BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE
1650 W. College, Grapevine, TX · Baylor Scott & White Health · · NPI 1073511762
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 |
|---|---|---|---|---|
| Diabetes training group per 30 min g0109 HCPCS G0136 | $32.81 | $54.68 | $8.20 – $81.06 | 21 |
| Diab manage trn ind/group HCPCS G0109 | $59.36 | $98.94 | $14.84 – $84.10 | 18 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,888.85 – $14,293.73 | 17 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $358.84 | $598.07 | $89.71 – $448.55 | 24 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $117.94 | $196.56 | $29.48 – $188.12 | 18 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $75.93 | $126.55 | $18.98 – $188.12 | 18 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $325.51 | $542.52 | $56.20 – $490.70 | 24 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $450.28 | $750.46 | $68.14 – $562.85 | 24 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $340.20 | $567.00 | $85.05 – $481.95 | 18 |
| Diagnostic Mammogram (one breast) CPT 77065 | $272.16 | $453.60 | $68.04 – $385.56 | 18 |
| Diagnostic radio unlisted proc CPT 76499 | $2,679.11 | $4,465.19 | $83.19 – $1,197.31 | 24 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $10,842.14 | $18,070.23 | $2,710.53 – $15,359.70 | 18 |
| Dialysis one evaluation CPT 90945 | $1,775.84 | $2,959.74 | $398.86 – $2,219.80 | 24 |
| Dialysis repeated eval CPT 90947 | $1,087.50 | $1,812.50 | $271.88 – $1,540.62 | 18 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $149.04 | $248.40 | $0.08 – $165.24 | 19 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $135.30 | $225.50 | $9.36 – $125.53 | 19 |
| Dicyclomine injection HCPCS J0500 | $229.36 | $382.26 | $0.18 – $10.30 | 19 |
| Diffusing capacity CPT 94729 | $395.37 | $658.95 | $98.84 – $560.11 | 18 |
| Digital analysis of eeg CPT 95957 | $744.70 | $1,241.17 | $186.18 – $1,054.99 | 18 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $371.87 | $619.79 | $4.95 – $28.05 | 19 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $8,613.00 | $14,355.00 | $2,153.25 – $11,109.03 | 24 |
| Digoxin total therapeutic drug level CPT 80162 | $140.84 | $234.74 | $10.00 – $176.06 | 24 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $357.05 | $595.08 | $51.76 – $293.29 | 19 |
| Dilate biliary duct/ampulla CPT 47542 | $1,866.73 | $3,111.21 | $466.68 – $2,644.53 | 18 |
| Dilate esophagus CPT 43453 | $1,641.50 | $2,735.83 | $564.97 – $4,713.77 | 22 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,484.17 | $2,473.61 | $334.95 – $3,693.00 | 22 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $4,322.56 | $7,204.26 | $599.31 – $6,123.62 | 16 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $1,670.90 | $2,784.83 | $299.65 – $4,063.00 | 16 |
| Dilate ic vasospasm init CPT 61640 | $9,260.60 | $15,434.33 | $853.30 – $13,119.18 | 16 |
| Dilate urethra stricture CPT 53600 | $514.79 | $857.98 | $34.88 – $643.49 | 24 |
| Dilate urethra stricture CPT 53605 | $3,745.07 | $6,241.78 | $1,142.90 – $8,636.11 | 24 |
| Dilation/female urethra/initial 53660 CPT 53660 | $204.60 | $341.00 | $39.59 – $386.96 | 24 |
| Dilation of cervical canal 57800 CPT 57800 | $4,715.67 | $7,859.45 | $39.86 – $7,744.80 | 24 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,386.89 | $2,311.48 | $92.46 – $1,733.61 | 24 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,277.43 | $2,129.05 | $18.65 – $99.46 | 17 |
| Dilat xst trc ndurlgc px CPT 50436 | $7,694.84 | $12,824.74 | $1,142.90 – $9,618.56 | 24 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $1,142.90 – $8,636.11 | 16 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $138.24 | $230.40 | $0.04 – $195.84 | 19 |
| Dimecaprol injection HCPCS J0470 | $457.03 | $761.72 | $114.26 – $647.46 | 19 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,258.20 | $2,097.00 | $314.55 – $1,610.31 | 24 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $10.84 | $18.06 | $0.76 – $5.98 | 19 |
| Disability dlco CPT 94727 | $356.06 | $593.43 | $89.01 – $467.11 | 24 |
| Disaccharidases CPT 82657 | $338.63 | $564.38 | $10.00 – $87.19 | 24 |
| Discography cerv/thor spine CPT 72285 | $2,050.91 | $3,418.19 | $132.31 – $4,783.04 | 24 |
| Dise eval slp do brth flx dx CPT 42975 | $244.89 | $408.15 | $68.14 – $4,204.56 | 22 |
| Dissolve clot heart vessel CPT 92975 | $2,604.47 | $4,340.79 | $651.12 – $3,689.67 | 18 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,954.22 – $14,507.25 | 16 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $1,380.35 | $2,300.59 | $345.09 – $7,038.00 | 16 |
| Dmpk gene detc abnor allele CPT 81234 | $7,487.95 | $12,479.92 | $35.00 – $1,453.12 | 24 |
| Dna antibody native/double stranded CPT 86225 | $141.17 | $235.29 | $10.00 – $32.98 | 24 |
| Dna gardnerella CPT 87510 | $61.20 | $102.00 | $10.00 – $76.50 | 24 |
| Dna probe chlamydia CPT 87490 | $114.48 | $190.80 | $10.00 – $143.10 | 24 |
| Dna probe gc CPT 87590 | $101.97 | $169.95 | $10.00 – $127.46 | 24 |
| Dna trichomonas CPT 87660 | $63.00 | $105.00 | $10.00 – $78.75 | 24 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $146.40 | $244.00 | $6.85 – $38.79 | 19 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,290.00 | $2,150.00 | $0.61 – $309.41 | 19 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $76.20 | $127.00 | $0.88 – $19.87 | 19 |
| Doppler echo complete CPT 93320 | $938.80 | $1,564.66 | $109.54 – $1,329.96 | 18 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $3,563.60 | $5,939.34 | $890.90 – $5,048.44 | 16 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $881.26 | $1,468.77 | $129.98 – $1,101.58 | 24 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $608.33 | $1,013.88 | $127.18 – $760.41 | 24 |
| Dornase alfa non-comp unit HCPCS J7639 | $350.67 | $584.45 | $50.93 – $496.78 | 19 |
| Dornhoffer fixed part w/window HCPCS L8614 | $50,985.00 | $84,975.00 | $82.37 – $439.30 | 17 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $20,843.62 | $34,739.36 | $226.76 – $26,054.52 | 24 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $740.18 | $1,233.64 | $3.00 – $292.65 | 19 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,278.13 | $3,796.88 | $68.27 – $1,556.25 | 24 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $97.79 | $162.98 | $0.10 – $138.53 | 19 |
| Dpyd gene common variants CPT 81232 | $851.19 | $1,418.65 | $35.00 – $515.62 | 24 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $866.92 | $1,444.87 | $111.00 – $1,742.94 | 24 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $3,325.73 | $5,542.89 | $147.56 – $4,157.17 | 24 |
| Drainage external ear complex 69005 CPT 69005 | $3,541.97 | $5,903.29 | $113.23 – $4,427.47 | 24 |
| Drainage external ear simple 69000 CPT 69000 | $984.69 | $1,641.15 | $107.14 – $1,742.94 | 24 |
| Drainage mouth roof lesion CPT 42000 | $641.66 | $1,069.44 | $87.58 – $802.08 | 24 |
| Drainage of arm bursa 23931 CPT 23931 | $3,155.93 | $5,259.88 | $486.45 – $4,016.35 | 24 |
| Drainage of bone lesion CPT 26992 | not published | not published | $1,699.28 – $7,078.51 | 15 |
| Drainage of eye CPT 65800 | $1,824.02 | $3,040.03 | $849.94 – $5,772.91 | 24 |
| Drainage of kidney lesion CPT 50390 | $1,719.93 | $2,866.55 | $257.60 – $2,149.91 | 24 |
| Drainage of mouth lesion CPT 41005 | $1,576.20 | $2,627.00 | $87.58 – $1,970.25 | 24 |
| Drainage of mouth lesion CPT 41007 | $3,021.62 | $5,036.04 | $420.64 – $3,777.93 | 24 |
| Drainage of mouth lesion CPT 41008 | $2,295.40 | $3,825.66 | $886.62 – $7,975.81 | 24 |
| Drainage of mouth lesion CPT 41009 | $583.82 | $973.04 | $187.22 – $1,363.00 | 24 |
| Drainage of mouth lesion CPT 41016 | $6,781.90 | $11,303.16 | $1,804.00 – $14,507.25 | 24 |
| Drainage of mouth lesion CPT 41017 | $2,412.60 | $4,021.00 | $886.62 – $7,975.81 | 24 |
| Drainage of mouth lesion CPT 41018 | $1,304.89 | $2,174.82 | $420.64 – $3,777.93 | 24 |
| Drainage of nose lesion int 30000 CPT 30000 | $901.48 | $1,502.46 | $87.58 – $1,126.85 | 24 |
| Drainage of nose lesion sept 30020 CPT 30020 | $781.44 | $1,302.40 | $180.23 – $1,363.00 | 24 |
| Drainage of pelvis lesion 26990 CPT 26990 | $2,668.63 | $4,447.71 | $1,088.27 – $8,018.48 | 22 |
| Drainage of prostate abscess CPT 55720 | $2,260.09 | $3,766.82 | $1,142.90 – $8,636.11 | 22 |
| Drainage of rectal abscess CPT 45005 | $2,299.90 | $3,833.16 | $429.26 – $2,923.34 | 24 |
| Drainage of urethra abscess 53060 CPT 53060 | $2,167.36 | $3,612.26 | $541.84 – $5,045.72 | 24 |
| Drain bladder by trocar/cath CPT 51101 | $1,078.00 | $1,796.66 | $98.83 – $2,590.07 | 24 |
| Drain blood from under nail 11740 CPT 11740 | $190.33 | $317.21 | $47.58 – $316.45 | 24 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $2,693.50 | $4,489.17 | $486.45 – $4,016.35 | 24 |
| Drain cath image guided visceral pq CPT 49405 | $2,839.24 | $4,732.07 | $709.81 – $4,016.35 | 24 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,192.95 | $1,988.25 | $262.86 – $1,713.14 | 24 |
| Drain finger abscess;simple 26010 CPT 26010 | $522.25 | $870.42 | $74.34 – $652.82 | 24 |
| Drain lower leg lesion 27603 CPT 27603 | $4,588.15 | $7,646.92 | $815.20 – $7,039.11 | 24 |
| Drain neck/chest lesion 21501 CPT 21501 | $2,727.07 | $4,545.12 | $815.20 – $7,039.11 | 24 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $815.20 – $7,039.11 | 17 |
| Drain thigh/knee lesion 27301 CPT 27301 | $3,606.86 | $6,011.43 | $815.20 – $7,039.11 | 24 |
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.