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 |
|---|---|---|---|---|
| Respirator motion mgmt simul CPT 77293 | $1,200.53 | $2,000.89 | $300.13 – $1,700.76 | 18 |
| #resp virpnl dfa-adenovirus CPT 87260 | $79.09 | $131.81 | $10.00 – $98.86 | 24 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $80.73 | $134.55 | $10.00 – $100.91 | 24 |
| Resp virus 6-11 targets CPT 87632 | $1,005.77 | $1,676.28 | $10.00 – $1,257.21 | 24 |
| Resuscitation delivery/birthing room CPT 99465 | $913.29 | $1,522.15 | $228.32 – $1,612.26 | 24 |
| Reticulated platelet assay CPT 85055 | $49.40 | $82.34 | $10.00 – $85.78 | 24 |
| Reticulocyte automated CPT 85045 | $63.76 | $106.26 | $3.35 – $79.69 | 24 |
| Reticulocyte direct measurement automated CPT 85046 | $66.44 | $110.73 | $4.68 – $71.72 | 24 |
| Revasc evasc fpvt angio cplx 1st CPT 37265 | $25,311.78 | $42,186.30 | $3,036.54 – $31,639.72 | 22 |
| Revasc evasc fpvt angio sf 1st CPT 37263 | $16,874.52 | $28,124.20 | $3,036.54 – $21,093.15 | 22 |
| Revasc evasc fpvt athrec cplx 1st CPT 37273 | $39,755.23 | $66,258.72 | $10,479.62 – $49,694.04 | 22 |
| Revasc evasc fpvt athrec sf 1st CPT 37271 | $26,503.49 | $44,172.48 | $10,479.62 – $39,657.85 | 22 |
| Revasc evasc fpvt st athrec sf 1st CPT 37275 | $49,101.56 | $81,835.93 | $10,564.28 – $61,376.95 | 22 |
| Revasc evasc fpvt stent cplx 1st CPT 37269 | $37,842.22 | $63,070.36 | $6,452.54 – $47,302.77 | 22 |
| Revasc evasc fpvt stent sf 1st CPT 37267 | $25,228.15 | $42,046.91 | $6,452.54 – $31,535.18 | 22 |
| Revasc evasc imvt angio cplx 1st CPT 37298 | $19,149.11 | $31,915.18 | $5,662.36 – $24,974.19 | 22 |
| Revasc evasc imvt angio sf 1st CPT 37296 | $10,433.75 | $17,389.59 | $5,662.36 – $24,974.19 | 22 |
| Revasc evasc ivt angio cplx 1st CPT 37256 | $19,149.11 | $31,915.18 | $2,869.66 – $23,936.38 | 22 |
| Revasc evasc ivt stent cplx 1st CPT 37260 | $36,082.78 | $60,137.97 | $6,132.14 – $45,103.48 | 22 |
| Revasc evasc ivt stent sf 1st CPT 37258 | $24,055.19 | $40,091.98 | $6,132.14 – $30,068.99 | 22 |
| Revasc evasc tpvt angio cplx 1st CPT 37282 | $27,584.07 | $45,973.45 | $5,662.36 – $34,480.09 | 22 |
| Revasc evasc tpvt angio sf 1st CPT 37280 | $18,389.38 | $30,648.97 | $5,662.36 – $24,974.19 | 22 |
| Revasc evasc tpvt athrec cplx 1st CPT 37290 | $41,886.61 | $69,811.02 | $9,898.27 – $52,358.26 | 22 |
| Revasc evasc tpvt athrec sf 1st CPT 37288 | $27,924.41 | $46,540.68 | $9,898.27 – $39,657.85 | 22 |
| Revasc intra lithotrip-ather HCPCS C9766 | $28,802.66 | $48,004.44 | $7,038.00 – $43,439.01 | 24 |
| Revasc intra lithotrip-stent HCPCS C9765 | $26,279.32 | $43,798.86 | $6,569.83 – $43,439.01 | 24 |
| Revasc intravasc lithotripsy HCPCS C9764 | $16,874.52 | $28,124.20 | $4,218.63 – $27,252.71 | 24 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $21,307.71 | $35,512.85 | $7,038.00 – $43,439.01 | 24 |
| Revasc lithotrip-stent-ather HCPCS C9767 | $50,858.14 | $84,763.57 | $7,038.00 – $63,572.68 | 24 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $14,653.34 | $24,422.24 | $4,750.24 – $27,252.71 | 24 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $22,322.36 | $37,203.94 | $7,038.00 – $43,439.01 | 24 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $18,789.86 | $31,316.44 | $7,038.00 – $43,439.01 | 24 |
| Revise arm/leg nerve CPT 64708 | not published | not published | $659.94 – $4,783.04 | 17 |
| Revise breast reconst 19380 CPT 19380 | not published | not published | $1,845.21 – $16,154.42 | 17 |
| Revise hip joint replacement CPT 27134 | not published | not published | $3,366.89 – $27,774.62 | 15 |
| Revise hip joint replacement CPT 27138 | not published | not published | $2,688.40 – $27,774.62 | 15 |
| Revise knuckle joint CPT 26530 | not published | not published | $2,763.00 – $17,722.46 | 17 |
| Revise knuckle with implant CPT 26531 | not published | not published | $3,500.43 – $17,722.46 | 17 |
| Revise lower leg tendon CPT 27690 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revise lower leg tendon CPT 27691 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revise middle ear bone CPT 69660 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear bone CPT 69662 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid CPT 69641 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid CPT 69642 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid CPT 69643 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid CPT 69644 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid CPT 69646 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise middle ear & mastoid 69645 CPT 69645 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revise/remove sling repair CPT 57287 | not published | not published | $1,063.52 – $7,744.80 | 16 |
| Revise/replace knee joint CPT 27486 | not published | not published | $2,469.14 – $27,774.62 | 15 |
| Revise/replace knee joint CPT 27487 | not published | not published | $3,089.76 – $37,931.89 | 15 |
| Revise spermatic cord veins CPT 55530 | not published | not published | $1,142.90 – $8,636.11 | 17 |
| Revise spine eltrd plate CPT 63664 | not published | not published | $7,423.93 – $33,745.27 | 16 |
| Revise ulnar nerve at wrist CPT 64719 | not published | not published | $659.94 – $4,783.04 | 17 |
| Revise urethra stage 1 CPT 53400 | not published | not published | $1,689.43 – $12,818.21 | 17 |
| Revise vag graft open abd CPT 57296 | not published | not published | $1,638.37 – $7,038.00 | 3 |
| Revise vag graft via vagina CPT 57295 | not published | not published | $1,063.52 – $7,744.80 | 16 |
| Revise wrist/forearm tendon CPT 25280 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Revision of arm nerve(s) CPT 64713 | not published | not published | $659.94 – $4,783.04 | 17 |
| Revision of big toe CPT 28310 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revision of bladder neck CPT 52500 | not published | not published | $1,142.90 – $8,636.11 | 17 |
| Revision of calf tendon CPT 27687 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Revision of cervix CPT 57720 | not published | not published | $1,063.52 – $7,744.80 | 17 |
| Revision of cervix CPT 59320 | $3,854.76 | $6,424.60 | $1,063.52 – $7,744.80 | 24 |
| Revision of cranial nerve CPT 64716 | not published | not published | $659.94 – $6,093.00 | 17 |
| Revision of eyelid CPT 67882 | $2,470.39 | $4,117.32 | $698.30 – $5,788.85 | 24 |
| Revision of foot CPT 28116 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Revision of foot bones CPT 28737 | not published | not published | $3,879.00 – $32,603.53 | 17 |
| Revision of foot fascia 28250 CPT 28250 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Revision of foot tendon CPT 28238 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revision of heart chamber CPT 92992 | $7,684.33 | $12,807.21 | $1,921.08 – $10,886.13 | 17 |
| Revision of iris CPT 66761 | $1,722.25 | $2,870.42 | $153.38 – $2,152.82 | 24 |
| Revision of jaw muscle/bone CPT 21296 | not published | not published | $886.62 – $7,975.81 | 17 |
| Revision of knee joint CPT 27446 | not published | not published | $7,038.00 – $32,603.53 | 16 |
| Revision of neck muscle CPT 21700 | $3,098.15 | $5,163.58 | $1,807.25 – $17,722.46 | 24 |
| Revision of nose CPT 30120 | not published | not published | $886.62 – $7,975.81 | 17 |
| Revision of nose CPT 30435 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revision of nose CPT 30450 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Revision of penis CPT 54420 | $4,044.67 | $6,741.12 | $1,142.90 – $8,636.11 | 24 |
| Revision of penis CPT 54430 | $4,337.39 | $7,228.99 | $1,084.35 – $6,144.64 | 18 |
| Revision of penis CPT 54435 | $3,745.07 | $6,241.78 | $1,142.90 – $8,636.11 | 24 |
| Revision of thigh muscles CPT 27430 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Revision open av fistula without thromb CPT 36832 | $10,714.76 | $17,857.94 | $1,939.15 – $13,613.39 | 24 |
| Revision tips CPT 37183 | $11,218.30 | $18,697.16 | $2,804.57 – $14,159.18 | 24 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $7,038.00 – $32,603.53 | 16 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $3,077.59 – $27,774.62 | 15 |
| Revita, per sq cm HCPCS Q4180 | $389.83 | $649.72 | $59.31 – $296.54 | 23 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $1,804.00 – $8,428.94 | 17 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $1,499.71 – $8,428.94 | 17 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $1,804.00 – $8,428.94 | 17 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | $13,780.06 | $22,966.76 | $6,472.62 – $33,745.27 | 22 |
| Revsc opn/prq tib/pero stent CPT 37234 | $11,094.73 | $18,491.22 | $2,773.68 – $15,717.54 | 16 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $2,450.84 | $4,084.73 | $659.94 – $4,783.04 | 24 |
| Rheumatoid factor qualitative CPT 86430 | $99.07 | $165.11 | $5.16 – $123.83 | 24 |
| Rheumatoid factor quantitative CPT 86431 | $83.19 | $138.65 | $4.76 – $16.88 | 24 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $449.62 | $749.36 | $5.33 – $636.96 | 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.