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 |
|---|---|---|---|---|
| Endoskel knee-shin mnl lock HCPCS L5810 | not published | not published | $658.08 – $1,724.17 | 6 |
| Endoskel posit rotat unit HCPCS L5926 | not published | not published | $823.06 – $2,156.42 | 6 |
| Energy storing foot HCPCS L5976 | not published | not published | $743.14 – $1,947.03 | 6 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | not published | not published | $11.98 – $31.39 | 6 |
| Entamoeb hist dispr ag ia CPT 87336 | not published | not published | $16.00 – $41.92 | 6 |
| Enterovirus antibody dfa CPT 87267 | not published | not published | $13.42 – $35.16 | 6 |
| Enzyme cell activity ra CPT 82658 | not published | not published | $44.03 – $115.36 | 6 |
| Enzyme histochemistry CPT 88319 | not published | not published | $149.97 – $149.97 | 1 |
| Eo, adj lock joint prefab ot HCPCS L3761 | not published | not published | $562.31 – $1,473.25 | 6 |
| Eo elas w/metal jnts pre ots HCPCS L3710 | not published | not published | $167.05 – $437.67 | 6 |
| Epilepsy gen seq alys panel CPT 81419 | not published | not published | $2,448.56 – $6,415.23 | 6 |
| Epstein barr early antigen antibody CPT 86663 | not published | not published | $13.12 – $34.37 | 6 |
| Epstein barr nuclear antigen antibody CPT 86664 | not published | not published | $15.29 – $40.06 | 6 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | not published | not published | $18.14 – $47.53 | 6 |
| Ercp biliary & pancreas CPT 74330 | not published | not published | $127.03 – $127.03 | 1 |
| Esophageal dilat s&i CPT 74360 | not published | not published | $139.16 – $139.16 | 1 |
| Esophageal motility CPT 78258 | not published | not published | $285.24 – $285.24 | 1 |
| Estradiol total CPT 82670 | not published | not published | $27.94 – $73.20 | 6 |
| Estrogens total-sendout CPT 82672 | not published | not published | $21.70 – $56.85 | 6 |
| Ethylene glycol -sendout CPT 82693 | not published | not published | $14.90 – $39.04 | 6 |
| Euglobulin lysis CPT 85360 | not published | not published | $8.41 – $22.03 | 6 |
| Eval/fit voice prosthesis iii, st CPT 92607 | not published | not published | $121.92 – $319.43 | 6 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $10.38 – $27.20 | 6 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | not published | not published | $98.11 – $257.05 | 6 |
| Evaluation of speech fluency 92521 CPT 92521 | not published | not published | $133.09 – $348.70 | 6 |
| Ewhfo w/joint(s) cf HCPCS L3766 | not published | not published | $1,526.74 – $4,000.06 | 6 |
| Ewho w/joint(s) cf HCPCS L3764 | not published | not published | $855.35 – $2,241.02 | 6 |
| Excursion amplifier lever ty HCPCS L6642 | not published | not published | $284.29 – $744.84 | 6 |
| Excursion amplifier pulley t HCPCS L6641 | not published | not published | $238.81 – $625.68 | 6 |
| Exhaled breath condensate CPT 83987 | not published | not published | $3.58 – $9.38 | 6 |
| Exome re-evaluation CPT 81417 | not published | not published | $320.00 – $838.40 | 6 |
| Exome sequence analysis CPT 81415 | not published | not published | $4,780.00 – $12,523.60 | 6 |
| Exome sequence analysis CPT 81416 | not published | not published | $12,000.00 – $31,440.00 | 6 |
| Exoskeletal ak ultra-light m HCPCS L5790 | not published | not published | $1,173.68 – $3,075.04 | 6 |
| Exoskeletal axial rotation u HCPCS L5982 | not published | not published | $766.26 – $2,007.60 | 6 |
| Exoskeletal bk ultralt mater HCPCS L5785 | not published | not published | $709.19 – $1,858.08 | 6 |
| Exoskel hip ultra-light mate HCPCS L5795 | not published | not published | $1,752.61 – $4,591.84 | 6 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | not published | not published | $764.47 – $2,002.91 | 6 |
| Ext antenna phren nerve stim HCPCS L8696 | not published | not published | $268.31 – $702.97 | 6 |
| Extended culture of oocytes CPT 89272 | not published | not published | $881.16 – $881.16 | 1 |
| Extended steel shank HCPCS L2360 | not published | not published | $79.27 – $207.69 | 6 |
| Extension drainage tubing HCPCS A4331 | not published | not published | $4.53 – $11.87 | 6 |
| Extension per extension per HCPCS L2760 | not published | not published | $93.09 – $243.90 | 6 |
| External chromosome analysis 20-25 cells CPT 88264 | not published | not published | $144.61 – $378.88 | 6 |
| External newborn metabolic screening panel HCPCS S3620 | not published | not published | $145.50 – $145.50 | 1 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | not published | not published | $46.07 – $46.07 | 1 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | not published | not published | $3,873.00 – $10,147.26 | 6 |
| External recharg sys extern HCPCS L8695 | not published | not published | $20.61 – $54.00 | 6 |
| External recharg sys intern HCPCS L8689 | not published | not published | $2,135.37 – $5,594.67 | 6 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | not published | not published | $143.75 – $376.63 | 6 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | not published | not published | $17.93 – $46.98 | 6 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $175.40 – $459.55 | 6 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $282.88 – $741.15 | 6 |
| F-18 fdg pet diag HCPCS A9552 | not published | not published | $774.04 – $774.04 | 1 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | not published | not published | $7,022.34 – $7,022.34 | 1 |
| F-18 fluciclovine per mci HCPCS A9588 | not published | not published | $1,269.71 – $1,269.71 | 1 |
| F-18 sodium fluoride HCPCS A9580 | not published | not published | $520.14 – $520.14 | 1 |
| F9 full gene sequence CPT 81238 | not published | not published | $600.00 – $1,572.00 | 6 |
| Fabrication & fitting HCPCS V2628 | not published | not published | $461.21 – $1,208.37 | 6 |
| Facial bones <3 CPT 70140 | $624.02 | $624.02 | $37.50 – $37.50 | 1 |
| Factor ix CPT 85250 | not published | not published | $19.04 – $49.88 | 6 |
| Factor viii CPT 85240 | not published | not published | $17.90 – $46.90 | 6 |
| Fancc gene CPT 81242 | not published | not published | $36.62 – $95.94 | 6 |
| Fat/lipids feces qualitative CPT 82705 | not published | not published | $5.10 – $13.36 | 6 |
| Fatty acids nonesterified CPT 82725 | not published | not published | $18.77 – $49.18 | 6 |
| Fda ide #g240020 carry bag HCPCS Q0499 | not published | not published | $206.61 – $541.32 | 6 |
| Fecal bilirubin test CPT 82252 | not published | not published | $4.56 – $11.95 | 6 |
| #fecal-sodium CPT 84302 | not published | not published | $4.86 – $12.73 | 6 |
| Feeding tube reposition CPT 74355 | not published | not published | $160.61 – $160.61 | 1 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $226.73 – $594.03 | 6 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | not published | not published | $18.64 – $48.84 | 6 |
| Fem focal defic constant fri HCPCS L5230 | not published | not published | $5,101.97 – $13,367.16 | 6 |
| Femoral lgth sock fx or equa HCPCS L2850 | not published | not published | $76.56 – $200.59 | 6 |
| Fem urinary collect pouch HCPCS A4328 | not published | not published | $12.64 – $33.12 | 6 |
| Fern test HCPCS Q0114 | not published | not published | $9.74 – $25.52 | 6 |
| Ferritin CPT 82728 | $219.55 | $219.55 | $13.63 – $35.71 | 6 |
| Fetal aneuploidy trisom risk CPT 81507 | not published | not published | $795.00 – $2,082.90 | 6 |
| Fetal biophys profile w/nst 76818 CPT 76818 | not published | not published | $108.24 – $108.24 | 1 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $759.05 – $1,988.71 | 6 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | not published | not published | $759.05 – $1,988.71 | 6 |
| Fetal fibronectin CPT 82731 | not published | not published | $64.41 – $168.75 | 6 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | not published | not published | $7.73 – $20.25 | 6 |
| Fetal hemoglobin rosette CPT 85461 | not published | not published | $9.36 – $24.52 | 6 |
| Fetal lung maturity assess lam body dnst CPT 83664 | not published | not published | $19.32 – $50.62 | 6 |
| #_fet/norfentcnfrmur CPT 80354 | not published | not published | $0.02 – $0.02 | 1 |
| Fibrin degradation d dimer quantitative CPT 85379 | not published | not published | $10.18 – $26.67 | 6 |
| Fibrin degradation products CPT 85362 | not published | not published | $6.89 – $18.05 | 6 |
| Fibrin degrade semiquant CPT 85378 | $215.41 | $215.41 | $9.72 – $25.47 | 6 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $10.18 – $26.67 | 6 |
| Fibrinogen activity CPT 85384 | not published | not published | $9.72 – $25.47 | 6 |
| Fibrinogen test CPT 85370 | not published | not published | $12.43 – $32.57 | 6 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | not published | not published | $15.48 – $40.56 | 6 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $7.71 – $20.20 | 6 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $7.71 – $20.20 | 6 |
| Fibrinolytic plasminogen CPT 85415 | not published | not published | $17.19 – $45.04 | 6 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $10.18 – $26.67 | 6 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | not published | not published | $6.53 – $17.11 | 6 |
| Filters elec/combo vad, rep HCPCS Q0500 | not published | not published | $37.80 – $99.04 | 6 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | not published | not published | $412.46 – $1,080.65 | 6 |
| Flecainide (tambocor)-sendout CPT 80181 | not published | not published | $18.64 – $48.84 | 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.