Methodist Mansfield Medical Center
2700 E Broad Street, Mansfield, TX · Methodisthealthsystem · · NPI 1689629941
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 |
|---|---|---|---|---|
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $38.50 | $77.00 | $1.08 – $1.08 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $70.87 | $141.75 | $1.63 – $1.63 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $33.50 | $67.00 | $14.29 – $64.27 | 61 |
| Hyoscyamine sulfate inj HCPCS J1980 | $200.75 | $401.50 | $142.49 – $142.49 | 1 |
| Hysterosalpingography s&i CPT 74740 | $673.00 | $1,346.00 | $63.49 – $648.23 | 74 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $341.25 | $682.50 | $403.22 – $403.22 | 1 |
| I125 iothalamate, dx HCPCS A9554 | $878.87 | $1,757.75 | $333.26 – $1,754.03 | 55 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $2,912.12 | $5,824.25 | $953.01 – $2,573.13 | 55 |
| I131 iodide cap, rx HCPCS A9517 | $536.87 | $1,073.75 | $24.07 – $64.99 | 69 |
| Iaadi respiratory synctial virus CPT 87280 | $96.50 | $193.00 | $10.71 – $48.16 | 61 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $73.00 | $146.00 | $28.01 – $125.98 | 61 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $60.50 | $121.00 | $36.14 – $162.56 | 61 |
| Idarubicin hcl injection HCPCS J9211 | $151.37 | $302.75 | $94.86 – $94.86 | 1 |
| Idh1 common variants CPT 81120 | $285.00 | $570.00 | $154.21 – $693.72 | 61 |
| Idh2 common variants CPT 81121 | $427.50 | $855.00 | $236.04 – $1,061.79 | 61 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $251.12 | $502.25 | $59.22 – $59.22 | 1 |
| Igh gene rearrang dir probe CPT 81262 | $111.50 | $223.00 | $54.70 – $246.07 | 61 |
| Igh gene rearrange amp meth CPT 81261 | $282.00 | $564.00 | $157.99 – $710.73 | 75 |
| Igh@ var region somatic mutation analy CPT 81263 | $371.50 | $743.00 | $235.03 – $1,057.26 | 75 |
| Igk rearrangeabn clonal pop CPT 81264 | $250.00 | $500.00 | $137.84 – $620.04 | 75 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $67.50 | $135.00 | $73.39 – $330.13 | 5 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $56.50 | $113.00 | $131.29 – $973.82 | 61 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $168.50 | $337.00 | $85.32 – $462.86 | 75 |
| Ikbkap gene CPT 81260 | $36.00 | $72.00 | $31.37 – $141.11 | 61 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,625.50 | $3,251.00 | $22.06 – $22.06 | 1 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | $36.00 | $72.00 | $37.52 – $101.47 | 70 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $62.39 | $124.79 | $132.02 – $356.45 | 68 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $14.80 | $29.61 | $63.18 – $170.59 | 68 |
| Immune complex assay CPT 86332 | $16.50 | $33.00 | $19.45 – $87.48 | 61 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $6,600.25 | $13,200.50 | $47.29 – $1,113.26 | 69 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $173.50 | $347.00 | $16.61 – $74.70 | 75 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $263.00 | $526.00 | $16.61 – $74.70 | 75 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $8.50 | $17.00 | $9.56 – $42.99 | 75 |
| Immunofixation electrophoresis serum CPT 86334 | $407.00 | $814.00 | $17.83 – $80.21 | 75 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $315.50 | $631.00 | $76.87 – $378.12 | 5 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $557.50 | $1,115.00 | $109.95 – $494.61 | 75 |
| Immunoglobulin assay CPT 86023 | $516.00 | $1,032.00 | $9.95 – $44.74 | 61 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $2,229.00 | $4,458.00 | $831.46 – $4,256.52 | 69 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $8,014.25 | $16,028.50 | $745.62 – $2,013.17 | 69 |
| In-111 pentetreotide HCPCS A9572 | $8,581.25 | $17,162.50 | $2,000.94 – $13,511.39 | 55 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $41.50 | $83.00 | $56.02 – $252.01 | 60 |
| Infect ag drug suscept pheno predict CPT 87900 | $264.50 | $529.00 | $104.02 – $467.91 | 61 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $544.00 | $1,088.00 | $205.45 – $924.19 | 75 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $278.00 | $556.00 | $205.45 – $924.19 | 75 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $427.50 | $855.00 | $102.72 – $462.09 | 61 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $262.50 | $525.00 | $205.45 – $924.19 | 61 |
| Infect ag ia optc obs influenza CPT 87804 | $193.50 | $387.00 | $13.21 – $59.40 | 75 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $96.50 | $193.00 | $9.56 – $42.99 | 61 |
| Infect ag if hep delta agent CPT 87380 | $94.00 | $188.00 | $14.65 – $65.90 | 61 |
| Infect ag if influenza a CPT 87276 | $96.50 | $193.00 | $12.83 – $57.69 | 61 |
| Infect ag if influenza b CPT 87275 | $96.50 | $193.00 | $9.78 – $43.97 | 61 |
| Infect ag if legionella pneumophila CPT 87278 | $28.00 | $56.00 | $12.45 – $55.98 | 75 |
| Infect ag if nos ea CPT 87299 | $96.50 | $193.00 | $12.84 – $57.78 | 75 |
| Infect ag if pneumocystis carinii CPT 87281 | $65.50 | $131.00 | $9.56 – $42.99 | 61 |
| Infect ag na herpes simplex quant CPT 87530 | $105.00 | $210.00 | $34.19 – $153.80 | 61 |
| Infect ag na hpv high-risk types CPT 87624 | $65.50 | $131.00 | $28.01 – $125.98 | 75 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $205.00 | $410.00 | $76.45 – $343.89 | 75 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $32.00 | $64.00 | $40.95 – $184.19 | 60 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $612.00 | $1,224.00 | $332.60 – $1,496.15 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $58.50 | $117.00 | $9.56 – $42.99 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $13.50 | $27.00 | $11.03 – $49.62 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $74.00 | $148.00 | $9.56 – $42.99 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $231.00 | $462.00 | $11.48 – $51.62 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $202.50 | $405.00 | $8.25 – $37.09 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $64.00 | $128.00 | $8.25 – $37.09 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $79.00 | $158.00 | $19.22 – $86.45 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $124.00 | $248.00 | $9.56 – $42.99 | 75 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $11.00 | $22.00 | $9.56 – $42.99 | 61 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $45.00 | $90.00 | $9.56 – $42.99 | 61 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $433.50 | $867.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $133.00 | $266.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $292.50 | $585.00 | $29.74 – $133.80 | 75 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $274.00 | $548.00 | $416.78 – $1,125.31 | 71 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $82.50 | $165.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $126.00 | $252.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $296.00 | $592.00 | $33.26 – $149.62 | 75 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $133.00 | $266.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $450.00 | $900.00 | $40.95 – $184.19 | 75 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $197.00 | $394.00 | $113.82 – $512.01 | 61 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $227.00 | $454.00 | $113.82 – $512.01 | 75 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $80.50 | $161.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $86.50 | $173.00 | $28.01 – $125.98 | 75 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $16.50 | $33.00 | $70.18 – $189.49 | 57 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $138.00 | $276.00 | $61.27 – $275.60 | 74 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $654.00 | $1,308.00 | $332.60 – $1,496.15 | 75 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $397.50 | $795.00 | $209.86 – $944.06 | 75 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $171.50 | $343.00 | $34.19 – $153.80 | 75 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $102.00 | $204.00 | $34.19 – $153.80 | 75 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $79.00 | $158.00 | $34.19 – $153.80 | 75 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $60.00 | $120.00 | $67.91 – $305.47 | 75 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,192.37 | $2,384.75 | $24.22 – $2,142.16 | 69 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $157.00 | $314.00 | $71.96 – $594.91 | 71 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,581.50 | $3,163.00 | $91.31 – $594.91 | 71 |
| Inj acetaminophen -fresenius HCPCS J0134 | $20.12 | $40.25 | $35.85 – $35.85 | 1 |
| Inj, artesunate, 1mg HCPCS J0391 | $5,647.50 | $11,295.00 | $51.83 – $11,854.16 | 55 |
| Inj, bupivacaine liposome HCPCS J0666 | $775.00 | $1,550.00 | $1.44 – $1,020.24 | 69 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $292.00 | $584.00 | $554.48 – $554.48 | 1 |
| Inj ceftolozane tazobactam HCPCS J0695 | $356.50 | $713.00 | $8.95 – $272.46 | 69 |
| Injection during cath supravalvular aortography CPT 93567 | $151.00 | $302.00 | $3,884.57 – $3,884.57 | 1 |
| Injection, fulvestrant HCPCS J9395 | $237.00 | $474.00 | $1,969.36 – $1,969.36 | 1 |
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.