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 |
|---|---|---|---|---|
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $560.63 | $934.38 | $85.42 – $700.78 | 24 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $473.02 | $788.36 | $44.31 – $591.27 | 24 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $597.49 | $995.82 | $171.51 – $987.79 | 24 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $306.77 | $511.29 | $24.59 – $269.22 | 23 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $1,911.50 | $3,185.84 | $477.88 – $2,707.96 | 18 |
| Drng of eyelid abscess 67700 CPT 67700 | $1,770.43 | $2,950.71 | $108.29 – $2,213.03 | 24 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,475.83 | $4,126.38 | $486.45 – $4,016.35 | 24 |
| Drng of hydrocele 55000 CPT 55000 | $732.01 | $1,220.02 | $54.26 – $1,742.94 | 24 |
| Drng of mouth lesion 40801 CPT 40801 | $1,746.68 | $2,911.14 | $187.22 – $2,183.36 | 24 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | $1,614.45 | $2,690.75 | $429.26 – $3,693.00 | 22 |
| Drng of salivary cyst 42409 CPT 42409 | $2,635.12 | $4,391.86 | $886.62 – $7,975.81 | 24 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,997.89 | $3,329.81 | $486.45 – $4,016.35 | 24 |
| Drng peritoneal abscess open 49020 CPT 49020 | $1,600.76 | $2,667.94 | $400.19 – $7,038.00 | 16 |
| Drng salivary gland simple 42300 CPT 42300 | $3,113.71 | $5,189.52 | $420.64 – $3,892.14 | 24 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $34.85 | $58.08 | $4.36 – $24.68 | 19 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $2,275.80 | $3,793.00 | $29.67 – $158.23 | 17 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $321.43 | $535.72 | $9.42 – $269.22 | 23 |
| Drug admin & hemodynmic meas CPT 93463 | $1,667.83 | $2,779.72 | $312.00 – $16,180.00 | 17 |
| Drug assay caffeine CPT 80155 | $97.19 | $161.99 | $10.00 – $121.49 | 24 |
| Drug assay posaconazole CPT 80187 | $96.75 | $161.25 | $10.00 – $120.11 | 24 |
| Drug assay rufinamide CPT 80210 | $100.32 | $167.20 | $10.00 – $94.14 | 24 |
| Drug assay vedolizumab CPT 80280 | $365.25 | $608.75 | $10.00 – $92.57 | 24 |
| Drug assay voriconazole CPT 80285 | $96.75 | $161.25 | $10.00 – $120.94 | 24 |
| Drug asy hydroxychloroquine CPT 80220 | $345.00 | $575.00 | $10.00 – $44.74 | 24 |
| Drug of abuse screen urine CPT 80305 | $106.41 | $177.35 | $10.00 – $133.01 | 24 |
| Drug screening tapentadol CPT 80372 | $183.77 | $306.28 | $3.92 – $10.62 | 17 |
| Drug test def 15-21 classes HCPCS G0482 | $203.97 | $339.95 | $10.00 – $476.98 | 24 |
| Drug test def 1-7 classes HCPCS G0480 | $346.50 | $577.50 | $10.00 – $274.63 | 24 |
| Drug test def 22+ classes HCPCS G0483 | $479.60 | $799.33 | $10.00 – $599.50 | 24 |
| Drug test prsmv instrmnt CPT 80306 | $182.16 | $303.60 | $10.00 – $227.70 | 24 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $1,041.00 | $1,735.00 | $3.92 – $149.14 | 24 |
| Drvvt confirm - quest CPT 85597 | $131.79 | $219.65 | $10.00 – $164.74 | 24 |
| Dry needling (97799) CPT 97799 | $132.19 | $220.32 | $32.34 – $183.26 | 19 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $2,600.42 | $4,334.04 | $538.55 – $4,783.04 | 24 |
| Ductogram sgl duct CPT 77053 | $295.75 | $492.92 | $54.13 – $607.02 | 24 |
| Duplex scan bilateral study 93985 CPT 93985 | $403.69 | $672.82 | $100.92 – $607.02 | 24 |
| Duplex scan unilateral study 93986 CPT 93986 | $181.18 | $301.96 | $45.29 – $272.35 | 24 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $499.72 | $832.87 | $99.94 – $624.65 | 24 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $865.58 | $1,442.64 | $156.46 – $1,081.98 | 24 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,005.61 | $1,676.01 | $197.14 – $1,257.01 | 24 |
| Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm HCPCS Q4432 | $23,767.23 | $39,612.05 | $6.19 – $269.22 | 23 |
| Dxa bone density axl vrt fx CPT 77085 | $365.14 | $608.57 | $53.46 – $456.43 | 24 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $525.71 – $4,204.56 | 17 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $525.71 – $4,204.56 | 17 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $525.71 – $4,204.56 | 17 |
| Dx gastr intub w/asp spec CPT 43754 | $310.25 | $517.08 | $77.56 – $777.56 | 24 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | $558.11 | $930.18 | $139.53 – $790.65 | 18 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | $558.11 | $930.18 | $139.53 – $790.65 | 18 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | $558.11 | $930.18 | $139.53 – $790.65 | 18 |
| Dx laryngoscopy w/oper scope CPT 31526 | $1,867.86 | $3,113.10 | $525.71 – $4,204.56 | 24 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | $558.11 | $930.18 | $139.53 – $790.65 | 18 |
| Dynamic fine wire emg CPT 96003 | $374.29 | $623.82 | $93.57 – $777.56 | 19 |
| Dynamic surface emg CPT 96002 | $711.79 | $1,186.32 | $69.69 – $889.74 | 24 |
| Ear and throat examination CPT 92502 | not published | not published | $515.55 – $1,363.00 | 15 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $94.96 – $7,038.00 | 16 |
| Ear cartilage graft CPT 21235 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Ear irrigation 69209 CPT 69209 | $215.33 | $358.89 | $53.83 – $269.17 | 24 |
| Ecallantide injection HCPCS J1290 | $29,917.98 | $49,863.30 | $540.47 – $37,397.47 | 24 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $145.26 | $242.10 | $36.31 – $181.57 | 24 |
| Ecg external < 48 hours recording CPT 93225 | $598.24 | $997.07 | $127.18 – $747.80 | 24 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $763.92 | $1,273.20 | $56.39 – $954.90 | 24 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $520.72 | $867.86 | $35.70 – $650.89 | 24 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $520.72 | $867.86 | $35.70 – $650.89 | 24 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,589.56 | $4,315.93 | $416.02 – $3,236.95 | 24 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $838.44 | $1,397.40 | $97.56 – $1,048.05 | 24 |
| Echocardiography doppler color flow mapping CPT 93325 | $702.59 | $1,170.98 | $68.58 – $995.33 | 18 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $572.29 | $953.82 | $60.85 – $810.75 | 18 |
| Echo exam of fetal heart CPT 76825 | $855.38 | $1,425.64 | $262.29 – $1,366.64 | 24 |
| Echo exam of fetal heart CPT 76826 | $378.00 | $630.00 | $157.04 – $607.02 | 24 |
| Echo exam of fetal heart CPT 76827 | $431.41 | $719.01 | $70.16 – $539.26 | 24 |
| Echo exam of fetal heart CPT 76828 | $318.34 | $530.57 | $48.79 – $397.93 | 24 |
| Echo exam uterus 76831- CPT 76831 | $409.50 | $682.50 | $116.61 – $607.02 | 24 |
| Echograp trans r pros study CPT 76873 | $459.40 | $765.66 | $99.94 – $574.25 | 24 |
| Echo guidance radiotherapy CPT 76965 | $627.20 | $1,045.34 | $50.46 – $888.54 | 18 |
| Echo guide cardiocentesis CPT 76930 | $364.99 | $608.31 | $91.25 – $517.06 | 18 |
| Echo guide for amniocentesis CPT 76946 | $304.49 | $507.49 | $26.66 – $431.37 | 18 |
| Echo guide for artery repair CPT 76936 | $687.35 | $1,145.58 | $206.40 – $859.18 | 24 |
| Echo guide for heart biopsy CPT 76932 | $455.26 | $758.77 | $67.76 – $644.95 | 18 |
| Echo guide for transfusion CPT 76941 | $256.36 | $427.26 | $64.09 – $363.17 | 18 |
| Echo stress CPT 93350 | $2,144.62 | $3,574.37 | $182.78 – $2,680.78 | 24 |
| Echo tee guidance CPT 93355 | $3,210.68 | $5,351.13 | $219.86 – $4,548.46 | 18 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,798.47 | $4,664.12 | $232.89 – $3,498.09 | 24 |
| Echo transesophageal CPT 93313 | $593.07 | $988.45 | $11.03 – $1,366.64 | 24 |
| Echo transesophageal CPT 93315 | $2,281.68 | $3,802.80 | $359.51 – $2,167.62 | 24 |
| Echo transesophageal intraop CPT 93318 | $2,734.24 | $4,557.07 | $257.31 – $3,417.80 | 24 |
| Echo transthoracic CPT 93303 | $2,646.00 | $4,410.00 | $215.51 – $3,307.50 | 24 |
| Echo transthoracic CPT 93304 | $1,413.63 | $2,356.05 | $151.70 – $1,767.04 | 24 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,806.55 | $3,010.92 | $135.33 – $2,258.19 | 24 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | $10,882.70 | $18,137.84 | $409.28 – $7,038.00 | 16 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $10,882.70 | $18,137.84 | $420.86 – $7,038.00 | 16 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | $4,320.83 | $7,201.38 | $607.23 – $7,038.00 | 16 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | $4,536.87 | $7,561.45 | $547.54 – $6,427.23 | 17 |
| Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 | $1,301.39 | $2,168.99 | $325.35 – $7,038.00 | 16 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | $1,313.68 | $2,189.46 | $328.42 – $7,038.00 | 16 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | $9,536.97 | $15,894.95 | $757.07 – $13,510.71 | 17 |
| Ecmo/ecls remove cent cannula 6yrs&older 33986 CPT 33986 | $1,394.09 | $2,323.49 | $348.52 – $7,038.00 | 16 |
| Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 | $1,880.46 | $3,134.10 | $470.12 – $7,038.00 | 16 |
| Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 | $1,898.66 | $3,164.44 | $420.86 – $7,038.00 | 16 |
| Ecmo/ecls repos cent cnula 6yrs&older 33964 CPT 33964 | $1,048.74 | $1,747.90 | $262.19 – $7,038.00 | 16 |
| Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 | $953.40 | $1,589.00 | $238.35 – $7,038.00 | 16 |
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.