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 |
|---|---|---|---|---|
| Rho d immune globulin inj HCPCS J2790 | $154.05 | $256.75 | $38.51 – $218.24 | 19 |
| R hrt cath chd abnl nt cnj CPT 93594 | $9,114.35 | $15,190.59 | $2,278.59 – $11,392.94 | 23 |
| R hrt cath chd nml nt cnj CPT 93593 | $8,285.78 | $13,809.63 | $2,071.44 – $10,357.22 | 23 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $394.69 | $657.82 | $42.44 – $493.37 | 24 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $550.49 | $917.49 | $52.79 – $688.12 | 24 |
| Rib X-ray (3 views, both sides) CPT 71110 | $381.04 | $635.06 | $44.10 – $476.30 | 24 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $485.11 | $808.52 | $0.19 – $687.24 | 19 |
| Right heart cath congenital CPT 93530 | $8,522.51 | $14,204.19 | $2,130.63 – $16,180.00 | 17 |
| Right ventric recording CPT 93603 | $1,468.47 | $2,447.45 | $367.12 – $2,948.27 | 24 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $1,659.38 | $2,765.64 | $10.26 – $1,382.76 | 24 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $8,485.68 | $14,142.80 | $70.45 – $2,151.42 | 24 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $1,551.99 | $2,586.65 | $29.72 – $1,939.99 | 24 |
| R & l heart cath congenital CPT 93531 | $10,707.77 | $17,846.29 | $2,676.94 – $16,180.00 | 17 |
| R & l heart cath congenital CPT 93532 | $7,547.27 | $12,578.79 | $1,886.82 – $16,180.00 | 17 |
| R & l heart cath congenital CPT 93533 | $7,046.49 | $11,744.15 | $1,761.62 – $16,180.00 | 17 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | $8,169.46 | $13,615.76 | $2,042.36 – $10,211.82 | 23 |
| R&l hrt cath chd nml nt cnj CPT 93596 | $8,577.93 | $14,296.55 | $2,144.48 – $10,722.41 | 23 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $1,960.57 – $15,697.77 | 15 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $846.42 | $1,410.70 | $61.74 – $1,742.94 | 24 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $593.04 – $3,981.46 | 17 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | $815.20 – $7,039.11 | 17 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $2,584.96 | $4,308.26 | $429.26 – $3,231.20 | 24 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $2,258.77 | $3,764.62 | $123.47 – $4,016.35 | 24 |
| Rmvl icd by tv extr CPT 33244 | $6,981.14 | $11,635.24 | $1,745.29 – $9,728.21 | 24 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $43,926.37 | $73,210.62 | $16,336.46 – $58,392.49 | 24 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $44,390.75 | $73,984.58 | $19,034.00 – $81,499.55 | 24 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $38,067.53 | $63,445.88 | $16,178.06 – $58,392.49 | 24 |
| Rmvl icd pulse gen only CPT 33241 | $5,987.37 | $9,978.95 | $1,425.44 – $9,728.21 | 24 |
| Rmvl imed rx delivery device CPT 20703 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $894.98 | $1,491.63 | $111.00 – $1,556.23 | 24 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Rmvl perm pm pulse gen CPT 33233 | $7,028.51 | $11,714.19 | $2,416.00 – $21,045.99 | 24 |
| Rmvl perq right heart vad CPT 33997 | $4,633.06 | $7,721.76 | $289.92 – $7,038.00 | 16 |
| Rmvl phrnc nrv stim pg only CPT 33280 | $3,831.08 | $6,385.14 | $1,518.53 – $8,428.94 | 22 |
| Rmvl phrnc nrv stim sys CPT 33278 | $12,743.72 | $21,239.53 | $1,518.53 – $15,929.65 | 22 |
| Rmvl phrnc nrv stim transvns CPT 33279 | $7,968.65 | $13,281.09 | $1,912.42 – $9,960.82 | 22 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $19,823.71 | $33,039.51 | $9,828.12 – $48,269.91 | 24 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $18,220.94 | $30,368.24 | $5,259.03 – $22,776.18 | 24 |
| Rmvl pq iabp CPT 33968 | $2,262.94 | $3,771.56 | $565.73 – $3,205.83 | 17 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $4,864.71 | $8,107.85 | $1,216.18 – $6,891.67 | 17 |
| Rmvl sq defib electrode CPT 33272 | $7,532.10 | $12,553.50 | $1,883.03 – $9,728.21 | 23 |
| Rmvl subq card rhythm mntr CPT 33286 | $2,761.75 | $4,602.91 | $257.60 – $3,452.18 | 24 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $815.20 – $7,039.11 | 17 |
| Rmvl tv pm lead dual CPT 33235 | $5,661.48 | $9,435.80 | $1,870.58 – $9,728.21 | 24 |
| Rmvl tv pm lead sgl CPT 33234 | $6,786.41 | $11,310.69 | $1,906.80 – $9,728.21 | 24 |
| Rmv ntr oi implt skl prq esp CPT 69726 | $3,700.84 | $6,168.06 | $1,088.27 – $9,814.00 | 22 |
| Rmv&rplcmt phrnc nrv stim ld CPT 33288 | $35,305.79 | $58,842.99 | $8,775.47 – $44,132.24 | 22 |
| Rmv&rplcmt phrnc nrv stim pg CPT 33287 | $34,440.90 | $57,401.50 | $19,328.56 – $76,924.35 | 22 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $5,787.57 | $9,645.95 | $29.26 – $7,234.46 | 24 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $4,736.26 | $7,893.76 | $10.55 – $2,970.70 | 24 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $912.24 | $1,520.40 | $0.05 – $3.57 | 19 |
| Rotavirus antibody CPT 86759 | $125.01 | $208.35 | $10.00 – $156.26 | 24 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $2,590.19 | $4,316.99 | $605.62 – $3,967.42 | 24 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,603.09 | $2,671.81 | $244.59 – $2,003.86 | 24 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $3,006.39 | $5,010.65 | $436.04 – $3,757.99 | 24 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $3,814.88 | $6,358.14 | $823.96 – $4,768.60 | 24 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $2,617.94 | $4,363.24 | $446.27 – $3,967.42 | 24 |
| Rpl tun-cvad w subq port CPT 36582 | $5,219.37 | $8,698.95 | $1,118.22 – $7,896.23 | 24 |
| Rpl tun-cvad w subq pump CPT 36583 | $4,440.98 | $7,401.63 | $2,763.00 – $13,613.39 | 22 |
| Rpl tun cvc wo subq port CPT 36581 | $4,420.98 | $7,368.30 | $1,477.77 – $7,896.23 | 24 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | not published | not published | $1,857.63 – $10,795.00 | 3 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $1,151.54 – $14,005.19 | 16 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $1,151.54 – $14,293.73 | 16 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $1,151.54 – $14,005.19 | 16 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | $1,151.54 – $8,570.48 | 16 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $1,151.54 – $14,293.73 | 16 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | not published | not published | $2,251.10 – $10,795.00 | 3 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | not published | not published | $1,559.80 – $10,795.00 | 3 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $1,888.85 – $14,005.19 | 16 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $1,888.85 – $8,570.48 | 16 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $5,319.10 – $13,613.39 | 16 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $5,836.04 | $9,726.73 | $1,459.01 – $13,613.39 | 24 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | not published | not published | $1,346.63 – $9,126.00 | 3 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $1,151.54 – $8,570.48 | 17 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Rp therapy unlisted px CPT 79999 | $2,430.66 | $4,051.10 | $223.05 – $3,038.32 | 24 |
| Rsv assay w/optic CPT 87807 | $110.46 | $184.10 | $10.00 – $138.07 | 24 |
| Rubella antibody igg CPT 86762 | $100.02 | $166.70 | $10.00 – $34.54 | 24 |
| Rubeola antibody igg CPT 86765 | $99.31 | $165.51 | $10.00 – $30.91 | 24 |
| Russell viper venom diluted CPT 85613 | $108.05 | $180.08 | $8.05 – $27.75 | 24 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $1,100.50 | $1,834.16 | $35.00 – $2,200.99 | 24 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $170.92 | $284.87 | $39.43 – $272.35 | 24 |
| Salivary glnd img serial img CPT 78231 | $367.06 | $611.77 | $104.25 – $1,021.72 | 24 |
| Salmonella antibody CPT 86768 | $54.57 | $90.95 | $10.00 – $31.66 | 24 |
| Sars-cov-2 antb quantitative CPT 86413 | $17.39 | $28.98 | $10.00 – $123.43 | 24 |
| Sarscov coronavirus ag ia CPT 87426 | $60.40 | $100.67 | $10.00 – $84.79 | 24 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $44.10 | $73.50 | $10.00 – $168.70 | 24 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $815.66 | $1,359.44 | $179.76 – $1,019.58 | 24 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $509.35 | $848.91 | $99.94 – $636.68 | 24 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $601.48 | $1,002.46 | $99.94 – $751.85 | 24 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $803.29 | $1,338.82 | $99.94 – $1,004.12 | 24 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $743.65 | $1,239.41 | $99.94 – $929.56 | 24 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $702.13 | $1,170.22 | $99.94 – $877.66 | 24 |
| Scan proc cranial extra CPT 61782 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Scan proc spinal CPT 61783 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,690.00 | $2,816.66 | $422.50 – $4,016.35 | 24 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $7,127.71 | $11,879.51 | $31.57 – $1,495.28 | 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.