MEDICAL CITY LEWISVILLE HOSPITAL
1596 W Main St, LEWISVILLE, TX · Medicalcityhealthcare · · NPI 1255384533
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 |
|---|---|---|---|---|
| Augmentation lower jaw bone CPT 21127 | not published | not published | $1,924.91 – $6,014.66 | 11 |
| Augmentation of facial bones CPT 21208 | not published | not published | $2,665.48 – $6,014.66 | 11 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | not published | not published | $28,060.03 – $28,060.03 | 1 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | not published | not published | $2,362.54 – $7,417.62 | 11 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $2,362.54 – $7,417.62 | 11 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $7,325.73 – $7,417.62 | 2 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $504.39 – $3,203.59 | 30 |
| Autologous blood op salvage CPT 86891 | not published | not published | $184.72 – $1,251.84 | 5 |
| Autologous blood process CPT 86890 | $335.34 | $335.34 | $130.97 – $887.23 | 5 |
| Autolog prp diab wound ulcer HCPCS G0465 | not published | not published | $2,169.08 – $2,169.08 | 1 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $1,347.26 – $2,012.20 | 2 |
| Automated diff wbc count CPT 85004 | not published | not published | $3.88 – $24.55 | 33 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $257.31 – $335.37 | 2 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $91.00 – $260.54 | 2 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $257.31 – $574.51 | 2 |
| Autopsy (necropsy) complete CPT 88020 | not published | not published | $27.96 – $3,239.03 | 5 |
| Autopsy (necropsy) complete CPT 88025 | not published | not published | $27.07 – $3,135.73 | 5 |
| Autopsy (necropsy) complete CPT 88027 | not published | not published | $28.88 – $3,345.39 | 5 |
| Autopsy (necropsy) complete CPT 88028 | not published | not published | $16.24 – $1,880.82 | 5 |
| Autopsy (necropsy) complete CPT 88029 | not published | not published | $16.24 – $1,880.82 | 5 |
| Autopsy (necropsy) gross CPT 88000 | not published | not published | $16.24 – $1,880.82 | 5 |
| Autopsy (necropsy) gross CPT 88005 | not published | not published | $18.97 – $2,193.79 | 5 |
| Autopsy (necropsy) gross CPT 88007 | not published | not published | $19.85 – $2,300.15 | 5 |
| Autopsy (necropsy) gross CPT 88012 | not published | not published | $16.24 – $1,880.82 | 5 |
| Autopsy (necropsy) gross CPT 88014 | not published | not published | $14.88 – $1,725.87 | 5 |
| Autopsy (necropsy) gross CPT 88016 | not published | not published | $20.74 – $2,403.45 | 5 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $94.23 – $606.92 | 4 |
| Av fistula revision CPT 36833 | not published | not published | $1,910.06 – $5,699.28 | 11 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $1,910.06 – $5,699.28 | 11 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $1,910.06 – $5,699.28 | 11 |
| Av fusion direct any site CPT 36821 | not published | not published | $1,101.45 – $3,436.39 | 11 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $1,910.06 – $5,699.28 | 11 |
| Avul nail plate addl CPT 11732 | not published | not published | $94.21 – $94.21 | 1 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | not published | not published | $202.56 – $343.02 | 3 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | not published | not published | $91.82 – $324.03 | 3 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $6.22 – $1,222,507.50 | 3 |
| Axillary crutch extension HCPCS L0978 | not published | not published | $219.78 – $593.64 | 27 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $1,860.52 – $6,103.44 | 11 |
| Azacitidine injection HCPCS J9025 | $2,645.08 | $2,645.08 | $0.31 – $3.59 | 4 |
| Azathioprine 50 mg tablet HCPCS J7500 | $26.02 | $26.02 | $0.10 – $12.95 | 4 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $403.65 – $2,146.11 | 4 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | not published | not published | $2.15 – $15.79 | 4 |
| Azithromycin dihydrate, oral HCPCS Q0144 | $1.57 | $1.57 | $21.50 – $152.42 | 4 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $1,081.41 | $1,081.41 | $2.41 – $16.16 | 4 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $169.56 – $1,063.89 | 4 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $52.21 – $406.63 | 4 |
| Baclofen eval charges CPT 97750 | not published | not published | $28.41 – $75.56 | 27 |
| Bacterial meningitis antigen CPT 86403 | $561.97 | $561.97 | $6.92 – $43.92 | 33 |
| Bacterial vaginosis pcr CPT 87801 | not published | not published | $42.12 – $267.29 | 33 |
| Bactericidal level serum CPT 87197 | not published | not published | $9.01 – $56.80 | 33 |
| #bac vag cand-c. albicans naa CPT 87481 | not published | not published | $21.05 – $134.29 | 33 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | not published | not published | $6.88 – $21.06 | 27 |
| Balloon dilate urtrl strix CPT 50706 | not published | not published | $5,495.54 – $5,495.54 | 1 |
| Banding pulmonary artery CPT 33690 | not published | not published | $1,554.27 – $8,560.76 | 2 |
| Barrier film 1.0ml wipe HCPCS A5120 | not published | not published | $0.29 – $0.92 | 27 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | not published | not published | $2.96 – $9.07 | 27 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | not published | not published | $12.04 – $36.86 | 27 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | not published | not published | $7.58 – $23.16 | 27 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | $17.00 | $17.00 | $6.01 – $18.37 | 27 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | $26.00 | $26.00 | $10.69 – $32.70 | 27 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $1,047.57 – $3,268.14 | 11 |
| Bartonella dna pcr-sendout CPT 87471 | $1,217.34 | $1,217.34 | $21.05 – $134.29 | 33 |
| Bartonella dna quant CPT 87472 | not published | not published | $25.70 – $162.69 | 33 |
| Basic vestibular evaluation CPT 92540 | not published | not published | $59.54 – $149.37 | 2 |
| Basiliximab HCPCS J0480 | not published | not published | $4,547.03 – $28,273.12 | 4 |
| Battery chrgr 12 volt utah/e HCPCS L7366 | not published | not published | $849.88 – $2,295.57 | 27 |
| Battery chrgr six volt otto HCPCS L7362 | not published | not published | $343.92 – $928.95 | 27 |
| Battery elec/combo vad, rep HCPCS Q0496 | $11,125.00 | $11,125.00 | $1,800.20 – $4,862.41 | 27 |
| Battery pneum vad replacemnt HCPCS Q0503 | not published | not published | $1,561.48 – $4,217.60 | 27 |
| B cells total count CPT 86355 | not published | not published | $22.64 – $143.31 | 33 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | not published | not published | $3.05 – $18.88 | 4 |
| Bcg vaccine intravesical CPT 90586 | not published | not published | $152.25 – $1,197.31 | 4 |
| Bcg vaccine percut CPT 90585 | not published | not published | $360.29 – $1,197.31 | 4 |
| Bckdhb gene CPT 81205 | not published | not published | $56.99 – $361.55 | 33 |
| Bebtelovimab injection HCPCS M0222 | not published | not published | $827.18 – $827.18 | 1 |
| Becaplermin 0.01% gel 15 gm HCPCS S0157 | $12,471.55 | $12,471.55 | $94.21 – $279.74 | 3 |
| Bedside drainage bag HCPCS A4357 | not published | not published | $10.07 – $30.81 | 27 |
| Behavior counsel obesity 15min medicare g0447 HCPCS G0447 | not published | not published | $14.45 – $14.45 | 1 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | not published | not published | $3.77 – $23.54 | 4 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | not published | not published | $53.32 – $338.92 | 4 |
| Below elbow myoelectronic CT HCPCS L6935 | not published | not published | $10,277.05 – $27,758.64 | 27 |
| Below elbow prosth tiss shap HCPCS L6400 | not published | not published | $2,978.56 – $8,045.18 | 27 |
| Below knee acrylic socket HCPCS L5629 | not published | not published | $503.18 – $1,359.10 | 27 |
| Below knee cuff suspension HCPCS L5666 | not published | not published | $110.83 – $299.36 | 27 |
| Below knee cushion socket HCPCS L5646 | not published | not published | $844.61 – $2,281.31 | 27 |
| Below knee flex cover system HCPCS L5962 | not published | not published | $753.37 – $2,034.88 | 27 |
| Below knee leather socket HCPCS L5638 | not published | not published | $599.41 – $1,619.03 | 27 |
| Below knee suction socket HCPCS L5647 | not published | not published | $944.62 – $2,551.46 | 27 |
| Below knee sus/seal sleeve HCPCS L5685 | not published | not published | $153.77 – $415.35 | 27 |
| Below knee total contact HCPCS L5637 | not published | not published | $457.41 – $1,235.49 | 27 |
| Below knee wood socket HCPCS L5639 | not published | not published | $1,331.42 – $3,596.21 | 27 |
| Belt ostomy lg 34-65in HCPCS A4367 | not published | not published | $8.31 – $25.41 | 27 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $5,943.09 | $5,943.09 | $1.20 – $105.60 | 4 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | not published | not published | $13.77 – $72.55 | 4 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | not published | not published | $13.17 – $79.39 | 4 |
| Bendamustine 25 mg/ml intravenous solution (vivimusta) HCPCS J9056 | not published | not published | $26.42 – $169.79 | 4 |
| Benign lesion paring 2-4 CPT 11056 | not published | not published | $202.56 – $246.37 | 3 |
| Benign lesion paring 4+ CPT 11057 | not published | not published | $54.82 – $202.56 | 11 |
| #_benzodiazconfur CPT 80346 | $2,016.08 | $2,016.08 | $0.02 – $91.69 | 11 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $1,253.47 | $1,253.47 | $16.27 – $104.50 | 4 |
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.