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 |
|---|---|---|---|---|
| Interrog dev eval icpms ip CPT 93290 | $162.05 | $270.09 | $35.67 – $202.57 | 24 |
| Interrog dev eval scrms ip CPT 93291 | $217.94 | $363.23 | $27.64 – $272.42 | 24 |
| Interrog device eval heart CPT 93289 | $247.93 | $413.22 | $35.67 – $309.92 | 24 |
| Interrog evl pm/ldls pm ip CPT 93288 | $232.60 | $387.66 | $35.67 – $290.75 | 24 |
| Interstitial brachy inter CPT 77799 | $1,244.40 | $2,074.00 | $97.53 – $1,555.50 | 24 |
| Int hrhc lig 1 hroid without img CPT 46945 | not published | not published | $939.93 – $7,038.00 | 16 |
| Intra-atrial pacing CPT 93610 | $2,602.26 | $4,337.10 | $650.57 – $18,500.61 | 24 |
| Intra-atrial recording CPT 93602 | $5,252.30 | $8,753.83 | $1,313.07 – $18,500.61 | 24 |
| Intracard echo interv w/s&i CPT 93662 | $5,320.98 | $8,868.30 | $450.31 – $7,538.06 | 18 |
| Intracran angioplsty w/stent CPT 61635 | $12,038.64 | $20,064.40 | $2,546.00 – $17,054.74 | 18 |
| Intracranial angioplasty CPT 61630 | $4,865.26 | $8,108.77 | $1,216.32 – $6,892.45 | 18 |
| Intracranial complete study CPT 93886 | $1,308.50 | $2,180.83 | $228.08 – $1,635.62 | 24 |
| Intracranial limited study CPT 93888 | $418.44 | $697.40 | $99.94 – $523.05 | 24 |
| Intraop epicard/endocard/pace/map/ 93631 CPT 93631 | $5,904.00 | $9,840.00 | $1,271.26 – $8,364.00 | 18 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | $1,568.50 | $2,614.16 | $83.33 – $1,960.62 | 24 |
| Intrapul surf admin endo tube CPT 94610 | $220.80 | $368.00 | $55.20 – $528.37 | 24 |
| Intraventricular pacing CPT 93612 | $5,976.77 | $9,961.28 | $1,494.19 – $18,500.61 | 24 |
| Intrinsic factor antibody CPT 86340 | $109.27 | $182.12 | $10.00 – $136.59 | 24 |
| Intro cath dialysis circuit CPT 36901 | $3,194.63 | $5,324.38 | $111.00 – $3,993.28 | 24 |
| Intro cath dialysis circuit w/pta CPT 36902 | $12,316.55 | $20,527.59 | $1,764.89 – $15,395.69 | 24 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $28,837.03 | $48,061.72 | $5,270.09 – $36,046.29 | 24 |
| Intro catheter aorta CPT 36200 | $2,597.66 | $4,329.44 | $649.42 – $3,680.02 | 18 |
| Intro cath svc/ivc CPT 36010 | $2,077.20 | $3,462.00 | $519.30 – $2,942.70 | 18 |
| Intro long gi tube CPT 44500 | $1,036.00 | $1,726.66 | $334.95 – $2,245.59 | 24 |
| Intro long gi tube w/mult fluo CPT 74340 | $644.50 | $1,074.16 | $55.50 – $913.04 | 18 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $5,505.46 | $9,175.77 | $1,376.37 – $7,799.40 | 18 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $4,360.00 | $7,266.67 | $1,090.00 – $6,176.67 | 15 |
| Intubation endotracheal emergency procedure CPT 31500 | $707.89 | $1,179.82 | $87.58 – $884.87 | 24 |
| Io anal gast n-stim subsq CPT 95981 | $129.56 | $215.94 | $32.39 – $161.96 | 24 |
| Io ga n-stim subsq w/reprog CPT 95982 | $202.72 | $337.86 | $35.67 – $253.40 | 24 |
| Ionm in operatng room 15 min CPT 95940 | $264.65 | $441.09 | $66.16 – $374.93 | 18 |
| Ionm remote/>1 pt or per hr CPT 95941 | $705.64 | $1,176.06 | $176.41 – $999.65 | 18 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $165.67 | $276.12 | $0.48 – $234.70 | 19 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $402.57 | $670.95 | $0.17 – $1.53 | 19 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $62,692.46 | $104,487.44 | $170.68 – $19,619.56 | 24 |
| Ipratropium bromide non-comp HCPCS J7644 | $0.97 | $1.62 | $0.20 – $1.10 | 19 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $152.40 | $254.00 | $1.69 – $183.46 | 19 |
| Iron CPT 83540 | $89.00 | $148.33 | $5.43 – $111.25 | 24 |
| Iron binding capacity CPT 83550 | $98.05 | $163.41 | $7.34 – $122.56 | 24 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $144.63 | $241.05 | $17.20 – $180.79 | 24 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $187.06 | $311.77 | $0.25 – $140.87 | 19 |
| Irradiation of blood product each unit reference CPT 86945 | $124.24 | $207.07 | $10.00 – $155.30 | 24 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $206.68 | $344.47 | $51.67 – $258.35 | 24 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | $230.40 | $384.00 | $56.39 – $288.00 | 24 |
| Ivc venogram s&i CPT 75825 | $2,950.06 | $4,916.76 | $114.28 – $7,896.23 | 24 |
| IV Fluids (each additional hour) CPT 96361 | $190.67 | $317.78 | $42.03 – $238.34 | 24 |
| IV Fluids (first hour) CPT 96360 | $488.60 | $814.34 | $118.38 – $610.75 | 24 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $235.84 | $393.07 | $58.96 – $334.11 | 18 |
| IV inj ra drug dx study CPT 78808 | $454.74 | $757.90 | $113.69 – $1,021.72 | 24 |
| IV Medicine Infusion (additional drug) CPT 96367 | $280.91 | $468.18 | $68.83 – $351.13 | 24 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $198.34 | $330.56 | $44.76 – $247.92 | 24 |
| IV Medicine Infusion (first hour) CPT 96365 | $541.27 | $902.11 | $135.32 – $676.58 | 24 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $111.00 – $987.04 | 16 |
| IV Push Injection (each additional drug) CPT 96375 | $235.24 | $392.06 | $44.76 – $294.05 | 24 |
| IV Push Injection (first drug) CPT 96374 | $314.60 | $524.33 | $78.65 – $530.97 | 24 |
| Ivp w/nephrotomography CPT 74415 | $673.80 | $1,123.00 | $151.36 – $842.25 | 24 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $687.80 | $1,146.33 | $135.33 – $859.75 | 24 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $10,695.32 | $17,825.54 | $124.09 – $4,481.39 | 24 |
| Jak2 targeted sequence analysis CPT 81279 | $465.74 | $776.24 | $34.22 – $444.48 | 24 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $477.80 | $796.34 | $53.13 – $597.25 | 24 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $181.22 | $302.04 | $43.78 – $272.35 | 24 |
| Jejunstmy tube plcmt CPT 44372 | $2,174.40 | $3,624.00 | $564.97 – $4,713.77 | 24 |
| John cunningham antibody CPT 86711 | $1,029.60 | $1,716.00 | $10.00 – $56.25 | 24 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | $1,660.81 | $2,768.02 | $415.20 – $2,214.42 | 17 |
| Kafo fem fx cast molded to p HCPCS L2128 | $2,264.75 | $3,774.58 | $566.19 – $3,019.66 | 17 |
| Kafo femoral fx cast rigid HCPCS L2136 | $1,701.94 | $2,836.57 | $425.49 – $2,269.26 | 17 |
| Ketogenic steroids fract CPT 83582 | $92.66 | $154.43 | $10.00 – $115.82 | 24 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $90.56 | $150.94 | $6.86 – $42.00 | 24 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $29.52 | $49.20 | $0.32 – $4.54 | 24 |
| Kidney imaging (3d) CPT 78710 | $472.92 | $788.20 | $118.23 – $669.97 | 18 |
| Kidney imaging morphology CPT 78700 | $539.97 | $899.95 | $157.04 – $1,021.72 | 24 |
| Kidney imag w/bld flow multi CPT 78709 | $1,193.73 | $1,989.55 | $332.13 – $1,492.16 | 24 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,468.04 | $2,446.73 | $212.84 – $1,835.05 | 24 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $691.73 | $1,152.88 | $99.94 – $864.66 | 24 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $518.80 | $864.66 | $59.81 – $648.50 | 24 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,585.18 | $15,975.30 | $2,396.30 – $13,579.00 | 17 |
| Kit gene analys d816 variant CPT 81273 | $598.36 | $997.27 | $35.00 – $508.16 | 24 |
| Kit hfx iq ipg bundle HCPCS C1822 | $50,985.00 | $84,975.00 | $8,905.04 – $47,493.54 | 17 |
| Kit lead specify 5-6-5 HCPCS C1778 | $20,394.00 | $33,990.00 | $0.00 – $0.01 | 17 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,867.64 | $3,112.73 | $190.81 – $1,017.63 | 17 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $288.32 | $480.54 | $17.68 – $269.22 | 23 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,541.00 | $4,235.00 | $629.61 – $3,357.91 | 17 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $3,300.05 – $17,722.46 | 17 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $6,093.00 – $32,603.53 | 17 |
| Knee joint drop lock ea jnt HCPCS L2405 | $225.00 | $375.00 | $56.25 – $300.00 | 17 |
| Knee MRI (with and without contrast) CPT 73723 | $3,690.46 | $6,150.76 | $333.49 – $4,613.07 | 24 |
| Knee MRI (with contrast) CPT 73722 | $2,394.58 | $3,990.96 | $323.44 – $2,993.22 | 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.