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 |
|---|---|---|---|---|
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $35.19 | $35.19 | $0.64 – $5.45 | 4 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $854.39 | $854.39 | $30.31 – $447.90 | 4 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.72 – $23.36 | 4 |
| Direct advanced life support CPT 99288 | not published | not published | $369.98 – $369.98 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $78.89 – $171.12 | 2 |
| Disability dlco CPT 94727 | $2,188.59 | $2,188.59 | $217.04 – $326.51 | 2 |
| Disaccharidases CPT 82657 | not published | not published | $13.30 – $83.95 | 33 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $698.37 – $2,083.05 | 11 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,451.04 – $8,000.98 | 2 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,977.02 – $10,581.90 | 2 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $270.82 – $1,486.18 | 2 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $120.35 – $2,252.35 | 12 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $98.00 – $264.70 | 27 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $230.56 – $622.75 | 27 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $67.12 – $1,796.95 | 11 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,972.55 – $1,972.55 | 1 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $75.67 – $75.67 | 1 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $490.68 – $2,702.10 | 2 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,617.79 – $5,699.28 | 2 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,492.60 – $8,219.74 | 2 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,924.91 – $6,014.66 | 11 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $417.84 – $2,301.27 | 2 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $91.69 | 11 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $387.00 – $2,140.60 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $167.40 – $1,062.71 | 33 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $164.90 – $1,047.19 | 30 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $82.20 – $521.67 | 30 |
| Dna antibody native/double stranded CPT 86225 | $1,789.32 | $1,789.32 | $8.24 – $52.95 | 33 |
| Dna gardnerella CPT 87510 | not published | not published | $12.03 – $76.17 | 33 |
| Dna probe chlamydia CPT 87490 | not published | not published | $13.65 – $86.52 | 33 |
| Dna probe gc CPT 87590 | not published | not published | $16.13 – $102.00 | 33 |
| Dna trichomonas CPT 87660 | not published | not published | $12.03 – $76.17 | 33 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | not published | $7.91 – $48.29 | 4 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $569.20 | $569.20 | $0.59 – $8.35 | 4 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $3.83 – $296.98 | 4 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $6.06 – $44.14 | 4 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $94.25 – $724.24 | 4 |
| Domicil/r-home visit est pat CPT 99334 | not published | not published | $425.22 – $425.22 | 1 |
| Domicil/r-home visit est pat CPT 99335 | not published | not published | $670.80 – $670.80 | 1 |
| Domicil/r-home visit est pat CPT 99336 | not published | not published | $958.24 – $958.24 | 1 |
| Domicil/r-home visit est pat CPT 99337 | not published | not published | $1,369.72 – $1,369.72 | 1 |
| Domicil/r-home visit new pat CPT 99324 | not published | not published | $390.38 – $390.38 | 1 |
| Domicil/r-home visit new pat CPT 99325 | not published | not published | $568.93 – $568.93 | 1 |
| Domicil/r-home visit new pat CPT 99326 | not published | not published | $987.57 – $987.57 | 1 |
| Domicil/r-home visit new pat CPT 99327 | not published | not published | $1,319.86 – $1,319.86 | 1 |
| Domicil/r-home visit new pat CPT 99328 | not published | not published | $1,546.27 – $1,546.27 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | not published | $0.69 – $3.99 | 4 |
| Doppler echo complete CPT 93320 | $3,904.66 | $3,904.66 | $84.20 – $246.37 | 2 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $1,427.31 – $1,427.31 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $4,955.27 | $4,955.27 | $126.39 – $412.69 | 11 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | not published | not published | $257.31 – $519.00 | 3 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $2.48 – $6.30 | 3 |
| Dornase alfa non-comp unit HCPCS J7639 | $1,508.84 | $1,508.84 | $51.98 – $333.77 | 4 |
| Dornhoffer fixed part w/window HCPCS L8614 | not published | not published | $22,984.63 – $62,082.21 | 27 |
| Dorsi & plantar flex ass/res HCPCS L2220 | $390.00 | $390.00 | $97.39 – $263.05 | 27 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $232.94 – $1,475.35 | 4 |
| Double transfer toe-hand CPT 26554 | not published | not published | $4,903.22 – $27,007.08 | 2 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $3.06 – $16.46 | 4 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $145.90 – $1,155.37 | 4 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | not published | not published | $0.12 – $0.73 | 4 |
| Dpyd gene common variants CPT 81232 | not published | not published | $104.89 – $666.31 | 30 |
| Drainable plastic pch w fcpl HCPCS A4375 | not published | not published | $20.95 – $64.11 | 27 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $129.80 – $714.92 | 11 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $145.35 – $714.92 | 11 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $111.53 – $1,667.42 | 11 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $105.53 – $714.92 | 11 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $802.97 – $2,932.54 | 11 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $802.97 – $2,932.54 | 11 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $86.27 – $252.51 | 11 |
| Drainage of abdomen CPT 48000 | not published | not published | $2,444.02 – $13,448.03 | 2 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $479.15 – $1,702.02 | 11 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $802.97 – $2,932.54 | 11 |
| Drainage of bone lesion CPT 26992 | not published | not published | $1,246.81 – $6,785.00 | 2 |
| Drainage of bone lesion CPT 27303 | not published | not published | $823.61 – $4,512.77 | 2 |
| Drainage of eye CPT 65800 | not published | not published | $837.19 – $2,507.11 | 11 |
| Drainage of eye CPT 65810 | not published | not published | $837.19 – $2,507.11 | 11 |
| Drainage of eye CPT 65815 | not published | not published | $837.19 – $2,507.11 | 11 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $584.14 – $1,680.68 | 11 |
| Drainage of kidney lesion CPT 50390 | not published | not published | $253.74 – $756.41 | 11 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $86.27 – $252.51 | 11 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $414.33 – $1,673.18 | 11 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $414.33 – $1,673.18 | 11 |
| Drainage of mouth lesion CPT 41008 | not published | not published | $873.32 – $3,347.22 | 11 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $184.41 – $547.73 | 11 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $184.41 – $547.73 | 11 |
| Drainage of mouth lesion CPT 41016 | not published | not published | $1,924.91 – $6,014.66 | 11 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $873.32 – $3,347.22 | 11 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $414.33 – $1,673.18 | 11 |
| Drainage of nose lesion int 30000 CPT 30000 | not published | not published | $86.27 – $239.12 | 11 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $177.53 – $544.50 | 11 |
| Drainage of pelvis bursa CPT 26991 | not published | not published | $584.14 – $1,680.68 | 11 |
| Drainage of pelvis lesion 26990 CPT 26990 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $1,125.76 – $3,742.99 | 11 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $1,125.76 – $3,558.75 | 11 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $1,125.76 – $3,742.99 | 11 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $422.82 – $1,245.23 | 11 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $925.83 – $2,906.78 | 11 |
| Drainage of salivary gland CPT 42305 | not published | not published | $873.32 – $3,347.22 | 11 |
| Drainage of salivary gland CPT 42320 | not published | not published | $184.41 – $547.73 | 11 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $1,808.09 – $10,019.69 | 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.