Methodist Charlton Medical Center
3500 W Wheatland Road, Dallas, TX · Methodisthealthsystem · · NPI 1275592131
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 |
|---|---|---|---|---|
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $113.50 | $227.00 | $28.01 – $120.63 | 61 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $150.00 | $300.00 | $28.01 – $120.63 | 60 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $82.50 | $165.00 | $34.19 – $147.27 | 61 |
| Mayo infliximab therapeutic drug level CPT 80230 | $244.00 | $488.00 | $30.78 – $132.58 | 61 |
| Mayo inhab inhibin a CPT 86336 | $42.00 | $84.00 | $12.45 – $53.61 | 61 |
| Mayo insft insulin free CPT 83527 | $9.00 | $18.00 | $10.34 – $44.52 | 61 |
| Mayo insulin antibodies CPT 86337 | $29.50 | $59.00 | $17.08 – $73.57 | 61 |
| Mayo iodine CPT 83789 | $157.00 | $314.00 | $19.24 – $82.86 | 61 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $48.50 | $97.00 | $21.63 – $93.17 | 61 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $75.00 | $150.00 | $21.63 – $93.17 | 61 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $16.00 | $32.00 | $10.57 – $45.54 | 61 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $9.50 | $19.00 | $10.20 – $43.95 | 61 |
| Mayo legionella antibody CPT 86713 | $10.50 | $21.00 | $12.21 – $52.58 | 61 |
| Mayo leptospira antibody igm CPT 86720 | $31.50 | $63.00 | $12.93 – $55.69 | 61 |
| Mayo lipoprotein electrophoresis CPT 83700 | $39.00 | $78.00 | $8.99 – $38.71 | 61 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $16.00 | $32.00 | $12.36 – $53.24 | 61 |
| Mayo manganese CPT 83785 | $17.00 | $34.00 | $21.27 – $91.62 | 61 |
| Mayo metanephrines plasma CPT 83835 | $56.50 | $113.00 | $13.52 – $58.23 | 61 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $46.00 | $92.00 | $10.47 – $183.09 | 31 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $107.50 | $215.00 | $9.61 – $41.41 | 60 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $205.00 | $410.00 | $14.69 – $63.26 | 60 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $11.00 | $22.00 | $11.61 – $50.00 | 61 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $206.00 | $412.00 | $14.88 – $64.08 | 61 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $435.00 | $870.00 | $109.33 – $470.91 | 61 |
| Mayo muramidase CPT 85549 | $12.00 | $24.00 | $14.96 – $64.45 | 61 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $535.50 | $1,071.00 | $14.69 – $63.26 | 60 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $22.50 | $45.00 | $14.40 – $62.03 | 61 |
| Mayo myoglobin CPT 83874 | $10.00 | $20.00 | $10.31 – $44.40 | 61 |
| Mayo nickel CPT 83885 | $53.00 | $106.00 | $19.56 – $84.25 | 61 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $100.50 | $201.00 | $13.57 – $183.09 | 31 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $42.50 | $85.00 | $11.31 – $183.09 | 31 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $146.50 | $293.00 | $16.93 – $72.92 | 61 |
| Mayo organic acids qualitative each specimen CPT 83919 | $90.00 | $180.00 | $13.13 – $56.55 | 61 |
| Mayo oxalate 24 hour urine CPT 83945 | $84.00 | $168.00 | $11.53 – $49.68 | 61 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $12.50 | $25.00 | $12.00 – $51.68 | 61 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $620.50 | $1,241.00 | $9.61 – $41.41 | 61 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $72.00 | $144.00 | $28.01 – $120.63 | 61 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $51.00 | $102.00 | $14.35 – $61.79 | 61 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $9.50 | $19.00 | $10.98 – $47.30 | 61 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $23.50 | $47.00 | $6.74 – $29.01 | 61 |
| Mayo pregnenolone CPT 84140 | $23.00 | $46.00 | $16.49 – $71.04 | 61 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $28.50 | $57.00 | $13.24 – $57.04 | 61 |
| Mayo proinsulin CPT 84206 | $18.00 | $36.00 | $21.30 – $91.74 | 61 |
| Mayo psaft prostate specific antigen free CPT 84154 | $12.50 | $25.00 | $14.68 – $63.22 | 61 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $309.50 | $619.00 | $14.69 – $63.26 | 61 |
| Mayo receptor assay transferrin soluble CPT 84238 | $17.00 | $34.00 | $29.18 – $125.71 | 61 |
| Mayo renin CPT 84244 | $15.00 | $30.00 | $17.55 – $75.58 | 61 |
| Mayo repu protein electrophoresis urine CPT 84166 | $331.00 | $662.00 | $14.23 – $61.30 | 61 |
| Mayo selenium CPT 84255 | $33.00 | $66.00 | $20.38 – $87.77 | 61 |
| Mayo serotonin CPT 84260 | $28.00 | $56.00 | $24.72 – $106.47 | 61 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $13.50 | $27.00 | $15.44 – $66.50 | 61 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $107.50 | $215.00 | $10.95 – $47.18 | 61 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $27.00 | $54.00 | $23.68 – $248.48 | 60 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $97.00 | $194.00 | $3.41 – $14.69 | 61 |
| Mayo tau phosphorylated 217 each CPT 84393 | $249.00 | $498.00 | $27.29 – $1,035.81 | 60 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $1,255.00 | $2,510.00 | $166.72 – $718.11 | 61 |
| Mayo tgrp testosterone free CPT 84402 | $8.00 | $16.00 | $20.32 – $87.53 | 61 |
| Mayo tgrp testosterone total CPT 84403 | $26.50 | $53.00 | $20.60 – $88.71 | 61 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $98.00 | $196.00 | $17.69 – $76.19 | 60 |
| Mayo thyroglobulin CPT 84432 | $52.00 | $104.00 | $12.82 – $55.20 | 61 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $68.50 | $137.00 | $8.12 – $34.99 | 61 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $13.50 | $27.00 | $9.89 – $42.60 | 61 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $75.00 | $150.00 | $9.81 – $183.09 | 31 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $19.00 | $38.00 | $11.30 – $48.65 | 61 |
| Mayo vasoactive intestinal peptide CPT 84586 | $21.50 | $43.00 | $28.20 – $121.45 | 61 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $132.00 | $264.00 | $16.15 – $69.56 | 61 |
| Mayo vitamin b3 (niacin) CPT 84591 | $79.00 | $158.00 | $13.61 – $58.64 | 61 |
| Mayo vitamin k CPT 84597 | $41.50 | $83.00 | $10.94 – $47.14 | 61 |
| Mcoln1 gene CPT 81290 | $36.00 | $72.00 | $31.37 – $135.12 | 61 |
| #mec-opiates CPT 80356 | $82.50 | $165.00 | $12.69 – $54.67 | 4 |
| Mecp2 gene dup/delet variant CPT 81304 | $431.50 | $863.00 | $119.70 – $515.59 | 61 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $163.78 | $327.57 | $122.27 – $330.14 | 54 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | $103.12 | $206.25 | $54.56 – $330.14 | 55 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | $128.43 | $256.86 | $122.27 – $330.14 | 54 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $46.25 | $92.50 | $1.09 – $1.09 | 1 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $47.50 | $95.00 | $26.41 – $26.41 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $52.50 | $105.00 | $84.61 – $84.61 | 1 |
| Metabolic Blood Panel (Basic) CPT 80048 | $349.50 | $699.00 | $6.75 – $29.09 | 61 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $405.00 | $810.00 | $8.43 – $36.30 | 61 |
| Metabolic panel ionized ca CPT 80047 | $137.00 | $274.00 | $10.95 – $47.18 | 61 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $21.00 | $42.00 | $30.09 – $30.09 | 1 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $57.25 | $114.50 | $2.84 – $2.84 | 1 |
| Methotrexate therapeutic drug level CPT 80204 | $60.00 | $120.00 | $30.78 – $132.58 | 61 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $1,530.00 | $3,060.00 | $2.77 – $26.48 | 55 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $66.75 | $133.50 | $32.65 – $32.65 | 1 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $347.37 | $694.75 | $275.33 – $275.33 | 1 |
| Methylphenidate CPT 80360 | $75.00 | $150.00 | $8.65 – $183.09 | 31 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $41.50 | $83.00 | $14.67 – $14.67 | 1 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $71.87 | $143.75 | $5.87 – $5.87 | 1 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $2.37 | $4.75 | $3.63 – $3.63 | 1 |
| Mgmt promoter methylation analysis CPT 81287 | $240.00 | $480.00 | $99.47 – $428.43 | 61 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $347.87 | $695.75 | $446.93 – $446.93 | 1 |
| Microalbumin urine screen CPT 82044 | $55.00 | $110.00 | $4.97 – $21.40 | 61 |
| Microbe susceptible mlc CPT 87187 | $90.00 | $180.00 | $32.05 – $138.06 | 61 |
| Microdissection laser CPT 88380 | $911.00 | $1,822.00 | $124.71 – $124.71 | 1 |
| Microdissection manual CPT 88381 | $213.00 | $426.00 | $205.56 – $205.56 | 1 |
| Microsatellite instability CPT 81301 | $480.00 | $960.00 | $278.15 – $1,198.10 | 61 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $72.75 | $145.50 | $0.38 – $0.38 | 1 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $63.00 | $126.00 | $81.26 – $81.26 | 1 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $19.37 | $38.75 | $16.83 – $16.83 | 1 |
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.