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 |
|---|---|---|---|---|
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $3,245.02 | $5,408.37 | $811.26 – $7,038.00 | 16 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | $2,667.85 | $4,446.41 | $666.96 – $7,038.00 | 16 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $8,412.85 | $14,021.41 | $2,036.70 – $11,918.20 | 18 |
| Evasc rpr ilio-iliac rpt CPT 34708 | $8,996.13 | $14,993.55 | $2,249.03 – $12,744.52 | 16 |
| Evasc st rpr thrc/aa x crsg CPT 33895 | $22,386.00 | $37,310.00 | $1,380.14 – $31,713.50 | 16 |
| Evoked auditory tst complete CPT 92588 | $374.62 | $624.37 | $14.40 – $807.28 | 24 |
| Evoked oa emissions ltd CPT 92587 | $234.32 | $390.54 | $11.05 – $777.56 | 24 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $359.72 | $599.53 | $74.74 – $509.60 | 18 |
| Evoked potentials upper limbs CPT 95925 | $908.54 | $1,514.23 | $206.40 – $1,135.67 | 24 |
| Evoked potential visual not glaucoma CPT 95930 | $1,041.27 | $1,735.45 | $154.88 – $1,301.59 | 24 |
| Exam plvc w/anes othr thn lcl CPT 57410 | $1,069.67 | $1,782.78 | $659.63 – $7,744.80 | 24 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc abdl tum deep < 5 cm CPT 22900 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc abdl tum deep 5 cm/> CPT 22901 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $1,063.52 – $7,744.80 | 17 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | not published | not published | $77.79 – $3,693.00 | 16 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $86.38 – $3,693.00 | 16 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $1,358.40 | $2,264.00 | $103.82 – $1,742.94 | 24 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $2,061.19 | $3,435.32 | $114.34 – $4,016.35 | 24 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | not published | not published | $86.66 – $3,693.00 | 16 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $104.38 – $4,016.35 | 16 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $707.65 | $1,179.41 | $89.14 – $987.79 | 24 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,466.01 | $2,443.35 | $105.20 – $1,832.51 | 24 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $2,776.62 – $7,039.11 | 16 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $152.26 – $4,016.35 | 16 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $486.45 – $10,795.00 | 16 |
| Exc forearm tum deep < 3 cm CPT 25076 | not published | not published | $486.45 – $6,093.00 | 17 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | not published | not published | $486.45 – $10,795.00 | 16 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exchange biliary drg cath CPT 47536 | $4,278.56 | $7,130.94 | $1,151.54 – $8,570.48 | 24 |
| Exchange blood transfusion newborn 36450 CPT 36450 | $485.65 | $809.42 | $164.30 – $1,075.39 | 24 |
| Exchange drainage catheter CPT 49423 | $2,256.80 | $3,761.34 | $564.97 – $4,713.77 | 24 |
| Exchange nephrostomy cath CPT 50435 | $2,628.13 | $4,380.22 | $652.80 – $5,045.72 | 24 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | not published | not published | $815.20 – $8,921.00 | 16 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | not published | not published | $815.20 – $10,795.00 | 16 |
| Excise anal ext tag/papilla CPT 46220 | not published | not published | $429.26 – $3,693.00 | 17 |
| Excise inferior turbinate CPT 30130 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $4,302.00 – $17,722.46 | 16 |
| Excise lesion testis CPT 54512 | not published | not published | $1,142.90 – $8,636.11 | 17 |
| Excise lip or cheek fold CPT 40819 | $1,969.57 | $3,282.61 | $420.64 – $3,777.93 | 24 |
| Excise mandible lesion CPT 21040 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $231.72 – $14,507.25 | 16 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Excise pharynx lesion CPT 42808 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Excise submaxillary gland CPT 42440 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $486.45 – $8,921.00 | 16 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $593.04 – $4,063.00 | 17 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $762.65 | $1,271.09 | $96.06 – $1,742.94 | 24 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $1,663.16 | $2,771.94 | $95.79 – $4,016.35 | 24 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | not published | not published | $96.62 – $3,693.00 | 16 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $3,858.66 | $6,431.10 | $486.45 – $4,823.32 | 24 |
| Excision breast lesion CPT 19125 | $3,694.96 | $6,158.26 | $963.66 – $9,442.65 | 24 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision graft extremity CPT 35903 | not published | not published | $3,018.24 – $7,896.23 | 16 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $147.84 – $7,975.81 | 16 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $939.93 – $6,955.62 | 17 |
| Excision of gum lesion CPT 41826 | not published | not published | $179.40 – $7,975.81 | 16 |
| Excision of neck cyst CPT 42815 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $709.01 – $4,517.58 | 17 |
| Excision of rectal stricture CPT 45150 | $1,157.12 | $1,928.54 | $429.26 – $2,923.34 | 24 |
| Excision of salivary cyst CPT 42408 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision of tongue lesion CPT 41112 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision of tongue lesion CPT 41114 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision of uvula CPT 42140 | not published | not published | $886.62 – $7,975.81 | 17 |
| Excision olecranon bursa CPT 24105 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $486.45 – $10,795.00 | 16 |
| Excis partial tal calc CPT 28120 | not published | not published | $1,088.27 – $8,921.00 | 17 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | not published | not published | $116.00 – $3,693.00 | 16 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | not published | not published | $138.98 – $3,693.00 | 16 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $984.27 | $1,640.45 | $112.95 – $4,016.35 | 24 |
| Exc malig tal <0.5cm 11600 CPT 11600 | not published | not published | $112.68 – $3,693.00 | 16 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $131.22 – $3,693.00 | 16 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc prtl bn phlnx toe CPT 28124 | $3,122.93 | $5,204.89 | $238.37 – $8,018.48 | 24 |
| Exc rect tum transanal full CPT 45172 | not published | not published | $939.93 – $10,795.00 | 16 |
| Exc rect tum transanal part CPT 45171 | not published | not published | $939.93 – $7,373.00 | 16 |
| Exc shoulder tum deep < 5 cm CPT 23076 | not published | not published | $815.20 – $7,039.11 | 17 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $815.20 – $10,795.00 | 16 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | not published | not published | $815.20 – $7,039.11 | 16 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $486.45 – $4,063.00 | 17 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | not published | not published | $815.20 – $10,795.00 | 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.