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 |
|---|---|---|---|---|
| Hpv types 16 & 18 only CPT 87625 | not published | not published | $40.55 – $106.24 | 6 |
| H pylori ag ia CPT 87339 | not published | not published | $16.00 – $41.92 | 6 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $67.36 – $176.48 | 6 |
| H pylori (c-13) breath CPT 83013 | not published | not published | $67.36 – $176.48 | 6 |
| H pylori drug admin CPT 83014 | not published | not published | $7.86 – $20.59 | 6 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $863.75 – $3,416.35 | 6 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $584.90 – $1,532.44 | 6 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $584.90 – $1,532.44 | 6 |
| Hsv dna dir probe CPT 87528 | not published | not published | $20.05 – $52.53 | 6 |
| Htt gene charac alleles CPT 81274 | not published | not published | $274.83 – $720.05 | 6 |
| Htt gene detc abnor alleles CPT 81271 | not published | not published | $137.00 – $358.94 | 6 |
| Human epididymis protein 4 (he4) CPT 86305 | not published | not published | $20.81 – $54.52 | 6 |
| Hydrocolld drg >16<=48 w/bdr HCPCS A6238 | not published | not published | $32.50 – $85.15 | 6 |
| Hydrocolld drg >16<=48 without b HCPCS A6235 | not published | not published | $23.97 – $62.80 | 6 |
| Hydrocolld drg <=16 in w/bdr HCPCS A6237 | not published | not published | $11.27 – $29.53 | 6 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | not published | not published | $9.33 – $24.44 | 6 |
| Hydrocolld drg filler paste HCPCS A6240 | not published | not published | $17.45 – $45.72 | 6 |
| Hydrogel drg <= 16 in w/bdr HCPCS A6245 | not published | not published | $10.36 – $27.14 | 6 |
| Hydrogel drg >48 in without bdr HCPCS A6244 | not published | not published | $55.99 – $146.69 | 6 |
| Hydrogel drg > 48 sq in w/b HCPCS A6247 | not published | not published | $33.89 – $88.79 | 6 |
| Hydrogel drsg gel filler HCPCS A6248 | not published | not published | $23.15 – $60.65 | 6 |
| Hydrogel dsg>16<=48 sq in HCPCS A6232 | not published | not published | $9.78 – $25.62 | 6 |
| Hydrogel dsg<=16 sq in HCPCS A6231 | not published | not published | $6.66 – $17.45 | 6 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | not published | not published | $17.90 – $46.90 | 6 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $10.18 – $26.67 | 6 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $1,602.79 – $1,602.79 | 1 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $780.29 – $780.29 | 1 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $1,014.89 – $1,014.89 | 1 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $1,116.88 – $1,116.88 | 1 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $1,757.64 – $1,757.64 | 1 |
| Hysterosalpingography s&i CPT 74740 | not published | not published | $134.99 – $134.99 | 1 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $6,065.36 – $6,065.36 | 1 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | not published | not published | $235.52 – $235.52 | 1 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $92.16 – $92.16 | 1 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $53.76 – $53.76 | 1 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $1,953.79 – $1,953.79 | 1 |
| I131 max 100uci HCPCS A9531 | not published | not published | $8.86 – $8.86 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $194.56 – $194.56 | 1 |
| I-131 sod iodide sol diag per mci HCPCS A9529 | not published | not published | $2.69 – $2.69 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | not published | not published | $13.42 – $35.16 | 6 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $35.09 – $91.94 | 6 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $18.09 – $47.40 | 6 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $58.03 | $58.03 | $45.28 – $118.63 | 6 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $6,415.23 | 6 |
| Identify sperm tissue CPT 89264 | not published | not published | $508.52 – $508.52 | 1 |
| Idh1 common variants CPT 81120 | not published | not published | $193.25 – $506.31 | 6 |
| Idh2 common variants CPT 81121 | not published | not published | $295.79 – $774.97 | 6 |
| Iduc valve sply repl HCPCS A4342 | not published | not published | $878.06 – $2,300.52 | 6 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $192.23 | 6 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $543.15 | 6 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $179.60 | 6 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $197.99 – $518.73 | 6 |
| Igh@ var region somatic mutation analy CPT 81263 | not published | not published | $294.52 – $771.64 | 6 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $172.73 – $452.55 | 6 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | not published | not published | $80.39 – $80.39 | 1 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | not published | not published | $175.92 – $175.92 | 1 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | not published | not published | $88.32 – $88.32 | 1 |
| Ikbkap gene CPT 81260 | not published | not published | $39.31 – $102.99 | 6 |
| Immob elbow child sm HCPCS L3762 | not published | not published | $120.93 – $316.84 | 6 |
| Immobilizer shldr cntor adlt HCPCS L3670 | not published | not published | $132.02 – $345.89 | 6 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | not published | not published | $63.18 – $165.53 | 6 |
| Immobilizer shldr sling med HCPCS L3660 | not published | not published | $115.57 – $302.79 | 6 |
| Immune complex assay CPT 86332 | not published | not published | $24.37 – $63.85 | 6 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | not published | not published | $20.81 – $54.52 | 6 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | not published | not published | $20.81 – $54.52 | 6 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $25.57 – $66.99 | 6 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | not published | not published | $11.98 – $31.39 | 6 |
| Immunodiffusion nes CPT 86329 | not published | not published | $14.05 – $36.81 | 6 |
| Immunofixation electrophoresis serum CPT 86334 | not published | not published | $22.34 – $58.53 | 6 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | not published | not published | $118.57 – $118.57 | 1 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | not published | not published | $156.05 – $156.05 | 1 |
| Immunoglobulin assay CPT 86023 | not published | not published | $12.46 – $32.65 | 6 |
| Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster HCPCS L8612 | not published | not published | $784.75 – $2,056.05 | 6 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | not published | not published | $1,057.34 – $2,770.23 | 6 |
| Implant cochlear osia osi300 HCPCS L8690 | not published | not published | $5,888.96 – $15,429.08 | 6 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | not published | not published | $960.44 – $2,516.35 | 6 |
| Implant ureth bulk agent HCPCS L8606 | not published | not published | $269.39 – $705.80 | 6 |
| Impl ear abutment ba300 9mm HCPCS L8693 | not published | not published | $1,877.12 – $4,918.05 | 6 |
| Impl eye bio-eye 16mm HCPCS L8042 | not published | not published | $3,996.01 – $10,469.55 | 6 |
| Imp neurosti pls gn any type HCPCS L8679 | not published | not published | $10,329.20 – $27,062.50 | 6 |
| Impreg gauze no h20/sal/yard HCPCS A6266 | not published | not published | $2.72 – $7.13 | 6 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $10,346.39 – $10,346.39 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | not published | not published | $10,346.39 – $10,346.39 | 1 |
| In-111 capromab pendet HCPCS A9507 | not published | not published | $10,803.64 – $10,803.64 | 1 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $7,556.12 – $7,556.12 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | not published | not published | $5,173.20 – $5,173.20 | 1 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | not published | not published | $2,176.20 – $2,176.20 | 1 |
| In-111 pentetreotide HCPCS A9572 | not published | not published | $13,949.34 – $13,949.34 | 1 |
| In-111 satumomab pend HCPCS A4642 | not published | not published | $3,430.40 – $3,430.40 | 1 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $183.92 | 6 |
| Infect ag drug suscept pheno predict CPT 87900 | not published | not published | $130.35 – $341.52 | 6 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $15.00 – $39.30 | 6 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $14.13 – $37.02 | 6 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $257.45 – $674.52 | 6 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $257.45 – $674.52 | 6 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $128.73 – $337.27 | 6 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $257.45 – $674.52 | 6 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $32.77 – $85.86 | 6 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $35.29 – $92.46 | 6 |
| Infect ag ia optc obs influenza CPT 87804 | $158.39 | $158.39 | $16.55 – $43.36 | 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.