
| Mapping io sentinel lymph node CPT 38900 | $468.21 | $780.35 | $132.66 – $663.30 | 21 |
| Map tachycard site(s) CPT 93609 | $7,600.81 | $12,668.01 | $896.19 – $10,767.81 | 21 |
| Marker biop eviva buckle ss HCPCS A4648 | $6,369.00 | $10,615.00 | $11.29 – $53.11 | 19 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,753.29 | $2,922.15 | $496.77 – $2,696.10 | 23 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,997.72 – $7,038.00 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $963.66 – $9,442.65 | 19 |
| Mast mod rad CPT 19307 | not published | not published | $6,336.91 – $16,154.42 | 18 |
| Mastoidectomy CPT 69501 | not published | not published | $1,954.22 – $14,507.25 | 19 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $1,954.22 – $14,507.25 | 19 |
| Mastoids complete CPT 70130 | $238.14 | $396.90 | $62.15 – $297.68 | 28 |
| Mastopexy CPT 19316 | not published | not published | $1,845.21 – $16,154.42 | 19 |
| Mast simple complete CPT 19303 | not published | not published | $1,845.21 – $16,154.42 | 19 |
| Matrion 1 sq cm HCPCS Q4201 | $361.00 | $601.66 | $11.17 – $451.25 | 27 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $6,522.00 | $10,870.00 | $4.13 – $268.77 | 27 |
| M.avium-intra dna amp prob CPT 87561 | $289.80 | $483.00 | $10.00 – $281.25 | 28 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $112.58 | $187.63 | $10.00 – $140.72 | 28 |
| Mayo aathr protein s free CPT 85306 | $200.93 | $334.89 | $10.00 – $50.62 | 28 |
| Mayo activated protein c resistance assay CPT 85307 | $164.66 | $274.43 | $10.00 – $128.21 | 28 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $645.00 | $1,075.00 | $10.00 – $806.25 | 28 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $152.13 | $253.55 | $10.00 – $194.40 | 20 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $84.63 | $141.05 | $9.42 – $47.60 | 20 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $106.69 | $177.81 | $10.00 – $35.47 | 28 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $83.43 | $139.05 | $10.00 – $42.50 | 20 |
| Mayo alpha 1 antitrypsin CPT 82103 | $115.67 | $192.78 | $10.00 – $144.59 | 28 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $122.94 | $204.90 | $10.00 – $153.68 | 28 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $156.82 | $261.36 | $10.00 – $65.88 | 20 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.