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 |
|---|---|---|---|---|
| Measure kidney pressure CPT 50396 | $803.99 | $1,339.98 | $238.15 – $1,692.24 | 24 |
| Measurement post void urine by ultrasound CPT 51798 | $192.63 | $321.05 | $48.16 – $240.79 | 24 |
| #mec-opiates CPT 80356 | $76.46 | $127.44 | $3.92 – $13.36 | 17 |
| Med genetics&genetic counseling svcs each 30 min CPT 96041 | $100.00 | $166.67 | $25.00 – $141.67 | 14 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $5,778.93 – $14,293.73 | 16 |
| Medical services after hrs CPT 99050 | $23.40 | $39.00 | $5.85 – $33.15 | 14 |
| Med physic dos eval rad exps CPT 76145 | $798.01 | $1,330.02 | $199.50 – $1,327.77 | 24 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $165.13 | $275.22 | $41.28 – $233.94 | 18 |
| Melphalan oral 2 mg HCPCS J8600 | $16.58 | $27.64 | $4.15 – $23.49 | 18 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $1,524.60 | $2,541.00 | $118.96 – $1,432.66 | 23 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $790.10 | $1,316.83 | $76.68 – $383.41 | 23 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | $511.67 | $852.78 | $48.11 – $269.22 | 23 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | $736.80 | $1,228.00 | $34.68 – $269.22 | 23 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $30.79 | $51.32 | $3.18 – $18.04 | 19 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $107.90 | $179.84 | $0.41 – $19.55 | 19 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $1,896.00 – $5,384.00 | 2 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $107.41 | $179.01 | $1.47 – $91.80 | 19 |
| Metabolic Blood Panel (Basic) CPT 80048 | $149.84 | $249.74 | $7.11 – $187.31 | 24 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $235.72 | $392.86 | $8.87 – $294.64 | 24 |
| Metabolic panel ionized ca CPT 80047 | $284.96 | $474.94 | $10.00 – $356.20 | 24 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $224.10 | $373.50 | $56.02 – $317.48 | 18 |
| Methadone injection HCPCS J1230 | $1,157.85 | $1,929.75 | $16.18 – $1,640.29 | 19 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $103.20 | $172.00 | $4.62 – $49.30 | 19 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $6.32 | $10.54 | $0.15 – $5.18 | 19 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $162.19 | $270.32 | $2.94 – $61.03 | 19 |
| Methotrexate therapeutic drug level CPT 80204 | $448.27 | $747.11 | $10.00 – $560.33 | 24 |
| Methyldopate hcl injection HCPCS J0210 | $144.00 | $240.00 | $36.00 – $204.00 | 18 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $2,185.54 | $3,642.57 | $9.78 – $80.54 | 24 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $109.33 | $182.22 | $17.78 – $100.78 | 19 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $432.83 | $721.39 | $3.07 – $613.18 | 19 |
| Methylphenidate CPT 80360 | $153.60 | $256.00 | $3.92 – $9.75 | 17 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $1.37 | $2.29 | $0.10 – $0.54 | 19 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $177.44 | $295.74 | $0.12 – $44.37 | 19 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $224.40 | $374.00 | $0.27 – $20.81 | 19 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $7.92 | $13.20 | $1.05 – $6.33 | 19 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $12.10 | $20.17 | $0.14 – $9.70 | 19 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $14.52 | $24.20 | $0.02 – $15.98 | 19 |
| Mgmt promoter methylation analysis CPT 81287 | $477.82 | $796.37 | $35.00 – $299.14 | 24 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $507.90 | $846.50 | $0.28 – $361.89 | 19 |
| Microalbumin urine screen CPT 82044 | $45.29 | $75.49 | $5.23 – $56.62 | 24 |
| Microdissection laser CPT 88380 | $1,025.87 | $1,709.79 | $10.00 – $1,453.32 | 18 |
| Microdissection manual CPT 88381 | $388.07 | $646.79 | $35.00 – $317.44 | 18 |
| Microprcsr cu combo vad, rep HCPCS Q0482 | $11,216.70 | $18,694.50 | $292.20 – $1,558.40 | 17 |
| Microsatellite instability CPT 81301 | $603.68 | $1,006.13 | $10.00 – $836.54 | 24 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | $298.58 | $497.64 | $34.75 – $373.23 | 24 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $24.84 | $41.40 | $0.09 – $0.50 | 19 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $108.00 | $180.00 | $0.17 – $112.20 | 19 |
| Middle cerebral artery echo CPT 76821 | $332.64 | $554.40 | $89.21 – $415.80 | 24 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $115.20 | $192.00 | $1.30 – $31.88 | 19 |
| Minocycline hydrochloride HCPCS J2265 | $648.30 | $1,080.50 | $2.53 – $810.38 | 24 |
| Mitochondrial gene CPT 81440 | $1,010.00 | $1,683.33 | $35.00 – $7,977.60 | 24 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $2,305.13 | $3,841.88 | $27.04 – $226.50 | 24 |
| Mitomycin instillation HCPCS J9281 | $43,275.00 | $72,125.00 | $293.89 – $54,093.75 | 24 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $1,130.68 | $1,884.47 | $36.68 – $619.89 | 24 |
| Mlh1 gene CPT 81288 | $1,536.54 | $2,560.90 | $35.00 – $461.57 | 24 |
| Mlh1 gene full seq CPT 81292 | $290.00 | $483.33 | $35.00 – $1,620.96 | 24 |
| Mnl appl strs jt radiography CPT 77071 | $101.73 | $169.55 | $55.73 – $225.11 | 24 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $593.04 – $3,981.46 | 17 |
| Mnt subs tx for change dx HCPCS G0270 | $57.53 | $95.88 | $14.38 – $90.72 | 18 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $825.00 | $1,375.00 | $10.00 – $150.00 | 24 |
| Mon cable elec/pneum vad rep HCPCS Q0486 | $1,596.00 | $2,660.00 | $101.25 – $540.00 | 17 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $9,446.50 | $15,744.17 | $145.53 – $776.16 | 17 |
| Mopath procedure level 1 CPT 81400 | $371.95 | $619.92 | $10.00 – $287.81 | 24 |
| Mopath procedure level 3 CPT 81402 | $1,198.70 | $1,997.83 | $10.00 – $360.79 | 24 |
| Mopath procedure level 5 CPT 81404 | $7,487.95 | $12,479.92 | $10.00 – $659.59 | 24 |
| Mopath procedure level 6 CPT 81405 | $2,250.00 | $3,750.00 | $0.04 – $723.24 | 24 |
| Mopath procedure level 7 CPT 81406 | $7,487.95 | $12,479.92 | $10.00 – $678.91 | 24 |
| Mopath procedure level 8 CPT 81407 | $3,496.50 | $5,827.50 | $10.00 – $2,031.05 | 24 |
| Mopath procedure level 9 CPT 81408 | $2,939.33 | $4,898.88 | $10.00 – $4,800.00 | 24 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $156.83 | $261.38 | $1.78 – $10.06 | 19 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $958.48 | $1,597.47 | $1.72 – $13.36 | 19 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $1,137.00 | $1,895.00 | $10.00 – $690.00 | 24 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $322.24 | $537.06 | $35.00 – $890.45 | 24 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $285.90 | $476.50 | $35.00 – $423.12 | 24 |
| Motor &/ sens nrve cndj test CPT 95905 | $296.34 | $493.90 | $74.08 – $987.04 | 24 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $1,194.59 | $1,990.99 | $35.00 – $423.12 | 24 |
| M/phmtrc alysishquant/semiq CPT 88369 | $331.55 | $552.58 | $35.00 – $469.69 | 18 |
| M/phmtrc alys skeletal musc CPT 88355 | $326.83 | $544.72 | $35.00 – $423.12 | 24 |
| Mpl gene analysis common variants CPT 81338 | $622.13 | $1,036.88 | $10.00 – $360.79 | 24 |
| MRA abdomen post contrast CPT 74185 | $1,948.22 | $3,247.04 | $487.06 – $2,759.98 | 18 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $2,552.76 | $4,254.60 | $638.19 – $3,616.41 | 18 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $1,982.02 | $3,303.36 | $495.50 – $2,807.86 | 18 |
| MRA pelvis CPT 72198 | $2,364.48 | $3,940.80 | $591.12 – $3,349.68 | 18 |
| MRA spinal canal CPT 72159 | $1,803.94 | $3,006.56 | $450.98 – $2,555.58 | 18 |
| MRA upper extremity post contrast-bil CPT 73225 | $1,224.43 | $2,040.71 | $306.11 – $2,149.00 | 18 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,691.95 | $2,819.92 | $422.99 – $2,396.93 | 19 |
| Mra, w/dye, spinal canal HCPCS C8931 | $1,033.39 | $1,722.32 | $258.35 – $2,149.00 | 24 |
| MRA without cont, lwr ext HCPCS C8913 | $1,691.95 | $2,819.92 | $422.99 – $2,396.93 | 19 |
| Mra, without dye, spinal canal HCPCS C8932 | $1,033.39 | $1,722.32 | $228.08 – $2,149.00 | 24 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,965.82 | $3,276.37 | $491.46 – $2,784.91 | 19 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $1,590.76 | $2,651.26 | $333.49 – $2,149.00 | 24 |
| Mr elastography CPT 76391 | $1,736.89 | $2,894.81 | $207.16 – $2,171.11 | 24 |
| MRI brain w/dye CPT 70558 | $2,505.67 | $4,176.11 | $167.67 – $3,132.08 | 24 |
| MRI brain without dye CPT 70557 | $2,005.45 | $3,342.42 | $501.36 – $2,506.82 | 24 |
| MRI brain without & w/dye CPT 70559 | $2,813.09 | $4,688.49 | $167.67 – $3,516.37 | 24 |
| MRI breast c- unilateral CPT 77046 | $1,780.67 | $2,967.78 | $228.08 – $2,225.84 | 24 |
| MRI breast c-+ w/cad uni CPT 77048 | $2,003.54 | $3,339.24 | $500.89 – $2,838.35 | 18 |
| MRI breast without cont bi CPT 77047 | $2,083.19 | $3,471.99 | $228.08 – $2,603.99 | 24 |
| MRI breast w IV cont bi CPT 77049 | $1,876.12 | $3,126.87 | $469.03 – $2,657.84 | 18 |
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.