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 |
|---|---|---|---|---|
| Quest t3 uptake CPT 84479 | $5.50 | $11.00 | $5.16 – $22.22 | 61 |
| Rabies ig ht&sol human im/sc CPT 90377 | $4,288.12 | $8,576.25 | $240.13 – $9,066.23 | 55 |
| Radiation physics consult CPT 77336 | $3,679.50 | $7,359.00 | $132.06 – $356.57 | 57 |
| Radiation therapy dose plan CPT 77300 | $3,679.50 | $7,359.00 | $85.46 – $356.57 | 57 |
| Radiation treatment aid(s) CPT 77332 | $820.00 | $1,640.00 | $72.10 – $356.57 | 57 |
| Radiation treatment aid(s) CPT 77333 | $1,226.50 | $2,453.00 | $132.06 – $356.57 | 57 |
| Radiation treatment aid(s) CPT 77334 | $3,679.50 | $7,359.00 | $170.92 – $993.32 | 57 |
| Radiation treatment delivery CPT 77402 | $775.00 | $1,550.00 | $100.25 – $348.05 | 57 |
| Radiation treatment delivery CPT 77412 | $3,679.50 | $7,359.00 | $542.90 – $1,465.83 | 57 |
| Radiology port images(s) CPT 77417 | $175.00 | $350.00 | $28.48 – $28.48 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | $5,117.00 | $10,234.00 | $1,359.98 – $3,839.29 | 57 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,717.50 | $3,435.00 | $274.26 – $1,440.44 | 60 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,632.50 | $3,265.00 | $533.49 – $2,465.18 | 60 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $1,717.50 | $3,435.00 | $619.62 – $3,434.56 | 60 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,717.50 | $3,435.00 | $337.43 – $1,453.44 | 60 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,181.50 | $2,363.00 | $223.78 – $1,060.55 | 60 |
| Radphm quant measure sgl area add-on CPT 78835 | $334.00 | $668.00 | $84.75 – $365.05 | 4 |
| Range of motion measurements CPT 95852 | $73.50 | $147.00 | $4.99 – $95.62 | 57 |
| Rapid Strep Test CPT 87880 | $93.00 | $186.00 | $13.20 – $56.84 | 61 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $1,408.87 | $2,817.75 | $383.37 – $1,920.63 | 55 |
| Rbc count only automated CPT 85041 | $69.50 | $139.00 | $2.41 – $10.39 | 61 |
| Rbc osmotic fragility CPT 85555 | $74.50 | $149.00 | $5.96 – $25.66 | 61 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $461.00 | $922.00 | $422.69 – $1,141.26 | 56 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $2,466.00 | $4,932.00 | $184.91 – $499.26 | 56 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $943.00 | $1,886.00 | $265.41 – $716.61 | 56 |
| Red blood cells washed each unit HCPCS P9022 | $341.50 | $683.00 | $368.58 – $995.17 | 56 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $63.00 | $126.00 | $580.67 – $580.67 | 1 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $892.87 | $1,785.75 | $6.90 – $1,242.80 | 55 |
| Remote 30 day ecg tech supp CPT 93229 | $161.50 | $323.00 | $23.93 – $989.94 | 57 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $358.00 | $716.00 | $115.32 – $532.26 | 57 |
| Remove cva lumen obstruct CPT 75902 | $422.00 | $844.00 | $102.33 – $102.33 | 1 |
| Renal cyst study s&i CPT 74470 | $534.50 | $1,069.00 | $77.28 – $1,449.58 | 60 |
| Renal function panel CPT 80069 | $387.00 | $774.00 | $6.93 – $29.83 | 61 |
| Renal venogram bil s&i CPT 75833 | $1,917.00 | $3,834.00 | $140.93 – $8,376.44 | 60 |
| Reptilase test CPT 85635 | $21.00 | $42.00 | $7.86 – $33.84 | 61 |
| Respirator motion mgmt simul CPT 77293 | $3,867.00 | $7,734.00 | $896.39 – $896.39 | 1 |
| #resp virpnl dfa-adenovirus CPT 87260 | $96.50 | $193.00 | $11.51 – $49.60 | 61 |
| Resp virus 6-11 targets CPT 87632 | $422.50 | $845.00 | $174.01 – $749.53 | 61 |
| Resuscitation cardiopulmonary CPT 92950 | $962.00 | $1,924.00 | $212.16 – $572.82 | 57 |
| Reticulated platelet assay CPT 85055 | $108.00 | $216.00 | $28.52 – $122.84 | 61 |
| Reticulocyte automated CPT 85045 | $101.00 | $202.00 | $3.18 – $13.71 | 61 |
| Reticulocyte direct measurement automated CPT 85046 | $47.00 | $94.00 | $4.45 – $19.15 | 61 |
| Revasc intra lithotrip-stent HCPCS C9765 | $10,862.50 | $21,725.00 | $11,890.18 – $48,631.74 | 57 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $18,233.50 | $36,467.00 | $8,618.37 – $48,631.74 | 60 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $11,399.50 | $22,799.00 | $4,750.24 – $30,625.42 | 60 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $18,233.50 | $36,467.00 | $8,497.34 – $48,631.74 | 60 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $18,233.50 | $36,467.00 | $8,648.20 – $48,631.74 | 60 |
| Revita, per sq cm HCPCS Q4180 | $109.37 | $218.75 | $122.27 – $330.14 | 54 |
| Rheumatoid factor qualitative CPT 86430 | $101.00 | $202.00 | $4.90 – $21.11 | 61 |
| Rheumatoid factor quantitative CPT 86431 | $250.50 | $501.00 | $4.52 – $19.48 | 61 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $6.40 | $12.80 | $23.23 – $23.23 | 1 |
| Rho d immune globulin inj HCPCS J2790 | $307.37 | $614.75 | $180.49 – $180.49 | 1 |
| Right ventric recording CPT 93603 | $2,345.00 | $4,690.00 | $1,185.07 – $3,229.99 | 57 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $954.25 | $1,908.50 | $13.27 – $1,964.34 | 55 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $15.00 | $30.00 | $10.76 – $10.76 | 1 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $816.00 | $1,632.00 | $242.83 – $1,060.55 | 60 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $1,717.50 | $3,435.00 | $414.24 – $3,434.56 | 60 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $1,831.50 | $3,663.00 | $782.76 – $3,793.49 | 60 |
| Rsv assay w/optic CPT 87807 | $74.00 | $148.00 | $10.45 – $45.01 | 61 |
| Rubella antibody igg CPT 86762 | $159.50 | $319.00 | $11.49 – $49.47 | 61 |
| Rubeola antibody igg CPT 86765 | $63.50 | $127.00 | $10.28 – $44.28 | 61 |
| Russell viper venom diluted CPT 85613 | $29.50 | $59.00 | $7.65 – $32.94 | 61 |
| Salivary gland function exam CPT 78232 | $780.00 | $1,560.00 | $96.81 – $1,060.55 | 60 |
| Salmonella antibody CPT 86768 | $8.00 | $16.00 | $10.53 – $45.34 | 61 |
| Sars-cov-2 antb quantitative CPT 86413 | $185.00 | $370.00 | $41.04 – $176.77 | 61 |
| Sarscov coronavirus ag ia CPT 87426 | $61.50 | $123.00 | $28.20 – $121.45 | 61 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $95.00 | $190.00 | $48.89 – $241.59 | 61 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $2,256.50 | $4,513.00 | $36.39 – $989.12 | 60 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $1,509.00 | $3,018.00 | $73.97 – $435.14 | 60 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $591.00 | $1,182.00 | $15.17 – $735.58 | 60 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,074.50 | $2,149.00 | $101.02 – $435.14 | 60 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $851.50 | $1,703.00 | $15.17 – $435.14 | 60 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,147.00 | $2,294.00 | $42.10 – $435.14 | 60 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,809.00 | $3,618.00 | $66.13 – $968.00 | 60 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,035.00 | $2,070.00 | $101.02 – $435.14 | 60 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,061.00 | $2,122.00 | $100.38 – $435.14 | 60 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,996.25 | $5,992.50 | $11.94 – $11.94 | 1 |
| Screening Mammogram CPT 77067 | $381.00 | $762.00 | $90.77 – $245.08 | 57 |
| Serpina1 gene CPT 81332 | $154.00 | $308.00 | $34.84 – $150.05 | 61 |
| Sertraline (zoloft) - sendout CPT 80332 | $97.50 | $195.00 | $15.81 – $183.09 | 31 |
| Set radiation therapy field CPT 77280 | $3,679.50 | $7,359.00 | $132.06 – $603.54 | 57 |
| Set radiation therapy field CPT 77290 | $3,679.50 | $7,359.00 | $367.90 – $1,077.09 | 57 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,110.00 | $6,220.00 | $342.79 – $1,499.39 | 59 |
| Shoulder MRI (with contrast) CPT 73222 | $2,751.50 | $5,503.00 | $306.95 – $2,444.14 | 59 |
| Shoulder MRI (without contrast) CPT 73221 | $2,392.00 | $4,784.00 | $198.70 – $855.88 | 59 |
| Shoulder X-ray CPT 73030 | $339.50 | $679.00 | $33.34 – $230.87 | 60 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $235.00 | $470.00 | $77.77 – $334.97 | 60 |
| Sialography s&i CPT 70390 | $300.50 | $601.00 | $110.14 – $632.98 | 60 |
| Sickling rbc CPT 85660 | $74.00 | $148.00 | $4.40 – $18.95 | 61 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $254.25 | $508.50 | $241.80 – $241.80 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,208.00 | $4,416.00 | $166.31 – $716.35 | 59 |
| Sinus CT scan (with contrast) CPT 70487 | $1,952.50 | $3,905.00 | $148.56 – $654.17 | 59 |
| Sinus CT scan (without contrast) CPT 70486 | $1,698.50 | $3,397.00 | $99.51 – $428.64 | 59 |
| Sinus/juglr venogram s&i CPT 75860 | $1,810.50 | $3,621.00 | $119.36 – $8,376.44 | 60 |
| Sirolimus, oral HCPCS J7520 | $1,989.50 | $3,979.00 | $1,300.64 – $1,300.64 | 1 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $133.50 | $267.00 | $10.65 – $183.09 | 31 |
| Sleep Study (Polysomnography) CPT 95810 | $3,734.50 | $7,469.00 | $248.09 – $2,278.14 | 57 |
| Sleep study unattended CPT 95806 | $359.00 | $718.00 | $179.34 – $572.82 | 57 |
| Sleeve fing rolyan med HCPCS L3933 | $206.00 | $412.00 | $239.91 – $647.76 | 54 |
| Small animal inoculation CPT 87003 | $16.00 | $32.00 | $13.44 – $57.90 | 61 |
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.