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 |
|---|---|---|---|---|
| Glucose body fluid CPT 82945 | not published | not published | $3.93 – $10.30 | 6 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $12.87 – $33.72 | 6 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | not published | not published | $3.92 – $10.27 | 6 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | not published | not published | $18.58 – $48.68 | 6 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $388.83 | 6 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $238.11 | $238.11 | $18.52 – $48.52 | 6 |
| Granulocyte pheresis ea unit HCPCS P9050 | not published | not published | $1,651.73 – $1,651.73 | 1 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $14.41 – $37.75 | 6 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $41.24 | 6 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $174.75 | 6 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $338.84 | 6 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $198.07 | 6 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $137.80 – $137.80 | 1 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | not published | not published | $681.49 – $1,785.50 | 6 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | $178.48 – $178.48 | 1 |
| Hair analysis HCPCS P2031 | not published | not published | $4.95 – $12.97 | 6 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $53.41 – $139.93 | 6 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $2,654.79 – $6,955.55 | 6 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $3,147.13 – $8,245.48 | 6 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $4,253.60 – $11,144.43 | 6 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $266.31 – $697.73 | 6 |
| Hand-held pefr meter a4614 HCPCS A4614 | not published | not published | $33.89 – $88.79 | 6 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $118.75 – $311.13 | 6 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $1,797.45 – $4,709.32 | 6 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,771.25 – $4,640.68 | 6 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $766.41 – $2,007.99 | 6 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,892.87 – $4,959.32 | 6 |
| Hand X-ray CPT 73130 | $792.72 | $792.72 | $47.08 – $47.08 | 1 |
| Haptoglobin quantitative CPT 83010 | not published | not published | $12.58 – $32.96 | 6 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $217.81 – $570.66 | 6 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $160.58 – $420.72 | 6 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $152.75 – $400.21 | 6 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $1,572.00 | 6 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $530.29 | 6 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $983.16 | 6 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $850.40 | 6 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $458.00 | 6 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $530.29 | 6 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $983.16 | 6 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $9.71 – $25.44 | 6 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $297.29 – $297.29 | 1 |
| Hcg free betachain test CPT 84704 | not published | not published | $15.29 – $40.06 | 6 |
| Hcg qualitative CPT 84703 | $201.14 | $201.14 | $7.52 – $19.70 | 6 |
| Hcg quantitative CPT 84702 | $193.36 | $193.36 | $15.05 – $39.43 | 6 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | not published | not published | $199.07 – $199.07 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $208.03 – $208.03 | 1 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $313.96 – $313.96 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $281.29 – $281.29 | 1 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $2,291.20 – $2,291.20 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $428.72 – $428.72 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $698.78 – $698.78 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $1,064.50 – $1,064.50 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $339.64 – $339.64 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $506.75 – $506.75 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | not published | not published | $584.00 – $584.00 | 1 |
| Head CT scan (with contrast) CPT 70460 | not published | not published | $584.00 – $584.00 | 1 |
| Head CT scan (without contrast) CPT 70450 | not published | not published | $584.00 – $584.00 | 1 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $1,780.47 | 6 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $4,257.50 | 6 |
| Heart first pass add-on CPT 78496 | not published | not published | $31.28 – $31.28 | 1 |
| Heart first pass multiple CPT 78483 | not published | not published | $273.38 – $273.38 | 1 |
| Heart image spect CPT 78494 | not published | not published | $273.38 – $273.38 | 1 |
| Heart infarct image CPT 78466 | not published | not published | $254.23 – $254.23 | 1 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $251.42 – $251.42 | 1 |
| Heavy duty control cable HCPCS L6660 | not published | not published | $126.38 – $331.12 | 6 |
| Heavy metal qual any number CPT 83015 | not published | not published | $20.94 – $54.86 | 6 |
| Heel leather reinforced HCPCS L3440 | not published | not published | $94.30 – $247.07 | 6 |
| Heinz bodies direct CPT 85441 | not published | not published | $4.20 – $11.00 | 6 |
| Heinz bodies induced CPT 85445 | not published | not published | $6.82 – $17.87 | 6 |
| Helicobacter pylori antibody igm CPT 86677 | not published | not published | $16.85 – $44.15 | 6 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.19 – $21.46 | 6 |
| Hematocrit CPT 85014 | $107.70 | $107.70 | $2.37 – $6.21 | 6 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $113.36 – $113.36 | 1 |
| Hemipelvect canad sing axis HCPCS L5280 | not published | not published | $7,144.39 – $18,718.30 | 6 |
| Hemipelvectomy canadian sach HCPCS L5341 | not published | not published | $7,400.44 – $19,389.15 | 6 |
| Hemoglobin CPT 85018 | $76.52 | $76.52 | $2.37 – $6.21 | 6 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $4.01 – $10.51 | 6 |
| Hemoglobin fetal qualitative CPT 83033 | not published | not published | $8.00 – $20.96 | 6 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $10.74 – $28.14 | 6 |
| Hemoglobin methemoglobin quantitative CPT 83050 | not published | not published | $8.20 – $21.48 | 6 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $13.34 – $34.95 | 6 |
| Hemoglobin plasma CPT 83051 | not published | not published | $7.31 – $19.15 | 6 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $9.00 – $23.58 | 6 |
| Hemoglobin urine CPT 83069 | not published | not published | $3.95 – $10.35 | 6 |
| Hemolysin acid CPT 85475 | not published | not published | $8.87 – $23.24 | 6 |
| Hemolysins/agglutinins auto CPT 86940 | not published | not published | $8.77 – $22.98 | 6 |
| Hemolysins and agglutinins incubated CPT 86941 | not published | not published | $12.11 – $31.73 | 6 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $15.84 – $41.50 | 6 |
| Heparin assay CPT 85520 | not published | not published | $13.09 – $34.30 | 6 |
| Heparin neutralization CPT 85525 | not published | not published | $11.84 – $31.02 | 6 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $13.09 – $34.30 | 6 |
| Hepatitis a antibody igm CPT 86709 | $185.33 | $185.33 | $11.26 – $29.50 | 6 |
| Hepatitis b core antibody igm CPT 86705 | $193.87 | $193.87 | $11.77 – $30.84 | 6 |
| Hepatitis b core antibody total CPT 86704 | not published | not published | $12.05 – $31.57 | 6 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $25.32 – $66.34 | 6 |
| Hepatitis b surface antibody CPT 86706 | $397.45 | $397.45 | $10.74 – $28.14 | 6 |
| Hepatitis c antibody CPT 86803 | $301.63 | $301.63 | $14.27 – $37.39 | 6 |
| Hepatitis c rna dir probe CPT 87520 | not published | not published | $31.22 – $81.80 | 6 |
| Hepatitis d quantification CPT 87523 | not published | not published | $42.84 – $112.24 | 6 |
| Hepatitis g dna amp probe CPT 87526 | not published | not published | $39.26 – $102.86 | 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.