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 |
|---|---|---|---|---|
| Smear fluorescent and/or acid fast stain CPT 87206 | $29.50 | $59.00 | $4.30 – $18.54 | 61 |
| Smear gram stain CPT 87205 | $70.50 | $141.00 | $3.41 – $14.69 | 61 |
| Smear nasal eosinophil CPT 89190 | $69.00 | $138.00 | $4.62 – $19.89 | 61 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $115.50 | $231.00 | $4.78 – $20.58 | 61 |
| Smear wet mount CPT 87210 | $70.50 | $141.00 | $4.65 – $20.01 | 61 |
| Smpd1 gene common variants CPT 81330 | $43.00 | $86.00 | $37.51 – $161.55 | 61 |
| Snrpn/ube3a gene CPT 81331 | $251.50 | $503.00 | $40.76 – $175.55 | 61 |
| Sodium 24 hour urine CPT 84300 | $134.00 | $268.00 | $4.04 – $17.39 | 61 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $353.50 | $707.00 | $404.58 – $404.58 | 1 |
| Sodium serum/plasma/whole blood CPT 84295 | $134.50 | $269.00 | $3.84 – $16.53 | 61 |
| So gsap cll fr mcrstl ins CPT 81464 | $1,751.50 | $3,503.00 | $477.13 – $8,878.98 | 60 |
| Somatosensory testing CPT 95927 | $1,439.50 | $2,879.00 | $35.68 – $572.82 | 57 |
| Special physics consult CPT 77370 | $812.50 | $1,625.00 | $132.06 – $356.57 | 57 |
| Special radiation dosimetry CPT 77331 | $346.50 | $693.00 | $48.07 – $356.57 | 57 |
| Special radiation treatment CPT 77470 | $2,966.00 | $5,932.00 | $64.10 – $1,465.83 | 57 |
| Special teletx port plan CPT 77321 | $1,166.00 | $2,332.00 | $110.38 – $993.32 | 57 |
| Specimen fat stain CPT 89125 | $11.50 | $23.00 | $4.69 – $20.21 | 61 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $629.50 | $1,259.00 | $91.31 – $989.94 | 57 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $381.50 | $763.00 | $444.32 – $1,199.66 | 53 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $73.00 | $146.00 | $60.42 – $163.13 | 54 |
| Splint finger frog med HCPCS L3927 | $77.00 | $154.00 | $39.34 – $106.22 | 54 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $71.00 | $142.00 | $97.81 – $264.09 | 54 |
| Split blood or products CPT 86985 | $63.00 | $126.00 | $167.40 – $451.97 | 57 |
| Srs linear based CPT 77372 | $11,659.00 | $23,318.00 | $2,691.86 – $19,539.28 | 57 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $433.00 | $866.00 | $2.85 – $297.97 | 57 |
| Staph a dna amp probe CPT 87640 | $97.00 | $194.00 | $28.01 – $120.63 | 61 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $425.00 | $850.00 | $55.42 – $279.53 | 57 |
| St evaluate speech sound production CPT 92522 | $433.00 | $866.00 | $9.52 – $304.16 | 57 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $433.00 | $866.00 | $5.71 – $616.44 | 57 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $433.00 | $866.00 | $67.55 – $247.02 | 57 |
| St evaluation swallow function CPT 92610 | $324.00 | $648.00 | $22.36 – $156.79 | 57 |
| Stimulants synthetic CPT 80371 | $117.00 | $234.00 | $11.22 – $183.09 | 31 |
| Strep a ag ia CPT 87430 | $231.00 | $462.00 | $13.41 – $57.78 | 61 |
| Strep b dna amp probe CPT 87653 | $74.50 | $149.00 | $28.01 – $120.63 | 61 |
| Stress test pulmonary CPT 94618 | $166.00 | $332.00 | $121.41 – $352.96 | 57 |
| Stress tte complete CPT 93351 | $3,013.50 | $6,027.00 | $107.99 – $1,449.58 | 57 |
| Str markers spec anal addl CPT 81266 | $292.00 | $584.00 | $243.24 – $1,047.72 | 61 |
| Str markers specimen anal CPT 81265 | $535.00 | $1,070.00 | $185.99 – $801.13 | 61 |
| St treatment speech individual CPT 92507 | $216.50 | $433.00 | $71.96 – $207.23 | 57 |
| St treatment swallow dysfunction/oral CPT 92526 | $216.50 | $433.00 | $6.18 – $228.93 | 57 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $42.00 | $84.00 | $31.79 – $31.79 | 1 |
| Sugars single quant CPT 84378 | $48.50 | $97.00 | $9.21 – $39.65 | 61 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $7.00 | $14.00 | $0.14 – $0.14 | 1 |
| Sulfonylurea screen qn-sendout CPT 80377 | $96.00 | $192.00 | $6.20 – $183.09 | 31 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $19.00 | $38.00 | $57.81 – $57.81 | 1 |
| Surgical pathology level 1 gross examination only CPT 88300 | $94.50 | $189.00 | $12.63 – $76.73 | 61 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $124.00 | $248.00 | $25.39 – $109.38 | 61 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $154.50 | $309.00 | $32.34 – $140.03 | 61 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $185.00 | $370.00 | $51.20 – $235.17 | 61 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $214.50 | $429.00 | $218.39 – $950.92 | 61 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $244.00 | $488.00 | $326.06 – $2,137.38 | 61 |
| Susceptibility agar dilution per agent CPT 87181 | $188.00 | $376.00 | $3.79 – $16.33 | 61 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $188.00 | $376.00 | $3.79 – $16.33 | 61 |
| Susceptibility mic per plate CPT 87186 | $188.00 | $376.00 | $6.91 – $29.75 | 61 |
| Suscept studies macrobroth dilution ea CPT 87188 | $35.50 | $71.00 | $5.30 – $22.83 | 61 |
| Svc venogram s&i CPT 75827 | $1,749.50 | $3,499.00 | $113.00 – $4,176.05 | 60 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $97.00 | $194.00 | $3.52 – $15.14 | 61 |
| System recell skin grafting/harvesting HCPCS C1832 | $4,640.62 | $9,281.25 | $1.88 – $1.88 | 1 |
| System sealant biosentry tract HCPCS C2613 | $300.00 | $600.00 | $252.02 – $252.02 | 1 |
| T3 (triiodothyronine) free CPT 84481 | $188.00 | $376.00 | $13.52 – $58.23 | 61 |
| T3 (triiodothyronine) total CPT 84480 | $208.00 | $416.00 | $11.31 – $48.74 | 61 |
| T4 (thyroxine) free CPT 84439 | $188.00 | $376.00 | $7.20 – $31.02 | 61 |
| T4 (thyroxine) total CPT 84436 | $208.00 | $416.00 | $5.48 – $23.61 | 61 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $7.00 | $14.00 | $8.68 – $8.68 | 1 |
| Tacrolimus therapeutic drug level CPT 80197 | $479.00 | $958.00 | $10.95 – $47.18 | 61 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $1,496.50 | $2,993.00 | $2,329.84 – $10,035.47 | 61 |
| Target gsa panel organ neop CPT 81445 | $1,376.50 | $2,753.00 | $597.91 – $1,614.36 | 57 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $743.87 | $1,487.75 | $0.25 – $587.94 | 55 |
| Tbs techl calculation only CPT 77091 | $89.50 | $179.00 | $85.51 – $230.87 | 57 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $45.00 | $90.00 | $79.80 – $343.73 | 61 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $139.00 | $278.00 | $49.46 – $213.03 | 61 |
| Tc-99m maa HCPCS A9540 | $430.00 | $860.00 | $71.41 – $71.41 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $776.75 | $1,553.50 | $1,844.32 – $1,844.32 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $214.37 | $428.75 | $232.00 – $232.00 | 1 |
| Tcd emboli detect w/inj CPT 93893 | $122.00 | $244.00 | $71.96 – $435.14 | 60 |
| Tcd emboli detect without inj CPT 93892 | $122.00 | $244.00 | $101.02 – $435.14 | 60 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $75.00 | $150.00 | $37.49 – $161.47 | 61 |
| T cells absolute cd 4 count CPT 86361 | $26.50 | $53.00 | $21.38 – $92.07 | 61 |
| T cells total count CPT 86359 | $45.00 | $90.00 | $30.11 – $129.68 | 61 |
| Telethx isodose plan cplx CPT 77307 | $2,335.50 | $4,671.00 | $347.16 – $993.32 | 57 |
| Telethx isodose plan simple CPT 77306 | $1,606.50 | $3,213.00 | $192.26 – $993.32 | 57 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $10,454.62 | $20,909.25 | $186.97 – $7,214.81 | 55 |
| Tert gene targeted seq alys CPT 81345 | $186.00 | $372.00 | $147.79 – $636.59 | 60 |
| Test for urine cystines CPT 82615 | $17.00 | $34.00 | $7.62 – $32.82 | 61 |
| Testicular imaging w/vasc flow CPT 78761 | $837.50 | $1,675.00 | $190.14 – $1,060.55 | 60 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $45.00 | $90.00 | $56.09 – $156.50 | 57 |
| Test stress cardiovascular tracing only CPT 93017 | $1,439.00 | $2,878.00 | $36.31 – $572.82 | 57 |
| Tetanus immune globulin inj HCPCS J1670 | $826.25 | $1,652.50 | $588.54 – $1,589.06 | 55 |
| Theophylline therapeutic drug level CPT 80198 | $9.50 | $19.00 | $11.29 – $48.61 | 61 |
| Therapeutic procd strg endur HCPCS G0237 | $124.00 | $248.00 | $28.42 – $76.73 | 57 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $58.50 | $117.00 | $22.36 – $71.47 | 57 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $58.50 | $117.00 | $18.79 – $59.70 | 57 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $981.50 | $1,963.00 | $166.31 – $716.35 | 60 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $12.00 | $24.00 | $14.67 – $14.67 | 1 |
| Thrombectmy crnry perq mechanical CPT 92973 | $5,346.00 | $10,692.00 | $36.31 – $36.31 | 1 |
| Thrombin time CPT 85670 | $104.50 | $209.00 | $4.61 – $19.85 | 61 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $37.50 | $75.00 | $5.16 – $22.22 | 61 |
| Thyroglobulin antibody CPT 86800 | $14.00 | $28.00 | $12.69 – $54.67 | 61 |
| Thyroid imaging CPT 78013 | $816.00 | $1,632.00 | $163.15 – $1,060.55 | 60 |
| Thyroid mets imag whole body CPT 78018 | $816.00 | $1,632.00 | $276.17 – $1,440.44 | 60 |
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.