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 |
|---|---|---|---|---|
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $3,051.89 | $5,086.48 | $90.81 – $4,016.35 | 24 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | not published | not published | $1,688.92 – $15,697.77 | 15 |
| Incision of anal sphincter CPT 46080 | not published | not published | $939.93 – $6,955.62 | 17 |
| Incision of breast lesion CPT 19020 | $3,030.26 | $5,050.44 | $486.45 – $4,016.35 | 24 |
| Incision of burn scab initi CPT 16035 | $693.60 | $1,156.00 | $143.08 – $987.79 | 24 |
| Incision of eardrum CPT 69421 | not published | not published | $886.62 – $7,975.81 | 17 |
| Incision of foot fascia CPT 28008 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Incision of heel bone CPT 28300 | not published | not published | $2,416.00 – $17,722.46 | 17 |
| Incision of metatarsal CPT 28308 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Incision of midfoot bones CPT 28304 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Incision of prostate CPT 52450 | not published | not published | $1,142.90 – $8,636.11 | 17 |
| Incision of rectal abscess CPT 46060 | $5,159.16 | $8,598.60 | $939.93 – $6,955.62 | 24 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $659.94 – $4,783.04 | 17 |
| Incision of tendon & muscle CPT 23405 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Incision of tendon sheath CPT 25000 | not published | not published | $593.04 – $6,093.00 | 17 |
| Incision of tibia CPT 27705 | not published | not published | $2,416.00 – $17,722.46 | 17 |
| Incision of tibia & fibula CPT 27709 | not published | not published | $2,416.00 – $32,603.53 | 17 |
| Incision of tongue fold CPT 41010 | $1,163.78 | $1,939.64 | $420.64 – $3,777.93 | 24 |
| Incision tendon sheath CPT 26055 | not published | not published | $593.04 – $4,063.00 | 17 |
| Incisn of toe tndn CPT 28010 | $2,298.99 | $3,831.65 | $100.50 – $3,981.46 | 24 |
| Incisn windpipe CPT 31600 | $5,256.07 | $8,760.12 | $1,314.02 – $7,975.81 | 24 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | $1,080.00 | $1,800.00 | $6.48 – $32.40 | 23 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | $1,997.99 | $3,329.99 | $499.50 – $2,830.49 | 18 |
| Induced abortion d&c CPT 59840 | $3,645.12 | $6,075.20 | $1,063.52 – $7,744.80 | 24 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $1,063.52 – $7,744.80 | 17 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $121.73 | $202.88 | $10.00 – $152.16 | 23 |
| Infec agen detec ampli probe HCPCS U0005 | $34.02 | $56.70 | $8.51 – $48.20 | 18 |
| Infect ag drug suscept pheno predict CPT 87900 | $1,208.07 | $2,013.45 | $10.00 – $312.84 | 24 |
| Infect ag eia influenza a or b ea CPT 87400 | $121.93 | $203.21 | $10.00 – $152.41 | 24 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,328.66 | $2,214.43 | $10.00 – $773.44 | 24 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $727.04 | $1,211.74 | $10.00 – $908.80 | 24 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $669.30 | $1,115.50 | $10.00 – $308.95 | 24 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $828.32 | $1,380.53 | $10.00 – $617.88 | 24 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $175.15 | $291.92 | $10.00 – $218.94 | 24 |
| Infect ag ia optc obs influenza CPT 87804 | $93.18 | $155.30 | $10.00 – $116.47 | 24 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $83.03 | $138.39 | $10.00 – $103.79 | 24 |
| Infect ag if hep delta agent CPT 87380 | $219.64 | $366.07 | $10.00 – $274.55 | 24 |
| Infect ag if influenza a CPT 87276 | $82.46 | $137.43 | $10.00 – $103.07 | 24 |
| Infect ag if influenza b CPT 87275 | $80.74 | $134.56 | $10.00 – $100.92 | 24 |
| Infect ag if legionella pneumophila CPT 87278 | $126.02 | $210.04 | $10.00 – $157.53 | 24 |
| Infect ag if pneumocystis carinii CPT 87281 | $154.04 | $256.74 | $10.00 – $28.75 | 24 |
| Infect ag if varicella zoster CPT 87290 | $92.78 | $154.63 | $10.00 – $115.97 | 24 |
| Infect ag na hep b amp CPT 87516 | $108.44 | $180.73 | $10.00 – $135.55 | 24 |
| Infect ag na herpes simplex quant CPT 87530 | $284.06 | $473.43 | $10.00 – $261.85 | 24 |
| Infect ag na hpv high-risk types CPT 87624 | $615.00 | $1,025.00 | $10.00 – $164.33 | 24 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $390.44 | $650.73 | $10.00 – $488.05 | 24 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $158.06 | $263.44 | $10.00 – $197.58 | 24 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $127.50 | $212.50 | $10.00 – $110.32 | 23 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,078.16 | $1,796.94 | $10.00 – $1,347.70 | 24 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $843.26 | $1,405.43 | $10.00 – $1,172.78 | 24 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $199.73 | $332.88 | $10.00 – $85.16 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $127.01 | $211.69 | $10.00 – $158.77 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $86.83 | $144.71 | $10.00 – $108.53 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $80.05 | $133.41 | $10.00 – $100.06 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $93.89 | $156.49 | $10.00 – $28.84 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $140.84 | $234.74 | $10.00 – $75.00 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $118.25 | $197.09 | $2.94 – $24.79 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $93.38 | $155.64 | $8.68 – $116.73 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $145.09 | $241.82 | $10.00 – $181.37 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $324.45 | $540.75 | $10.00 – $56.66 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $153.61 | $256.01 | $10.00 – $192.01 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $68.11 | $113.52 | $10.00 – $85.14 | 24 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $849.00 | $1,415.00 | $2.94 – $84.22 | 24 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $165.34 | $275.56 | $10.00 – $84.22 | 24 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $215.18 | $358.64 | $10.00 – $268.98 | 24 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $855.45 | $1,425.75 | $10.00 – $1,000.27 | 24 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $652.67 | $1,087.78 | $10.00 – $154.69 | 24 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $168.42 | $280.70 | $10.00 – $210.53 | 24 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $345.17 | $575.28 | $10.00 – $299.01 | 24 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $162.62 | $271.03 | $10.00 – $84.22 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $900.00 | $1,500.00 | $10.00 – $129.38 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $61.45 | $102.41 | $10.00 – $342.31 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $104.93 | $174.88 | $10.00 – $342.31 | 24 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $126.60 | $211.00 | $10.00 – $158.25 | 24 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $162.85 | $271.42 | $10.00 – $84.22 | 24 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $327.95 | $546.59 | $10.00 – $409.94 | 23 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $248.18 | $413.64 | $10.00 – $310.23 | 23 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $1,069.61 | $1,782.68 | $10.00 – $1,461.51 | 23 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $727.50 | $1,212.50 | $10.00 – $1,000.27 | 24 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $375.00 | $625.00 | $10.00 – $468.75 | 24 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $515.40 | $859.00 | $10.00 – $644.25 | 24 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,105.50 | $1,842.50 | $10.00 – $102.82 | 24 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $331.97 | $553.28 | $10.00 – $184.69 | 24 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $381.92 | $636.53 | $10.00 – $150.00 | 24 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $448.31 | $747.18 | $10.00 – $560.38 | 24 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $345.55 | $575.91 | $10.00 – $342.31 | 24 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $2,102.08 | $3,503.46 | $29.49 – $2,627.59 | 24 |
| Influenza dna amp prob addl CPT 87503 | $94.30 | $157.16 | $10.00 – $117.87 | 24 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $1,321.38 | $2,202.30 | $330.35 – $1,871.95 | 18 |
| Infuse radioactive materials CPT 77750 | $600.89 | $1,001.49 | $150.22 – $834.39 | 24 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $394.10 | $656.83 | $98.52 – $528.37 | 24 |
| Init/sub psych care m 1st 30 HCPCS G2214 | $89.84 | $149.74 | $22.46 – $220.82 | 24 |
| Inj acetaminophen -fresenius HCPCS J0134 | $34.56 | $57.60 | $0.06 – $48.96 | 19 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | $16.63 | $27.72 | $4.16 – $23.56 | 18 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $7,176.71 | $11,961.18 | $3.62 – $8,775.00 | 24 |
| Inj alymsys 10 mg HCPCS Q5126 | $676.74 | $1,127.90 | $49.01 – $845.92 | 24 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | $20.40 | $34.00 | $0.17 – $28.90 | 19 |
| Inj, bupivacaine liposome HCPCS J0666 | $507.76 | $846.27 | $1.32 – $634.70 | 24 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $35.82 | $59.70 | $6.75 – $38.26 | 18 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $34.59 | $57.65 | $0.94 – $49.00 | 19 |
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.