CHRISTUS Trinity Mother Frances Hospital - Jacksonville
2026 S Jackson St, Jacksonville, TX · Christushealth · · NPI 1952306672
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 |
|---|---|---|---|---|
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $2,059.25 – $2,059.25 | 1 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | not published | not published | $1,490.92 – $1,490.92 | 1 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $104.93 – $162.61 | 6 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $74.34 – $113.01 | 6 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $223.65 – $223.65 | 1 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $223.65 – $223.65 | 1 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $130.95 – $198.17 | 6 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $709.01 – $2,077.11 | 6 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $111.02 – $132.58 | 6 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $215.94 – $321.46 | 6 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $280.45 – $452.25 | 6 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $160.02 – $239.28 | 6 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $939.93 – $3,000.55 | 6 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $137.87 – $206.66 | 6 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $340.77 – $1,039.42 | 6 |
| Destruction ciliary body CPT 66700 | not published | not published | $849.94 – $2,587.98 | 6 |
| Destruction ciliary body CPT 66720 | not published | not published | $698.30 – $2,477.06 | 6 |
| Destruction ciliary body CPT 66740 | not published | not published | $698.30 – $2,477.06 | 6 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $74.34 – $113.01 | 6 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $939.93 – $3,000.55 | 6 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $70.60 – $112.72 | 6 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $107.42 – $166.76 | 6 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $120.15 – $188.01 | 6 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $109.08 – $169.08 | 6 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $120.15 – $186.16 | 6 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $408.97 – $408.97 | 1 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $709.01 – $2,077.11 | 6 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $939.93 – $3,000.55 | 6 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,063.52 – $3,197.57 | 6 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $98.83 – $117.34 | 6 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $73.09 – $102.09 | 6 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $18.02 – $92.49 | 7 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $26.20 – $134.50 | 7 |
| Determination venous press CPT 93770 | not published | not published | $26.53 – $595.00 | 2 |
| Determine refractive state CPT 92015 | not published | not published | $63.42 – $63.42 | 1 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $32.29 – $32.29 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $442.72 – $442.72 | 1 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | not published | not published | $10.31 – $10.31 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,457.56 – $1,554.34 | 2 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $145.31 – $595.00 | 2 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,895.03 – $1,895.03 | 1 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $139.00 – $251.33 | 2 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $190.27 – $190.27 | 1 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $110.68 – $230.35 | 2 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $2.03 – $2.71 | 2 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $204.68 – $325.74 | 6 |
| Dexamethasone panel CPT 80420 | not published | not published | $97.13 – $498.59 | 7 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.64 – $1.01 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $80.96 – $324.15 | 2 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $45.37 – $51.53 | 2 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $2.14 – $2.14 | 1 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $87.49 – $87.49 | 1 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $190.55 – $190.55 | 1 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $30.56 – $30.56 | 1 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $30.56 – $30.56 | 1 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $30.56 – $30.56 | 1 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $49.60 – $324.00 | 2 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $63.53 – $63.53 | 1 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $30.56 – $30.56 | 1 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $525.71 – $1,831.18 | 6 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,888.85 – $6,187.15 | 6 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $139.56 – $139.56 | 1 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,285.40 – $1,285.40 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $56.20 – $82.23 | 6 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $68.14 – $101.25 | 6 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $109.47 – $227.35 | 7 |
| Dialysis one evaluation CPT 90945 | not published | not published | $750.00 – $750.00 | 1 |
| Dialysis repeated eval CPT 90947 | not published | not published | $750.00 – $750.00 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $23.07 – $185.00 | 3 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.15 | 2 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.09 – $0.31 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $538.56 – $1,256.00 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,968.58 – $6,533.91 | 2 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $85.75 – $331.95 | 2 |
| Dilate esophagus CPT 43453 | not published | not published | $564.97 – $1,993.47 | 6 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $453.91 – $453.91 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $226.96 – $226.96 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $646.28 – $646.28 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $465.40 – $465.40 | 1 |
| Dilate urethra stricture CPT 53601 | not published | not published | $39.07 – $139.56 | 6 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,142.90 – $2,267.58 | 6 |
| Dilate urethra stricture CPT 53621 | not published | not published | $94.13 – $114.56 | 6 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $39.59 – $56.36 | 6 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $429.26 – $1,285.40 | 6 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $39.86 – $51.74 | 6 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $429.26 – $1,285.40 | 6 |
| Dilation of salivary duct CPT 42660 | not published | not published | $57.03 – $96.55 | 6 |
| Dilation of urethra CPT 53661 | not published | not published | $29.60 – $139.56 | 6 |
| Dilation of urethra CPT 53665 | not published | not published | $652.80 – $2,267.58 | 6 |
| Dilation of vagina CPT 57400 | not published | not published | $1,063.52 – $3,197.57 | 6 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $37.38 – $63.28 | 6 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $92.46 – $111.80 | 6 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $1,142.90 – $2,267.58 | 6 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $1,142.90 – $3,863.73 | 6 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $96.48 – $96.48 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $8.35 – $17.15 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $714.72 – $1,057.79 | 2 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.03 – $1.30 | 2 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.84 – $4.69 | 2 |
| Direct advanced life support CPT 99288 | not published | not published | $501.66 – $501.66 | 1 |
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.