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 |
|---|---|---|---|---|
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | not published | not published | $325.49 – $1,046.00 | 12 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | not published | not published | $277.12 – $1,046.00 | 12 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | not published | not published | $193.20 – $1,046.00 | 12 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $329.93 – $1,799.76 | 11 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $329.93 – $1,799.76 | 11 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | not published | not published | $453.11 – $1,223.85 | 27 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $5,095.66 – $5,095.66 | 1 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $329.93 – $1,799.76 | 11 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $1,860.52 – $11,069.20 | 11 |
| Urea nitrogen CPT 84520 | not published | not published | $2.37 – $15.48 | 33 |
| Urea nitrogen 24 hour urine CPT 84540 | $823.78 | $823.78 | $3.34 – $20.66 | 33 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $4.32 – $27.11 | 33 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $3.08 – $19.37 | 33 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $11,887.30 – $11,887.30 | 1 |
| Ureteral reflux study CPT 78740 | $4,744.90 | $4,744.90 | $200.77 – $417.75 | 11 |
| Ureter endoscopy CPT 50970 | not published | not published | $1,125.76 – $6,912.46 | 11 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $1,125.76 – $6,912.46 | 11 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $1,664.09 – $9,690.41 | 11 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $21,932.65 – $21,932.65 | 1 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $22,385.37 – $22,385.37 | 1 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $2,125.14 | $2,125.14 | $80.16 – $525.78 | 12 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,558.75 – $6,912.46 | 2 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $102.69 – $347.07 | 12 |
| Uric acid blood CPT 84550 | not published | not published | $2.71 – $16.81 | 33 |
| Uric acid urine CPT 84560 | not published | not published | $3.05 – $19.37 | 33 |
| Urinalysis glass test CPT 81020 | not published | not published | $2.82 – $18.09 | 33 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $1.83 – $11.63 | 33 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.30 – $7.74 | 33 |
| Urinalysis (with microscopy) CPT 81001 | not published | not published | $1.90 – $11.63 | 33 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $1.35 – $9.02 | 33 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $98.26 – $148.40 | 2 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $3.87 – $11.87 | 27 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $7.33 – $22.45 | 27 |
| Urinary reflex study CPT 51792 | not published | not published | $59.56 – $125.97 | 2 |
| Urinary suspensory HCPCS A5105 | not published | not published | $49.74 – $152.25 | 27 |
| Urine Culture Test CPT 87086 | not published | not published | $4.84 – $31.01 | 33 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $134.32 – $249.68 | 2 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $7.95 – $24.34 | 27 |
| Urine pregnancy test CPT 81025 | not published | not published | $5.17 – $32.29 | 33 |
| Urine screen for bacteria CPT 81007 | not published | not published | $17.99 – $113.63 | 33 |
| Urine shunt to intestine CPT 50815 | not published | not published | $24,257.54 – $24,257.54 | 1 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.00 – $32.29 | 30 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $383.81 – $383.81 | 1 |
| Urography, antegrade CPT 74425 | not published | not published | $133.95 – $523.13 | 12 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $134.30 – $460.46 | 12 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $2,769.72 – $2,769.72 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $55.43 – $55.43 | 1 |
| Use 1st target lesion CPT 76982 | $3,195.08 | $3,195.08 | $92.16 – $252.81 | 12 |
| User adjustable heel height HCPCS L5990 | not published | not published | $2,178.44 – $5,884.02 | 27 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $11.27 – $80.42 | 4 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $672.72 – $1,749.28 | 3 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $27,252.63 – $27,252.63 | 1 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $156.80 – $961.02 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $142.65 – $874.25 | 4 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $163.32 – $926.77 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $91.96 – $521.84 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $108.03 – $389.68 | 3 |
| Vaccine dtap < 7 years im CPT 90700 | $167.00 | $167.00 | $31.98 – $200.53 | 4 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $818.27 | $818.27 | $114.34 – $702.22 | 4 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $67.99 – $425.75 | 4 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $172.08 – $1,061.41 | 3 |
| Vaccine dtap-ipv/hib im CPT 90698 | $388.59 | $388.59 | $134.21 – $813.68 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $86.72 | $86.72 | $31.59 – $207.25 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $14.11 – $89.25 | 4 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $71.52 – $551.13 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $140.87 – $897.48 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $40.88 – $263.28 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $51.81 – $51.81 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $72.90 – $466.35 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $72.90 – $466.35 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $172.23 – $1,055.54 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $413.36 | $413.36 | $32.20 – $189.15 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $337.93 – $2,084.69 | 4 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $186.83 – $1,085.49 | 3 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $95.22 – $497.15 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $95.22 – $497.15 | 4 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $21.41 – $130.82 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $22.52 – $133.73 | 4 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $54.41 – $124.95 | 2 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $58.03 – $460.72 | 2 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $64.58 – $129.49 | 2 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $58.03 – $133.73 | 2 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $28.67 – $62.51 | 2 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $79.18 – $166.04 | 2 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $157.84 – $437.18 | 2 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $48.02 – $219.89 | 4 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.70 – $65.41 | 4 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $251.10 – $1,607.09 | 4 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $222.72 – $1,405.04 | 4 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $182.11 – $1,165.48 | 4 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $1,278.33 | $1,278.33 | $178.28 – $1,130.08 | 4 |
| Vaccine mmr live subcutaneous CPT 90707 | $1,266.72 | $1,266.72 | $99.45 – $645.16 | 4 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $297.32 – $1,885.13 | 4 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $1,148.47 | $1,148.47 | $129.47 – $793.47 | 4 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $1,585.13 | $1,585.13 | $425.45 – $1,534.53 | 3 |
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.