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 |
|---|---|---|---|---|
| Tissue culture placenta CPT 88235 | $585.14 | $975.24 | $35.00 – $731.43 | 24 |
| Tissue culture skin/biopsy CPT 88233 | $687.36 | $1,145.60 | $35.00 – $859.20 | 24 |
| Tissue culture tumor CPT 88239 | $772.11 | $1,286.85 | $35.00 – $965.14 | 24 |
| Tissue exam koh skin/hair/nails CPT 87220 | $51.02 | $85.04 | $3.59 – $63.78 | 24 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $304.84 | $508.07 | $13.82 – $269.22 | 23 |
| Tissue matrix xcm thk 20x30cm -cost per sq cm HCPCS Q4142 | $19,288.03 | $32,146.72 | $15.03 – $269.22 | 23 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $1,403.42 | $2,339.04 | $6.46 – $36.59 | 18 |
| Tissue transglutaminase iga CPT 86364 | $137.80 | $229.67 | $9.69 – $27.67 | 24 |
| Tixagev and cilgav inj HCPCS M0220 | $180.60 | $301.00 | $45.15 – $462.04 | 19 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $3,110.01 – $25,500.18 | 16 |
| Tlh uterus over 250 g CPT 58572 | not published | not published | $9,126.00 – $25,500.18 | 16 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $3,110.01 – $25,500.18 | 16 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $3,110.01 – $25,500.18 | 16 |
| Tlso 2 piece rigid shell HCPCS L0491 | $569.93 | $949.89 | $142.48 – $759.91 | 17 |
| Tlso 2 shl symphys-stern cst HCPCS L0460 | $1,535.15 | $2,558.58 | $383.79 – $2,046.86 | 17 |
| Tlso r fram soft ant pre cst HCPCS L0466 | $652.36 | $1,087.26 | $163.09 – $869.81 | 17 |
| Tlso rigid frame pre subclav HCPCS L0470 | $1,461.90 | $2,436.50 | $365.48 – $1,949.20 | 17 |
| Tlso rigid lined custom fab HCPCS L0482 | $2,547.21 | $4,245.35 | $636.80 – $3,396.28 | 17 |
| Tlso rigid plastic cust fab HCPCS L0484 | $2,347.16 | $3,911.93 | $586.79 – $3,129.54 | 17 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $228.45 | $380.75 | $2.22 – $14.35 | 19 |
| Tobramycin non-comp unit HCPCS J7682 | $143.38 | $238.96 | $2.22 – $74.25 | 19 |
| Tobramycin peak therapeutic drug level CPT 80200 | $171.40 | $285.66 | $10.00 – $214.25 | 24 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $2,390.24 | $3,983.73 | $5.25 – $1,195.11 | 24 |
| Toe X-ray (both feet) CPT 73660 | $191.86 | $319.76 | $29.40 – $239.82 | 24 |
| Tomosynthesis breast screen bilateral CPT 77063 | $95.23 | $158.71 | $50.46 – $134.90 | 18 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | not published | not published | $109.63 – $7,975.81 | 16 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $886.62 – $7,975.81 | 17 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $664.50 | $1,107.50 | $2.32 – $941.38 | 19 |
| Total hip arthroplasty CPT 27132 | not published | not published | $2,943.59 – $27,774.62 | 15 |
| Total Hip Replacement CPT 27130 | not published | not published | $7,038.00 – $32,603.53 | 16 |
| Total hysterectomy CPT 58150 | not published | not published | $1,772.37 – $7,038.00 | 3 |
| Total Knee Replacement CPT 27447 | not published | not published | $7,038.00 – $32,603.53 | 16 |
| Total tau CPT 84394 | $600.00 | $1,000.00 | $10.00 – $621.88 | 23 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | not published | not published | $7,038.00 – $46,166.33 | 16 |
| Toxoplasma antibody igg CPT 86777 | $315.00 | $525.00 | $10.00 – $34.54 | 24 |
| Toxoplasma antibody igm CPT 86778 | $252.00 | $420.00 | $10.00 – $34.58 | 24 |
| Tp53 gene full gene sequence CPT 81351 | $660.00 | $1,100.00 | $35.00 – $1,540.44 | 24 |
| Tp53 gene trgt sequence alys CPT 81352 | $1,828.50 | $3,047.50 | $35.00 – $984.30 | 24 |
| Tpmt gene com vrnts CPT 81335 | $637.50 | $1,062.50 | $35.00 – $592.50 | 24 |
| Tprnl plmt biodegrdabl matrl CPT 55874 | $5,980.69 | $9,967.81 | $2,405.54 – $12,818.21 | 24 |
| Trabeculoplasty laser surg CPT 65855 | $1,387.38 | $2,312.30 | $109.35 – $1,734.22 | 24 |
| Trachelectomy (cervicectomy) 57530 CPT 57530 | not published | not published | $1,526.99 – $12,321.66 | 17 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | $1,926.42 | $3,210.70 | $187.22 – $2,408.03 | 24 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $100.98 | $168.30 | $25.25 – $172.60 | 18 |
| Transabdom amnioinfus w/us CPT 59070 | $506.35 | $843.92 | $126.59 – $3,693.00 | 22 |
| Transab esoph hiat hern repair 43332 CPT 43332 | not published | not published | $2,045.83 – $7,038.00 | 3 |
| Transcath biopsy CPT 37200 | $4,285.93 | $7,143.21 | $1,939.15 – $13,613.39 | 24 |
| Transcath closure of asd CPT 93580 | $27,128.00 | $45,213.34 | $6,782.00 – $43,439.01 | 23 |
| Transcath closure of vsd CPT 93581 | $24,215.41 | $40,359.01 | $6,053.85 – $43,439.01 | 23 |
| Transcatheter bx s&i CPT 75970 | $1,774.94 | $2,958.24 | $81.44 – $2,514.50 | 18 |
| Transcath mv repair addl prosthesis CPT 33419 | $17,969.54 | $29,949.24 | $4,492.39 – $25,456.85 | 17 |
| Transcath mv repair init prosthesis CPT 33418 | $27,199.84 | $45,333.07 | $6,799.96 – $38,533.11 | 18 |
| Transcath occlusion cns CPT 61624 | $8,944.39 | $14,907.32 | $2,053.15 – $39,657.85 | 23 |
| Transcath occlusion non-cns CPT 61626 | $12,427.79 | $20,712.98 | $3,106.95 – $27,252.71 | 24 |
| Trans cath replace aortic valve 33366 CPT 33366 | $25,539.49 | $42,565.82 | $2,546.00 – $36,180.95 | 16 |
| Transcath rmvl perm ldss pmkr rv CPT 33275 | $4,127.40 | $6,879.00 | $1,031.85 – $7,896.23 | 23 |
| Transcutaneous hgb 88738 CPT 88738 | $31.12 | $51.86 | $4.77 – $38.90 | 24 |
| Transferrin CPT 84466 | $119.00 | $198.34 | $10.00 – $148.75 | 24 |
| Transorl lwr esophgl myotomy CPT 43497 | $4,229.53 | $7,049.22 | $1,057.38 – $14,118.49 | 22 |
| Transplant forearm tendon CPT 25310 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Transplt allo hct/donor CPT 38240 | $28,236.60 | $47,061.00 | $7,038.00 – $136,077.50 | 21 |
| Transplt allo lymphocytes CPT 38242 | $3,388.64 | $5,647.73 | $564.62 – $4,235.80 | 23 |
| Transplt autol hct/donor CPT 38241 | $9,000.00 | $15,000.00 | $564.62 – $12,750.00 | 24 |
| Transtemporal approach/skull CPT 61595 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $643.21 | $1,072.02 | $99.94 – $804.01 | 24 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $509.00 | $848.33 | $92.89 – $636.25 | 24 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $8,258.47 | $13,764.11 | $69.76 – $3,543.95 | 24 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $8,026.96 | $13,378.27 | $147.86 – $6,858.00 | 24 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $2,286.90 | $3,811.50 | $338.67 – $1,919.15 | 18 |
| Treat ankle dislocation CPT 27842 | $3,563.19 | $5,938.65 | $785.98 – $4,453.99 | 24 |
| Treat ankle dislocation CPT 27846 | not published | not published | $2,398.52 – $17,722.46 | 17 |
| Treat ankle fracture CPT 28445 | not published | not published | $2,763.00 – $17,722.46 | 17 |
| Treat big toe fracture CPT 28505 | $3,478.12 | $5,796.86 | $1,088.27 – $8,018.48 | 24 |
| Treat cheek bone fracturemalar 21360 CPT 21360 | not published | not published | $1,954.22 – $14,507.25 | 16 |
| Treat clavicle dislocation 23545 CPT 23545 | $825.57 | $1,375.95 | $85.32 – $1,031.96 | 24 |
| Treat ectopic pregnancy CPT 59150 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Treat ectopic pregnancy CPT 59151 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Treat elbow dislocation CPT 24605 | $3,477.41 | $5,795.68 | $593.04 – $4,346.76 | 24 |
| Treat elbow dislocation CPT 24615 | $7,292.92 | $12,154.86 | $2,763.00 – $17,722.46 | 24 |
| Treat elbow fracture CPT 24586 | $13,908.81 | $23,181.35 | $3,410.00 – $32,603.53 | 24 |
| Treat elbow fracture CPT 24620 | $2,687.10 | $4,478.50 | $593.04 – $3,981.46 | 24 |
| Treat elbow fracture CPT 24635 | not published | not published | $2,763.00 – $17,722.46 | 17 |
| Treat finger fracture each CPT 26742 | $1,808.00 | $3,013.33 | $593.04 – $3,981.46 | 24 |
| Treat foot bone lesion CPT 28005 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Treat foot dislocation CPT 28540 | $435.60 | $726.00 | $85.32 – $584.19 | 24 |
| Treat foot dislocation CPT 28545 | $3,160.37 | $5,267.28 | $1,088.27 – $8,018.48 | 24 |
| Treat foot dislocation CPT 28570 | $807.09 | $1,345.15 | $85.32 – $1,008.86 | 24 |
| Treat foot dislocation CPT 28600 | $733.69 | $1,222.82 | $85.32 – $917.12 | 24 |
| Treat foot dislocation CPT 28605 | $245.81 | $409.68 | $85.32 – $584.19 | 24 |
| Treat fracture of radius CPT 25505 | $2,116.73 | $3,527.88 | $593.04 – $3,981.46 | 24 |
| Treat fracture of radius CPT 25520 | $1,849.00 | $3,081.67 | $593.04 – $3,981.46 | 24 |
| Treat fracture of ulna CPT 25535 | $1,348.67 | $2,247.78 | $85.32 – $1,685.84 | 24 |
| Treat heel fracture CPT 28415 | not published | not published | $2,763.00 – $17,722.46 | 17 |
| Treat hip dislocation CPT 27252 | $3,445.45 | $5,742.42 | $593.04 – $4,306.81 | 24 |
| Treat hip dislocation CPT 27257 | $4,625.34 | $7,708.90 | $593.04 – $5,781.68 | 24 |
| Treat hip socket fracture CPT 27222 | $3,424.29 | $5,707.15 | $235.79 – $4,280.36 | 23 |
| Treat humerus fracture CPT 24515 | not published | not published | $3,410.00 – $32,603.53 | 17 |
| Treat humerus fracture CPT 24516 | not published | not published | $3,410.00 – $32,603.53 | 17 |
| Treat humerus fracture CPT 24535 | $2,413.16 | $4,021.94 | $593.04 – $3,981.46 | 24 |
| Treat humerus fracture CPT 24545 | $12,653.00 | $21,088.34 | $3,410.00 – $32,603.53 | 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.