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 |
|---|---|---|---|---|
| Prq trluml revsc ch occ ant CPT 92943 | $17,474.24 | $29,123.73 | $4,368.56 – $27,252.71 | 23 |
| Pr removal drug delivery implant CPT 11982 | $271.48 | $452.47 | $54.42 – $987.04 | 24 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $280.79 | $467.99 | $70.20 – $350.99 | 24 |
| Pr removal intrauterine device CPT 58301 | $483.35 | $805.59 | $51.22 – $794.72 | 24 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $814.87 | $1,358.12 | $111.00 – $1,018.59 | 24 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $452.17 | $753.62 | $111.00 – $565.22 | 24 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $517.20 | $862.00 | $129.30 – $646.50 | 24 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $483.80 | $806.34 | $111.00 – $604.75 | 24 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $480.84 | $801.40 | $120.21 – $601.05 | 24 |
| Pr robotic surgical system HCPCS S2900 | not published | not published | $1,826.96 – $1,826.96 | 1 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $709.01 – $4,517.58 | 17 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,835.30 | $3,058.83 | $458.82 – $3,967.42 | 24 |
| PSA (Prostate) Test CPT 84153 | $150.44 | $250.73 | $10.00 – $47.29 | 24 |
| Psychoeducation 45 min + HCPCS G0177 | $168.81 | $281.35 | $42.20 – $239.15 | 18 |
| Psychotherapy group therapy CPT 90853 | $643.20 | $1,072.00 | $40.20 – $220.82 | 24 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $200.43 | $334.05 | $50.11 – $394.97 | 24 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $274.50 | $457.50 | $68.62 – $394.97 | 24 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $287.47 | $479.11 | $71.87 – $394.97 | 24 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $339.40 | $565.66 | $84.85 – $777.56 | 24 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $281.16 | $468.60 | $70.29 – $398.31 | 18 |
| Psychthrp grp 45-50min mcr HCPCS G0410 | $95.80 | $159.67 | $23.95 – $135.72 | 18 |
| Psycl/nrpsyc tech 1st CPT 96138 | $277.03 | $461.72 | $69.26 – $987.04 | 24 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $224.75 | $374.58 | $56.19 – $316.45 | 24 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $181.03 | $301.71 | $45.26 – $256.45 | 18 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $173.06 | $288.44 | $43.27 – $245.17 | 18 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $43.19 | $71.98 | $10.80 – $134.00 | 19 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $154.64 | $257.74 | $38.66 – $219.08 | 19 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $85.93 | $143.21 | $21.48 – $134.00 | 19 |
| Pt application of modality traction mechanical CPT 97012 | $86.94 | $144.90 | $21.73 – $134.00 | 19 |
| Pten gene dup/delet variant CPT 81323 | $825.86 | $1,376.44 | $35.00 – $840.94 | 24 |
| Pten gene full sequence CPT 81321 | $926.64 | $1,544.40 | $35.00 – $1,440.00 | 24 |
| Pt-focused hlth risk assmt CPT 96160 | $64.40 | $107.33 | $16.10 – $81.06 | 21 |
| Pt prgrm for implt neurostim HCPCS L8681 | $2,922.62 | $4,871.04 | $655.67 – $3,715.44 | 18 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $148.17 | $246.95 | $37.04 – $209.91 | 19 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $87.34 | $145.56 | $21.83 – $157.00 | 19 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $89.14 | $148.56 | $22.28 – $134.00 | 19 |
| Pt wheelchair management each 15 minutes CPT 97542 | $95.03 | $158.39 | $23.76 – $134.63 | 19 |
| Pul art balloon repr percut CPT 92997 | $9,721.21 | $16,202.01 | $2,430.30 – $27,252.71 | 23 |
| Pul art balloon repr percut CPT 92998 | $3,712.69 | $6,187.82 | $928.17 – $16,180.00 | 16 |
| Pulmonary vent imaging CPT 78579 | $828.73 | $1,381.21 | $169.08 – $1,035.91 | 24 |
| Pulse ox continuous overnight monitoring CPT 94762 | $394.75 | $657.92 | $98.69 – $493.44 | 24 |
| Pulse ox multiple CPT 94761 | $194.33 | $323.88 | $13.26 – $275.30 | 18 |
| Pulse ox single CPT 94760 | $112.05 | $186.75 | $7.74 – $158.74 | 18 |
| Punc of shunt for asp or inj CPT 61070 | $1,041.57 | $1,735.95 | $262.86 – $1,713.14 | 24 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $127.50 | $212.50 | $10.00 – $316.45 | 24 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $645.13 | $1,075.22 | $67.83 – $987.79 | 24 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,173.65 | $1,956.09 | $262.86 – $1,713.14 | 24 |
| Puraply 1 sq cm HCPCS Q4195 | $1,431.49 | $2,385.82 | $43.68 – $269.22 | 23 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $1,013.20 | $1,688.66 | $253.30 – $1,435.36 | 18 |
| Pvb thoracic single inj site CPT 64461 | $1,021.03 | $1,701.71 | $111.00 – $1,713.14 | 24 |
| Pwr pck base combo vad, rep HCPCS Q0489 | $16,315.20 | $27,192.00 | $4,078.80 – $21,753.60 | 17 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $78.23 | $130.38 | $16.38 – $110.82 | 19 |
| Pyruvate CPT 84210 | $94.50 | $157.50 | $10.00 – $118.12 | 24 |
| Pyruvate kinase CPT 84220 | $295.94 | $493.23 | $7.93 – $65.62 | 24 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,610.93 | $2,684.88 | $269.31 – $2,013.66 | 24 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,199.16 | $1,998.60 | $181.76 – $1,498.95 | 24 |
| Quest t3 uptake CPT 84479 | $90.83 | $151.39 | $5.43 – $113.54 | 24 |
| Quinupristin/dalfopristin HCPCS J2770 | $1,261.22 | $2,102.04 | $16.20 – $1,786.73 | 19 |
| Rabies ig ht&sol human im/sc CPT 90377 | $6,129.43 | $10,215.72 | $230.07 – $1,682.14 | 24 |
| Radiation handling CPT 77790 | $213.57 | $355.95 | $24.18 – $302.56 | 18 |
| Radiation physics consult CPT 77336 | $694.39 | $1,157.31 | $127.06 – $867.98 | 24 |
| Radiation therapy dose plan CPT 77300 | $473.01 | $788.35 | $53.98 – $591.26 | 24 |
| Radiation treatment aid(s) CPT 77332 | $262.55 | $437.59 | $45.54 – $336.13 | 24 |
| Radiation treatment aid(s) CPT 77333 | $730.71 | $1,217.85 | $111.32 – $913.39 | 24 |
| Radiation treatment aid(s) CPT 77334 | $1,207.28 | $2,012.13 | $107.95 – $1,509.10 | 24 |
| Radiation treatment delivery CPT 77401 | $130.96 | $218.27 | $32.74 – $297.05 | 19 |
| Radiation treatment delivery CPT 77402 | $1,200.00 | $2,000.00 | $97.53 – $1,500.00 | 24 |
| Radiation treatment delivery CPT 77412 | $2,400.00 | $4,000.00 | $378.92 – $3,000.00 | 24 |
| Radiation tx management x5 CPT 77427 | $326.16 | $543.60 | $81.54 – $462.06 | 18 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $3,122.04 – $15,697.77 | 15 |
| Radiology port images(s) CPT 77417 | $230.29 | $383.81 | $17.99 – $326.24 | 18 |
| Radiotherapy dose plan imrt CPT 77301 | $5,996.41 | $9,994.01 | $1,323.09 – $7,495.51 | 24 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,175.81 | $3,626.35 | $275.66 – $3,517.62 | 24 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $3,357.46 | $5,595.76 | $519.02 – $4,196.82 | 24 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,731.46 | $4,552.43 | $652.23 – $3,517.62 | 24 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,723.06 | $4,538.43 | $338.81 – $3,517.62 | 24 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,494.49 | $2,490.81 | $228.55 – $1,868.11 | 24 |
| Radphm quant measure sgl area add-on CPT 78835 | $734.09 | $1,223.48 | $89.21 – $1,039.96 | 18 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $815.20 – $7,039.11 | 17 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $815.20 – $10,795.00 | 16 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $815.20 – $7,039.11 | 16 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $2,652.22 | $4,420.37 | $70.38 – $3,315.28 | 24 |
| Rapid desensitization CPT 95180 | $331.20 | $552.00 | $82.80 – $987.04 | 21 |
| Rapid Strep Test CPT 87880 | $259.93 | $433.21 | $10.00 – $324.91 | 24 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $1,934.13 | $3,223.55 | $363.08 – $2,417.66 | 24 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $42,296.39 | $70,493.98 | $206.22 – $14,446.50 | 24 |
| Rbc count only automated CPT 85041 | $11.85 | $19.75 | $2.54 – $14.81 | 24 |
| Rbc deglycerolized each unit HCPCS P9039 | $856.71 | $1,427.85 | $214.18 – $1,070.89 | 24 |
| Rbc depletion of harvest CPT 38212 | $1,803.18 | $3,005.30 | $35.00 – $2,253.97 | 24 |
| Rbc irradiated each unit HCPCS P9038 | $517.86 | $863.10 | $129.47 – $647.33 | 24 |
| Rbc osmotic fragility CPT 85555 | $151.80 | $253.00 | $6.27 – $189.75 | 24 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $1,954.22 – $14,507.25 | 16 |
| Realignment of knee CPT 27457 | not published | not published | $1,686.48 – $15,697.77 | 15 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Recon, cta for surg plan HCPCS G0288 | $508.91 | $848.18 | $72.80 – $1,841.00 | 18 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $2,569.02 – $14,507.25 | 16 |
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.