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 |
|---|---|---|---|---|
| Smear fluorescent and/or acid fast stain CPT 87206 | not published | not published | $5.39 – $14.12 | 6 |
| Smear gram stain CPT 87205 | not published | not published | $4.27 – $11.19 | 6 |
| Smear nasal eosinophil CPT 89190 | not published | not published | $5.79 – $15.17 | 6 |
| Smear special stain inclusion bodies/parasites CPT 87207 | not published | not published | $5.99 – $15.69 | 6 |
| Smear wet mount CPT 87210 | not published | not published | $5.82 – $15.25 | 6 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.35 – $789.54 | 6 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.20 – $485.22 | 6 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $47.00 – $123.14 | 6 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $51.07 – $133.80 | 6 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $1,329.12 – $3,482.29 | 6 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $1,013.18 – $2,654.53 | 6 |
| Socket insert above knee HCPCS L5658 | not published | not published | $445.13 – $1,166.24 | 6 |
| Socket insert below knee HCPCS L5655 | not published | not published | $375.45 – $983.68 | 6 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $465.36 – $1,219.24 | 6 |
| Socket insert symes HCPCS L5654 | not published | not published | $482.61 – $1,264.44 | 6 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $747.37 – $1,958.11 | 6 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $896.90 – $2,349.88 | 6 |
| Sock fracture or equal each HCPCS L3995 | not published | not published | $47.94 – $125.60 | 6 |
| Sock wool above knee HCPCS L8430 | not published | not published | $27.95 – $73.23 | 6 |
| Sodium 24 hour urine CPT 84300 | not published | not published | $5.06 – $13.26 | 6 |
| Sodium serum/plasma/whole blood CPT 84295 | $156.63 | $156.63 | $4.81 – $12.60 | 6 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $99.79 – $261.45 | 6 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $3,524.71 | 6 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $3,133.07 | 6 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $8,615.90 | 6 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $2,741.44 | 6 |
| Solid skin barrier HCPCS A4362 | not published | not published | $4.56 – $11.95 | 6 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $10.17 – $26.65 | 6 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $7,832.62 | 6 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $2,349.80 | 6 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $197.33 – $517.00 | 6 |
| Special physics consult CPT 77370 | not published | not published | $228.79 – $228.79 | 1 |
| Special radiation dosimetry CPT 77331 | not published | not published | $32.72 – $32.72 | 1 |
| Special radiation treatment CPT 77470 | not published | not published | $50.71 – $50.71 | 1 |
| Special teletx port plan CPT 77321 | not published | not published | $76.52 – $76.52 | 1 |
| Specific gravity body fluid CPT 84315 | not published | not published | $3.28 – $8.59 | 6 |
| Specimen fat stain CPT 89125 | not published | not published | $5.88 – $15.41 | 6 |
| Speech evaluation complex CPT 70371 | not published | not published | $109.06 – $109.06 | 1 |
| Sperm antibody test CPT 89325 | not published | not published | $10.67 – $27.96 | 6 |
| Sperm evaluation test CPT 89329 | not published | not published | $19.59 – $51.33 | 6 |
| Sperm identification CPT 89257 | not published | not published | $428.58 – $428.58 | 1 |
| Sperm isolation complex CPT 89261 | not published | not published | $154.29 – $154.29 | 1 |
| Sperm isolation simple CPT 89260 | not published | not published | $158.62 – $158.62 | 1 |
| Sperm washing 58323 CPT 58323 | not published | not published | $23.60 – $23.60 | 1 |
| Spleen imaging CPT 78185 | not published | not published | $247.48 – $247.48 | 1 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | not published | not published | $444.32 – $1,164.12 | 6 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $60.42 – $158.30 | 6 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $97.81 – $256.26 | 6 |
| Splint finger frog med HCPCS L3927 | not published | not published | $39.34 – $103.07 | 6 |
| Splint fing stax assort 1-7in HCPCS Q4049 | not published | not published | $2.68 – $7.02 | 6 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | not published | not published | $97.81 – $256.26 | 6 |
| Split blood or products CPT 86985 | not published | not published | $33.88 – $33.88 | 1 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $92.77 – $243.06 | 6 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $824.65 – $2,160.58 | 6 |
| Sputum specimen collection CPT 89220 | not published | not published | $24.42 – $24.42 | 1 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $175.40 – $459.55 | 6 |
| Srs multisource CPT 77371 | not published | not published | $1,970.43 – $1,970.43 | 1 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $351.80 – $921.72 | 6 |
| St analysis behavior qualitative voice/resonance CPT 92524 | not published | not published | $109.38 – $286.58 | 6 |
| Stance phase only HCPCS L5858 | not published | not published | $23,006.90 – $60,278.08 | 6 |
| Standard control cable extra HCPCS L6655 | not published | not published | $113.34 – $296.95 | 6 |
| Staph a dna amp probe CPT 87640 | not published | not published | $35.09 – $91.94 | 6 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $207.40 – $543.39 | 6 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $67.83 – $177.71 | 6 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $67.83 – $177.71 | 6 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | not published | not published | $102.59 – $268.79 | 6 |
| Stem cells total count CPT 86367 | not published | not published | $77.78 – $203.78 | 6 |
| Stereotactic radiation trmt CPT 77432 | not published | not published | $727.45 – $727.45 | 1 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.15 – $0.39 | 6 |
| Sterile water/saline, 10 ml HCPCS A4216 | not published | not published | $0.54 – $1.41 | 6 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $4.47 – $11.71 | 6 |
| Sternal pad HCPCS L1050 | not published | not published | $123.34 – $323.15 | 6 |
| St evaluate speech sound production CPT 92522 | not published | not published | $111.65 – $292.52 | 6 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | not published | not published | $226.20 – $592.64 | 6 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | not published | not published | $91.05 – $238.55 | 6 |
| St evaluation swallow function CPT 92610 | not published | not published | $84.61 – $221.68 | 6 |
| Stimulants synthetic CPT 80371 | not published | not published | $0.02 – $0.02 | 1 |
| Stocking sup grips 4 pre ots HCPCS L0982 | not published | not published | $24.95 – $65.37 | 6 |
| Stoma absorptive cover HCPCS A5083 | not published | not published | $0.92 – $2.41 | 6 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $331.02 – $331.02 | 1 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $463.77 – $463.77 | 1 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $201.32 – $201.32 | 1 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $368.82 – $368.82 | 1 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $198.72 – $520.65 | 6 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $13.00 – $34.06 | 6 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $4.70 – $12.31 | 6 |
| Strep a ag ia CPT 87430 | not published | not published | $16.81 – $44.04 | 6 |
| Strep a dna dir probe CPT 87650 | not published | not published | $20.05 – $52.53 | 6 |
| Strep a dna quant CPT 87652 | not published | not published | $41.76 – $109.41 | 6 |
| Strep b assay w/optic CPT 87802 | not published | not published | $12.73 – $33.35 | 6 |
| Strep b dna amp probe CPT 87653 | not published | not published | $35.09 – $91.94 | 6 |
| Streptokinase antibody CPT 86590 | not published | not published | $12.66 – $33.17 | 6 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.81 – $798.60 | 6 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.07 – $610.64 | 6 |
| St treatment speech individual CPT 92507 | not published | not published | $76.05 – $199.25 | 6 |
| St treatment swallow dysfunction/oral CPT 92526 | not published | not published | $83.98 – $220.03 | 6 |
| Suction socket HCPCS L6686 | not published | not published | $793.42 – $2,078.76 | 6 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $622.71 – $1,631.50 | 6 |
| Sugars multiple quant CPT 84379 | not published | not published | $11.53 – $30.21 | 6 |
| Sugars single quant CPT 84378 | not published | not published | $11.53 – $30.21 | 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.