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 |
|---|---|---|---|---|
| Impres&prep nasal prosth CPT 21087 | not published | not published | $521.40 – $5,976.54 | 11 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $86.27 – $239.12 | 11 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $1,228.42 – $5,976.54 | 2 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $512.12 – $3,347.22 | 11 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $873.10 – $3,347.22 | 3 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $979.15 – $3,347.22 | 3 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $289.88 – $1,566.45 | 11 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $41.85 – $261.95 | 4 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $70.00 – $30,700.10 | 6 |
| In-111 autol wbc diag per dose HCPCS A9570 | not published | not published | $70.00 – $30,700.10 | 6 |
| In-111 capromab pendet HCPCS A9507 | not published | not published | $70.00 – $27,132.26 | 6 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $70.00 – $30,045.54 | 6 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $12,490.57 | $12,490.57 | $70.00 – $15,350.05 | 6 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $10,816.52 | $10,816.52 | $70.00 – $5,465.32 | 6 |
| In-111 pentetreotide HCPCS A9572 | $17,666.28 | $17,666.28 | $70.00 – $48,725.28 | 6 |
| In-111 satumomab pend HCPCS A4642 | $23,711.06 | $23,711.06 | $2,766.04 – $8,350.99 | 3 |
| Inactivated je vacc im CPT 90738 | not published | not published | $504.42 – $2,133.66 | 4 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $569.33 – $3,115.51 | 2 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $2,362.54 – $7,417.62 | 11 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $2,326.49 – $12,686.16 | 2 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $1,939.48 – $10,567.66 | 2 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $1,931.44 – $10,542.84 | 2 |
| Incis addl spine segment CPT 22216 | not published | not published | $474.14 – $2,599.65 | 2 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $1,640.52 – $9,024.82 | 2 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $55.08 – $1,006.43 | 11 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incise hip/thigh nerve CPT 64766 | not published | not published | $1,971.43 – $4,442.52 | 3 |
| Incise inner ear CPT 69801 | not published | not published | $122.44 – $1,566.45 | 11 |
| Incise inner ear nerve CPT 69915 | not published | not published | $873.32 – $3,347.22 | 11 |
| Incise inner ear nerve CPT 69950 | not published | not published | $2,261.69 – $12,484.35 | 2 |
| Incise inner eye adhesions CPT 65860 | not published | not published | $139.35 – $555.27 | 11 |
| Incise inner eye adhesions CPT 65865 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incise inner eye adhesions CPT 65870 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incise inner eye adhesions CPT 65875 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incise inner eye adhesions CPT 65880 | not published | not published | $1,510.49 – $4,734.73 | 11 |
| Incise inner eye strands CPT 67030 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incise nerve back of head CPT 64744 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incise perq finger tendon 26060 CPT 26060 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incise skull/brain surgery CPT 61720 | not published | not published | $3,448.87 – $9,017.60 | 3 |
| Incise skull/brain surgery CPT 61735 | not published | not published | $2,091.42 – $11,284.32 | 2 |
| Incise skull for treatment CPT 61770 | not published | not published | $3,448.87 – $11,535.77 | 3 |
| Incise skull repair CPT 62121 | not published | not published | $2,043.61 – $11,968.57 | 2 |
| Incise skull/sutures CPT 61556 | not published | not published | $2,242.02 – $12,099.84 | 2 |
| Incise skull/sutures CPT 61557 | not published | not published | $2,208.50 – $11,927.58 | 2 |
| Incise sperm duct pouch CPT 55600 | not published | not published | $643.01 – $2,110.41 | 11 |
| Incise spinal cord tract(s) CPT 63170 | not published | not published | $2,074.89 – $11,303.56 | 2 |
| Incise spine accessory nerve CPT 63191 | not published | not published | $1,810.77 – $9,779.89 | 2 |
| Incise spine nrv >2 segmnts CPT 63190 | not published | not published | $1,608.34 – $8,890.90 | 2 |
| Incise spine nrv half segmnt CPT 63185 | not published | not published | $1,485.45 – $8,053.21 | 2 |
| Incise tear duct opening 68440 CPT 68440 | not published | not published | $19.39 – $320.45 | 11 |
| Incise tendon(s) & muscle(s) CPT 23406 | not published | not published | $3,055.92 – $7,417.62 | 11 |
| Incise thigh tendon & fascia CPT 27305 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incise & treat bladder CPT 51030 | not published | not published | $3,742.99 – $3,742.99 | 1 |
| Incise wrist/forearm tendon CPT 25290 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision anal septum infant CPT 46070 | not published | not published | $925.83 – $2,906.78 | 11 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $11,816.33 | $11,816.33 | $89.45 – $1,667.42 | 11 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | not published | not published | $1,239.21 – $1,239.21 | 1 |
| Incision/fixation of femur CPT 27165 | not published | not published | $1,762.96 – $9,730.75 | 2 |
| Incision of achilles tendon CPT 27605 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incision of achilles tendon CPT 27606 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision of anal sphincter CPT 46080 | not published | not published | $925.83 – $2,906.78 | 11 |
| Incision of ankle bone CPT 28302 | not published | not published | $3,075.70 – $7,417.62 | 11 |
| Incision of bile duct CPT 47425 | not published | not published | $1,774.58 – $9,732.61 | 2 |
| Incision of bile duct 47420 CPT 47420 | not published | not published | $1,738.38 – $9,530.66 | 2 |
| Incision of brain tissue CPT 61541 | not published | not published | $2,802.41 – $15,260.70 | 2 |
| Incision of brain tissue CPT 61567 | not published | not published | $3,259.58 – $3,259.58 | 1 |
| Incision of breast lesion CPT 19020 | not published | not published | $479.15 – $1,702.02 | 11 |
| Incision of brow nerve CPT 64732 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incision of burn scab initi CPT 16035 | not published | not published | $140.93 – $410.41 | 11 |
| Incision of cheek nerve CPT 64734 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incision of chin nerve CPT 64736 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incision of eardrum CPT 69420 | not published | not published | $86.27 – $239.12 | 11 |
| Incision of eardrum CPT 69421 | not published | not published | $873.32 – $3,347.22 | 11 |
| Incision of esophagus CPT 43020 | not published | not published | $1,566.45 – $3,950.56 | 3 |
| Incision of eye CPT 65850 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incision of eye CPT 66172 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incision of eyelid CPT 67710 | not published | not published | $167.98 – $1,006.43 | 11 |
| Incision of facial nerve CPT 64742 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incision of fibula CPT 27707 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision of finger tendon CPT 26455 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incision of foot fascia CPT 28008 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision of foot tendon 28234 CPT 28234 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incision of gallbladder 47480 CPT 47480 | not published | not published | $1,135.98 – $6,226.08 | 2 |
| Incision of heel bone CPT 28300 | not published | not published | $3,331.99 – $7,417.62 | 11 |
| Incision of hip bone CPT 27146 | not published | not published | $1,646.32 – $9,096.72 | 2 |
| Incision of hip bones CPT 27151 | not published | not published | $2,054.33 – $11,324.38 | 2 |
| Incision of hip tendon CPT 27000 | not published | not published | $584.14 – $1,680.68 | 11 |
| Incision of hip tendon CPT 27001 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision of hip tendon CPT 27003 | not published | not published | $2,362.54 – $7,417.62 | 11 |
| Incision of hip tendons CPT 27006 | not published | not published | $3,303.34 – $5,168.41 | 3 |
| Incision of iris CPT 66500 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incision of iris CPT 66505 | not published | not published | $837.19 – $2,507.11 | 11 |
| Incision of jaw joint CPT 21010 | not published | not published | $873.32 – $3,347.22 | 11 |
| Incision of jaw nerve CPT 64738 | not published | not published | $650.04 – $2,131.99 | 11 |
| Incision of knee joint CPT 27435 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Incision of liver duct CPT 47400 | not published | not published | $2,798.39 – $15,351.77 | 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.