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 |
|---|---|---|---|---|
| Brain MRI (with contrast) CPT 70552 | not published | not published | $761.00 – $761.00 | 1 |
| Brain MRI (without contrast) CPT 70551 | not published | not published | $761.00 – $761.00 | 1 |
| Bra surgical elizabeth pink sm HCPCS L8000 | not published | not published | $45.92 – $120.31 | 6 |
| Brca1&2 gene full seq alys CPT 81163 | not published | not published | $468.00 – $1,226.16 | 6 |
| Brca1&2 gen ful dup/del alys CPT 81164 | not published | not published | $584.23 – $1,530.68 | 6 |
| Brca1 dna gene analy known fam var CPT 81215 | not published | not published | $375.25 – $983.16 | 6 |
| Brca1 gene full dup/del alys CPT 81166 | not published | not published | $301.35 – $789.54 | 6 |
| Brca1 gene full seq alys CPT 81165 | not published | not published | $282.88 – $741.15 | 6 |
| Brca2 dna gene analy full seq analy CPT 81216 | not published | not published | $185.12 – $485.01 | 6 |
| Brca2 dna gene analy known fam var CPT 81217 | not published | not published | $375.25 – $983.16 | 6 |
| Brca2 gene full dup/del alys CPT 81167 | not published | not published | $282.88 – $741.15 | 6 |
| Brcassure ashkenazi panel-sendout CPT 81212 | not published | not published | $440.00 – $1,152.80 | 6 |
| Brcassure comprehensive panel-sendout CPT 81162 | not published | not published | $1,824.88 – $4,781.19 | 6 |
| Breast prosthesis bra & form HCPCS L8001 | not published | not published | $155.27 – $406.81 | 6 |
| Breast prosthesis w adhesive HCPCS L8031 | not published | not published | $408.38 – $1,069.96 | 6 |
| Breast prosthes without adhesive HCPCS L8030 | not published | not published | $408.38 – $1,069.96 | 6 |
| Breath test analysis c-14 CPT 78268 | not published | not published | $94.41 – $247.35 | 6 |
| Breath tst attain/anal c-14 CPT 78267 | not published | not published | $11.06 – $28.98 | 6 |
| Brief chkin, 5-10, non-e/m HCPCS G2251 | not published | not published | $13.99 – $36.65 | 6 |
| Brst prsth bra & bilat form HCPCS L8002 | not published | not published | $204.23 – $535.08 | 6 |
| Brush provox 4-10mm HCPCS L8513 | not published | not published | $6.47 – $16.95 | 6 |
| Btk gene common variants CPT 81233 | not published | not published | $175.40 – $459.55 | 6 |
| Bundled special stain group 1 microorganisms CPT 88312 | not published | not published | $114.95 – $114.95 | 1 |
| Bundled special stain group 2 CPT 88313 | not published | not published | $91.48 – $91.48 | 1 |
| Buprenorphine and metabolite - sendout CPT 80348 | not published | not published | $0.02 – $0.02 | 1 |
| C1 esterase inhibitor func - sendout CPT 86161 | not published | not published | $12.00 – $31.44 | 6 |
| Cacna1a gen detc abnor allel CPT 81184 | not published | not published | $137.00 – $358.94 | 6 |
| Cacna1a gene full gene seq CPT 81185 | not published | not published | $846.27 – $2,217.23 | 6 |
| Cacna1a gen known famil vrnt CPT 81186 | not published | not published | $185.20 – $485.22 | 6 |
| Calcitonin stimul panel CPT 80410 | not published | not published | $80.37 – $210.57 | 6 |
| Calcium 24 hour urine CPT 82340 | not published | not published | $6.03 – $15.80 | 6 |
| Calcium infusion test CPT 82331 | not published | not published | $13.34 – $34.95 | 6 |
| Calcium ionized CPT 82330 | not published | not published | $13.68 – $35.84 | 6 |
| Calcium total CPT 82310 | $166.47 | $166.47 | $5.16 – $13.52 | 6 |
| Calculi urinary-sendout CPT 82360 | not published | not published | $12.87 – $33.72 | 6 |
| Calculus analysis qual CPT 82355 | not published | not published | $11.58 – $30.34 | 6 |
| Calprotectin fecal CPT 83993 | not published | not published | $19.63 – $51.43 | 6 |
| Camisole mastectomy wht/l post-surg gental touch HCPCS L8015 | not published | not published | $74.19 – $194.38 | 6 |
| Campylobacter antibody CPT 86625 | not published | not published | $13.12 – $34.37 | 6 |
| Candida dna CPT 87480 | not published | not published | $20.05 – $52.53 | 6 |
| Candida dna quant CPT 87482 | not published | not published | $55.74 – $146.04 | 6 |
| Candida skin test CPT 86485 | not published | not published | $26.20 – $26.20 | 1 |
| Cannabinoids synthetic 1-3 CPT 80350 | not published | not published | $0.02 – $0.02 | 1 |
| Cannabinoids synthetic 4-6 CPT 80351 | not published | not published | $0.02 – $0.02 | 1 |
| Cannabinoid synthetic 7/more CPT 80352 | not published | not published | $0.02 – $0.02 | 1 |
| Cannula nasal HCPCS A4615 | not published | not published | $1.04 – $2.72 | 6 |
| Carbamazepine free CPT 80157 | not published | not published | $13.25 – $34.72 | 6 |
| Carbamazepine free -sendout CPT 80161 | not published | not published | $18.64 – $48.84 | 6 |
| Carbamazepine total therapeutic drug level CPT 80156 | $483.56 | $483.56 | $14.57 – $38.17 | 6 |
| Carbohydrate deficient transf - sendout CPT 82373 | not published | not published | $18.06 – $47.32 | 6 |
| Carbohydrate urine - sendout CPT 84377 | not published | not published | $5.50 – $14.41 | 6 |
| Carbon dioxide CPT 82374 | not published | not published | $4.88 – $12.79 | 6 |
| Carbon graphite lamination HCPCS L2755 | not published | not published | $161.48 – $423.08 | 6 |
| Carboxyhemoglobin quantitative CPT 82375 | not published | not published | $12.32 – $32.28 | 6 |
| Carcinoembryonic ag (cea) CPT 82378 | not published | not published | $18.96 – $49.68 | 6 |
| Cardiac MRI w/stress img CPT 75559 | not published | not published | $761.00 – $761.00 | 1 |
| Cardiac perf planar mult/ef/wm CPT 78454 | not published | not published | $584.81 – $584.81 | 1 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | not published | not published | $392.29 – $392.29 | 1 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | not published | not published | $434.30 – $434.30 | 1 |
| Cardiac shunt imaging CPT 78428 | not published | not published | $239.59 – $239.59 | 1 |
| Cardiolipin antibody iga CPT 86147 | not published | not published | $25.45 – $66.68 | 6 |
| Cardiology hrt trnspl mrna CPT 81595 | not published | not published | $3,240.00 – $8,488.80 | 6 |
| Card MRI veloc flow mapping CPT 75565 | not published | not published | $761.00 – $761.00 | 1 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | not published | not published | $52.76 – $138.23 | 6 |
| Caregiver training strategies&tq ea addl 15 min CPT 97551 | not published | not published | $26.10 – $68.38 | 6 |
| Car ion chnnlpath inc 10 gns CPT 81413 | not published | not published | $584.90 – $1,532.44 | 6 |
| Car ion chnnlpath inc 2 gns CPT 81414 | not published | not published | $584.90 – $1,532.44 | 6 |
| Carotene CPT 82380 | not published | not published | $9.22 – $24.16 | 6 |
| Cassette provox xtraflow hme HCPCS A7507 | not published | not published | $3.56 – $9.33 | 6 |
| Cast sup lng arm splint fbrg HCPCS Q4018 | not published | not published | $18.48 – $48.42 | 6 |
| Cast sup lng arm splint plst HCPCS Q4017 | not published | not published | $11.60 – $30.39 | 6 |
| Cast sup lng arm splnt ped f HCPCS Q4020 | not published | not published | $9.28 – $24.31 | 6 |
| Cast sup lng arm splnt ped p HCPCS Q4019 | not published | not published | $5.80 – $15.20 | 6 |
| Cast sup lng leg ped fbrgls HCPCS Q4032 | not published | not published | $48.46 – $126.97 | 6 |
| Cast sup lng leg ped plaster HCPCS Q4031 | not published | not published | $18.39 – $48.18 | 6 |
| Cast sup lng leg splnt fbrgl HCPCS Q4042 | not published | not published | $43.49 – $113.94 | 6 |
| Cast sup lng leg splnt ped f HCPCS Q4044 | not published | not published | $21.78 – $57.06 | 6 |
| Cast sup lng leg splnt ped p HCPCS Q4043 | not published | not published | $12.74 – $33.38 | 6 |
| Cast sup long arm adult fbrg HCPCS Q4006 | not published | not published | $37.20 – $97.46 | 6 |
| Cast sup long arm adult plst HCPCS Q4005 | not published | not published | $16.51 – $43.26 | 6 |
| Cast sup long arm ped fbrgls HCPCS Q4008 | not published | not published | $18.59 – $48.71 | 6 |
| Cast sup long arm ped plster HCPCS Q4007 | not published | not published | $8.25 – $21.62 | 6 |
| Cast sup long leg fiberglass HCPCS Q4030 | not published | not published | $96.92 – $253.93 | 6 |
| Cast sup shrt leg ped fbrgls HCPCS Q4040 | not published | not published | $26.23 – $68.72 | 6 |
| Cast sup shrt leg ped plster HCPCS Q4039 | not published | not published | $10.50 – $27.51 | 6 |
| Cast sup shrt leg plaster HCPCS Q4037 | not published | not published | $20.92 – $54.81 | 6 |
| Cast sup sht arm adult fbrgl HCPCS Q4010 | not published | not published | $24.80 – $64.98 | 6 |
| Cast sup sht arm adult plstr HCPCS Q4009 | not published | not published | $11.03 – $28.90 | 6 |
| Cast sup sht arm ped fbrglas HCPCS Q4012 | not published | not published | $12.43 – $32.57 | 6 |
| Cast sup sht arm ped plaster HCPCS Q4011 | not published | not published | $5.50 – $14.41 | 6 |
| Cast sup sht arm splint fbrg HCPCS Q4022 | not published | not published | $15.50 – $40.61 | 6 |
| Cast sup sht arm splint plst HCPCS Q4021 | not published | not published | $8.59 – $22.51 | 6 |
| Cast sup sht arm splnt ped f HCPCS Q4024 | not published | not published | $7.76 – $20.33 | 6 |
| Cast sup sht arm splnt ped p HCPCS Q4023 | not published | not published | $4.31 – $11.29 | 6 |
| Cast sup sht leg splnt fbrgl HCPCS Q4046 | not published | not published | $23.79 – $62.33 | 6 |
| Cast sup sht leg splnt ped f HCPCS Q4048 | not published | not published | $11.90 – $31.18 | 6 |
| Cast sup sht leg splnt ped p HCPCS Q4047 | not published | not published | $7.36 – $19.28 | 6 |
| Cast sup sht leg splnt plstr HCPCS Q4045 | not published | not published | $14.79 – $38.75 | 6 |
| Catecholamines,fractionated, urine CPT 82382 | not published | not published | $27.30 – $71.53 | 6 |
| Cath council tip 16fr 5cc HCPCS A4344 | not published | not published | $19.39 – $50.80 | 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.