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 |
|---|---|---|---|---|
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $328.50 – $4,063.00 | 17 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $2,265.62 | $3,776.04 | $328.50 – $4,063.00 | 22 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $41.09 | $68.48 | $10.00 – $51.36 | 24 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $28.90 | $48.16 | $7.22 – $57.79 | 24 |
| Screening Mammogram CPT 77067 | $227.22 | $378.70 | $56.80 – $321.89 | 18 |
| Screening prostate cancer PSA HCPCS G0103 | $147.55 | $245.91 | $10.00 – $184.43 | 24 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $58.41 | $97.35 | $14.60 – $82.75 | 14 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $36,885.10 | $61,475.16 | $0.00 – $0.01 | 17 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $612.55 | $1,020.91 | $99.94 – $765.68 | 24 |
| Sc ther infusion reset pump CPT 96371 | $125.46 | $209.10 | $31.36 – $174.51 | 24 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $1,439.81 – $7,038.00 | 3 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $4,651.60 | $7,752.67 | $1,162.90 – $6,589.77 | 18 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $375.34 | $625.57 | $17.71 – $531.73 | 18 |
| Sedimentation rate erythrocyte automated CPT 85652 | $67.06 | $111.76 | $2.27 – $83.82 | 24 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $118.90 | $198.16 | $29.72 – $168.44 | 19 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | $51.98 | $86.63 | $12.99 – $73.64 | 18 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | $31.92 | $53.20 | $7.98 – $45.22 | 18 |
| Semen analysis presence/motility CPT 89321 | $79.92 | $133.20 | $10.00 – $99.90 | 24 |
| Semen analysis w/count CPT 89310 | $85.80 | $143.00 | $8.18 – $107.25 | 24 |
| Sept9 promoter methylation analysis CPT 81327 | $376.58 | $627.64 | $35.00 – $470.73 | 24 |
| Serial casting application 97139app CPT 97139 | $67.42 | $112.36 | $16.85 – $95.51 | 19 |
| Serpina1 gene CPT 81332 | $335.18 | $558.63 | $35.00 – $418.97 | 24 |
| Sertraline (zoloft) - sendout CPT 80332 | $306.00 | $510.00 | $10.00 – $202.42 | 17 |
| Set radiation therapy field CPT 77280 | $834.76 | $1,391.26 | $128.48 – $1,043.44 | 24 |
| Set radiation therapy field CPT 77285 | $669.97 | $1,116.61 | $167.49 – $915.33 | 24 |
| Set radiation therapy field CPT 77290 | $1,636.36 | $2,727.26 | $357.92 – $2,045.44 | 24 |
| Set-up cardiovert-defibrill CPT 93745 | $373.29 | $622.15 | $93.32 – $739.93 | 24 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $7.14 | $11.90 | $0.09 – $0.50 | 18 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $21.42 | $35.70 | $2.84 – $16.07 | 18 |
| Sf3b1 gene common variants CPT 81347 | $115.95 | $193.25 | $28.99 – $463.80 | 24 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $232.20 | $387.00 | $58.05 – $495.95 | 24 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | $370.92 | $618.20 | $92.73 – $987.79 | 24 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $6,108.01 | $10,180.01 | $12.90 – $73.11 | 18 |
| Sheath laser cavaclear 14f HCPCS C1603 | $6,108.01 | $10,180.01 | $1,527.00 – $8,653.01 | 18 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $1,088.27 – $12,343.00 | 17 |
| Shoe post-op mens m HCPCS L3260 | $229.82 | $383.04 | $2.70 – $325.58 | 18 |
| Shoe wedge sach HCPCS L3340 | $225.00 | $375.00 | $56.25 – $300.00 | 17 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $192.72 | $321.20 | $48.18 – $240.90 | 24 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $199.75 | $332.92 | $29.08 – $249.69 | 24 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $223.85 | $373.08 | $24.06 – $279.81 | 24 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,354.00 | $3,923.33 | $333.49 – $2,942.50 | 24 |
| Shoulder MRI (with contrast) CPT 73222 | $2,857.68 | $4,762.80 | $323.10 – $3,572.10 | 24 |
| Shoulder MRI (without contrast) CPT 73221 | $1,788.37 | $2,980.61 | $209.16 – $2,235.46 | 24 |
| Shoulder prosthesis removal CPT 23334 | $2,808.74 | $4,681.24 | $815.20 – $15,697.77 | 24 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $2,245.00 – $15,697.77 | 15 |
| Shoulder X-ray CPT 73030 | $306.88 | $511.46 | $35.09 – $383.60 | 24 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $268.60 | $447.67 | $21.71 – $335.75 | 24 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $5,047.52 | $8,412.53 | $381.15 – $2,032.80 | 17 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $697.07 | $1,161.78 | $81.86 – $871.34 | 24 |
| Sialography s&i CPT 70390 | $295.76 | $492.93 | $115.94 – $607.02 | 24 |
| Sialolithotomy 42330 CPT 42330 | $2,436.84 | $4,061.40 | $121.82 – $7,975.81 | 24 |
| Sickling rbc CPT 85660 | $71.95 | $119.91 | $4.63 – $49.46 | 24 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $328.50 – $3,693.00 | 16 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $429.26 – $3,693.00 | 17 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $328.50 – $3,693.00 | 16 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $429.26 – $3,693.00 | 16 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $939.93 – $6,955.62 | 16 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $429.26 – $3,693.00 | 17 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $328.50 – $3,693.00 | 17 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $429.26 – $3,693.00 | 17 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $328.50 – $3,693.00 | 17 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $373.12 | $621.86 | $31.74 – $466.39 | 24 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $429.26 – $3,693.00 | 17 |
| Sim ang w/prs cath rad emb HCPCS C8004 | $13,001.06 | $21,668.44 | $3,250.27 – $24,974.19 | 21 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,908.20 | $3,180.33 | $167.67 – $2,385.25 | 24 |
| Sinus CT scan (with contrast) CPT 70487 | $2,004.41 | $3,340.68 | $156.38 – $2,505.51 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $1,704.54 | $2,840.90 | $99.94 – $2,130.68 | 24 |
| Sinus/juglr venogram s&i CPT 75860 | $2,052.67 | $3,421.11 | $125.64 – $7,896.23 | 24 |
| Sinus X-ray (complete) CPT 70220 | $328.04 | $546.74 | $37.76 – $410.06 | 24 |
| Sinus X-ray (limited) CPT 70210 | $151.82 | $253.04 | $32.41 – $225.11 | 24 |
| Sipuleucel-t - su HCPCS Q2043 | $112,684.50 | $187,807.50 | $28,171.12 – $140,855.62 | 24 |
| Sirolimus, oral HCPCS J7520 | $42.11 | $70.18 | $1.31 – $24.32 | 19 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $252.00 | $420.00 | $10.00 – $104.96 | 17 |
| Skin Biopsy CPT 11102 | $269.02 | $448.37 | $64.23 – $879.44 | 24 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $709.01 – $6,093.00 | 17 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $1,896.00 – $2,763.00 | 2 |
| Skull X-ray (1 to 3 views) CPT 70250 | $277.54 | $462.56 | $36.09 – $346.92 | 24 |
| Skull X-ray (complete) CPT 70260 | $350.76 | $584.60 | $44.78 – $438.45 | 24 |
| Slco1b1 gene com variants CPT 81328 | $37.80 | $63.00 | $9.45 – $419.54 | 24 |
| Sleep Study (Polysomnography) CPT 95810 | $4,658.81 | $7,764.68 | $820.87 – $5,823.51 | 24 |
| Sleep study unattended CPT 95806 | $794.20 | $1,323.67 | $198.55 – $992.75 | 24 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $41.10 | $68.50 | $2.00 – $10.65 | 17 |
| Sling suprapubic suburetheral HCPCS C1771 | $16,564.21 | $27,607.02 | $192.97 – $1,029.18 | 17 |
| Slitting of prepuce CPT 54001 | $2,761.01 | $4,601.68 | $652.80 – $5,045.72 | 24 |
| Slp pure tone screening CPT 92551 | $82.04 | $136.73 | $20.51 – $116.22 | 18 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $561.67 | $936.12 | $121.96 – $702.09 | 24 |
| Small bowel endoscopy CPT 44360 | not published | not published | $564.97 – $4,713.77 | 17 |
| Small bowel endoscopy CPT 44366 | not published | not published | $564.97 – $4,713.77 | 17 |
| Small bowel endoscopy CPT 44382 | not published | not published | $334.95 – $3,693.00 | 17 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $564.97 – $4,713.77 | 17 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $334.95 – $3,693.00 | 17 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $87.49 | $145.82 | $4.53 – $39.47 | 24 |
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.