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 |
|---|---|---|---|---|
| Transferrin CPT 84466 | $206.07 | $206.07 | $12.76 – $33.43 | 6 |
| Transparent film >16<=48 in HCPCS A6258 | not published | not published | $6.14 – $16.09 | 6 |
| Transparent film <= 16 sq in HCPCS A6257 | not published | not published | $2.18 – $5.71 | 6 |
| Trans shoe caliper plate new HCPCS L3610 | not published | not published | $124.12 – $325.19 | 6 |
| Trans shoe calip plate exist HCPCS L3600 | not published | not published | $94.30 – $247.07 | 6 |
| Trans shoe solid stirrup exi HCPCS L3620 | not published | not published | $94.30 – $247.07 | 6 |
| Trans shoe solid stirrup new HCPCS L3630 | not published | not published | $124.12 – $325.19 | 6 |
| Trapezius sling HCPCS L1070 | not published | not published | $117.10 – $306.80 | 6 |
| Tray trach basic clean/care ster HCPCS A4626 | not published | not published | $3.86 – $10.11 | 6 |
| Trb@ gene rearrange dirprobe CPT 81341 | not published | not published | $49.59 – $129.93 | 6 |
| Treatment radiation delivery level 2 CPT 77407 | not published | not published | $321.28 – $321.28 | 1 |
| Treponema pallidum ag if CPT 87285 | not published | not published | $12.18 – $31.91 | 6 |
| Treponema pallidum antibody CPT 86780 | not published | not published | $13.24 – $34.69 | 6 |
| Trg gene rearrangement anal CPT 81342 | not published | not published | $201.50 – $527.93 | 6 |
| Trh stimulation panel CPT 80439 | not published | not published | $67.21 – $176.09 | 6 |
| Trichinella antibody CPT 86784 | not published | not published | $12.56 – $32.91 | 6 |
| Trichomonas assay w/optic CPT 87808 | not published | not published | $15.29 – $40.06 | 6 |
| #tricyclicantidprssnt CPT 80337 | not published | not published | $0.02 – $0.02 | 1 |
| Triglycerides CPT 84478 | $299.31 | $299.31 | $5.74 – $15.04 | 6 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $640.73 – $1,678.71 | 6 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $3,240.00 – $8,488.80 | 6 |
| Troponin quantitative CPT 84484 | $721.75 | $721.75 | $12.47 – $32.67 | 6 |
| Truss addition to std pad wa HCPCS L8320 | not published | not published | $75.29 – $197.26 | 6 |
| Truss add to std pad scrotal HCPCS L8330 | not published | not published | $80.58 – $211.12 | 6 |
| Truss double with standard pad HCPCS L8310 | not published | not published | $163.05 – $427.19 | 6 |
| Truss single with standard pad HCPCS L8300 | not published | not published | $103.28 – $270.59 | 6 |
| Tube drain vert dev st 5-40f HCPCS A5200 | not published | not published | $16.10 – $42.18 | 6 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | not published | not published | $67.04 – $175.64 | 6 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $7.95 – $20.83 | 6 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $67.66 – $177.27 | 6 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.08 – $0.21 | 6 |
| Tubular dressing HCPCS A6457 | not published | not published | $1.62 – $4.24 | 6 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $645.85 – $1,692.13 | 6 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $458.00 | 6 |
| U2af1 gene common variants CPT 81357 | not published | not published | $193.25 – $506.31 | 6 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $4.02 – $10.53 | 6 |
| Ue triple control harness HCPCS L6677 | not published | not published | $367.25 – $962.20 | 6 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $234.00 – $613.08 | 6 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | not published | not published | $136.68 – $136.68 | 1 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $7.07 – $7.07 | 1 |
| Ultrasound breast complete CPT 76641 | not published | not published | $116.40 – $116.40 | 1 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | not published | not published | $88.78 – $88.78 | 1 |
| Ultrasound chest CPT 76604 | not published | not published | $51.58 – $51.58 | 1 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | not published | not published | $35.81 – $35.81 | 1 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $29.03 – $29.03 | 1 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $62.28 – $62.28 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | not published | not published | $128.23 – $128.23 | 1 |
| Ultrasound encephalogram CPT 76506 | not published | not published | $144.00 – $144.00 | 1 |
| Ultrasound exam k transpl w/doppler CPT 76776 | not published | not published | $192.20 – $192.20 | 1 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | not published | not published | $78.64 – $78.64 | 1 |
| Ultrasound guidance for vascular access CPT 76937 | not published | not published | $43.39 – $43.39 | 1 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | not published | not published | $45.95 – $45.95 | 1 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $96.26 – $96.26 | 1 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $99.07 – $99.07 | 1 |
| Ultrasound hips infant dynamic CPT 76885 | not published | not published | $134.17 – $134.17 | 1 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $120.91 – $120.91 | 1 |
| Ultrasound joint complete left CPT 76881 | $1,373.72 | $1,373.72 | $47.64 – $47.64 | 1 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | not published | not published | $55.53 – $55.53 | 1 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | not published | not published | $70.17 – $70.17 | 1 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | not published | not published | $36.07 – $36.07 | 1 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | not published | not published | $139.83 – $139.83 | 1 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | not published | not published | $116.97 – $116.97 | 1 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | not published | not published | $85.40 – $85.40 | 1 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | not published | not published | $96.67 – $96.67 | 1 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $180.63 – $180.63 | 1 |
| Ultrasound retroperitoneal limited CPT 76775 | not published | not published | $51.02 – $51.02 | 1 |
| Ultrasound scrotum and contents CPT 76870 | $1,343.52 | $1,343.52 | $119.78 – $119.78 | 1 |
| Ultrasound spinal canal and contents CPT 76800 | not published | not published | $147.94 – $147.94 | 1 |
| Ultrasound transabd ea addl gest CPT 76812 | not published | not published | $182.63 – $182.63 | 1 |
| Ultrasound transvaginal non obstetric CPT 76830 | not published | not published | $147.94 – $147.94 | 1 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $374.25 – $374.25 | 1 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $265.73 – $265.73 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.26 – $21.64 | 6 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $14,823.50 – $38,837.57 | 6 |
| Unlisted CT procedure CPT 76497 | not published | not published | $173.44 – $173.44 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $134.43 – $134.43 | 1 |
| Unlisted mr procedure CPT 76498 | not published | not published | $761.00 – $761.00 | 1 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | not published | not published | $761.00 – $761.00 | 1 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | not published | not published | $761.00 – $761.00 | 1 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | not published | not published | $761.00 – $761.00 | 1 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | not published | not published | $467.12 – $1,223.85 | 6 |
| Urea nitrogen CPT 84520 | $116.51 | $116.51 | $3.95 – $10.35 | 6 |
| Urea nitrogen 24 hour urine CPT 84540 | not published | not published | $5.56 – $14.57 | 6 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $7.20 – $18.86 | 6 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $5.13 – $13.44 | 6 |
| Ureteral reflux study CPT 78740 | not published | not published | $303.82 – $303.82 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $382.39 – $382.39 | 1 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $153.57 – $153.57 | 1 |
| Uric acid blood CPT 84550 | $75.06 | $75.06 | $4.52 – $11.84 | 6 |
| Uric acid urine CPT 84560 | not published | not published | $5.08 – $13.31 | 6 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.70 – $12.31 | 6 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $3.05 – $7.99 | 6 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $2.17 – $5.69 | 6 |
| Urinalysis (with microscopy) CPT 81001 | $221.92 | $221.92 | $3.17 – $8.31 | 6 |
| Urinalysis (without microscopy) CPT 81003 | $82.35 | $82.35 | $2.25 – $5.90 | 6 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $107.93 – $107.93 | 1 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $4.53 – $11.87 | 6 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $8.57 – $22.45 | 6 |
| Urinary suspensory HCPCS A5105 | not published | not published | $58.11 – $152.25 | 6 |
| Urine Culture Test CPT 87086 | $392.74 | $392.74 | $8.07 – $21.14 | 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.