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 |
|---|---|---|---|---|
| Thyroid (TSH) Test CPT 84443 | $345.00 | $690.00 | $13.40 – $57.74 | 61 |
| Thyroid Ultrasound CPT 76536 | $497.00 | $994.00 | $99.51 – $428.64 | 60 |
| Thyroid uptake measurement CPT 78012 | $816.00 | $1,632.00 | $77.14 – $1,060.55 | 60 |
| Thyrotropin releasing hormone CPT 80438 | $36.00 | $72.00 | $40.22 – $173.26 | 61 |
| Thyroxine binding globulin (tbg) CPT 84442 | $12.50 | $25.00 | $11.80 – $50.82 | 61 |
| Tilt table study CPT 93660 | $2,001.50 | $4,003.00 | $22.36 – $989.94 | 57 |
| Tissue culture skin/biopsy CPT 88233 | $169.00 | $338.00 | $112.30 – $483.72 | 61 |
| Tissue culture tumor CPT 88239 | $288.50 | $577.00 | $117.72 – $507.08 | 61 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $89.58 | $179.17 | $122.27 – $330.14 | 54 |
| Tissue transglutaminase iga CPT 86364 | $16.00 | $32.00 | $9.21 – $39.65 | 60 |
| Tlso r fram soft pre ots HCPCS L0467 | $215.39 | $430.79 | $284.88 – $769.18 | 54 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $148.87 | $297.75 | $1.08 – $1.08 | 1 |
| Tobramycin peak therapeutic drug level CPT 80200 | $47.00 | $94.00 | $12.87 – $55.45 | 61 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $3,346.37 | $6,692.75 | $5.61 – $2,001.72 | 55 |
| Tomosynthesis breast screen bilateral CPT 77063 | $135.00 | $270.00 | $23.29 – $216.02 | 60 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $304.12 | $608.25 | $225.62 – $225.62 | 1 |
| Total tau CPT 84394 | $347.50 | $695.00 | $27.29 – $1,035.81 | 60 |
| Toxoplasma antibody igg CPT 86777 | $150.00 | $300.00 | $11.49 – $49.47 | 61 |
| Toxoplasma antibody igm CPT 86778 | $72.00 | $144.00 | $11.50 – $49.51 | 61 |
| Tp53 gene full gene sequence CPT 81351 | $1,050.00 | $2,100.00 | $512.19 – $2,206.20 | 61 |
| Tp53 gene trgt sequence alys CPT 81352 | $485.00 | $970.00 | $262.95 – $1,132.62 | 61 |
| Tpmt gene com vrnts CPT 81335 | $296.50 | $593.00 | $174.81 – $471.99 | 57 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $148.50 | $297.00 | $18.04 – $150.55 | 57 |
| Transcath closure of asd CPT 93580 | $15,698.00 | $31,396.00 | $18,011.76 – $48,631.74 | 57 |
| Transcath closure of vsd CPT 93581 | $16,520.00 | $33,040.00 | $18,011.76 – $48,631.74 | 57 |
| Transcatheter bx s&i CPT 75970 | $1,377.50 | $2,755.00 | $68.82 – $68.82 | 1 |
| Transcutaneous hgb 88738 CPT 88738 | $12.50 | $25.00 | $5.02 – $13.55 | 57 |
| Transferrin CPT 84466 | $211.00 | $422.00 | $10.18 – $43.87 | 61 |
| Transfusion blood/blood component(s) CPT 36430 | $1,275.00 | $2,550.00 | $433.48 – $1,170.39 | 56 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $2,145.50 | $4,291.00 | $73.48 – $3,693.98 | 55 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $10,995.50 | $21,991.00 | $1,309.65 – $3,536.06 | 56 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $250.50 | $501.00 | $71.96 – $352.96 | 57 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $250.50 | $501.00 | $121.41 – $121.41 | 1 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $151.00 | $302.00 | $121.41 – $580.92 | 57 |
| Treatment radiation delivery level 2 CPT 77407 | $1,052.50 | $2,105.00 | $378.97 – $1,023.21 | 57 |
| Treponema pallidum antibody CPT 86780 | $180.00 | $360.00 | $10.56 – $45.50 | 61 |
| Trg gene rearrangement anal CPT 81342 | $281.50 | $563.00 | $160.80 – $692.61 | 61 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $25.50 | $51.00 | $12.14 – $12.14 | 1 |
| Trichinella antibody CPT 86784 | $33.50 | $67.00 | $10.02 – $43.17 | 61 |
| #tricyclicantidprssnt CPT 80337 | $63.00 | $126.00 | $8.26 – $183.09 | 31 |
| Triglycerides CPT 84478 | $239.00 | $478.00 | $4.58 – $19.72 | 61 |
| Troponin quantitative CPT 84484 | $222.00 | $444.00 | $9.95 – $42.84 | 61 |
| Tx atrial fib pulm vein isol CPT 93656 | $27,791.00 | $55,582.00 | $24,522.32 – $69,340.76 | 57 |
| Tx l/r atrial fib addl CPT 93657 | $1,384.50 | $2,769.00 | $84.92 – $84.92 | 1 |
| Ugt1a1 gene analy common variants CPT 81350 | $658.00 | $1,316.00 | $186.73 – $804.32 | 61 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $506.50 | $1,013.00 | $99.51 – $428.64 | 60 |
| Ultrasound breast complete CPT 76641 | $499.50 | $999.00 | $97.76 – $421.11 | 60 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $288.50 | $577.00 | $80.94 – $348.64 | 60 |
| Ultrasound chest CPT 76604 | $188.00 | $376.00 | $54.28 – $277.35 | 60 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $357.00 | $714.00 | $42.54 – $277.35 | 60 |
| Ultrasound dx ophth b-scan CPT 76512 | $145.50 | $291.00 | $45.70 – $277.35 | 60 |
| Ultrasound elastography ea l target les CPT 76983 | $310.50 | $621.00 | $57.87 – $252.93 | 4 |
| Ultrasound elastography parenchyma CPT 76981 | $387.00 | $774.00 | $99.36 – $427.98 | 60 |
| Ultrasound encephalogram CPT 76506 | $715.50 | $1,431.00 | $99.51 – $428.64 | 60 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $595.50 | $1,191.00 | $99.51 – $428.64 | 60 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $426.50 | $853.00 | $81.59 – $351.42 | 60 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $818.50 | $1,637.00 | $42.64 – $42.64 | 1 |
| Ultrasound guide intraoperative CPT 76998 | $1,155.00 | $2,310.00 | $110.24 – $110.24 | 1 |
| Ultrasound hips infant dynamic CPT 76885 | $406.00 | $812.00 | $82.25 – $354.29 | 60 |
| Ultrasound infant hips ltd without stress CPT 76886 | $364.00 | $728.00 | $82.25 – $354.29 | 60 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $506.50 | $1,013.00 | $28.83 – $277.35 | 60 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $567.00 | $1,134.00 | $73.09 – $358.21 | 4 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $531.50 | $1,063.00 | $37.15 – $246.09 | 4 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,023.00 | $2,046.00 | $143.13 – $727.39 | 60 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $363.00 | $726.00 | $99.51 – $428.64 | 60 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $478.50 | $957.00 | $77.14 – $332.27 | 60 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $414.50 | $829.00 | $88.25 – $380.11 | 60 |
| Ultrasound prostate/transrectal CPT 76872 | $661.50 | $1,323.00 | $99.51 – $428.64 | 60 |
| Ultrasound retroperitoneal limited CPT 76775 | $549.50 | $1,099.00 | $56.82 – $277.35 | 60 |
| Ultrasound scrotum and contents CPT 76870 | $573.50 | $1,147.00 | $95.23 – $410.18 | 60 |
| Ultrasound spinal canal and contents CPT 76800 | $463.00 | $926.00 | $99.51 – $428.64 | 60 |
| Ultrasound transabd ea addl gest CPT 76812 | $612.00 | $1,224.00 | $182.52 – $786.20 | 4 |
| Ultrasound transvaginal non obstetric CPT 76830 | $661.50 | $1,323.00 | $99.51 – $428.64 | 60 |
| Unlisted misc path test CPT 89240 | $69.00 | $138.00 | $51.20 – $138.25 | 57 |
| Unlisted surgical path px CPT 88399 | $360.00 | $720.00 | $51.20 – $138.25 | 57 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $3,632.50 | $7,265.00 | $10.71 – $1,820.71 | 57 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,998.00 | $5,996.00 | $313.93 – $1,370.84 | 59 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,652.50 | $5,305.00 | $267.27 – $1,370.84 | 59 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,307.00 | $4,614.00 | $186.33 – $836.61 | 59 |
| Urea nitrogen CPT 84520 | $117.00 | $234.00 | $3.15 – $13.59 | 61 |
| Urea nitrogen 24 hour urine CPT 84540 | $101.00 | $202.00 | $4.44 – $19.11 | 61 |
| Ureteral reflux study CPT 78740 | $475.50 | $951.00 | $193.64 – $1,060.55 | 60 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $442.50 | $885.00 | $77.31 – $632.98 | 60 |
| Urethrocystography void s&i CPT 74455 | $547.50 | $1,095.00 | $99.04 – $632.98 | 60 |
| Uric acid blood CPT 84550 | $108.00 | $216.00 | $3.61 – $15.55 | 61 |
| Uric acid urine CPT 84560 | $61.00 | $122.00 | $4.06 – $17.47 | 61 |
| Urinalysis microscopic only CPT 81015 | $70.00 | $140.00 | $2.43 – $10.48 | 61 |
| Urinalysis (with microscopy) CPT 81001 | $117.00 | $234.00 | $2.53 – $10.88 | 61 |
| Urinalysis (without microscopy) CPT 81003 | $47.00 | $94.00 | $1.80 – $7.73 | 61 |
| Urine Culture Test CPT 87086 | $201.00 | $402.00 | $6.44 – $27.74 | 61 |
| Urine pregnancy test CPT 81025 | $55.50 | $111.00 | $6.87 – $29.59 | 61 |
| Urography, antegrade CPT 74425 | $505.00 | $1,010.00 | $129.19 – $925.52 | 60 |
| Vaccine dtap < 7 years im CPT 90700 | $55.75 | $111.50 | $66.11 – $66.11 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $200.00 | $400.00 | $221.34 – $221.34 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | $206.12 | $412.25 | $268.83 – $268.83 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $64.62 | $129.25 | $70.07 – $70.07 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $148.12 | $296.25 | $160.51 – $160.51 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $78.25 | $156.50 | $91.32 – $91.32 | 1 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $138.37 | $276.75 | $135.99 – $135.99 | 1 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $61.75 | $123.50 | $54.56 – $54.56 | 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.