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 |
|---|---|---|---|---|
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $698.37 – $2,083.05 | 11 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $95.72 – $410.41 | 11 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $925.83 – $2,906.78 | 11 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,047.57 – $3,268.14 | 11 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $97.35 – $3,268.14 | 11 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $71.99 – $2,083.05 | 11 |
| Detect agent nos dna dir CPT 87797 | $734.66 | $734.66 | $18.02 – $114.92 | 33 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $26.20 – $166.58 | 33 |
| Determination venous press CPT 93770 | not published | not published | $19.56 – $57.73 | 2 |
| Determine refractive state CPT 92015 | not published | not published | $46.78 – $140.64 | 2 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $23.81 – $69.68 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $326.51 – $326.51 | 1 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $29,371.00 | $29,371.00 | $12.59 – $12.59 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $2,519.43 – $7,802.97 | 4 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $28.04 – $107.17 | 2 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,835.81 – $10,073.77 | 2 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $69.68 – $185.35 | 2 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $140.33 – $140.33 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $757.45 | $757.45 | $30.69 – $83.67 | 12 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $107.36 – $614.12 | 4 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $4.11 – $7.08 | 3 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.02 – $0.12 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.07 – $0.73 | 4 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $199.08 – $1,242.15 | 11 |
| Dexamethasone panel CPT 80420 | not published | not published | $97.13 – $617.21 | 33 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $1.45 – $2.04 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $10,504.59 | $10,504.59 | $78.53 – $653.98 | 4 |
| Dextran 40 infusion HCPCS J7100 | $882.80 | $882.80 | $91.53 – $628.63 | 4 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $87.86 – $103.87 | 2 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $2.43 – $4.31 | 3 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $199.97 | $199.97 | $1.21 – $8.23 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $9.98 – $49.26 | 4 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.77 – $26.15 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | $271.97 | $271.97 | $3.53 – $52.30 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $1,259.02 | $1,259.02 | $13.34 – $85.23 | 33 |
| Diabetes (HbA1c) Test CPT 83036 | not published | not published | $5.83 – $37.46 | 33 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $64.52 – $64.52 | 1 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $232.65 – $712.12 | 27 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $37.31 – $119.97 | 27 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $37.31 – $119.97 | 27 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $37.31 – $119.97 | 27 |
| Diab manage trn ind/group HCPCS G0109 | $249.05 | $249.05 | $14.37 – $40.95 | 27 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $77.56 – $237.45 | 27 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $37.31 – $119.97 | 27 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $517.82 – $1,796.95 | 11 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,860.52 – $6,103.44 | 11 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $135.20 – $451.00 | 3 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $437.23 – $1,245.23 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $134.32 – $328.50 | 3 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $113.26 – $431.02 | 5 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $91.91 – $338.05 | 5 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $55.36 – $201.52 | 11 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $67.12 – $201.52 | 11 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $1,216.18 | $1,216.18 | $99.33 – $274.81 | 27 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $77.97 – $214.21 | 27 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $83.86 – $316.19 | 11 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $12,015.43 – $12,015.43 | 1 |
| Dialysis one evaluation CPT 90945 | not published | not published | $606.20 – $606.20 | 1 |
| Dialysis repeated eval CPT 90947 | not published | not published | $880.19 – $880.19 | 1 |
| Dialysis training complete CPT 90989 | not published | not published | $2,521.89 – $2,521.89 | 1 |
| Dialysis training incompl CPT 90993 | not published | not published | $547.33 – $547.33 | 1 |
| Diathermy eg microwave CPT 97024 | $273.14 | $273.14 | $6.63 – $18.50 | 27 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.08 – $0.42 | 5 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | not published | not published | $5.62 – $37.33 | 4 |
| Dicyclomine injection HCPCS J0500 | $817.94 | $817.94 | $12.47 – $96.88 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.46 – $1.45 | 3 |
| Diffusing capacity CPT 94729 | $2,296.76 | $2,296.76 | $110.57 – $311.26 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $397.19 – $1,255.05 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $4.73 – $24.20 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $26,282.47 | $26,282.47 | $4,819.52 – $30,064.88 | 4 |
| Digoxin total therapeutic drug level CPT 80162 | not published | not published | $7.97 – $50.38 | 33 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $1,860.94 | $1,860.94 | $83.18 – $669.71 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $2,217.50 – $2,217.50 | 1 |
| Dilate esophagus CPT 43453 | not published | not published | $556.50 – $1,937.29 | 11 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $329.93 – $974.54 | 11 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $439.73 – $439.73 | 1 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $219.86 – $219.86 | 1 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $626.09 – $626.09 | 1 |
| Dilate tear duct opening CPT 68801 | not published | not published | $67.67 – $451.00 | 3 |
| Dilate urethra stricture CPT 53600 | not published | not published | $34.36 – $252.24 | 11 |
| Dilate urethra stricture CPT 53601 | not published | not published | $38.48 – $135.20 | 11 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,125.76 – $3,558.75 | 11 |
| Dilate urethra stricture CPT 53621 | not published | not published | $92.72 – $252.24 | 11 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $39.00 – $129.91 | 11 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $422.82 – $1,245.23 | 11 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $39.26 – $3,268.14 | 11 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $422.82 – $1,245.23 | 11 |
| Dilation of salivary duct CPT 42660 | not published | not published | $56.17 – $544.50 | 11 |
| Dilation of urethra CPT 53661 | not published | not published | $29.16 – $135.20 | 11 |
| Dilation of urethra CPT 53665 | not published | not published | $643.01 – $2,196.72 | 11 |
| Dilation of vagina CPT 57400 | not published | not published | $1,047.57 – $3,268.14 | 11 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $36.82 – $1,566.45 | 11 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $91.07 – $703.98 | 11 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $1,125.76 – $3,558.75 | 11 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $1,125.76 – $3,742.99 | 11 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.05 – $0.24 | 3 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $194.65 – $389.30 | 3 |
| Dimenhydrinate injection HCPCS J1240 | $186.97 | $186.97 | $1.52 – $46.83 | 4 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $4,311.18 | $4,311.18 | $693.28 – $4,495.29 | 4 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.07 – $2.34 | 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.