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 |
|---|---|---|---|---|
| Pet image w/ct lmtd CPT 78814 | not published | not published | $2,291.20 – $2,291.20 | 1 |
| Pet scan brain perf study CPT 78609 | not published | not published | $2,291.20 – $2,291.20 | 1 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $25.01 – $65.53 | 6 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $34.75 – $91.05 | 6 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $13.66 – $35.79 | 6 |
| Ph body fluid CPT 83986 | not published | not published | $3.58 – $9.38 | 6 |
| Phencyclidine (pcp) CPT 83992 | not published | not published | $0.02 – $0.02 | 1 |
| Phenobarbital therapeutic drug level CPT 80184 | $268.02 | $268.02 | $15.30 – $40.09 | 6 |
| Phenytoin total therapeutic drug level CPT 80185 | $260.92 | $260.92 | $13.25 – $34.72 | 6 |
| Phosphorus CPT 84100 | $34.94 | $34.94 | $4.74 – $12.42 | 6 |
| Phosphorus 24 hour urine CPT 84105 | not published | not published | $5.78 – $15.14 | 6 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $63.85 – $63.85 | 1 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $63.85 – $63.85 | 1 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $63.85 – $63.85 | 1 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $274.83 – $720.05 | 6 |
| Pillow shldr abduc inflat univ HCPCS L3960 | not published | not published | $1,007.62 – $2,639.96 | 6 |
| Pinworm exam CPT 87172 | not published | not published | $4.27 – $11.19 | 6 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $4.27 – $11.19 | 6 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $579.48 – $1,518.24 | 6 |
| Placental lactogen CPT 83632 | not published | not published | $20.22 – $52.98 | 6 |
| Plaelet rich plasma unit HCPCS P9020 | not published | not published | $495.76 – $495.76 | 1 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | not published | not published | $135.79 – $135.79 | 1 |
| Plasmaprotein fract,5%,250ml HCPCS P9048 | not published | not published | $107.65 – $107.65 | 1 |
| Plasma protein fract,5%,50ml HCPCS P9043 | not published | not published | $45.83 – $45.83 | 1 |
| Plasma volume multiple CPT 78111 | not published | not published | $107.70 – $107.70 | 1 |
| Plasma volume single CPT 78110 | not published | not published | $102.63 – $102.63 | 1 |
| Plas shoe insert w ank joint HCPCS L2180 | not published | not published | $179.43 – $470.11 | 6 |
| Plastic mod low ext pad/line HCPCS L2275 | not published | not published | $150.13 – $393.34 | 6 |
| Plastic mold recipro hip & c HCPCS L2627 | not published | not published | $1,969.94 – $5,161.24 | 6 |
| Plast socket jts/thgh lacer HCPCS L5105 | not published | not published | $4,252.97 – $11,142.78 | 6 |
| Platelet aggregation each agent teg CPT 85576 | not published | not published | $24.91 – $65.26 | 6 |
| Platelet automated CPT 85049 | $104.11 | $104.11 | $4.48 – $11.74 | 6 |
| Platelet pheresis each unit HCPCS P9034 | not published | not published | $965.49 – $965.49 | 1 |
| Platelet pheresis irr ea HCPCS P9036 | not published | not published | $992.22 – $992.22 | 1 |
| Platelets each unit HCPCS P9019 | not published | not published | $334.85 – $334.85 | 1 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | not published | not published | $1,047.15 – $1,047.15 | 1 |
| Platelets irradiated ea unit HCPCS P9032 | not published | not published | $98.83 – $98.83 | 1 |
| Platelets leukocytes reduced each unit HCPCS P9031 | not published | not published | $297.27 – $297.27 | 1 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | not published | not published | $728.39 – $728.39 | 1 |
| Platelets leukoreduced cmv negative apheresis/phresis each unit HCPCS P9055 | not published | not published | $389.44 – $389.44 | 1 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | not published | not published | $1,165.32 – $1,165.32 | 1 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | not published | not published | $1,173.97 – $1,173.97 | 1 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | not published | not published | $1,713.68 – $1,713.68 | 1 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | not published | not published | $1,773.32 – $1,773.32 | 1 |
| Platelet survival CPT 78191 | not published | not published | $166.63 – $166.63 | 1 |
| Plating chrome/nickel pr bar HCPCS L2750 | not published | not published | $126.30 – $330.91 | 6 |
| Plcg2 gene common variants CPT 81320 | not published | not published | $291.36 – $763.36 | 6 |
| Plug insert indwelling 16f HCPCS L8511 | not published | not published | $90.03 – $235.88 | 6 |
| Pml/raralpha 1 breakpoint CPT 81316 | not published | not published | $207.31 – $543.15 | 6 |
| Pmp22 gene dup/delet CPT 81324 | not published | not published | $758.36 – $1,986.90 | 6 |
| Pmp22 gene full sequence CPT 81325 | not published | not published | $769.58 – $2,016.30 | 6 |
| Pmp22 gene known fam variant CPT 81326 | not published | not published | $46.60 – $122.09 | 6 |
| Pms2 gene dup/delet variants CPT 81319 | not published | not published | $203.50 – $533.17 | 6 |
| Pms2 gene full seq analysis CPT 81317 | not published | not published | $676.50 – $1,772.43 | 6 |
| Pms2 known familial variants CPT 81318 | not published | not published | $331.00 – $867.22 | 6 |
| Pneum full leg splnt pre ots HCPCS L4370 | not published | not published | $216.94 – $568.38 | 6 |
| #pnh-flow cytometry interp CPT 88187 | not published | not published | $46.03 – $46.03 | 1 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | not published | not published | $26.07 – $68.30 | 6 |
| Polycentric hinge pair HCPCS L6600 | not published | not published | $306.19 – $802.22 | 6 |
| Polysom any age 1-3> param CPT 95808 | not published | not published | $1,373.97 – $1,373.97 | 1 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | not published | not published | $1,205.82 – $1,205.82 | 1 |
| Polyvalent mult org ea ag ia CPT 87451 | not published | not published | $10.51 – $27.54 | 6 |
| Portable 02 contents, gas HCPCS E0443 | not published | not published | $61.47 – $161.05 | 6 |
| Portable 02 contents, liquid HCPCS E0444 | not published | not published | $61.47 – $161.05 | 6 |
| Post-coital mucous exam HCPCS Q0115 | not published | not published | $25.00 – $65.50 | 6 |
| Postop applicat rigid dsg on HCPCS L6388 | not published | not published | $611.64 – $1,602.50 | 6 |
| Postop app non-wgt bear dsg HCPCS L5450 | not published | not published | $665.02 – $1,742.35 | 6 |
| Postop app non-wgt bear dsg HCPCS L5460 | not published | not published | $890.08 – $2,332.01 | 6 |
| Postop dress & 1 cast chg bk HCPCS L5400 | not published | not published | $1,745.96 – $4,574.42 | 6 |
| Postop dsg & 1 cast chg ak/d HCPCS L5420 | not published | not published | $2,235.96 – $5,858.22 | 6 |
| Postop dsg ak ea add cast ch HCPCS L5430 | not published | not published | $821.42 – $2,152.12 | 6 |
| Postop dsg bk ea add cast ch HCPCS L5410 | not published | not published | $682.01 – $1,786.87 | 6 |
| Postop dsg cast chg elb dis/ HCPCS L6382 | not published | not published | $1,906.55 – $4,995.16 | 6 |
| Postop dsg cast chg wrst/elb HCPCS L6380 | not published | not published | $1,607.09 – $4,210.58 | 6 |
| Postop ea cast chg & realign HCPCS L6386 | not published | not published | $547.30 – $1,433.93 | 6 |
| Post-operative body jacket HCPCS L1310 | not published | not published | $2,131.40 – $5,584.27 | 6 |
| Post-op hip abduct custom fa HCPCS L1685 | not published | not published | $1,366.86 – $3,581.17 | 6 |
| Potassium 24 hour urine CPT 84133 | not published | not published | $4.73 – $12.39 | 6 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $5.83 – $15.27 | 6 |
| Potassium serum/plasma/whole blood CPT 84132 | $98.29 | $98.29 | $4.76 – $12.47 | 6 |
| Pouch clsd w barr attached HCPCS A5051 | not published | not published | $2.94 – $7.70 | 6 |
| Pouch drainable w barrier at HCPCS A5061 | not published | not published | $5.04 – $13.20 | 6 |
| Pouch high output 2pc 50mm red HCPCS A4413 | not published | not published | $7.85 – $20.57 | 6 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | not published | not published | $6.21 – $16.27 | 6 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | not published | not published | $2.96 – $7.76 | 6 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | not published | not published | $5.11 – $13.39 | 6 |
| Powder prem protct 1oz HCPCS A4371 | not published | not published | $5.20 – $13.62 | 6 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $137.00 – $358.94 | 6 |
| Pq biliary strict dil s&i CPT 74363 | not published | not published | $125.59 – $125.59 | 1 |
| Pq dr cath chg w cont s&i CPT 75984 | not published | not published | $101.17 – $101.17 | 1 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | not published | not published | $100.50 – $263.31 | 6 |
| Prealbumin CPT 84134 | $1,243.68 | $1,243.68 | $14.59 – $38.23 | 6 |
| Prefab glove for term device HCPCS L6890 | not published | not published | $225.71 – $591.36 | 6 |
| Pregabalin - sendout CPT 80366 | not published | not published | $0.02 – $0.02 | 1 |
| Pregnancy associated plasma protein-a CPT 84163 | not published | not published | $15.05 – $39.43 | 6 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | not published | not published | $149.07 – $149.07 | 1 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | not published | not published | $119.78 – $119.78 | 1 |
| Prep ak ischial direct form HCPCS L5570 | not published | not published | $3,094.56 – $8,107.75 | 6 |
| Prep ak ischial laminated HCPCS L5590 | not published | not published | $3,391.89 – $8,886.75 | 6 |
| Prep ak ischial plast molded HCPCS L5560 | not published | not published | $3,134.29 – $8,211.84 | 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.