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 |
|---|---|---|---|---|
| Sinus CT scan (with and without contrast) CPT 70488 | $1,908.20 | $3,180.33 | $167.39 – $2,385.25 | 28 |
| Sinus CT scan (with contrast) CPT 70487 | $2,004.41 | $3,340.68 | $156.38 – $2,505.51 | 28 |
| Sinus CT scan (without contrast) CPT 70486 | $1,704.54 | $2,840.90 | $99.77 – $2,130.68 | 28 |
| Sinus/juglr venogram s&i CPT 75860 | $2,052.67 | $3,421.11 | $125.64 – $7,896.23 | 28 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $1,954.22 – $14,507.25 | 19 |
| Sinus X-ray (complete) CPT 70220 | $328.04 | $546.74 | $37.76 – $410.06 | 28 |
| Sinus X-ray (limited) CPT 70210 | $151.82 | $253.04 | $32.41 – $225.11 | 28 |
| Sipuleucel-t - su HCPCS Q2043 | $112,684.50 | $187,807.50 | $6,299.00 – $140,855.62 | 28 |
| Sirolimus, oral HCPCS J7520 | $42.11 | $70.18 | $1.39 – $24.32 | 22 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $252.00 | $420.00 | $10.00 – $104.96 | 20 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,457.62 – $8,887.48 | 19 |
| Skin Biopsy CPT 11102 | $269.02 | $448.37 | $64.23 – $878.00 | 28 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $709.01 – $6,093.00 | 19 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $1,896.00 – $2,763.00 | 2 |
| Skull X-ray (1 to 3 views) CPT 70250 | $277.54 | $462.56 | $36.09 – $346.92 | 28 |
| Skull X-ray (complete) CPT 70260 | $350.76 | $584.60 | $44.78 – $438.45 | 28 |
| Slco1b1 gene com variants CPT 81328 | $37.80 | $63.00 | $10.71 – $419.54 | 28 |
| Sleep Study (Polysomnography) CPT 95810 | $4,658.81 | $7,764.68 | $819.52 – $5,823.51 | 28 |
| Sleep study unattended CPT 95806 | $794.20 | $1,323.67 | $206.06 – $992.75 | 28 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $41.10 | $68.50 | $2.26 – $10.65 | 20 |
| Sling suprapubic suburetheral HCPCS C1771 | $16,564.21 | $27,607.02 | $218.70 – $1,029.18 | 19 |
| Slitting of prepuce CPT 54001 | $2,761.01 | $4,601.68 | $652.80 – $5,045.72 | 28 |
| Slp pure tone screening CPT 92551 | $82.04 | $136.73 | $23.24 – $116.22 | 21 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $561.67 | $936.12 | $121.96 – $702.09 | 28 |
| Small bowel endoscopy CPT 44360 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44364 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44366 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44369 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44376 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44378 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy CPT 44382 | not published | not published | $334.95 – $3,693.00 | 19 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $564.97 – $4,713.77 | 19 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $334.95 – $3,693.00 | 19 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $564.97 – $6,703.00 | 18 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $87.49 | $145.82 | $4.53 – $39.47 | 28 |
| Smear gram stain CPT 87205 | $74.19 | $123.65 | $3.59 – $92.74 | 28 |
| Smear nasal eosinophil CPT 89190 | $60.60 | $101.00 | $4.86 – $75.75 | 28 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $100.78 | $167.96 | $5.03 – $125.97 | 28 |
| Smear wet mount CPT 87210 | $75.59 | $125.99 | $4.89 – $94.49 | 28 |
| Smn1 gene full gene sequence CPT 81336 | $1,200.00 | $2,000.00 | $35.00 – $1,500.00 | 28 |
| Snrpn/ube3a gene CPT 81331 | $458.90 | $764.83 | $10.00 – $573.62 | 28 |
| Sodium 24 hour urine CPT 84300 | $70.34 | $117.24 | $4.25 – $87.93 | 28 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $45.90 | $76.50 | $2.40 – $26.72 | 22 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $30.00 | $50.00 | $1.49 – $42.50 | 22 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $30.00 | $50.00 | $0.77 – $21.68 | 22 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $31.39 | $52.32 | $3.06 – $15.30 | 21 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $131.28 | $218.80 | $2.63 – $185.98 | 22 |
| Sodium serum/plasma/whole blood CPT 84295 | $62.12 | $103.54 | $4.04 – $77.66 | 28 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $156.60 | $261.00 | $0.84 – $195.75 | 27 |
| Soft interface below knee se HCPCS L2820 | $220.56 | $367.60 | $62.49 – $294.08 | 20 |
| Somatosensory testing CPT 95927 | $1,066.46 | $1,777.44 | $206.06 – $1,333.08 | 28 |
| So neo gsap dna/dna&rna CPT 81459 | $3,402.00 | $5,670.00 | $35.00 – $6,427.53 | 27 |
| So neo gsap dna mcrstl ins CPT 81457 | $3,975.00 | $6,625.00 | $35.00 – $2,733.75 | 27 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $6,497.00 – $6,497.00 | 1 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Special physics consult CPT 77370 | $945.67 | $1,576.11 | $128.27 – $1,182.08 | 28 |
| Special radiation dosimetry CPT 77331 | $539.97 | $899.95 | $30.36 – $674.96 | 28 |
| Special radiation treatment CPT 77470 | $1,787.51 | $2,979.19 | $40.48 – $2,234.39 | 28 |
| Special supplies phys/qhp CPT 99070 | $60.00 | $100.00 | $8.50 – $42.50 | 21 |
| Special teletx port plan CPT 77321 | $530.47 | $884.11 | $69.72 – $915.33 | 28 |
| Specific gravity body fluid CPT 84315 | $29.54 | $49.24 | $2.76 – $36.93 | 28 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $423.40 | $705.66 | $112.00 – $612.96 | 22 |
| Speech evaluation complex CPT 70371 | $527.06 | $878.44 | $109.60 – $658.83 | 28 |
| Speech Therapy Session (one-on-one) CPT 92507 | $293.11 | $488.51 | $83.05 – $415.23 | 22 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $939.93 – $6,955.62 | 19 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $6,497.00 – $6,497.00 | 1 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,692.88 | $2,821.46 | $262.86 – $3,693.00 | 26 |
| Spine X-ray (single view, one level) CPT 72020 | $283.12 | $471.86 | $24.39 – $353.89 | 28 |
| Spleen imaging CPT 78185 | $367.06 | $611.77 | $153.36 – $1,021.72 | 28 |
| Splicing of ureters CPT 50770 | not published | not published | $2,031.21 – $7,038.00 | 3 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $107.85 | $179.75 | $30.56 – $143.80 | 20 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $4,543.60 | $7,572.67 | $1,457.62 – $8,887.48 | 28 |
| Split blood or products CPT 86985 | $125.72 | $209.54 | $10.00 – $423.12 | 28 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $1,612.78 | $2,687.96 | $456.95 – $2,284.77 | 20 |
| Sputum specimen collection CPT 89220 | $120.37 | $200.61 | $10.00 – $423.12 | 28 |
| Srs linear based CPT 77372 | $13,067.46 | $21,779.10 | $1,700.12 – $19,291.06 | 28 |
| Srs multisource CPT 77371 | $31,800.00 | $53,000.00 | $1,700.12 – $39,750.00 | 28 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $382.60 | $637.67 | $108.00 – $542.02 | 22 |
| Staph a dna amp probe CPT 87640 | $116.39 | $193.98 | $10.00 – $145.49 | 28 |
| Static or dynami afo pre ots HCPCS L4397 | $101.56 | $169.26 | $28.77 – $135.41 | 20 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $313.96 | $523.27 | $88.96 – $444.78 | 22 |
| Stem cells total count CPT 86367 | $357.60 | $596.00 | $10.00 – $447.00 | 28 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $49,101.56 | $81,835.93 | $6,299.00 – $69,560.54 | 22 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $50,985.00 | $84,975.00 | $1.03 – $4.84 | 19 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $6,120.24 | $10,200.40 | $12.35 – $333.13 | 21 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $35,204.12 | $58,673.54 | $0.00 – $0.01 | 21 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $8,229.86 | $13,716.43 | $81.79 – $384.91 | 19 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $24,055.19 | $40,091.98 | $6,299.00 – $34,078.18 | 22 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $14,391.32 | $23,985.53 | $4,077.54 – $20,387.70 | 21 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $27,840.56 | $46,400.94 | $6,299.00 – $43,439.01 | 22 |
| Sternal debridement CPT 21627 | not published | not published | $943.44 – $7,066.86 | 17 |
| St evaluate speech sound production CPT 92522 | $363.57 | $605.95 | $103.01 – $515.06 | 22 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $470.28 | $783.80 | $112.00 – $666.23 | 22 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,861.14 | $3,101.90 | $296.71 – $2,326.43 | 28 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $258.86 | $431.44 | $10.80 – $390.34 | 28 |
| Strapping of chest CPT 29200 | $226.35 | $377.25 | $15.78 – $390.34 | 28 |
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.