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 |
|---|---|---|---|---|
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $705.58 | $1,175.96 | $111.00 – $987.79 | 24 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $641.66 | $1,069.44 | $111.00 – $987.79 | 24 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $707.26 | $1,178.77 | $111.00 – $987.79 | 24 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $761.08 | $1,268.46 | $111.00 – $987.79 | 24 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $754.35 | $1,257.25 | $111.00 – $987.79 | 24 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $878.82 | $1,464.70 | $143.08 – $1,098.53 | 24 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $901.84 | $1,503.07 | $143.08 – $1,127.30 | 24 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $719.66 | $1,199.43 | $216.80 – $1,598.87 | 24 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $921.70 | $1,536.17 | $143.08 – $1,152.13 | 24 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $1,025.14 | $1,708.57 | $216.80 – $1,598.87 | 24 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $1,061.92 | $1,769.87 | $143.08 – $1,327.40 | 24 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $857.02 | $1,428.36 | $216.80 – $1,598.87 | 24 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $1,517.03 | $2,528.38 | $143.08 – $1,896.29 | 24 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $3,753.41 | $6,255.69 | $709.01 – $4,691.77 | 24 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $370.14 | $616.90 | $143.08 – $987.79 | 24 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $90.00 | $150.00 | $7.22 – $110.75 | 24 |
| Ghs mbp CPT 83873 | $140.57 | $234.28 | $10.00 – $175.71 | 24 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $240.00 | $400.00 | $60.00 – $340.00 | 18 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $154.86 | $258.10 | $38.72 – $281.03 | 18 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $170.15 | $283.58 | $42.54 – $247.84 | 18 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $107.42 | $179.03 | $26.85 – $152.18 | 18 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $107.42 | $179.03 | $26.85 – $201.36 | 18 |
| Ghs musc test done w/n test comp CPT 95886 | $352.97 | $588.29 | $88.24 – $500.05 | 18 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $277.25 | $462.08 | $69.31 – $392.77 | 18 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $312.74 | $521.23 | $78.18 – $443.05 | 18 |
| Ghs myocardial strain img spckl track CPT 93356 | $564.48 | $940.80 | $24.50 – $799.68 | 18 |
| Ghs nailbed repair/nail removal CPT 11760 | $1,010.84 | $1,684.74 | $105.20 – $1,598.87 | 24 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,445.51 | $2,409.18 | $340.77 – $2,257.97 | 24 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,232.23 | $2,053.71 | $262.86 – $1,713.14 | 24 |
| Ghs nerve block axillary nerve CPT 64417 | $1,125.57 | $1,875.95 | $340.77 – $2,257.97 | 24 |
| Ghs nerve block brachial plexus CPT 64415 | $1,789.51 | $2,982.52 | $340.77 – $2,257.97 | 24 |
| Ghs nerve block celiac plexus CPT 64530 | $2,215.57 | $3,692.62 | $340.77 – $2,769.47 | 24 |
| Ghs nerve block interscaline CPT 64510 | $1,526.09 | $2,543.49 | $340.77 – $2,257.97 | 24 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $2,079.21 | $3,465.35 | $340.77 – $2,599.01 | 24 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,922.03 | $3,203.39 | $73.64 – $2,402.54 | 24 |
| Ghs nerve block suprascapular CPT 64418 | $1,386.00 | $2,310.00 | $38.76 – $1,732.50 | 24 |
| Ghs ng placement w fluoro guidance CPT 43752 | $423.76 | $706.27 | $111.00 – $987.04 | 24 |
| Ghs o2 saturation CPT 82810 | $96.35 | $160.59 | $8.21 – $120.44 | 24 |
| Ghs o2 uptake rest & indirect CPT 94690 | $299.16 | $498.60 | $56.39 – $373.95 | 24 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $292.70 | $487.83 | $44.76 – $365.87 | 24 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,229.24 | $2,048.74 | $223.75 – $1,556.23 | 24 |
| Ghs opcc repair cvp w subq port CPT 36576 | $2,672.42 | $4,454.03 | $446.27 – $3,967.42 | 24 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $102.06 | $170.10 | $20.64 – $127.58 | 24 |
| Ghs ot group caregiver training CPT 97552 | $13.88 | $23.13 | $3.47 – $157.00 | 19 |
| Ghs ot prosthetic training/15 min CPT 97761 | $107.70 | $179.50 | $26.93 – $152.57 | 19 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $114.90 | $191.50 | $28.73 – $182.79 | 19 |
| Ghs pacing - transcutaneous CPT 92953 | $1,102.70 | $1,837.83 | $275.67 – $1,612.26 | 24 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $1,210.58 | $2,017.63 | $302.64 – $1,714.99 | 18 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $843.23 | $1,405.38 | $210.81 – $1,194.57 | 18 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $92.44 | $154.07 | $23.11 – $130.96 | 18 |
| Ghs peritonsillar abscess i andd CPT 42700 | $1,453.82 | $2,423.03 | $87.58 – $1,817.27 | 24 |
| Ghs phenylketonurid CPT 84030 | $86.44 | $144.07 | $4.62 – $108.05 | 24 |
| Ghs picc line insert < 5 CPT 36568 | $2,630.88 | $4,384.80 | $446.27 – $3,967.42 | 24 |
| Ghs plngl fx pm cl CPT 26725 | $713.14 | $1,188.57 | $85.32 – $891.43 | 24 |
| Ghs plt ct-manual CPT 85032 | $64.46 | $107.43 | $3.62 – $80.57 | 24 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $2,902.39 | $4,837.31 | $725.60 – $3,627.98 | 24 |
| Ghs ppd (tb intradermal) CPT 86580 | $60.68 | $101.13 | $8.33 – $73.76 | 24 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $67.83 | $113.05 | $8.11 – $84.79 | 24 |
| Ghs protein, misc fluid CPT 84160 | $24.60 | $41.00 | $4.71 – $30.75 | 24 |
| Ghs protoporphyrins fract CPT 84202 | $88.90 | $148.16 | $10.00 – $111.12 | 24 |
| Ghs pr without cont pulse ox CPT 94625 | $197.83 | $329.71 | $49.46 – $247.28 | 24 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $61.85 | $103.09 | $10.00 – $77.32 | 24 |
| Ghs quinidine CPT 80194 | $475.50 | $792.50 | $10.00 – $112.22 | 24 |
| Ghs refill of implantable pump CPT 95990 | $566.55 | $944.25 | $141.64 – $838.97 | 24 |
| Ghs removal intranasal foreign body CPT 30300 | $301.22 | $502.04 | $75.31 – $376.53 | 24 |
| Ghs removal pharyngeal foreign body CPT 42809 | $460.00 | $766.67 | $115.00 – $987.04 | 24 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $2,923.60 | $4,872.66 | $593.04 – $3,981.46 | 24 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $525.00 | $875.00 | $10.00 – $656.25 | 24 |
| Ghs reticulocyte count CPT 85044 | $58.09 | $96.81 | $3.62 – $72.61 | 24 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $139.81 | $233.02 | $10.00 – $174.76 | 24 |
| Ghs sedimentation rate CPT 85651 | $80.08 | $133.46 | $3.59 – $100.09 | 24 |
| Ghs semen analysis fert CPT 89320 | $129.00 | $215.00 | $10.00 – $161.25 | 24 |
| Ghs sensitivity (per antimicro) CPT 87184 | $79.31 | $132.19 | $6.28 – $99.14 | 24 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $744.69 | $1,241.15 | $143.08 – $987.79 | 24 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $875.44 | $1,459.07 | $143.08 – $1,094.30 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $974.17 | $1,623.61 | $143.08 – $1,217.71 | 24 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $564.61 | $941.02 | $143.08 – $987.79 | 24 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $644.19 | $1,073.65 | $161.05 – $805.24 | 24 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $569.06 | $948.43 | $142.26 – $711.32 | 24 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $593.27 | $988.78 | $74.34 – $741.59 | 24 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $980.75 | $1,634.59 | $74.34 – $1,225.94 | 24 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $589.18 | $981.96 | $74.34 – $736.47 | 24 |
| Ghs sleep study unattended CPT 95800 | $503.38 | $838.97 | $125.85 – $629.23 | 24 |
| Ghs somatosensory testing lower extremit CPT 95926 | $885.81 | $1,476.35 | $206.40 – $1,107.26 | 24 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $1,765.32 | $2,942.20 | $441.33 – $2,206.65 | 24 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $162.65 | $271.08 | $40.66 – $230.42 | 19 |
| Ghs sphenopalatine ganglion block CPT 64505 | $762.91 | $1,271.52 | $70.60 – $953.64 | 24 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $281.16 | $468.60 | $70.29 – $398.31 | 19 |
| Ghs strapping shoulder - 29240 CPT 29240 | $262.91 | $438.18 | $65.73 – $328.63 | 24 |
| Ghs st - re-eval for alt comm CPT 92597 | $407.74 | $679.57 | $101.94 – $577.63 | 19 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $99.98 | $166.63 | $24.99 – $124.97 | 24 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $393.99 | $656.65 | $98.50 – $530.97 | 24 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,665.04 | $2,775.07 | $216.80 – $2,081.30 | 24 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $901.36 | $1,502.27 | $143.08 – $1,126.70 | 24 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,634.36 | $4,390.60 | $420.64 – $3,777.93 | 24 |
| Ghs trypsin (fecal) CPT 84488 | $79.83 | $133.05 | $6.13 – $99.79 | 24 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $705.76 | $1,176.26 | $85.32 – $882.20 | 24 |
| Ghs urine, porphyrins quant CPT 84120 | $127.80 | $213.00 | $10.00 – $53.53 | 24 |
| Ghs vaginal delivery only CPT 59409 | $3,142.35 | $5,237.25 | $785.59 – $7,744.80 | 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.