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 |
|---|---|---|---|---|
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $1,758.71 – $4,826.69 | 2 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $1,982.15 – $4,826.69 | 2 |
| Surgical revision intestine CPT 44680 | not published | not published | $1,399.66 – $4,826.69 | 2 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $2,930.23 – $6,108.74 | 2 |
| Susceptibility agar dilution per agent CPT 87181 | not published | not published | $4.28 – $18.29 | 2 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $51.72 | $51.72 | $4.28 – $18.29 | 2 |
| Susceptibility mic per plate CPT 87186 | $156.98 | $156.98 | $7.79 – $33.30 | 2 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $5.98 – $25.56 | 2 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $1,313.63 – $4,826.69 | 2 |
| Suspension of testis CPT 54620 | not published | not published | $3,773.18 – $7,079.01 | 2 |
| Suspension of uterus CPT 58410 | not published | not published | $1,026.66 – $4,826.69 | 2 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $572.13 – $4,826.69 | 2 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $1,383.45 – $4,826.69 | 2 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $1,790.69 – $4,826.69 | 2 |
| Svc venogram s&i CPT 75827 | not published | not published | $2,427.46 – $2,427.46 | 1 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $190.46 – $190.46 | 1 |
| Sympathectomy cervical CPT 64802 | not published | not published | $2,149.19 – $4,231.41 | 2 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $2,149.19 – $4,231.41 | 2 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $1,015.85 – $4,826.69 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,421.81 – $7,079.01 | 2 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $1,397.86 – $4,826.69 | 2 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $22.06 – $22.06 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $128.71 – $128.71 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | $1,257.54 | $1,257.54 | $45.62 – $45.62 | 1 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $115.73 | $115.73 | $3.96 – $16.94 | 2 |
| T3 (triiodothyronine) free CPT 84481 | $404.79 | $404.79 | $15.25 – $65.22 | 2 |
| T3 (triiodothyronine) total CPT 84480 | $236.76 | $236.76 | $12.76 – $54.59 | 2 |
| T4 (thyroxine) free CPT 84439 | $251.77 | $251.77 | $8.12 – $34.73 | 2 |
| T4 (thyroxine) total CPT 84436 | $227.20 | $227.20 | $6.18 – $26.45 | 2 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $1.81 – $1.81 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $5.01 – $5.01 | 1 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $13.98 – $13.98 | 1 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $778.05 – $778.05 | 1 |
| Tacrolimus therapeutic drug level CPT 80197 | $526.09 | $526.09 | $12.36 – $52.86 | 2 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $54.25 – $54.25 | 1 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $2,882.23 – $4,826.69 | 2 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $2,654.28 – $4,826.69 | 2 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,603.29 – $4,826.69 | 2 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $195.81 – $195.81 | 1 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $290.21 – $290.21 | 1 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $2.12 – $2.12 | 1 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $4,826.69 – $4,826.69 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $683.58 – $2,924.19 | 2 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,627.64 – $11,240.46 | 2 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $538.12 – $2,301.95 | 2 |
| Tas congenital car anomal CPT 33741 | not published | not published | $1,430.16 – $1,430.16 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $171.88 – $4,826.69 | 2 |
| Tavr perq femoral CPT 33361 | not published | not published | $1,778.53 – $4,826.69 | 2 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $2,323.66 | $2,323.66 | $3.16 – $3.16 | 1 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $123.30 – $527.45 | 2 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $166.51 – $166.51 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $41.62 – $41.62 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $331.60 – $331.60 | 1 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $330.21 – $330.21 | 1 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $90.00 – $385.00 | 2 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $355.06 | $355.06 | $55.78 – $238.62 | 2 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $4,754.75 – $4,754.75 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $1,426.81 – $1,426.81 | 1 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $268.42 – $268.42 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $5,583.04 – $5,583.04 | 1 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $5,583.04 – $5,583.04 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $1,203.05 – $1,203.05 | 1 |
| Tc-99m labeled rbc HCPCS A9560 | not published | not published | $358.17 – $358.17 | 1 |
| Tc-99m maa HCPCS A9540 | not published | not published | $115.04 – $115.04 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | not published | not published | $212.14 – $212.14 | 1 |
| Tc-99m medronate HCPCS A9503 | not published | not published | $49.86 – $49.86 | 1 |
| Tc-99m mertiatide HCPCS A9562 | not published | not published | $2,970.97 – $2,970.97 | 1 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $168.71 – $168.71 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $120.16 – $120.16 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | not published | not published | $15.13 – $15.13 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $191.73 – $191.73 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | not published | not published | $524.10 – $524.10 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $2,298.53 – $2,298.53 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | not published | not published | $205.05 – $205.05 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $373.72 – $373.72 | 1 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $1,801.49 – $1,801.49 | 1 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $313.93 – $4,826.69 | 2 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $431.51 – $431.51 | 1 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $431.51 – $431.51 | 1 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $897.20 – $897.20 | 1 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $485.05 – $4,826.69 | 2 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $850.28 | $850.28 | $42.28 – $180.87 | 2 |
| T cells absolute cd 4 count CPT 86361 | $218.89 | $218.89 | $24.10 – $103.10 | 2 |
| T cells total count CPT 86359 | $322.01 | $322.01 | $33.96 – $145.26 | 2 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $97.14 – $97.14 | 1 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $707.63 – $707.63 | 1 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $608.61 – $4,826.69 | 2 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $1,346.06 – $4,826.69 | 2 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $147.07 – $147.07 | 1 |
| Team conf without pat by phys CPT 99367 | not published | not published | $223.38 – $223.38 | 1 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $165.13 – $165.13 | 1 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $719.37 – $719.37 | 1 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $2,621.16 – $2,621.16 | 1 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $2,621.16 – $2,621.16 | 1 |
| Telavancin injection HCPCS J3095 | not published | not published | $22.10 – $22.10 | 1 |
| Telethx isodose plan cplx CPT 77307 | $1,794.37 | $1,794.37 | $541.12 – $541.12 | 1 |
| Telethx isodose plan simple CPT 77306 | $3,663.61 | $3,663.61 | $299.68 – $299.68 | 1 |
| Temozolomide HCPCS J8700 | not published | not published | $15.82 – $15.82 | 1 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $39.77 – $39.77 | 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.