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 |
|---|---|---|---|---|
| Bld prd mix CPT 86965 | not published | not published | $42.91 – $42.91 | 1 |
| Blm gene CPT 81209 | not published | not published | $39.31 – $102.99 | 6 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | not published | not published | $17.48 – $45.80 | 6 |
| Blood clot lysis time CPT 85175 | not published | not published | $20.37 – $53.37 | 6 |
| Blood clot retraction CPT 85170 | not published | not published | $16.30 – $42.71 | 6 |
| Blood Clotting (PT/INR) Test CPT 85610 | $123.45 | $123.45 | $4.29 – $11.24 | 6 |
| Blood Clotting (PTT) Test CPT 85730 | $289.30 | $289.30 | $6.01 – $15.75 | 6 |
| Blood Count (CBC) Test CPT 85025 | not published | not published | $7.77 – $20.36 | 6 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $501.94 | $501.94 | $6.47 – $16.95 | 6 |
| Blood count spun microhematocrit CPT 85013 | not published | not published | $7.00 – $18.34 | 6 |
| Blood Culture Test CPT 87040 | not published | not published | $10.32 – $27.04 | 6 |
| Blood gases o2 saturation direct measurement CPT 82805 | not published | not published | $78.77 – $206.38 | 6 |
| Blood gases ph venous CPT 82800 | not published | not published | $11.00 – $28.82 | 6 |
| Blood, l/r, irradiated HCPCS P9056 | not published | not published | $248.87 – $248.87 | 1 |
| Blood mucoprotein HCPCS P2038 | not published | not published | $4.95 – $12.97 | 6 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | not published | not published | $15.92 – $41.71 | 6 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | not published | not published | $4.23 – $11.08 | 6 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $36.98 | $36.98 | $4.38 – $11.48 | 6 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | not published | not published | $5.32 – $13.94 | 6 |
| Blood smear interpretation CPT 85060 | not published | not published | $31.16 – $31.16 | 1 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $110.96 | $110.96 | $3.80 – $9.96 | 6 |
| Blood split unit HCPCS P9011 | not published | not published | $82.66 – $82.66 | 1 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $4.95 – $12.97 | 6 |
| Blood typing abo CPT 86900 | not published | not published | $2.99 – $7.83 | 6 |
| Blood typing ag donor ea ag CPT 86902 | not published | not published | $6.35 – $16.64 | 6 |
| Blood typing antigen system CPT 86911 | not published | not published | $29.36 – $29.36 | 1 |
| Blood typing paternity test CPT 86910 | not published | not published | $33.88 – $33.88 | 1 |
| Blood typing patient serum CPT 86904 | not published | not published | $16.34 – $42.81 | 6 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | not published | not published | $3.83 – $10.03 | 6 |
| Blood typing rh (d) CPT 86901 | not published | not published | $2.99 – $7.83 | 6 |
| Blood typing rh phenotype complete reference CPT 86906 | not published | not published | $7.75 – $20.30 | 6 |
| Blood volume CPT 78122 | not published | not published | $128.00 – $128.00 | 1 |
| Body jacket mold to patient HCPCS L1300 | not published | not published | $2,212.58 – $5,796.96 | 6 |
| Bone Density Scan (DEXA) CPT 77080 | not published | not published | $45.95 – $45.95 | 1 |
| Bone imaging multiple areas CPT 78305 | not published | not published | $373.71 – $373.71 | 1 |
| Bone/joint imaging ltd area CPT 78300 | not published | not published | $313.96 – $313.96 | 1 |
| Bone marrow imaging body CPT 78104 | not published | not published | $336.51 – $336.51 | 1 |
| Bone marrow imaging ltd CPT 78102 | not published | not published | $232.81 – $232.81 | 1 |
| Bone marrow imaging mult CPT 78103 | not published | not published | $251.98 – $251.98 | 1 |
| Bone marrow interpretation CPT 85097 | not published | not published | $62.05 – $62.05 | 1 |
| Bone mineral dual photon CPT 78351 | not published | not published | $16.61 – $16.61 | 1 |
| Bone mineral single photon CPT 78350 | not published | not published | $34.12 – $34.12 | 1 |
| Bone survey-lead poisoning CPT 77074 | not published | not published | $74.70 – $74.70 | 1 |
| Boot heel care softcare one sz HCPCS E0191 | not published | not published | $13.34 – $34.95 | 6 |
| Boot j walker l HCPCS L4386 | not published | not published | $195.88 – $513.21 | 6 |
| Boot mlti podous univ xlg HCPCS L4396 | not published | not published | $207.40 – $543.39 | 6 |
| Boot softgait shrt m HCPCS L4387 | not published | not published | $195.88 – $513.21 | 6 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | not published | not published | $318.18 – $833.63 | 6 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | not published | not published | $318.18 – $833.63 | 6 |
| Borrelia antibody CPT 86619 | not published | not published | $13.38 – $35.06 | 6 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | not published | not published | $17.03 – $44.62 | 6 |
| Borrelia miyamotoi amp prb CPT 87478 | not published | not published | $35.09 – $91.94 | 6 |
| (both sides) smear without diff wbc count CPT 85008 | not published | not published | $3.43 – $8.99 | 6 |
| Bowel imaging CPT 78290 | not published | not published | $471.50 – $471.50 | 1 |
| Brace adj motion lerman type HCPCS L2186 | not published | not published | $173.00 – $453.26 | 6 |
| Brace afo dbl upright cust HCPCS L1990 | not published | not published | $512.22 – $1,342.02 | 6 |
| Brace afo lg left 6607 HCPCS L1930 | not published | not published | $362.45 – $949.62 | 6 |
| Brace afopos solid ankle cust HCPCS L1960 | not published | not published | $636.95 – $1,668.81 | 6 |
| Brace afo spiral prefab HCPCS L1951 | not published | not published | $1,037.61 – $2,718.54 | 6 |
| Brace ank aftr bioskn med lg HCPCS L1906 | not published | not published | $138.20 – $362.08 | 6 |
| Brace ank air stirrup univ HCPCS L4350 | not published | not published | $105.64 – $276.78 | 6 |
| Brace ankle joint dflxn assist HCPCS L2210 | not published | not published | $77.24 – $202.37 | 6 |
| Brace ankle stablizing lg HCPCS L1902 | not published | not published | $122.31 – $320.45 | 6 |
| Brace back epic lo 627 HCPCS L0642 | not published | not published | $301.13 – $788.96 | 6 |
| Brace back epic lso 637 HCPCS L0650 | not published | not published | $870.15 – $2,279.79 | 6 |
| Brace back epic tslo 456 HCPCS L0457 | not published | not published | $728.43 – $1,908.49 | 6 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | not published | not published | $507.88 – $1,330.65 | 6 |
| Brace back pinnacle tlso 464 HCPCS L0464 | not published | not published | $1,836.48 – $4,811.58 | 6 |
| Brace back t-lso custom HCPCS L0486 | not published | not published | $2,203.61 – $5,773.46 | 6 |
| Brace back vista 464 tlso HCPCS L0648 | not published | not published | $752.04 – $1,970.34 | 6 |
| Brace cust back lso HCPCS L0631 | not published | not published | $1,268.37 – $3,323.13 | 6 |
| Brace fx hum ovr shldr lg HCPCS L3981 | not published | not published | $1,131.82 – $2,965.37 | 6 |
| Brace fx hum ovr shldr sm HCPCS L3980 | not published | not published | $413.94 – $1,084.52 | 6 |
| Brace halo bremer l2830 HCPCS L2830 | not published | not published | $107.96 – $282.86 | 6 |
| Brace kafo dbl upright cust HCPCS L2036 | not published | not published | $2,240.26 – $5,869.48 | 6 |
| Brace knee 32in univ t-scope short lt/rt HCPCS L1852 | not published | not published | $573.13 – $1,501.60 | 6 |
| Brace knee extender plus 22-30in HCPCS L1832 | not published | not published | $698.63 – $1,830.41 | 6 |
| Brace knee hing pat open med HCPCS L1820 | not published | not published | $165.33 – $433.16 | 6 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | not published | not published | $455.16 – $1,192.52 | 6 |
| Brace knee postop tscope xl HCPCS L1845 | not published | not published | $1,076.32 – $2,819.96 | 6 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | not published | not published | $122.90 – $322.00 | 6 |
| Brace m arm board HCPCS L3809 | not published | not published | $281.17 – $736.67 | 6 |
| Brace ortho exos 28-50in sm HCPCS L0637 | not published | not published | $1,501.02 – $3,932.67 | 6 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | not published | not published | $1,228.79 – $3,219.43 | 6 |
| Brace oths wrist hnd fngr without HCPCS L3807 | not published | not published | $281.17 – $736.67 | 6 |
| Brace tlso flex cust HCPCS L0450 | not published | not published | $136.83 – $358.49 | 6 |
| Brace wrist classic lft sm HCPCS L3908 | not published | not published | $67.37 – $176.51 | 6 |
| Brachytx isodose complex CPT 77318 | not published | not published | $530.79 – $530.79 | 1 |
| Brachytx isodose intermed CPT 77317 | not published | not published | $392.78 – $392.78 | 1 |
| Brachytx isodose plan simple CPT 77316 | not published | not published | $297.04 – $297.04 | 1 |
| Braf gene CPT 81210 | not published | not published | $175.40 – $459.55 | 6 |
| Brain flow imaging only CPT 78610 | not published | not published | $255.36 – $255.36 | 1 |
| Brain image < 4 views CPT 78600 | not published | not published | $258.18 – $258.18 | 1 |
| Brain image 4+ views CPT 78605 | not published | not published | $277.35 – $277.35 | 1 |
| Brain image w/flow < 4 views CPT 78601 | not published | not published | $303.82 – $303.82 | 1 |
| Brain image w/flow 4 + views CPT 78606 | not published | not published | $471.50 – $471.50 | 1 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | not published | not published | $761.00 – $761.00 | 1 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | not published | not published | $761.00 – $761.00 | 1 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | not published | not published | $761.00 – $761.00 | 1 |
| Brain MRI (with and without contrast) CPT 70553 | not published | not published | $761.00 – $761.00 | 1 |
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.