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 |
|---|---|---|---|---|
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,063.52 – $3,197.57 | 6 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,088.27 – $3,503.94 | 6 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $1,088.27 – $3,503.94 | 6 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $429.26 – $1,285.40 | 6 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $886.62 – $3,352.69 | 6 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $1,468.77 – $1,468.77 | 1 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $1,333.16 – $1,333.16 | 1 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $913.83 – $913.83 | 1 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $2,127.97 – $2,127.97 | 1 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $420.64 – $1,727.16 | 6 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $187.22 – $565.40 | 6 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.48 – $2.77 | 2 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $2.63 – $12.53 | 2 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $12.01 – $20.04 | 2 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $9.09 – $9.09 | 1 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $10.92 – $10.92 | 1 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $11.45 – $89.92 | 2 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $29.93 – $32.64 | 2 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $49.79 – $68.78 | 2 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | not published | not published | $0.48 – $0.48 | 1 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $8.14 – $80.54 | 2 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $325.22 – $8,283.00 | 2 |
| Drug assay posaconazole CPT 80187 | not published | not published | $16.27 – $83.50 | 7 |
| Drug assay rufinamide CPT 80210 | not published | not published | $16.27 – $83.50 | 7 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $23.14 – $118.80 | 7 |
| Drug assay voriconazole CPT 80285 | not published | not published | $16.27 – $83.50 | 7 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $11.18 – $57.41 | 7 |
| Drug screening tapentadol CPT 80372 | not published | not published | $12.64 – $13.27 | 5 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $16.27 – $83.50 | 7 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $22.37 – $23.49 | 5 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $119.24 – $612.12 | 7 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $68.66 – $352.44 | 7 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $148.15 – $760.51 | 7 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $93.95 – $482.30 | 7 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $37.28 – $191.39 | 7 |
| Dry needling (97799) CPT 97799 | not published | not published | $155.00 – $185.00 | 2 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $133.72 – $210.65 | 6 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $133.72 – $206.66 | 6 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $117.10 – $183.86 | 6 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $128.74 – $202.79 | 6 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $153.38 – $241.60 | 6 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $208.33 – $327.86 | 6 |
| Ductogram sgl duct CPT 77053 | not published | not published | $105.00 – $540.65 | 7 |
| Duodenal exclusion CPT 48547 | not published | not published | $2,394.15 – $2,394.15 | 1 |
| Duodenal motility study CPT 91022 | not published | not published | $306.75 – $306.75 | 1 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $537.61 – $1,037.00 | 3 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $306.01 – $1,037.00 | 3 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $83.87 – $127.19 | 2 |
| Dxa bone density axl vrt fx CPT 77085 | not published | not published | $134.67 – $306.01 | 7 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $365.00 – $476.26 | 2 |
| Dx aly aud oi snd prcsr each CPT 92623 | not published | not published | $56.38 – $365.00 | 2 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $525.71 – $1,831.18 | 6 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $525.71 – $1,831.18 | 6 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $525.71 – $1,831.18 | 6 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $1,163.49 – $1,163.49 | 1 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $1,005.98 – $1,005.98 | 1 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $334.95 – $1,005.98 | 6 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $323.97 – $323.97 | 1 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $177.09 – $177.09 | 1 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $82.55 – $232.00 | 2 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $220.91 – $232.00 | 2 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $72.34 – $232.00 | 2 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $155.59 – $483.70 | 6 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $525.71 – $1,831.18 | 6 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $140.73 – $232.00 | 2 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $82.69 – $82.69 | 1 |
| Dynamic fine wire emg CPT 96003 | not published | not published | $1,320.00 – $1,320.00 | 1 |
| Dynamic surface emg CPT 96002 | not published | not published | $72.64 – $1,320.00 | 2 |
| Ear and throat examination CPT 92502 | not published | not published | $565.40 – $565.40 | 1 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $94.96 – $140.43 | 6 |
| Ear cartilage graft CPT 21235 | not published | not published | $1,954.22 – $6,208.68 | 6 |
| Ear protector evaluation CPT 92596 | not published | not published | $102.96 – $365.00 | 2 |
| Ecallantide injection HCPCS J1290 | not published | not published | $564.64 – $838.40 | 2 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $23.07 – $23.07 | 1 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $176.03 – $331.00 | 2 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $438.00 – $544.32 | 2 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | not published | not published | $348.90 – $438.00 | 2 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | not published | not published | $104.23 – $331.00 | 2 |
| Ecg external >7 days up to 15 days recording CPT 93246 | not published | not published | $171.43 – $331.00 | 2 |
| Ecg record/review CPT 93268 | not published | not published | $438.00 – $657.34 | 2 |
| Echo exam of eye CPT 76516 | not published | not published | $134.67 – $306.01 | 7 |
| Echo exam of eye CPT 76519 | not published | not published | $134.67 – $306.01 | 7 |
| Echo exam of eye CPT 76529 | not published | not published | $109.47 – $227.35 | 7 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $31.45 – $69.43 | 7 |
| Echo exam of fetal heart CPT 76825 | not published | not published | $416.00 – $1,358.04 | 7 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $288.45 – $646.72 | 7 |
| Echo exam of fetal heart CPT 76827 | not published | not published | $134.67 – $306.01 | 7 |
| Echo exam of fetal heart CPT 76828 | not published | not published | $134.67 – $306.01 | 7 |
| Echo exam uterus 76831- CPT 76831 | not published | not published | $232.00 – $646.72 | 7 |
| Echograp trans r pros study CPT 76873 | not published | not published | $134.67 – $306.01 | 7 |
| Echo guidance radiotherapy CPT 76965 | not published | not published | $58.53 – $232.00 | 2 |
| Echo guidance radiotherapy HCPCS G6001 | not published | not published | $276.11 – $444.53 | 3 |
| Echo guide for amniocentesis CPT 76946 | not published | not published | $30.93 – $232.00 | 2 |
| Echo guide for artery repair CPT 76936 | not published | not published | $232.00 – $743.84 | 7 |
| Echo guide for heart biopsy CPT 76932 | not published | not published | $78.60 – $232.00 | 2 |
| Echo guide for transfusion CPT 76941 | not published | not published | $164.72 – $232.00 | 2 |
| Echo guide ova aspiration CPT 76948 | not published | not published | $94.47 – $232.00 | 2 |
| Echo guide villus sampling CPT 76945 | not published | not published | $82.78 – $232.00 | 2 |
| Echo tee cngntl wo ctrst probe plcmnt CPT 93316 | not published | not published | $91.10 – $665.64 | 6 |
| Echo tee guidance CPT 93355 | not published | not published | $237.11 – $757.70 | 6 |
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.