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 |
|---|---|---|---|---|
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $160.00 | $320.00 | $42.30 – $42.30 | 1 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $264.12 | $528.25 | $393.16 – $393.16 | 1 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $220.50 | $441.00 | $16.82 – $72.43 | 61 |
| Galectin-3 CPT 82777 | $157.00 | $314.00 | $44.25 – $119.48 | 57 |
| Gamma globulin 1 cc inj HCPCS J1460 | $775.00 | $1,550.00 | $49.92 – $710.55 | 55 |
| Gammaglobulin iga CPT 82784 | $15.00 | $30.00 | $7.42 – $31.96 | 61 |
| Gammaglobulin ige CPT 82785 | $11.50 | $23.00 | $13.14 – $56.59 | 61 |
| Gamma glutamyltransferase CPT 82977 | $188.00 | $376.00 | $5.75 – $24.76 | 61 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $181.00 | $362.00 | $99.11 – $99.11 | 1 |
| Gastroesophageal reflux test CPT 91034 | $2,012.00 | $4,024.00 | $43.76 – $989.94 | 57 |
| Gba gene CPT 81251 | $238.00 | $476.00 | $37.71 – $162.41 | 61 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $160.37 | $320.75 | $73.13 – $73.13 | 1 |
| Genetic tstg severe inh cond CPT 81443 | $4,050.00 | $8,100.00 | $1,953.95 – $8,416.38 | 60 |
| Gen, neuro, clo loop, rechg HCPCS C1826 | $14,218.20 | $28,436.40 | $3,650.41 – $3,650.41 | 1 |
| Genome sequence analysis CPT 81425 | $2,516.50 | $5,033.00 | $4,014.90 – $17,293.65 | 60 |
| Genome sequence analysis CPT 81426 | $2,100.00 | $4,200.00 | $2,162.54 – $9,314.87 | 60 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $79.75 | $159.50 | $3.94 – $3.94 | 1 |
| Gentamicin peak therapeutic drug level CPT 80170 | $275.00 | $550.00 | $13.07 – $56.31 | 61 |
| G-esoph reflx tst w/electrod CPT 91035 | $2,104.50 | $4,209.00 | $502.60 – $2,278.14 | 57 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $115.00 | $230.00 | $13.65 – $58.80 | 61 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $94.00 | $188.00 | $81.61 – $351.50 | 61 |
| Ghs antibodies (torch) igm CPT 86694 | $14.00 | $28.00 | $11.49 – $49.47 | 61 |
| Ghs bladder cath - complex-foley CPT 51703 | $291.50 | $583.00 | $57.79 – $341.35 | 60 |
| Ghs chemo >8 hrs CPT 96416 | $547.50 | $1,095.00 | $122.26 – $876.26 | 57 |
| Ghs chemo IV push, ea addtl CPT 96411 | $211.00 | $422.00 | $70.17 – $191.01 | 57 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $200.00 | $400.00 | $28.01 – $120.63 | 61 |
| Ghs community re-entry 15 minutes CPT 97537 | $112.00 | $224.00 | $16.33 – $87.10 | 57 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $80.50 | $161.00 | $12.14 – $52.30 | 61 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $335.00 | $670.00 | $212.16 – $572.82 | 57 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $22.50 | $45.00 | $5.57 – $23.98 | 61 |
| Ghs fish cytogen CPT 88271 | $167.00 | $334.00 | $17.09 – $73.62 | 61 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $140.50 | $281.00 | $40.85 – $175.96 | 61 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $263.00 | $526.00 | $12.36 – $53.24 | 61 |
| Ghs hgb stability-thal CPT 83068 | $62.50 | $125.00 | $7.55 – $32.53 | 61 |
| Ghs histoplasma antigen CPT 87385 | $85.50 | $171.00 | $10.57 – $45.54 | 61 |
| Ghs HIV antibody CPT 86703 | $172.00 | $344.00 | $10.94 – $47.14 | 61 |
| Ghs inhibitor screen CPT 85335 | $146.50 | $293.00 | $10.27 – $44.23 | 61 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $168.50 | $337.00 | $39.91 – $124.22 | 57 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $45.00 | $90.00 | $6.86 – $29.54 | 61 |
| Ghs mbp CPT 83873 | $14.50 | $29.00 | $13.73 – $59.13 | 61 |
| Ghs musc test done w/n test comp CPT 95886 | $346.00 | $692.00 | $45.19 – $45.19 | 1 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $344.00 | $688.00 | $37.82 – $37.82 | 1 |
| Ghs myocardial strain img spckl track CPT 93356 | $320.50 | $641.00 | $20.70 – $20.70 | 1 |
| Ghs o2 saturation CPT 82810 | $224.50 | $449.00 | $7.80 – $33.60 | 61 |
| Ghs ot dds rom CPT 95851 | $73.50 | $147.00 | $6.68 – $78.49 | 57 |
| Ghs ot prosthetic training/15 min CPT 97761 | $112.00 | $224.00 | $20.69 – $109.70 | 57 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $112.00 | $224.00 | $31.16 – $164.73 | 57 |
| Ghs ot work hardening-additional hours CPT 97546 | $335.00 | $670.00 | $7.61 – $7.61 | 1 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $16.00 | $32.00 | $16.84 – $82.04 | 5 |
| Ghs ppd (tb intradermal) CPT 86580 | $21.00 | $42.00 | $7.62 – $76.73 | 61 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $10.00 | $20.00 | $7.70 – $33.19 | 61 |
| Ghs protein, misc fluid CPT 84160 | $7.00 | $14.00 | $4.47 – $19.27 | 61 |
| Ghs pr without cont pulse ox CPT 94625 | $64.50 | $129.00 | $11.18 – $156.50 | 57 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $8.00 | $16.00 | $9.78 – $42.11 | 61 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $666.00 | $1,332.00 | $16.18 – $16.18 | 1 |
| Ghs sedimentation rate CPT 85651 | $72.00 | $144.00 | $3.41 – $14.69 | 61 |
| Ghs semen analysis fert CPT 89320 | $10.00 | $20.00 | $12.31 – $33.24 | 57 |
| Ghs sensitivity (per antimicro) CPT 87184 | $28.00 | $56.00 | $5.97 – $25.70 | 61 |
| Ghs somatosensory testing lower extremit CPT 95926 | $1,439.50 | $2,879.00 | $36.31 – $572.82 | 57 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,880.00 | $5,760.00 | $104.66 – $2,278.14 | 57 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $323.00 | $646.00 | $25.45 – $129.28 | 57 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $324.00 | $648.00 | $45.19 – $278.78 | 57 |
| Ghs st - eval for alt comm CPT 92567 | $33.00 | $66.00 | $22.06 – $99.09 | 57 |
| Ghs st - re-eval for alt comm CPT 92597 | $433.00 | $866.00 | $60.18 – $193.48 | 57 |
| Ghs urine, porphyrins quant CPT 84120 | $22.00 | $44.00 | $11.74 – $50.58 | 61 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $553.50 | $1,107.00 | $140.34 – $989.94 | 57 |
| Giardia ag if CPT 87269 | $35.50 | $71.00 | $10.86 – $46.77 | 61 |
| Giardia lamblia antibody CPT 86674 | $32.50 | $65.00 | $11.74 – $50.58 | 61 |
| Gi inhouse confirmation CPT 87045 | $204.00 | $408.00 | $7.53 – $32.45 | 61 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $2,989.00 | $5,978.00 | $251.62 – $2,999.03 | 60 |
| Gjb2 gene full sequence CPT 81252 | $755.00 | $1,510.00 | $80.69 – $347.57 | 61 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $470.00 | $940.00 | $143.25 – $431.04 | 55 |
| Glucagon plasma - sendout CPT 82943 | $48.50 | $97.00 | $11.40 – $49.10 | 61 |
| Glucose 1 hr post dose CPT 82950 | $150.50 | $301.00 | $3.79 – $16.33 | 61 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $21.00 | $42.00 | $3.28 – $8.86 | 57 |
| Glucose blood quantitative CPT 82947 | $106.00 | $212.00 | $3.14 – $13.50 | 61 |
| Glucose body fluid CPT 82945 | $117.00 | $234.00 | $3.14 – $13.50 | 61 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $380.00 | $760.00 | $10.27 – $44.23 | 61 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $6.50 | $13.00 | $14.83 – $63.88 | 61 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $41.50 | $83.00 | $14.78 – $63.67 | 61 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $22.92 | $45.85 | $81.69 – $330.14 | 55 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $187.50 | $375.00 | $122.27 – $330.14 | 54 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $25.21 | $50.42 | $84.34 – $330.14 | 55 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $143.57 | $287.14 | $122.27 – $330.14 | 55 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $98.44 | $196.88 | $79.30 – $330.14 | 55 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $167.06 | $334.13 | $122.27 – $330.14 | 54 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $242.70 | $485.40 | $109.25 – $330.14 | 55 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $21.56 | $43.13 | $122.27 – $330.14 | 54 |
| Granisetron hcl injection HCPCS J1626 | $19.00 | $38.00 | $12.67 – $12.67 | 1 |
| Growth hormone antibody CPT 86277 | $103.50 | $207.00 | $12.56 – $54.10 | 61 |
| Growth stimulation gene 2 CPT 83006 | $180.50 | $361.00 | $60.33 – $259.84 | 61 |
| Gu dilat ureter/urethra s&i CPT 74485 | $730.00 | $1,460.00 | $113.65 – $5,545.55 | 60 |
| Guid loc target vol rad tx CPT 77387 | $371.00 | $742.00 | $291.09 – $291.09 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $2.25 | $4.50 | $9.49 – $9.49 | 1 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $12.00 | $24.00 | $19.36 – $19.36 | 1 |
| Hand X-ray CPT 73130 | $283.50 | $567.00 | $35.56 – $230.87 | 60 |
| Haptoglobin quantitative CPT 83010 | $192.00 | $384.00 | $10.04 – $43.25 | 61 |
| Hba1/hba2 full gene sequence CPT 81259 | $450.00 | $900.00 | $478.80 – $2,062.37 | 61 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $337.50 | $675.00 | $161.52 – $695.72 | 61 |
| Hbb full gene sequence CPT 81364 | $675.00 | $1,350.00 | $259.02 – $1,115.68 | 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.