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 |
|---|---|---|---|---|
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $3,508.38 – $27,774.62 | 17 |
| Pr correction hammertoe CPT 28285 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $48.71 | $81.19 | $12.18 – $81.06 | 24 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | $1,769.84 | $2,949.74 | $442.46 – $2,507.28 | 18 |
| Prcrd drg 6+yr without anomly CPT 33017 | $3,161.89 | $5,269.82 | $790.47 – $4,479.35 | 18 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $4,342.83 | $7,238.05 | $1,142.90 – $8,636.11 | 24 |
| Prealbumin CPT 84134 | $115.26 | $192.10 | $10.00 – $144.07 | 24 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $63.65 | $106.08 | $0.81 – $51.17 | 19 |
| Prednisone 1 mg tablet HCPCS J7512 | $0.40 | $0.67 | $0.00 – $0.14 | 19 |
| Pregabalin - sendout CPT 80366 | $5.00 | $8.33 | $3.92 – $7.42 | 17 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $564.97 – $4,713.77 | 17 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $590.27 | $983.78 | $99.94 – $737.84 | 24 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $660.98 | $1,101.64 | $99.94 – $826.23 | 24 |
| Pregnancy Ultrasound (limited) CPT 76815 | $459.00 | $765.00 | $81.20 – $573.75 | 24 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | $3,907.86 | $6,513.10 | $206.40 – $4,884.82 | 24 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | $2,062.26 | $3,437.10 | $356.71 – $2,577.82 | 24 |
| Preparation for bladder xray CPT 51605 | $1,143.32 | $1,905.54 | $285.83 – $1,619.71 | 18 |
| Preparation palate mold CPT 42280 | $583.82 | $973.04 | $145.96 – $1,363.00 | 24 |
| Prep skin to 100cm2 other CPT 15004 | $1,198.40 | $1,997.34 | $262.63 – $1,555.84 | 24 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $706.48 – $4,517.58 | 16 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Pressure max expiratory/inspiratory CPT 94799 | $349.83 | $583.05 | $35.44 – $386.96 | 24 |
| Pressure treatment esophagus CPT 43460 | $2,587.56 | $4,312.60 | $646.89 – $3,665.71 | 18 |
| Pressure velocity wire add ves CPT 93572 | $2,208.05 | $3,680.08 | $552.01 – $3,128.07 | 16 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $107.65 | $179.42 | $10.00 – $423.12 | 24 |
| Pretreat rbc absorption reference CPT 86978 | $255.19 | $425.31 | $10.00 – $287.88 | 24 |
| Pretreat rbc density gradient separation reference CPT 86972 | $47.73 | $79.55 | $10.00 – $423.12 | 24 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $132.48 | $220.80 | $10.00 – $165.60 | 24 |
| Pretreat rbc w enzyme reference CPT 86971 | $214.33 | $357.21 | $10.00 – $423.12 | 24 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $328.28 | $547.13 | $82.07 – $410.35 | 24 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | $178.57 | $297.62 | $44.64 – $327.47 | 21 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | not published | not published | $74.19 – $4,016.35 | 16 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $486.45 – $4,016.35 | 17 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $1,015.52 | $1,692.54 | $84.71 – $1,269.40 | 24 |
| Prgrmg dev eval impltbl sys CPT 93260 | $210.00 | $350.00 | $35.67 – $262.50 | 24 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $194.40 | $324.00 | $35.67 – $243.00 | 24 |
| Prgrmg dev eval scrms ip CPT 93285 | $180.33 | $300.55 | $35.67 – $225.41 | 24 |
| Prgrmg eval implantable dfb CPT 93282 | $202.13 | $336.89 | $35.67 – $252.67 | 24 |
| Prgrmg eval implantable dfb CPT 93283 | $218.79 | $364.65 | $35.67 – $273.49 | 24 |
| Prgrmg eval implantable dfb CPT 93284 | $247.66 | $412.77 | $35.67 – $309.58 | 24 |
| Prgr stim/pace a/iv drug CPT 93623 | $6,468.87 | $10,781.45 | $510.05 – $9,164.23 | 18 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $6,534.20 | $10,890.34 | $4,029.43 – $43,439.01 | 24 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $5,187.67 | $8,646.11 | $1,296.92 – $7,349.19 | 18 |
| Prin care mgmt staff 1st 30 CPT 99426 | $91.70 | $152.84 | $22.93 – $220.82 | 21 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $782.98 | $1,304.97 | $98.28 – $987.79 | 24 |
| Pr incision & drainage abscess simple/single CPT 10060 | $596.67 | $994.45 | $65.06 – $745.84 | 24 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $692.24 | $1,153.73 | $75.58 – $865.30 | 24 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $699.02 | $1,165.03 | $86.38 – $987.79 | 24 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | $84.79 | $141.32 | $21.20 – $327.47 | 21 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | $64.44 | $107.40 | $16.11 – $327.47 | 21 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $232.42 | $387.37 | $38.71 – $329.26 | 18 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $659.94 – $4,783.04 | 17 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $12,640.20 | $21,067.00 | $365.48 – $2,071.03 | 18 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $248.56 | $414.27 | $49.11 – $461.84 | 24 |
| Procalcitonin CPT 84145 | $194.93 | $324.88 | $10.00 – $243.66 | 24 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $22.86 | $38.10 | $3.38 – $19.12 | 19 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $0.97 | $1.62 | $0.09 – $0.48 | 18 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $1,650.30 | $2,750.50 | $82.50 – $2,264.11 | 24 |
| Progesterone CPT 84144 | $146.26 | $243.77 | $10.00 – $50.06 | 24 |
| Prolactin CPT 84146 | $181.04 | $301.73 | $10.00 – $61.09 | 24 |
| Prolng svc o/p 1st hour CPT 99354 | $178.76 | $297.94 | $44.69 – $253.25 | 18 |
| Prolng svc o/p ea addl 30 CPT 99355 | $67.09 | $111.82 | $16.77 – $95.05 | 18 |
| Promethazine hcl injection HCPCS J2550 | $12.96 | $21.60 | $3.24 – $18.36 | 19 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $108.00 | $180.00 | $0.10 – $1.53 | 19 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $28.80 | $48.00 | $7.20 – $40.80 | 18 |
| Prostate biopsy, any mthd HCPCS G0416 | $614.11 | $1,023.51 | $35.00 – $890.45 | 24 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $1,689.43 – $12,818.21 | 17 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $2,641.03 | $4,401.71 | $68.16 – $363.53 | 17 |
| Prosthetic sock multi ply bk HCPCS L8420 | $57.89 | $96.48 | $14.47 – $77.18 | 17 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $159.63 | $266.05 | $1.84 – $102.75 | 19 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $3,326.26 | $5,543.77 | $831.57 – $4,435.02 | 17 |
| Protein c activity CPT 85303 | $216.97 | $361.61 | $10.00 – $50.62 | 24 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $129.22 | $215.37 | $8.39 – $25.78 | 24 |
| Protein s total CPT 85305 | $164.26 | $273.76 | $9.75 – $71.19 | 24 |
| Protein total 24 hour urine CPT 84156 | $77.09 | $128.49 | $3.08 – $46.67 | 24 |
| Protein total body fluid CPT 84157 | $77.77 | $129.62 | $3.36 – $15.06 | 24 |
| Protein total serum plasma whole blood CPT 84155 | $225.00 | $375.00 | $3.08 – $13.39 | 24 |
| Prothrombin complex kcentra HCPCS J7168 | $27.53 | $45.88 | $1.95 – $34.41 | 24 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $84.79 | $141.31 | $3.31 – $105.98 | 24 |
| Provide inr test mater/equip HCPCS G0249 | $151.14 | $251.90 | $37.78 – $327.47 | 24 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $1,151.54 – $10,795.00 | 17 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | $17,010.00 | $28,350.00 | $1,939.15 – $43,439.01 | 23 |
| Prq av fstl crt uxtr sep acs CPT 36837 | $16,135.50 | $26,892.50 | $1,939.15 – $43,439.01 | 23 |
| Prq card angio/athrect addl CPT 92925 | $11,537.46 | $19,229.10 | $2,884.36 – $16,344.74 | 16 |
| Prq cardiac angio addl art CPT 92921 | $12,185.48 | $20,309.14 | $3,046.37 – $17,262.77 | 16 |
| Prq card revasc chronic addl CPT 92944 | $20,797.93 | $34,663.21 | $5,199.48 – $29,463.73 | 16 |
| Prq card revasc mi 1 vsl CPT 92941 | $18,392.20 | $30,653.67 | $1,726.04 – $26,055.62 | 17 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $25,591.93 | $42,653.22 | $6,397.98 – $36,255.24 | 17 |
| Prq card stent/ath/angio CPT 92934 | $10,817.96 | $18,029.93 | $2,704.49 – $16,180.00 | 16 |
| Prq card stent w/angio addl CPT 92929 | $16,507.97 | $27,513.29 | $4,126.99 – $23,386.30 | 16 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $12,920.31 | $21,533.85 | $3,230.08 – $27,252.71 | 23 |
| Prq revasc byp graft addl CPT 92938 | $15,079.29 | $25,132.15 | $3,769.82 – $21,362.33 | 16 |
| Prq skel fix sprcndlr hum fx CPT 24538 | $6,731.17 | $11,218.62 | $2,398.52 – $17,722.46 | 24 |
| Prq skel fix talus fx w/mnpj CPT 28436 | $6,731.17 | $11,218.62 | $2,416.00 – $17,722.46 | 24 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $16,220.54 | $27,034.24 | $4,055.14 – $27,252.71 | 23 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | $22,098.20 | $36,830.34 | $10,273.60 – $39,657.85 | 23 |
| Prq trlml c athrc st angiop1 CPT 92933 | $14,295.96 | $23,826.60 | $3,573.99 – $43,439.01 | 23 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | $23,158.66 | $38,597.77 | $5,950.65 – $28,948.33 | 22 |
| Prq trluml c angiop 1art&/br CPT 92920 | $12,569.50 | $20,949.17 | $3,142.38 – $16,180.00 | 23 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $14,770.25 | $24,617.09 | $3,692.56 – $27,252.71 | 23 |
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.