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 |
|---|---|---|---|---|
| Iron stain peripheral blood CPT 85536 | not published | not published | $4.13 – $25.83 | 33 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $1,186.96 | $1,186.96 | $0.23 – $1.33 | 4 |
| Irradiation of blood product each unit reference CPT 86945 | not published | not published | $33.84 – $261.31 | 5 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $1,879.58 | $1,879.58 | $129.82 – $190.72 | 2 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $583.89 – $1,566.45 | 11 |
| Irrigation syringe HCPCS A4322 | not published | not published | $3.43 – $10.53 | 27 |
| Irrigation tray HCPCS A4320 | not published | not published | $5.54 – $16.95 | 27 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $59.56 – $111.10 | 3 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $76.49 – $501.39 | 4 |
| Island pedicle flap graft CPT 15740 | not published | not published | $698.37 – $2,083.05 | 11 |
| IV cipaglucosidase alfa-atga HCPCS G0138 | not published | not published | $1,535.18 – $1,535.18 | 1 |
| Ivc venogram s&i CPT 75825 | not published | not published | $103.99 – $3,630.38 | 12 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $285.21 – $919.63 | 2 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | not published | not published | $74.84 – $217.33 | 2 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | not published | not published | $50.17 – $144.86 | 2 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | not published | not published | $51.87 – $152.30 | 2 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | not published | not published | $171.81 – $499.54 | 2 |
| IV inj ra drug dx study CPT 78808 | $2,665.36 | $2,665.36 | $66.51 – $482.25 | 4 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $450.85 – $772.38 | 3 |
| Ivp w/nephrotomography CPT 74415 | $2,643.39 | $2,643.39 | $149.09 – $513.41 | 12 |
| Ivp w/wo kub w/wo tomography CPT 74400 | not published | not published | $125.58 – $438.52 | 12 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $132.12 – $839.09 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $111.12 – $706.30 | 30 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $556.50 – $1,937.29 | 11 |
| John cunningham antibody CPT 86711 | not published | not published | $10.13 – $64.58 | 30 |
| J-tube placement CPT 44015 | not published | not published | $184.56 – $1,016.83 | 2 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,301.52 – $3,515.44 | 27 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,141.62 – $3,083.56 | 27 |
| Kafo fem fx cast molded to p HCPCS L2128 | $5,744.00 | $5,744.00 | $1,911.33 – $5,162.55 | 27 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,268.68 – $3,426.75 | 27 |
| Kafo fem fx cast thermoplas HCPCS L2126 | $6,115.00 | $6,115.00 | $1,334.75 – $3,605.20 | 27 |
| Kafo femoral fx cast rigid HCPCS L2136 | $3,670.00 | $3,670.00 | $1,436.37 – $3,879.67 | 27 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $1,014.36 – $2,739.81 | 27 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $2,516.69 – $6,797.67 | 27 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $1,856.55 – $5,014.60 | 27 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $207.63 – $560.81 | 27 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,130.57 – $3,053.71 | 27 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $4,910.83 – $13,264.30 | 27 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $1,104.03 – $2,982.03 | 27 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $1,593.65 – $4,304.50 | 27 |
| Keratomileusis CPT 65760 | not published | not published | $1,887.19 – $1,887.19 | 1 |
| Keratophakia CPT 65765 | not published | not published | $2,064.17 – $2,064.17 | 1 |
| Keratoprosthesis CPT 65770 | not published | not published | $7,687.14 – $14,645.07 | 2 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $60.18 – $3,674.83 | 3 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $0.02 – $91.69 | 11 |
| Ketogenic steroids fract CPT 83582 | $1,153.97 | $1,153.97 | $9.28 – $59.40 | 33 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | not published | not published | $4.90 – $31.01 | 33 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | not published | not published | $0.48 – $2.12 | 4 |
| Kidney endoscopy CPT 50551 | not published | not published | $1,664.09 – $5,413.16 | 11 |
| Kidney endoscopy CPT 50553 | not published | not published | $1,664.09 – $5,413.16 | 11 |
| Kidney endoscopy CPT 50570 | not published | not published | $1,125.76 – $3,742.99 | 11 |
| Kidney endoscopy CPT 50575 | not published | not published | $1,664.09 – $5,413.16 | 11 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $3,272.44 – $10,004.23 | 11 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $1,125.76 – $3,558.75 | 11 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $3,272.44 – $10,004.23 | 11 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $1,664.09 – $5,413.16 | 11 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $1,664.09 – $9,557.15 | 11 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $1,664.09 – $5,413.16 | 11 |
| Kidney function study CPT 78725 | not published | not published | $111.25 – $157.31 | 11 |
| Kidney imaging morphology CPT 78700 | not published | not published | $158.30 – $237.34 | 11 |
| Kidney imag w/bld flow multi CPT 78709 | $16,431.99 | $16,431.99 | $340.31 – $479.39 | 11 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $7,377.47 | $7,377.47 | $215.25 – $296.50 | 11 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | not published | not published | $103.18 – $287.71 | 12 |
| Kit case 4.2mm spinejack HCPCS C1062 | not published | not published | $3,856.13 – $3,856.13 | 1 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $44.91 – $137.50 | 27 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $8.53 – $26.12 | 27 |
| Kit gene analys d816 variant CPT 81273 | not published | not published | $74.92 – $475.18 | 33 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $14.64 – $44.80 | 27 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $22.55 – $209.78 | 4 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $2,067.93 – $5,585.55 | 27 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $20.00 – $61.26 | 27 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $584.14 – $1,680.68 | 11 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $584.14 – $1,680.68 | 11 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $1,071.95 – $3,394.44 | 11 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $2,362.54 – $7,417.62 | 11 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $3,250.55 – $7,417.62 | 11 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $6,502.97 – $14,756.88 | 11 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $118.89 – $321.13 | 27 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $96.90 – $261.74 | 27 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $109.18 – $294.91 | 27 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $707.46 – $1,910.87 | 27 |
| Knee disarticulat leather so HCPCS L5640 | not published | not published | $759.35 – $2,051.01 | 27 |
| Knee disc/dial lock/adj flex HCPCS L2425 | $1,136.00 | $1,136.00 | $171.80 – $464.03 | 27 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | not published | not published | $171.80 – $464.03 | 27 |
| Knee joint cam lock each joi HCPCS L2415 | $451.00 | $451.00 | $145.57 – $393.18 | 27 |
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.