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 |
|---|---|---|---|---|
| Prep ak ischial thermo mold HCPCS L5580 | not published | not published | $3,455.29 – $9,052.86 | 6 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $482.11 – $482.11 | 1 |
| Prep bk ptb laminated socket HCPCS L5540 | not published | not published | $2,606.10 – $6,827.98 | 6 |
| Prep bk ptb open end socket HCPCS L5535 | not published | not published | $2,430.65 – $6,368.30 | 6 |
| Prep bk ptb plaster molded HCPCS L5510 | not published | not published | $2,088.64 – $5,472.24 | 6 |
| Prep bk ptb thermopls molded HCPCS L5530 | not published | not published | $2,425.89 – $6,355.83 | 6 |
| Pre-tibial shell molded to p HCPCS L2340 | not published | not published | $636.87 – $1,668.60 | 6 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $46.07 – $46.07 | 1 |
| Pretreat rbc absorption reference CPT 86978 | not published | not published | $46.07 – $46.07 | 1 |
| Pretreat rbc density gradient separation reference CPT 86972 | not published | not published | $53.74 – $53.74 | 1 |
| Pretreat rbc w chem/drugs reference CPT 86970 | not published | not published | $38.39 – $38.39 | 1 |
| Pretreat rbc w enzyme reference CPT 86971 | not published | not published | $30.72 – $30.72 | 1 |
| Procalcitonin CPT 84145 | not published | not published | $27.22 – $71.32 | 6 |
| Progesterone CPT 84144 | not published | not published | $20.86 – $54.65 | 6 |
| Prolactin CPT 84146 | not published | not published | $19.38 – $50.78 | 6 |
| _propoxygc/msur CPT 80367 | not published | not published | $0.02 – $0.02 | 1 |
| Pros sheath/sock w gel cushn HCPCS L8417 | not published | not published | $93.09 – $243.90 | 6 |
| Pros soc insert gasket/seal HCPCS L7700 | not published | not published | $138.17 – $362.01 | 6 |
| Pros sock multi ply upper lm HCPCS L8435 | not published | not published | $29.52 – $77.34 | 6 |
| Pros sock single ply ak HCPCS L8480 | not published | not published | $12.87 – $33.72 | 6 |
| Pros sock single ply upper l HCPCS L8485 | not published | not published | $13.62 – $35.68 | 6 |
| Prostate biopsy, any mthd HCPCS G0416 | not published | not published | $313.82 – $313.82 | 1 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | not published | not published | $135.20 – $354.22 | 6 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | not published | not published | $51.85 – $135.85 | 6 |
| Prosthetic sock multi ply bk HCPCS L8420 | not published | not published | $25.45 – $66.68 | 6 |
| Prosthetic type socket molde HCPCS L2350 | not published | not published | $1,091.08 – $2,858.63 | 6 |
| Prost sock sgl ply blw knee ea HCPCS L8470 | not published | not published | $9.80 – $25.68 | 6 |
| Protect body sock ea pre ots HCPCS L0984 | not published | not published | $69.77 – $182.80 | 6 |
| Protein analysis w/probe CPT 88372 | not published | not published | $26.22 – $68.70 | 6 |
| Protein c activity CPT 85303 | not published | not published | $13.84 – $36.26 | 6 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | not published | not published | $10.74 – $28.14 | 6 |
| Protein s total CPT 85305 | not published | not published | $11.61 – $30.42 | 6 |
| Protein total 24 hour urine CPT 84156 | not published | not published | $3.67 – $9.62 | 6 |
| Protein total body fluid CPT 84157 | not published | not published | $4.00 – $10.48 | 6 |
| Protein total serum plasma whole blood CPT 84155 | $118.53 | $118.53 | $3.67 – $9.62 | 6 |
| Protein western blot tissue CPT 88371 | not published | not published | $22.23 – $58.24 | 6 |
| Prothrombin time substitution plasma fractions each CPT 85611 | not published | not published | $3.94 – $10.32 | 6 |
| Proton treatment complex CPT 77525 | not published | not published | $1,994.44 – $1,994.44 | 1 |
| Proton trmt intermediate CPT 77523 | not published | not published | $1,802.70 – $1,802.70 | 1 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $1,551.87 – $1,551.87 | 1 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $1,547.67 – $1,547.67 | 1 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $9.74 – $25.52 | 6 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $86.43 – $226.45 | 6 |
| PSA (Prostate) Test CPT 84153 | not published | not published | $18.39 – $48.18 | 6 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | not published | not published | $12.88 – $33.75 | 6 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | not published | not published | $16.66 – $43.64 | 6 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | not published | not published | $12.57 – $32.92 | 6 |
| Pt application of modality traction mechanical CPT 97012 | $105.22 | $105.22 | $12.59 – $32.99 | 6 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $300.00 – $786.00 | 6 |
| Pten gene full sequence CPT 81321 | not published | not published | $600.00 – $1,572.00 | 6 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $122.09 | 6 |
| Pt evaluation high complexity patient/family CPT 97163 | $1,045.99 | $1,045.99 | $85.92 – $225.12 | 6 |
| Pt evaluation low complexity patient/family CPT 97161 | $485.76 | $485.76 | $85.92 – $225.12 | 6 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $700.88 | $700.88 | $85.92 – $225.12 | 6 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $1,320.72 – $3,460.29 | 6 |
| Pt re-evaluation patient/family CPT 97164 | $383.43 | $383.43 | $59.15 – $154.98 | 6 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | not published | not published | $35.78 – $93.75 | 6 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $11.10 – $29.07 | 6 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $188.70 | $188.70 | $25.48 – $66.77 | 6 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $102.34 | $102.34 | $26.00 – $68.11 | 6 |
| Pt wheelchair management each 15 minutes CPT 97542 | not published | not published | $27.25 – $71.38 | 6 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,409.60 – $14,173.15 | 6 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $259.87 – $259.87 | 1 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $849.41 – $2,225.45 | 6 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $20,122.00 – $52,719.64 | 6 |
| Pyruvate CPT 84210 | not published | not published | $14.48 – $37.94 | 6 |
| Pyruvate kinase CPT 84220 | not published | not published | $9.44 – $24.73 | 6 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $402.57 – $1,054.73 | 6 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $418.23 – $418.23 | 1 |
| Quant diff pulm perf w/imaging CPT 78597 | not published | not published | $264.93 – $264.93 | 1 |
| Quest t3 uptake CPT 84479 | $155.56 | $155.56 | $6.47 – $16.95 | 6 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $631.93 – $1,655.66 | 6 |
| Radiation handling CPT 77790 | not published | not published | $11.39 – $11.39 | 1 |
| Radiation physics consult CPT 77336 | not published | not published | $143.54 – $143.54 | 1 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $57.32 – $57.32 | 1 |
| Radiation therapy management CPT 77431 | not published | not published | $183.48 – $183.48 | 1 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $25.52 – $25.52 | 1 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $176.69 – $176.69 | 1 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $112.51 – $112.51 | 1 |
| Radiation treatment delivery CPT 77402 | not published | not published | $234.29 – $234.29 | 1 |
| Radiation treatment delivery CPT 77412 | not published | not published | $426.57 – $426.57 | 1 |
| Radiation tx management x5 CPT 77427 | not published | not published | $326.55 – $326.55 | 1 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $6,496.09 – $17,019.76 | 6 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $955.74 – $2,504.04 | 6 |
| Radiology port images(s) CPT 77417 | not published | not published | $21.91 – $21.91 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $2,488.73 – $2,488.73 | 1 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $432.31 – $432.31 | 1 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | not published | not published | $961.87 – $961.87 | 1 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $984.96 – $984.96 | 1 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | not published | not published | $527.85 – $527.85 | 1 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $352.84 – $352.84 | 1 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $123.72 – $123.72 | 1 |
| Range of motion measurements CPT 95852 | not published | not published | $21.12 – $55.33 | 6 |
| Rapid Strep Test CPT 87880 | $144.21 | $144.21 | $16.53 – $43.31 | 6 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $953.04 – $953.04 | 1 |
| Rbc count only automated CPT 85041 | not published | not published | $3.02 – $7.91 | 6 |
| Rbc deglycerolized each unit HCPCS P9039 | not published | not published | $421.82 – $421.82 | 1 |
| Rbc irradiated each unit HCPCS P9038 | not published | not published | $27.62 – $27.62 | 1 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $22.53 | 6 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.47 – $19.57 | 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.