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 |
|---|---|---|---|---|
| Smear gram stain CPT 87205 | $74.19 | $123.65 | $3.59 – $92.74 | 24 |
| Smear nasal eosinophil CPT 89190 | $60.60 | $101.00 | $4.86 – $75.75 | 24 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $100.78 | $167.96 | $5.03 – $125.97 | 24 |
| Smear wet mount CPT 87210 | $75.59 | $125.99 | $4.89 – $94.49 | 24 |
| Smn1 gene full gene sequence CPT 81336 | $1,200.00 | $2,000.00 | $35.00 – $1,500.00 | 24 |
| Snrpn/ube3a gene CPT 81331 | $458.90 | $764.83 | $10.00 – $573.62 | 24 |
| Sodium 24 hour urine CPT 84300 | $70.34 | $117.24 | $4.25 – $87.93 | 24 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $45.90 | $76.50 | $2.40 – $26.72 | 19 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $30.00 | $50.00 | $1.49 – $42.50 | 19 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $30.00 | $50.00 | $0.77 – $21.68 | 19 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $31.39 | $52.32 | $2.70 – $15.30 | 18 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $131.28 | $218.80 | $2.63 – $185.98 | 19 |
| Sodium serum/plasma/whole blood CPT 84295 | $62.12 | $103.54 | $4.04 – $77.66 | 24 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $156.60 | $261.00 | $0.84 – $195.75 | 23 |
| Soft interface below knee se HCPCS L2820 | $220.56 | $367.60 | $55.14 – $294.08 | 17 |
| Somatosensory testing CPT 95927 | $1,066.46 | $1,777.44 | $206.40 – $1,333.08 | 24 |
| So neo gsap dna/dna&rna CPT 81459 | $3,402.00 | $5,670.00 | $35.00 – $6,427.53 | 23 |
| So neo gsap dna mcrstl ins CPT 81457 | $3,975.00 | $6,625.00 | $35.00 – $2,733.75 | 23 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Special physics consult CPT 77370 | $945.67 | $1,576.11 | $128.48 – $1,182.08 | 24 |
| Special radiation dosimetry CPT 77331 | $539.97 | $899.95 | $30.36 – $674.96 | 24 |
| Special radiation treatment CPT 77470 | $1,787.51 | $2,979.19 | $40.48 – $2,234.39 | 24 |
| Special supplies phys/qhp CPT 99070 | $60.00 | $100.00 | $7.50 – $42.50 | 18 |
| Special teletx port plan CPT 77321 | $530.47 | $884.11 | $69.72 – $915.33 | 24 |
| Specific gravity body fluid CPT 84315 | $29.54 | $49.24 | $2.76 – $36.93 | 24 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $423.40 | $705.66 | $105.85 – $612.96 | 19 |
| Speech evaluation complex CPT 70371 | $527.06 | $878.44 | $109.60 – $658.83 | 24 |
| Speech Therapy Session (one-on-one) CPT 92507 | $293.11 | $488.51 | $73.28 – $415.23 | 19 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $6,497.00 – $6,497.00 | 1 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,692.88 | $2,821.46 | $262.86 – $3,693.00 | 22 |
| Spine X-ray (single view, one level) CPT 72020 | $283.12 | $471.86 | $24.39 – $353.89 | 24 |
| Spleen imaging CPT 78185 | $367.06 | $611.77 | $153.36 – $1,021.72 | 24 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $107.85 | $179.75 | $26.96 – $143.80 | 17 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $4,543.60 | $7,572.67 | $1,457.62 – $8,887.48 | 24 |
| Split blood or products CPT 86985 | $125.72 | $209.54 | $10.00 – $423.12 | 24 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $1,612.78 | $2,687.96 | $403.19 – $2,284.77 | 17 |
| Sputum specimen collection CPT 89220 | $120.37 | $200.61 | $10.00 – $423.12 | 24 |
| Srs linear based CPT 77372 | $13,067.46 | $21,779.10 | $1,700.12 – $19,291.06 | 24 |
| Srs multisource CPT 77371 | $31,800.00 | $53,000.00 | $1,700.12 – $39,750.00 | 24 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $382.60 | $637.67 | $95.65 – $542.02 | 19 |
| Staph a dna amp probe CPT 87640 | $116.39 | $193.98 | $10.00 – $145.49 | 24 |
| Static or dynami afo pre ots HCPCS L4397 | $101.56 | $169.26 | $25.39 – $135.41 | 17 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $313.96 | $523.27 | $78.49 – $444.78 | 19 |
| Stem cells total count CPT 86367 | $357.60 | $596.00 | $10.00 – $447.00 | 24 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $49,101.56 | $81,835.93 | $7,038.00 – $69,560.54 | 19 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $50,985.00 | $84,975.00 | $0.91 – $4.84 | 17 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $6,120.24 | $10,200.40 | $10.90 – $333.13 | 18 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $35,204.12 | $58,673.54 | $0.00 – $0.01 | 18 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $8,229.86 | $13,716.43 | $72.17 – $384.91 | 17 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $24,055.19 | $40,091.98 | $6,013.80 – $34,078.18 | 19 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $14,391.32 | $23,985.53 | $3,597.83 – $20,387.70 | 18 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $27,840.56 | $46,400.94 | $6,960.14 – $43,439.01 | 19 |
| St evaluate speech sound production CPT 92522 | $363.57 | $605.95 | $90.89 – $515.06 | 19 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $470.28 | $783.80 | $112.00 – $666.23 | 19 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,861.14 | $3,101.90 | $296.71 – $2,326.43 | 24 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $258.86 | $431.44 | $10.80 – $390.34 | 24 |
| Strapping of chest CPT 29200 | $226.35 | $377.25 | $15.78 – $390.34 | 24 |
| Strapping of elbow or wrist 29260 CPT 29260 | $215.27 | $358.79 | $53.82 – $269.09 | 24 |
| Strapping of hand or finger CPT 29280 | $216.60 | $361.00 | $54.15 – $270.75 | 24 |
| Strapping of hip CPT 29520 | $140.74 | $234.56 | $35.18 – $316.45 | 24 |
| Strapping of knee CPT 29530 | $216.34 | $360.56 | $54.08 – $316.45 | 24 |
| Strapping of toes 29550 CPT 29550 | $244.30 | $407.16 | $56.39 – $305.37 | 24 |
| Strep a ag ia CPT 87430 | $104.03 | $173.39 | $10.00 – $130.04 | 24 |
| Strep b dna amp probe CPT 87653 | $194.21 | $323.69 | $10.00 – $242.77 | 24 |
| Stress test pulmonary CPT 94618 | $363.12 | $605.20 | $90.78 – $453.90 | 24 |
| Stress tte complete CPT 93351 | $2,721.33 | $4,535.55 | $459.15 – $3,401.66 | 24 |
| Str markers spec anal addl CPT 81266 | $479.17 | $798.61 | $35.00 – $731.54 | 24 |
| Str markers specimen anal CPT 81265 | $984.41 | $1,640.68 | $35.00 – $1,230.51 | 24 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $72.13 | $120.22 | $6.00 – $34.00 | 18 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $2,763.00 – $8,887.48 | 17 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $2,763.00 – $8,887.48 | 17 |
| Sugars single quant CPT 84378 | $77.40 | $129.00 | $9.69 – $96.75 | 24 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $1,979,710.86 | $3,299,518.10 | $2.12 – $102.00 | 18 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $138.43 | $230.72 | $0.04 – $68.20 | 19 |
| Sulfonylurea screen qn-sendout CPT 80377 | $241.66 | $402.76 | $6.53 – $110.45 | 17 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $237.70 | $396.16 | $59.42 – $336.74 | 18 |
| Support clav 29.6-40.5in med HCPCS L3650 | $175.89 | $293.15 | $36.90 – $196.80 | 17 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $939.93 – $6,955.62 | 16 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $1,405.10 – $7,038.00 | 3 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $6,497.00 – $17,722.46 | 16 |
| Surgical pathology level 1 gross examination only CPT 88300 | $110.02 | $183.37 | $27.51 – $137.53 | 24 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $176.63 | $294.38 | $35.00 – $220.78 | 24 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $239.50 | $399.16 | $35.00 – $299.37 | 24 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $474.00 | $790.00 | $35.00 – $371.42 | 24 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $476.75 | $794.58 | $35.00 – $890.45 | 24 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $657.12 | $1,095.20 | $35.00 – $2,130.15 | 24 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $939.93 – $6,955.62 | 17 |
| Susceptibility agar dilution per agent CPT 87181 | $54.62 | $91.04 | $3.99 – $68.28 | 24 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $88.04 | $146.73 | $3.99 – $58.78 | 24 |
| Susceptibility mic per plate CPT 87186 | $169.46 | $282.44 | $7.27 – $211.83 | 24 |
| Suscept studies macrobroth dilution ea CPT 87188 | $59.71 | $99.52 | $5.58 – $74.64 | 24 |
| Svc venogram s&i CPT 75827 | $1,934.62 | $3,224.36 | $118.95 – $3,967.42 | 24 |
| Swallowing Evaluation (Bedside) CPT 92610 | $340.13 | $566.88 | $85.03 – $481.85 | 19 |
| Swallowing Therapy Session CPT 92526 | $297.77 | $496.28 | $74.44 – $421.84 | 19 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $659.94 – $7,038.00 | 16 |
| Synvisc or synvisc-one HCPCS J7325 | $1,232.66 | $2,054.43 | $6.61 – $1,540.82 | 24 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $69.79 | $116.31 | $3.70 – $41.93 | 24 |
| System cardiomems hosp electronics HCPCS C2624 | $45,886.50 | $76,477.50 | $11,471.62 – $61,182.00 | 17 |
| System pacing micra av HCPCS C1786 | $32,426.46 | $54,044.10 | $642.41 – $3,426.19 | 17 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $8,861.20 | $14,768.66 | $741.00 – $3,952.00 | 17 |
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.