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 |
|---|---|---|---|---|
| X-ray forearm 2 views (both sides) CPT 73090 | not published | not published | $35.81 – $35.81 | 1 |
| X-ray hand 2 views (both sides) CPT 73120 | not published | not published | $38.63 – $38.63 | 1 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $12.70 – $12.70 | 1 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | not published | not published | $35.25 – $35.25 | 1 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | not published | not published | $76.95 – $76.95 | 1 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $581.20 | $581.20 | $51.02 – $51.02 | 1 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | not published | not published | $66.23 – $66.23 | 1 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | not published | not published | $78.08 – $78.08 | 1 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $688.18 | $688.18 | $39.19 – $39.19 | 1 |
| X-ray humerus >= 2 views left CPT 73060 | not published | not published | $40.32 – $40.32 | 1 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $51.02 – $51.02 | 1 |
| X-ray knee 1-2 views (both sides) CPT 73560 | not published | not published | $43.70 – $43.70 | 1 |
| X-ray knee 3 views (both sides) CPT 73562 | not published | not published | $53.27 – $53.27 | 1 |
| X-ray knee ap standing bilateral CPT 73565 | not published | not published | $53.84 – $53.84 | 1 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | not published | not published | $40.32 – $40.32 | 1 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | not published | not published | $50.46 – $50.46 | 1 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | not published | not published | $65.10 – $65.10 | 1 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | not published | not published | $79.77 – $79.77 | 1 |
| X-ray male genital tract CPT 74440 | not published | not published | $137.24 – $137.24 | 1 |
| X-ray mandible complete > 4 views CPT 70110 | not published | not published | $53.84 – $53.84 | 1 |
| X-ray mandible ltd <4 views CPT 70100 | $386.95 | $386.95 | $49.89 – $49.89 | 1 |
| X-ray nasal bones complete > 3 views CPT 70160 | not published | not published | $49.89 – $49.89 | 1 |
| X-ray neck soft tissue CPT 70360 | $395.12 | $395.12 | $38.07 – $38.07 | 1 |
| X-ray nose to rectum for foreign body child CPT 76010 | not published | not published | $35.25 – $35.25 | 1 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $79.77 – $79.77 | 1 |
| X-ray optic foramina CPT 70190 | not published | not published | $45.95 – $45.95 | 1 |
| X-ray pelvis 1-2 views CPT 72170 | $439.73 | $439.73 | $32.41 – $32.41 | 1 |
| X-ray pelvis complete > 3 views CPT 72190 | not published | not published | $50.46 – $50.46 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | not published | not published | $88.22 – $88.22 | 1 |
| X-ray ribs 2 views left CPT 71100 | not published | not published | $43.70 – $43.70 | 1 |
| X-ray ribs 3 views bilateral CPT 71110 | $581.20 | $581.20 | $50.46 – $50.46 | 1 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | not published | not published | $49.33 – $49.33 | 1 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | not published | not published | $62.85 – $62.85 | 1 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | not published | not published | $47.64 – $47.64 | 1 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | not published | not published | $40.32 – $40.32 | 1 |
| X-ray scapula complete (both sides) CPT 73010 | not published | not published | $25.09 – $25.09 | 1 |
| X-ray sella turcica CPT 70240 | not published | not published | $40.32 – $40.32 | 1 |
| X-ray shoulder 1 view (both sides) CPT 73020 | not published | not published | $23.40 – $23.40 | 1 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | not published | not published | $45.95 – $45.95 | 1 |
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $60.03 – $60.03 | 1 |
| X-ray skull < 4 views CPT 70250 | $569.84 | $569.84 | $45.39 – $45.39 | 1 |
| X-ray skull > 4 views complete CPT 70260 | not published | not published | $52.71 – $52.71 | 1 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $104.55 – $104.55 | 1 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | not published | not published | $147.38 – $147.38 | 1 |
| X-ray small intestine follow-through study CPT 74248 | not published | not published | $87.09 – $87.09 | 1 |
| X-ray spine single view CPT 72020 | not published | not published | $27.90 – $27.90 | 1 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | not published | not published | $52.15 – $52.15 | 1 |
| X-ray sternum > 2 views CPT 71120 | not published | not published | $40.88 – $40.88 | 1 |
| X-ray surgical specimen CPT 76098 | not published | not published | $42.57 – $42.57 | 1 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | not published | not published | $176.69 – $176.69 | 1 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | not published | not published | $70.73 – $70.73 | 1 |
| X-ray thoracic spine 2 views CPT 72070 | $376.11 | $376.11 | $38.63 – $38.63 | 1 |
| X-ray thoracic spine 3 views CPT 72072 | not published | not published | $47.64 – $47.64 | 1 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | not published | not published | $41.45 – $41.45 | 1 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | not published | not published | $50.46 – $50.46 | 1 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | not published | not published | $92.72 – $92.72 | 1 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | not published | not published | $39.76 – $39.76 | 1 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | not published | not published | $38.07 – $38.07 | 1 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | not published | not published | $171.06 – $171.06 | 1 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | not published | not published | $148.51 – $148.51 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | not published | not published | $43.14 – $43.14 | 1 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $120.35 – $120.35 | 1 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $33.82 | 6 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $34.56 | 6 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $51.31 – $134.43 | 6 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $44.15 | 6 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.79 – $4.69 | 6 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $506.31 | 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.