Adventhealth Rollins Brook
608 North Key Avenue, Lampasas, TX · AdventHealth · · NPI 1750392916
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 |
|---|---|---|---|---|
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $982.40 – $2,234.24 | 2 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $982.40 – $2,234.24 | 2 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $334.71 – $4,826.69 | 2 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $982.40 – $2,234.24 | 2 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $6,042.14 – $8,715.36 | 2 |
| Urea nitrogen CPT 84520 | $100.88 | $100.88 | $3.56 – $15.21 | 2 |
| Urea nitrogen 24 hour urine CPT 84540 | not published | not published | $5.00 – $21.41 | 2 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $6.48 – $27.72 | 2 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $4.62 – $19.75 | 2 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Ureteral reflux study CPT 78740 | not published | not published | $764.53 – $764.53 | 1 |
| Ureter endoscopy CPT 50970 | not published | not published | $3,773.18 – $7,079.01 | 2 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $3,773.18 – $7,079.01 | 2 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $5,289.53 – $8,715.36 | 2 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,440.66 – $4,826.69 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,470.40 – $4,826.69 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $897.20 – $897.20 | 1 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,773.18 – $4,826.69 | 2 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $897.20 – $897.20 | 1 |
| Uric acid blood CPT 84550 | $160.38 | $160.38 | $4.07 – $17.40 | 2 |
| Uric acid urine CPT 84560 | $178.67 | $178.67 | $4.57 – $19.56 | 2 |
| Urinalysis glass test CPT 81020 | not published | not published | $4.23 – $18.10 | 2 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $2.75 – $11.74 | 2 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.95 – $8.35 | 2 |
| Urinalysis (with microscopy) CPT 81001 | $132.23 | $132.23 | $2.85 – $12.20 | 2 |
| Urinalysis (without microscopy) CPT 81003 | $67.11 | $67.11 | $2.03 – $8.66 | 2 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $276.12 – $276.12 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $68.76 – $4,826.69 | 2 |
| Urine Culture Test CPT 87086 | $203.12 | $203.12 | $7.26 – $31.07 | 2 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $136.29 – $4,826.69 | 2 |
| Urine pregnancy test CPT 81025 | not published | not published | $7.75 – $33.15 | 2 |
| Urine screen for bacteria CPT 81007 | not published | not published | $26.98 – $115.42 | 2 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,593.38 – $4,826.69 | 2 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $8.18 – $8.18 | 1 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $481.83 – $481.83 | 1 |
| Urography, antegrade CPT 74425 | not published | not published | $1,470.12 – $1,470.12 | 1 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $377.42 – $377.42 | 1 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $1,655.85 – $1,655.85 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $33.11 – $33.11 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $431.51 – $431.51 | 1 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $46,707.98 | $46,707.98 | $46.05 – $46.05 | 1 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $914.03 – $914.03 | 1 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $14,875.89 – $14,875.89 | 1 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $561.79 – $561.79 | 1 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $561.79 – $561.79 | 1 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $504.74 – $504.74 | 1 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $337.95 – $337.95 | 1 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $251.64 – $251.64 | 1 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $106.49 – $106.49 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $356.55 – $356.55 | 1 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $234.77 – $234.77 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $433.05 – $433.05 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $112.88 – $112.88 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $48.86 – $48.86 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $287.19 | $287.19 | $258.57 – $258.57 | 1 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $812.17 | $812.17 | $386.35 – $386.35 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $147.11 – $147.11 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $226.11 – $226.11 | 1 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $419.87 | $419.87 | $219.07 – $219.07 | 1 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $440.98 – $440.98 | 1 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $87.90 – $87.90 | 1 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $1,595.52 | $1,595.52 | $785.09 – $785.09 | 1 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $613.69 – $613.69 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $566.82 | $566.82 | $166.05 – $166.05 | 1 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $255.39 | $255.39 | $170.09 – $170.09 | 1 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $60.21 – $60.21 | 1 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $170.77 | $170.77 | $65.49 – $65.49 | 1 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $145.34 | $145.34 | $60.71 – $60.71 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $64.76 – $64.76 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $72.07 – $72.07 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $64.76 – $64.76 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $31.99 – $31.99 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $88.36 – $88.36 | 1 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $176.14 – $176.14 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $280.72 | $280.72 | $101.29 – $101.29 | 1 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $61.06 – $61.06 | 1 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $909.45 | $909.45 | $769.15 – $769.15 | 1 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $628.47 – $628.47 | 1 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $327.56 – $327.56 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $878.03 | $878.03 | $327.56 – $327.56 | 1 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $270.50 – $270.50 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $779.24 – $779.24 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $620.18 | $620.18 | $451.30 – $451.30 | 1 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $711.48 – $711.48 | 1 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $954.34 – $954.34 | 1 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $1,281.69 | $1,281.69 | $954.34 – $954.34 | 1 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $122.08 – $122.08 | 1 |
| Vaccine rabies im CPT 90675 | not published | not published | $1,140.06 – $1,140.06 | 1 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $837.34 – $837.34 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $1,905.75 – $1,905.75 | 1 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $1,905.75 – $1,905.75 | 1 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $837.34 – $837.34 | 1 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $465.66 – $465.66 | 1 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $380.77 – $380.77 | 1 |
| Vaccine tdap >=7 years im CPT 90715 | $395.35 | $395.35 | $152.15 – $152.15 | 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.