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 |
|---|---|---|---|---|
| Glassia injection HCPCS J0257 | not published | not published | $19.37 – $19.37 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $219.22 – $219.22 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $163.74 – $163.74 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,772.91 – $8,715.36 | 2 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,772.91 – $8,715.36 | 2 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,527.33 – $6,108.74 | 2 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,527.33 – $6,108.74 | 2 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $318.16 – $318.16 | 1 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $694.35 – $694.35 | 1 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $12.86 – $55.02 | 2 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $41.46 – $177.37 | 2 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $45.45 – $194.43 | 2 |
| Glucagon tolerance test CPT 82946 | not published | not published | $15.99 – $68.41 | 2 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.28 – $18.29 | 2 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.45 – $23.29 | 2 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.95 – $12.63 | 2 |
| Glucose blood quantitative CPT 82947 | $108.83 | $108.83 | $3.54 – $15.13 | 2 |
| Glucose body fluid CPT 82945 | $116.35 | $116.35 | $3.54 – $15.13 | 2 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $216.45 – $216.45 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $217.81 | $217.81 | $11.58 – $49.55 | 2 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $87.83 | $87.83 | $3.53 – $15.09 | 2 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $59.61 | $59.61 | $2.62 – $2.62 | 1 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $55.94 – $55.94 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,733.54 | $2,733.54 | $136.10 – $136.10 | 1 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $305.52 | $305.52 | $16.72 – $71.53 | 2 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $133.57 – $571.38 | 2 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $292.16 | $292.16 | $16.67 – $71.30 | 2 |
| Gonioscopy CPT 92020 | not published | not published | $419.77 – $419.77 | 1 |
| Goniotomy CPT 65820 | not published | not published | $4,772.91 – $8,715.36 | 2 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $2,249.82 – $2,249.82 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $131.59 – $131.59 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $1,679.75 | $1,679.75 | not published | 0 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $3,421.81 – $4,826.69 | 2 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $135.87 – $135.87 | 1 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $3,941.05 – $3,941.05 | 1 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $204.20 – $204.20 | 1 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,423.55 – $4,826.69 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $175.98 – $175.98 | 1 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $32.73 – $32.73 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $2.04 – $2.04 | 1 |
| Granulocyte pheresis ea unit HCPCS P9050 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Great toe-hand transfer CPT 26551 | not published | not published | $4,262.98 – $4,826.69 | 2 |
| Great toe with reduction 28495 CPT 28495 | $1,346.17 | $1,346.17 | $136.20 – $4,826.69 | 2 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $2,028.43 – $4,827.98 | 2 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,721.61 – $8,715.36 | 2 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,721.61 – $8,715.36 | 2 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $62.45 – $62.45 | 1 |
| Growth hormone antibody CPT 86277 | not published | not published | $14.17 – $60.60 | 2 |
| Growth hormone panel CPT 80428 | not published | not published | $60.03 – $256.80 | 2 |
| Growth hormone panel CPT 80430 | not published | not published | $116.40 – $497.92 | 2 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $68.04 – $291.06 | 2 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $105.18 – $105.18 | 1 |
| Grp adapt bhv tx by tech CPT 97154 | not published | not published | $105.18 – $105.18 | 1 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,514.18 – $4,826.69 | 2 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,648.79 – $4,826.69 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $2,117.75 – $4,826.69 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $2,347.05 – $4,826.69 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,558.24 – $4,826.69 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,946.75 – $4,826.69 | 2 |
| G-tube reposition CPT 43761 | not published | not published | $293.63 – $4,826.69 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $6,820.47 – $6,820.47 | 1 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $762.51 – $4,826.69 | 2 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | $453.72 – $453.72 | 1 |
| Gum graft CPT 41870 | not published | not published | $1,686.68 – $2,991.88 | 2 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $3,786.94 – $6,691.14 | 2 |
| Hair analysis HCPCS P2031 | not published | not published | $4.46 – $19.06 | 2 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $313.93 – $4,826.69 | 2 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $399.39 – $4,826.69 | 2 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $399.39 – $4,826.69 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $122.68 | $122.68 | $46.35 – $46.35 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $23.06 | $23.06 | $15.28 – $15.28 | 1 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $47.16 – $47.16 | 1 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $3,421.81 – $7,079.01 | 2 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $7,477.44 – $8,715.36 | 2 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $3,421.81 – $7,079.01 | 2 |
| Hand X-ray CPT 73130 | $586.01 | $586.01 | $307.27 – $307.27 | 1 |
| Haptoglobin quantitative CPT 83010 | $154.31 | $154.31 | $11.32 – $48.43 | 2 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $107.21 – $4,826.69 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $1,654.53 – $3,432.54 | 2 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $2,028.43 – $4,827.98 | 2 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $2,419.00 – $4,826.69 | 2 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $485.05 – $4,826.69 | 2 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $419.77 – $419.77 | 1 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $419.77 – $419.77 | 1 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $540.00 – $2,310.00 | 2 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $182.16 – $779.24 | 2 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $337.73 – $1,444.71 | 2 |
| Hbb full gene sequence CPT 81364 | not published | not published | $292.12 – $1,249.63 | 2 |
| Hbb gene com variants CPT 81361 | not published | not published | $157.33 – $673.02 | 2 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $182.16 – $779.24 | 2 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $337.73 – $1,444.71 | 2 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $8.74 – $37.38 | 2 |
| Hbot, full body chamber, 30m HCPCS G0277 | not published | not published | $442.98 – $442.98 | 1 |
| Hc ea ha check monaural CPT 92594 | not published | not published | $66.61 – $66.61 | 1 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $701.55 – $701.55 | 1 |
| Hcg free betachain test CPT 84704 | not published | not published | $13.76 – $58.87 | 2 |
| Hcg qualitative CPT 84703 | $208.14 | $208.14 | $6.77 – $28.95 | 2 |
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.