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 |
|---|---|---|---|---|
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $185.20 – $485.22 | 6 |
| John cunningham antibody CPT 86711 | not published | not published | $16.89 – $44.25 | 6 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,341.77 – $3,515.44 | 6 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,176.93 – $3,083.56 | 6 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $1,970.44 – $5,162.55 | 6 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,307.92 – $3,426.75 | 6 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $1,376.03 – $3,605.20 | 6 |
| Kafo femoral fx cast rigid HCPCS L2136 | not published | not published | $1,480.79 – $3,879.67 | 6 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $1,045.73 – $2,739.81 | 6 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $2,594.53 – $6,797.67 | 6 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $1,913.97 – $5,014.60 | 6 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $214.05 – $560.81 | 6 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,165.54 – $3,053.71 | 6 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $5,062.71 – $13,264.30 | 6 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $1,138.18 – $2,982.03 | 6 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $1,642.94 – $4,304.50 | 6 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $0.02 – $0.02 | 1 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $15.47 – $40.53 | 6 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | not published | not published | $8.17 – $21.41 | 6 |
| Kidney function study CPT 78725 | not published | not published | $157.31 – $157.31 | 1 |
| Kidney imaging morphology CPT 78700 | not published | not published | $237.34 – $237.34 | 1 |
| Kidney imag w/bld flow multi CPT 78709 | not published | not published | $479.39 – $479.39 | 1 |
| Kidney img w/bldflw sgl without rx CPT 78707 | not published | not published | $296.50 – $296.50 | 1 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,122.08 | $1,122.08 | $125.41 – $125.41 | 1 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $52.48 – $137.50 | 6 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $9.97 – $26.12 | 6 |
| Kit gene analys d816 variant CPT 81273 | not published | not published | $124.87 – $327.16 | 6 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $17.10 – $44.80 | 6 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $2,131.89 – $5,585.55 | 6 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $23.38 – $61.26 | 6 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $122.57 – $321.13 | 6 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $99.90 – $261.74 | 6 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $112.56 – $294.91 | 6 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $729.34 – $1,910.87 | 6 |
| Knee disarticulat leather so HCPCS L5640 | not published | not published | $782.83 – $2,051.01 | 6 |
| Knee disc/dial lock/adj flex HCPCS L2425 | not published | not published | $177.11 – $464.03 | 6 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | not published | not published | $177.11 – $464.03 | 6 |
| Knee joint cam lock each joi HCPCS L2415 | not published | not published | $150.07 – $393.18 | 6 |
| Knee joint drop lock ea jnt HCPCS L2405 | not published | not published | $107.73 – $282.25 | 6 |
| Knee lift loop drop lock rin HCPCS L2492 | not published | not published | $130.79 – $342.67 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | not published | not published | $761.00 – $761.00 | 1 |
| Knee MRI (with contrast) CPT 73722 | not published | not published | $761.00 – $761.00 | 1 |
| Knee MRI (without contrast) CPT 73721 | not published | not published | $761.00 – $761.00 | 1 |
| Knee orth pos locking joint HCPCS L1831 | not published | not published | $363.62 – $952.68 | 6 |
| Knee-shin exo fluid swing ph HCPCS L5724 | not published | not published | $2,463.86 – $6,455.31 | 6 |
| Knee-shin exo frct swg & sta HCPCS L5718 | not published | not published | $1,145.99 – $3,002.49 | 6 |
| Knee-shin exo frict swg & st HCPCS L5712 | not published | not published | $695.57 – $1,822.39 | 6 |
| Knee-shin exo mech stance ph HCPCS L5716 | not published | not published | $1,038.73 – $2,721.47 | 6 |
| Knee-shin exo mnl lock ultra HCPCS L5711 | not published | not published | $663.71 – $1,738.92 | 6 |
| Knee-shin exo variable frict HCPCS L5714 | not published | not published | $587.64 – $1,539.62 | 6 |
| Knee-shin ext jnts fld swg e HCPCS L5726 | not published | not published | $2,839.54 – $7,439.59 | 6 |
| Knee-shin fluid swg & stance HCPCS L5728 | not published | not published | $3,033.70 – $7,948.29 | 6 |
| Knee-shin pneum/hydra pneum HCPCS L5780 | not published | not published | $1,614.94 – $4,231.14 | 6 |
| Knee-shin pneum swg frct exo HCPCS L5722 | not published | not published | $1,114.06 – $2,918.84 | 6 |
| Knee-shin pro flex/ext cont HCPCS L5859 | not published | not published | $17,961.30 – $47,058.61 | 6 |
| Knee-shin sys hydraul stance HCPCS L5848 | not published | not published | $1,331.15 – $3,487.61 | 6 |
| Knee-shin sys stance flexion HCPCS L5845 | not published | not published | $2,218.82 – $5,813.31 | 6 |
| Knee X-ray CPT 73564 | not published | not published | $59.47 – $59.47 | 1 |
| Kne-shin exo sng axi mnl loc HCPCS L5710 | not published | not published | $523.99 – $1,372.85 | 6 |
| Kne sing axis fric shin sach HCPCS L5200 | not published | not published | $4,635.37 – $12,144.67 | 6 |
| Ko dbl upright w/air pre cst HCPCS L1847 | not published | not published | $710.64 – $1,861.88 | 6 |
| Ko dbl upright w/air pre ots HCPCS L1848 | not published | not published | $710.64 – $1,861.88 | 6 |
| Ko derot ant cruciate custom HCPCS L1840 | not published | not published | $1,298.28 – $3,401.49 | 6 |
| Ko elastic w/joints pre ots HCPCS L1812 | not published | not published | $70.12 – $183.71 | 6 |
| Ko rigid without joints pre ots HCPCS L1836 | not published | not published | $89.34 – $234.07 | 6 |
| Ko single upright pre cst HCPCS L1843 | not published | not published | $1,108.58 – $2,904.48 | 6 |
| Ko single upright prefab ots HCPCS L1851 | not published | not published | $600.78 – $1,574.04 | 6 |
| Ko supracondylar socket mold HCPCS L1860 | not published | not published | $1,256.72 – $3,292.61 | 6 |
| Ko swedish type pre ots HCPCS L1850 | not published | not published | $205.78 – $539.14 | 6 |
| Ko w/0 joint rigid molded to HCPCS L1834 | not published | not published | $892.02 – $2,337.09 | 6 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | not published | not published | $1,348.79 – $3,533.83 | 6 |
| Ko w/adj jt rot cntrl molded HCPCS L1844 | not published | not published | $1,917.72 – $5,024.43 | 6 |
| Kras gene addl variants CPT 81276 | not published | not published | $193.25 – $506.31 | 6 |
| Kras gene variants exon 2 CPT 81275 | not published | not published | $193.25 – $506.31 | 6 |
| Kyphosis pad HCPCS L1020 | not published | not published | $125.95 – $329.99 | 6 |
| Kyphosis pad floating HCPCS L1025 | not published | not published | $143.30 – $375.45 | 6 |
| Lacer molded to patient mode HCPCS L2330 | not published | not published | $478.23 – $1,252.96 | 6 |
| Lactate dehydrogenase (ldh) CPT 83615 | not published | not published | $6.04 – $15.82 | 6 |
| Lactic acid CPT 83605 | $398.95 | $398.95 | $11.57 – $30.31 | 6 |
| Lactoferrin fecal qualitative CPT 83630 | not published | not published | $19.70 – $51.61 | 6 |
| Lactoferrin fecal quant CPT 83631 | not published | not published | $19.63 – $51.43 | 6 |
| Lamination collar with couplin HCPCS L6629 | not published | not published | $217.28 – $569.27 | 6 |
| Laryngeal function studies CPT 92520 | not published | not published | $90.06 – $235.96 | 6 |
| Laryngoscopic sensory vid CPT 92614 | not published | not published | $150.24 – $393.63 | 6 |
| Lateral thoracic extension HCPCS L1210 | not published | not published | $300.68 – $787.78 | 6 |
| Lateral trochanteric pad HCPCS L1290 | not published | not published | $90.32 – $236.64 | 6 |
| Latex suspension sleeve each HCPCS L6632 | not published | not published | $79.54 – $208.39 | 6 |
| Lead capillary CPT 83655 | not published | not published | $12.11 – $31.73 | 6 |
| Leads any type vad, rep only HCPCS Q0487 | not published | not published | $422.56 – $1,107.11 | 6 |
| Left compres band >=3" <5"/yd HCPCS A6449 | not published | not published | $2.50 – $6.55 | 6 |
| Left compres band <3"/yd HCPCS A6448 | not published | not published | $1.64 – $4.30 | 6 |
| Left compres band >=5"/yd HCPCS A6450 | not published | not published | $2.50 – $6.55 | 6 |
| Legg perthes orth newington HCPCS L1710 | not published | not published | $2,534.68 – $6,640.86 | 6 |
| Legg perthes orthosis trilat HCPCS L1720 | not published | not published | $1,880.37 – $4,926.57 | 6 |
| Legg perthes orth scottish r HCPCS L1730 | not published | not published | $1,488.44 – $3,899.71 | 6 |
| Legg perthes patten bottom t HCPCS L1755 | not published | not published | $1,819.35 – $4,766.70 | 6 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $20.05 – $52.53 | 6 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $41.76 – $109.41 | 6 |
| Leg perthes orth toronto typ HCPCS L1700 | not published | not published | $1,971.13 – $5,164.36 | 6 |
| Leishmania antibody CPT 86717 | not published | not published | $12.25 – $32.09 | 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.