MEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER - ALLIANCE
3100 Alliance Town Ctr, FORT WORTH, TX · Medicalcityhealthcare · · NPI 1316775935
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 |
|---|---|---|---|---|
| Cyclic citrullinated peptide antibody CPT 86200 | not published | not published | $12.95 – $33.93 | 6 |
| Cyclosporine 2 hour CPT 80158 | not published | not published | $18.05 – $47.29 | 6 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $291.36 – $763.36 | 6 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $458.00 | 6 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $450.91 – $1,181.38 | 6 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $458.00 | 6 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $458.00 | 6 |
| Cystatin c CPT 82610 | not published | not published | $18.52 – $48.52 | 6 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $1,307.38 | 6 |
| Cystine urine quantitative CPT 82131 | not published | not published | $22.98 – $60.21 | 6 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | not published | not published | $43.14 – $43.14 | 1 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,197.94 – $3,138.60 | 6 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $42.38 – $111.04 | 6 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $40.70 – $106.63 | 6 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $3,039.20 | 6 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $900.00 – $2,358.00 | 6 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,863.22 – $4,881.64 | 6 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $11.98 – $31.39 | 6 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | not published | not published | $14.39 – $37.70 | 6 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | not published | not published | $16.85 – $44.15 | 6 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.42 – $35.16 | 6 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $30.03 – $78.68 | 6 |
| Cyto/molecular report CPT 88291 | not published | not published | $42.89 – $42.89 | 1 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $25.37 – $66.47 | 6 |
| Cytopath c/v automated CPT 88147 | not published | not published | $50.56 – $132.47 | 6 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $27.64 – $72.42 | 6 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $18.54 – $48.57 | 6 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.65 – $38.38 | 6 |
| Cytopath c/v manual CPT 88150 | not published | not published | $18.54 – $48.57 | 6 |
| Cytopath c/v redo CPT 88153 | not published | not published | $24.03 – $62.96 | 6 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $23.04 – $60.36 | 6 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $63.92 – $63.92 | 1 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | not published | not published | $51.73 – $51.73 | 1 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $26.61 – $69.72 | 6 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | not published | not published | $20.26 – $53.08 | 6 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | not published | not published | $55.80 – $55.80 | 1 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | not published | not published | $53.08 – $53.08 | 1 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | not published | not published | $9.48 – $9.48 | 1 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | not published | not published | $25.52 – $25.52 | 1 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | not published | not published | $115.67 – $115.67 | 1 |
| Cytopath smear other source CPT 88160 | not published | not published | $61.20 – $61.20 | 1 |
| Cytopath smear other source CPT 88162 | not published | not published | $98.94 – $98.94 | 1 |
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $64.36 – $64.36 | 1 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $18.54 – $48.57 | 6 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $18.54 – $48.57 | 6 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $42.22 – $110.62 | 6 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $18.54 – $48.57 | 6 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $78.65 – $206.06 | 6 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.68 – $77.76 | 6 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $516.45 – $516.45 | 1 |
| Dark field exam spec collj CPT 87164 | not published | not published | $10.74 – $28.14 | 6 |
| Dark field exam without collj CPT 87166 | not published | not published | $11.30 – $29.61 | 6 |
| Dch glucoscan CPT 82948 | not published | not published | $5.04 – $13.20 | 6 |
| Dch validity tests CPT 81002 | not published | not published | $3.48 – $9.12 | 6 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $12.05 – $31.57 | 6 |
| Debridement (>20 cm) charge pt CPT 97598 | not published | not published | $47.24 – $123.77 | 6 |
| Decalcification CPT 88311 | not published | not published | $11.09 – $11.09 | 1 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | not published | not published | $3.69 – $9.67 | 6 |
| Design mlc device for imrt CPT 77338 | not published | not published | $410.80 – $410.80 | 1 |
| Desoxycorticosterone CPT 82633 | not published | not published | $30.98 – $81.17 | 6 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $78.68 | 6 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $114.42 | 6 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $35.25 – $35.25 | 1 |
| Dexamethasone panel CPT 80420 | not published | not published | $161.88 – $424.13 | 6 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $22.23 – $58.24 | 6 |
| Diabetes (HbA1c) Test CPT 83036 | $168.98 | $168.98 | $9.71 – $25.44 | 6 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $271.80 – $712.12 | 6 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $45.79 – $119.97 | 6 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $45.79 – $119.97 | 6 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $45.79 – $119.97 | 6 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $15.96 – $41.82 | 6 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $90.63 – $237.45 | 6 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $45.79 – $119.97 | 6 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $187.96 – $187.96 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $147.38 – $147.38 | 1 |
| Diagnostic Mammogram (both breasts) CPT 77066 | not published | not published | $108.93 – $285.40 | 6 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $84.93 – $222.52 | 6 |
| Diathermy eg microwave CPT 97024 | not published | not published | $7.25 – $19.00 | 6 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.20 – $0.20 | 1 |
| Digoxin total therapeutic drug level CPT 80162 | not published | not published | $13.28 – $34.79 | 6 |
| Disaccharidases CPT 82657 | not published | not published | $22.17 – $58.09 | 6 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $120.35 – $120.35 | 1 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $101.03 – $264.70 | 6 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $237.69 – $622.75 | 6 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $0.02 | 1 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $730.98 | 6 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $720.05 | 6 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $358.94 | 6 |
| Dna antibody native/double stranded CPT 86225 | not published | not published | $13.74 – $36.00 | 6 |
| Dna gardnerella CPT 87510 | not published | not published | $20.05 – $52.53 | 6 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $59.61 | 6 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $70.43 | 6 |
| Dna trichomonas CPT 87660 | not published | not published | $20.05 – $52.53 | 6 |
| Dornhoffer fixed part w/window HCPCS L8614 | not published | not published | $23,695.50 – $62,082.21 | 6 |
| Dorsi & plantar flex ass/res HCPCS L2220 | not published | not published | $100.40 – $263.05 | 6 |
| Dpyd gene common variants CPT 81232 | not published | not published | $174.81 – $458.00 | 6 |
| Drainable plastic pch w fcpl HCPCS A4375 | not published | not published | $24.47 – $64.11 | 6 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $108.93 – $285.40 | 6 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $3.86 – $10.11 | 6 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $111,492.00 – $292,109.04 | 6 |
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.