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 |
|---|---|---|---|---|
| #creutz-prot.,western blot CPT 84182 | not published | not published | $29.21 – $76.53 | 6 |
| Crh stimulation panel CPT 80412 | not published | not published | $801.62 – $2,100.24 | 6 |
| Crutches underarm other than wood adjustable or e0114 HCPCS E0114 | not published | not published | $58.68 – $153.74 | 6 |
| Cryofibrinogen qualitative - sendout CPT 82585 | not published | not published | $14.14 – $37.05 | 6 |
| Cryoprecipitate each unit HCPCS P9012 | not published | not published | $16.28 – $16.28 | 1 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $826.93 – $826.93 | 1 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $877.34 – $877.34 | 1 |
| Cryopreservation sperm CPT 89259 | not published | not published | $417.60 – $417.60 | 1 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $225.36 – $225.36 | 1 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $14.41 – $37.75 | 6 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $11.98 – $31.39 | 6 |
| Crystal identification light microscopy CPT 89060 | not published | not published | $7.33 – $19.20 | 6 |
| Csf leakage imaging CPT 78650 | not published | not published | $400.49 – $400.49 | 1 |
| Csf ventriculography CPT 78635 | not published | not published | $487.83 – $487.83 | 1 |
| Cstb gene detc abnor allele CPT 81188 | not published | not published | $137.00 – $358.94 | 6 |
| Cstb gene full gene sequence CPT 81189 | not published | not published | $274.83 – $720.05 | 6 |
| Cstb gene known famil vrnt CPT 81190 | not published | not published | $185.20 – $485.22 | 6 |
| CT 3d report other modality w/workstation CPT 76377 | not published | not published | $584.00 – $584.00 | 1 |
| Cta abdomen without & /or w/contrast CPT 74175 | not published | not published | $584.00 – $584.00 | 1 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | not published | not published | $584.00 – $584.00 | 1 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | not published | not published | $382.18 – $382.18 | 1 |
| Cta neck without &/or w/contrast CPT 70498 | not published | not published | $584.00 – $584.00 | 1 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | not published | not published | $584.00 – $584.00 | 1 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | not published | not published | $584.00 – $584.00 | 1 |
| CT Angiogram of the Head CPT 70496 | not published | not published | $584.00 – $584.00 | 1 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $584.00 – $584.00 | 1 |
| CT angio pelvis CPT 72191 | not published | not published | $584.00 – $584.00 | 1 |
| Cta upper extremity w &/or without contrast left CPT 73206 | not published | not published | $584.00 – $584.00 | 1 |
| CT bone density axial CPT 77078 | not published | not published | $584.00 – $584.00 | 1 |
| CT cerebral perf w cont & prcssng CPT 70473 | not published | not published | $584.00 – $584.00 | 1 |
| CT colonography dx CPT 74261 | not published | not published | $584.00 – $584.00 | 1 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $584.00 – $584.00 | 1 |
| CT colonography screening CPT 74263 | not published | not published | $584.00 – $584.00 | 1 |
| CT guidance for needle placement CPT 77012 | not published | not published | $584.00 – $584.00 | 1 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | not published | not published | $584.00 – $584.00 | 1 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $584.00 – $584.00 | 1 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | not published | not published | $584.00 – $584.00 | 1 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $584.00 – $584.00 | 1 |
| CT hrt w/3d image CPT 75572 | not published | not published | $584.00 – $584.00 | 1 |
| CT limited or localized follow-up study CPT 76380 | not published | not published | $584.00 – $584.00 | 1 |
| CT lower extremity w/contrast (both sides) CPT 73701 | not published | not published | $584.00 – $584.00 | 1 |
| CT lower extremity without contrast (both sides) CPT 73700 | not published | not published | $584.00 – $584.00 | 1 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $2,358.12 – $6,178.27 | 6 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $2,540.31 – $6,655.61 | 6 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $90.90 – $238.16 | 6 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $2,536.39 – $6,645.34 | 6 |
| CT lwr extremity w/o&w/dye CPT 73702 | not published | not published | $584.00 – $584.00 | 1 |
| CT neck soft tissue w/contrast CPT 70491 | not published | not published | $584.00 – $584.00 | 1 |
| CT neck soft tissue without contrast CPT 70490 | not published | not published | $584.00 – $584.00 | 1 |
| CT neck soft tissue without & w/contrast CPT 70492 | not published | not published | $584.00 – $584.00 | 1 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | not published | not published | $584.00 – $584.00 | 1 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | not published | not published | $584.00 – $584.00 | 1 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | not published | not published | $584.00 – $584.00 | 1 |
| CT scan for localization CPT 77011 | not published | not published | $584.00 – $584.00 | 1 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | not published | not published | $584.00 – $584.00 | 1 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | not published | not published | $584.00 – $584.00 | 1 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | not published | not published | $584.00 – $584.00 | 1 |
| CT thoracic spine w/contrast CPT 72129 | not published | not published | $584.00 – $584.00 | 1 |
| CT thoracic spine without contrast CPT 72128 | not published | not published | $584.00 – $584.00 | 1 |
| CT thorax low dose for lung screening without contrast CPT 71271 | not published | not published | $584.00 – $584.00 | 1 |
| CT t-spine w /wo contrast CPT 72130 | not published | not published | $584.00 – $584.00 | 1 |
| CT upper extremity w/contrast (both sides) CPT 73201 | not published | not published | $584.00 – $584.00 | 1 |
| CT upper extremity without contrast (both sides) CPT 73200 | not published | not published | $584.00 – $584.00 | 1 |
| CT uppr extremity w/o&w/dye CPT 73202 | not published | not published | $584.00 – $584.00 | 1 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $1,602.37 – $4,198.21 | 6 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $1,382.92 – $1,382.92 | 1 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $1,438.46 – $1,438.46 | 1 |
| Culture aerobic additional method definitive id each CPT 87077 | not published | not published | $8.08 – $21.17 | 6 |
| Culture afb any source CPT 87116 | not published | not published | $10.80 – $28.30 | 6 |
| Culture anaerobic additional method definitive id each CPT 87076 | not published | not published | $8.08 – $21.17 | 6 |
| Culture anaerobic except blood CPT 87075 | not published | not published | $9.47 – $24.81 | 6 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $9.66 – $25.31 | 6 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $24.38 – $24.38 | 1 |
| Culture bact stool aero addl path ea CPT 87046 | not published | not published | $9.44 – $24.73 | 6 |
| Culture body fluid CPT 87070 | $337.15 | $337.15 | $8.62 – $22.58 | 6 |
| Culture fungi definitive id mold CPT 87107 | not published | not published | $10.32 – $27.04 | 6 |
| Culture fungi definitive id yeast CPT 87106 | $108.75 | $108.75 | $10.32 – $27.04 | 6 |
| Culture fungi other (except blood) CPT 87102 | not published | not published | $8.41 – $22.03 | 6 |
| Culture fungi skin/hair/nail CPT 87101 | not published | not published | $7.71 – $20.20 | 6 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $14.61 – $38.28 | 6 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $15.39 – $40.32 | 6 |
| Culture of specimen by kit CPT 87084 | not published | not published | $27.07 – $70.92 | 6 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $9.89 – $25.91 | 6 |
| Culture screening strep group a CPT 87081 | not published | not published | $6.63 – $17.37 | 6 |
| Culture type pulse field gel CPT 87152 | not published | not published | $7.74 – $20.28 | 6 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $20.28 | 6 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $12.52 – $32.80 | 6 |
| Culture typing immunologic CPT 87147 | not published | not published | $5.18 – $13.57 | 6 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $218.06 – $571.32 | 6 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $35.09 – $91.94 | 6 |
| Culture urine each isolate CPT 87088 | not published | not published | $8.09 – $21.20 | 6 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $51.25 | 6 |
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,628.34 – $4,266.25 | 6 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,628.34 – $4,266.25 | 6 |
| Custom glove for term device HCPCS L6895 | not published | not published | $683.61 – $1,791.06 | 6 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $1,172.40 – $3,071.69 | 6 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $656.17 – $1,719.17 | 6 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,515.21 – $3,969.85 | 6 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $1,149.30 – $3,011.17 | 6 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $14.32 – $37.52 | 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.