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 |
|---|---|---|---|---|
| Test urine urobilinogen CPT 84578 | not published | not published | $4.47 – $11.71 | 6 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $137.00 – $358.94 | 6 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $759.53 – $1,989.97 | 6 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $2,919.60 – $7,649.35 | 6 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $597.91 – $1,566.52 | 6 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $17.94 – $17.94 | 1 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $17.94 – $17.94 | 1 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $12.78 – $12.78 | 1 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $17.94 – $17.94 | 1 |
| Theophylline therapeutic drug level CPT 80198 | not published | not published | $14.14 – $37.05 | 6 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | not published | not published | $31.11 – $81.51 | 6 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | not published | not published | $26.85 – $70.35 | 6 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $273.05 – $273.05 | 1 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $288.15 – $288.15 | 1 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $185.24 – $185.24 | 1 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $122.04 – $122.04 | 1 |
| Thigh/wght bear high roll cu HCPCS L2550 | not published | not published | $330.04 – $864.70 | 6 |
| Thigh/wght bear lacer molded HCPCS L2540 | not published | not published | $516.79 – $1,353.99 | 6 |
| Thigh/wght bear lacer non-mo HCPCS L2530 | not published | not published | $272.20 – $713.16 | 6 |
| Thi/glut/ischia wgt bearing HCPCS L2500 | not published | not published | $422.73 – $1,107.55 | 6 |
| Thorac cont lat support upri HCPCS L2680 | not published | not published | $239.76 – $628.17 | 6 |
| Thorac cont paraspinal uprig HCPCS L2670 | not published | not published | $261.36 – $684.76 | 6 |
| Thoracic control thoracic ba HCPCS L2660 | not published | not published | $258.68 – $677.74 | 6 |
| Thoracic intern lock elbow HCPCS L6350 | not published | not published | $4,795.29 – $12,563.66 | 6 |
| Thoracic pad HCPCS L1060 | not published | not published | $119.70 – $313.61 | 6 |
| Thor rib belt custom fabrica HCPCS L0220 | not published | not published | $187.65 – $491.64 | 6 |
| Throat x-ray & fluoroscopy CPT 70370 | not published | not published | $134.43 – $134.43 | 1 |
| Thrombin time CPT 85670 | not published | not published | $5.77 – $15.12 | 6 |
| Thrombin time titer CPT 85675 | not published | not published | $6.85 – $17.95 | 6 |
| Thrombomodulin CPT 85337 | not published | not published | $17.27 – $45.25 | 6 |
| Thromboplastin inhibition CPT 85705 | not published | not published | $9.63 – $25.23 | 6 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | not published | not published | $6.47 – $16.95 | 6 |
| Thromboxane urine CPT 84431 | not published | not published | $35.11 – $91.99 | 6 |
| Th/wght bear nar m-l brim cu HCPCS L2526 | not published | not published | $787.09 – $2,062.18 | 6 |
| Th/wght bear nar m-l brim mo HCPCS L2525 | not published | not published | $1,400.77 – $3,670.02 | 6 |
| Th/wght bear quad-lat brim c HCPCS L2520 | not published | not published | $605.28 – $1,585.83 | 6 |
| Th/wght bear quad-lat brim m HCPCS L2510 | not published | not published | $958.79 – $2,512.03 | 6 |
| Thyroglobulin antibody CPT 86800 | not published | not published | $15.91 – $41.68 | 6 |
| Thyroid imaging CPT 78013 | not published | not published | $280.17 – $280.17 | 1 |
| Thyroid met imaging CPT 78015 | not published | not published | $312.27 – $312.27 | 1 |
| Thyroid met imaging/studies CPT 78016 | not published | not published | $394.85 – $394.85 | 1 |
| Thyroid mets imag whole body CPT 78018 | not published | not published | $433.18 – $433.18 | 1 |
| Thyroid met uptake CPT 78020 | not published | not published | $87.96 – $87.96 | 1 |
| Thyroid (TSH) Test CPT 84443 | $302.42 | $302.42 | $16.80 – $44.02 | 6 |
| Thyroid Ultrasound CPT 76536 | not published | not published | $144.00 – $144.00 | 1 |
| Thyroid uptake measurement CPT 78012 | not published | not published | $118.99 – $118.99 | 1 |
| Thyrotropin releasing hormone CPT 80438 | not published | not published | $50.41 – $132.07 | 6 |
| Thyroxine binding globulin (tbg) CPT 84442 | not published | not published | $14.78 – $38.72 | 6 |
| Tibial length sock fx or equ HCPCS L2840 | not published | not published | $66.94 – $175.38 | 6 |
| Tibial tubercle hgt with toe f HCPCS L5020 | not published | not published | $2,813.27 – $7,370.77 | 6 |
| Tilt table locking hip sing HCPCS L5270 | not published | not published | $6,563.13 – $17,195.40 | 6 |
| Tissue culture placenta CPT 88235 | not published | not published | $150.30 – $393.79 | 6 |
| Tissue culture skin/biopsy CPT 88233 | not published | not published | $140.73 – $368.71 | 6 |
| Tissue culture tumor CPT 88239 | not published | not published | $147.52 – $386.50 | 6 |
| Tissue exam koh skin/hair/nails CPT 87220 | not published | not published | $4.27 – $11.19 | 6 |
| Tissue transglutaminase iga CPT 86364 | not published | not published | $11.53 – $30.21 | 6 |
| Tl-201 thallium diag per mci HCPCS A9505 | not published | not published | $80.26 – $80.26 | 1 |
| Tlso 2mod symphis-xipho pre HCPCS L0458 | not published | not published | $1,101.88 – $2,886.93 | 6 |
| Tlso 2 piece rigid shell HCPCS L0491 | not published | not published | $948.87 – $2,486.04 | 6 |
| Tlso 2 shl symphys-stern cst HCPCS L0460 | not published | not published | $1,240.27 – $3,249.51 | 6 |
| Tlso 3mod sacro-scap pre HCPCS L0462 | not published | not published | $1,542.64 – $4,041.72 | 6 |
| Tlso 3 piece rigid shell HCPCS L0492 | not published | not published | $614.96 – $1,611.20 | 6 |
| Tlso corset front HCPCS L0970 | not published | not published | $167.07 – $437.72 | 6 |
| Tlso flex trnk sj-t9 pre ots HCPCS L0455 | not published | not published | $254.02 – $665.53 | 6 |
| Tlso full corset HCPCS L0974 | not published | not published | $230.94 – $605.06 | 6 |
| Tlso r fram soft ant pre cst HCPCS L0466 | not published | not published | $491.93 – $1,288.86 | 6 |
| Tlso r fram soft pre ots HCPCS L0467 | not published | not published | $284.88 – $746.39 | 6 |
| Tlso rig fram pelvic pre cst HCPCS L0468 | not published | not published | $569.51 – $1,492.12 | 6 |
| Tlso rig fram pelvic pre ots HCPCS L0469 | not published | not published | $362.99 – $951.03 | 6 |
| Tlso rigid frame pre subclav HCPCS L0470 | not published | not published | $732.62 – $1,919.46 | 6 |
| Tlso rigid lined custom fab HCPCS L0482 | not published | not published | $1,781.97 – $4,668.76 | 6 |
| Tlso rigid lined pre one pie HCPCS L0488 | not published | not published | $1,240.27 – $3,249.51 | 6 |
| Tlso rigid plastic cust fab HCPCS L0484 | not published | not published | $2,042.14 – $5,350.41 | 6 |
| Tlso rigid plastic custom fa HCPCS L0480 | not published | not published | $1,762.06 – $4,616.60 | 6 |
| Tlso rigid plastic pre one HCPCS L0490 | not published | not published | $349.48 – $915.64 | 6 |
| Tlso trnk sj-t9 pre cst HCPCS L0454 | not published | not published | $428.50 – $1,122.67 | 6 |
| Tobramycin peak therapeutic drug level CPT 80200 | not published | not published | $16.13 – $42.26 | 6 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | not published | not published | $12.51 – $32.78 | 6 |
| Tomosynthesis breast screen bilateral CPT 77063 | not published | not published | $23.05 – $60.39 | 6 |
| Torsion ank & half solid sti HCPCS L2375 | not published | not published | $173.12 – $453.57 | 6 |
| Torsion straight knee joint HCPCS L2380 | not published | not published | $188.63 – $494.21 | 6 |
| Total tau CPT 84394 | not published | not published | $128.92 – $337.77 | 6 |
| Tot contact ak/knee disart s HCPCS L5650 | not published | not published | $701.34 – $1,837.51 | 6 |
| Tot estradiol response panel CPT 80415 | not published | not published | $55.89 – $146.43 | 6 |
| Toxoplasma antibody igg CPT 86777 | not published | not published | $14.39 – $37.70 | 6 |
| Toxoplasma antibody igm CPT 86778 | not published | not published | $14.41 – $37.75 | 6 |
| Tp53 gene full gene sequence CPT 81351 | not published | not published | $641.85 – $1,681.65 | 6 |
| Tp53 gene known famil vrnt CPT 81353 | not published | not published | $308.00 – $806.96 | 6 |
| Tp53 gene trgt sequence alys CPT 81352 | not published | not published | $329.51 – $863.32 | 6 |
| Tpmt gene com vrnts CPT 81335 | not published | not published | $174.81 – $458.00 | 6 |
| Trach care kit for new trach HCPCS A4625 | not published | not published | $9.87 – $25.86 | 6 |
| Tracheostoma hmes filter HCPCS A7504 | not published | not published | $0.97 – $2.54 | 6 |
| Tracheostoma stent/stud/bttn HCPCS A7524 | not published | not published | $110.33 – $289.06 | 6 |
| Tracheostomy care kit HCPCS A4629 | not published | not published | $6.63 – $17.37 | 6 |
| Trach/laryn tube plug/stop HCPCS A7527 | not published | not published | $5.10 – $13.36 | 6 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | not published | not published | $55.54 – $145.51 | 6 |
| Transcatheter bx s&i CPT 75970 | not published | not published | $617.55 – $617.55 | 1 |
| Transcutaneous carboxyhb CPT 88740 | not published | not published | $9.37 – $24.55 | 6 |
| Transcutaneous hgb 88738 CPT 88738 | not published | not published | $5.02 – $13.15 | 6 |
| Transcutaneous methb CPT 88741 | not published | not published | $9.37 – $24.55 | 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.