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 |
|---|---|---|---|---|
| Injection, glucarpidase HCPCS C9293 | $54,473.62 | $108,947.25 | $448.69 – $1,211.47 | 54 |
| Injection,onabotulinumtoxina HCPCS J0585 | $820.37 | $1,640.75 | $6.51 – $1,395.76 | 69 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $445.50 | $891.00 | $23.54 – $833.92 | 74 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $230.50 | $461.00 | $26.40 – $127.21 | 71 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $230.50 | $461.00 | $39.91 – $39.91 | 1 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $230.50 | $461.00 | $26.40 – $577.87 | 71 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $168.50 | $337.00 | $25.15 – $195.61 | 71 |
| Inject sacroiliac joint CPT 27096 | $1,107.50 | $2,215.00 | $710.27 – $1,136.43 | 27 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $185.00 | $370.00 | $3,884.57 – $3,884.57 | 1 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $1,320.50 | $2,641.00 | $5.44 – $2,332.64 | 55 |
| Inj ivig privigen 500 mg HCPCS J1459 | $4,980.00 | $9,960.00 | $50.28 – $1,140.27 | 55 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $81.75 | $163.50 | $79.16 – $79.16 | 1 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $36.25 | $72.50 | $6.31 – $6.31 | 1 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | $87.50 | $175.00 | $103.53 – $103.53 | 1 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $775.00 | $1,550.00 | $51.15 – $51.15 | 1 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | $270.25 | $540.50 | $346.55 – $346.55 | 1 |
| Inj testosterone cypionate HCPCS J1071 | $46.25 | $92.50 | $9.56 – $9.56 | 1 |
| Insertion catheter bladder temporary simple CPT 51702 | $190.50 | $381.00 | $133.87 – $361.46 | 57 |
| Insert swan-ganz cath CPT 93503 | $1,855.50 | $3,711.00 | $1,583.93 – $4,276.62 | 57 |
| Insitu hybridization auto CPT 88367 | $155.50 | $311.00 | $83.04 – $973.82 | 61 |
| Insitu hybridization (fish) CPT 88366 | $366.00 | $732.00 | $171.15 – $918.42 | 75 |
| Insitu hybridization manual CPT 88368 | $325.50 | $651.00 | $110.30 – $973.82 | 75 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $154.50 | $309.00 | $98.28 – $442.09 | 5 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $401.50 | $803.00 | $132.55 – $596.28 | 75 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $358.00 | $716.00 | $44.85 – $1,894.40 | 74 |
| Insulin total CPT 83525 | $8.00 | $16.00 | $9.12 – $41.03 | 75 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $1,698.00 | $3,396.00 | $3,917.16 – $3,917.16 | 1 |
| Interrog dev eval icpms ip CPT 93290 | $83.50 | $167.00 | $29.97 – $101.39 | 57 |
| Interrog evl pm/ldls pm ip CPT 93288 | $383.00 | $766.00 | $23.93 – $101.39 | 71 |
| Intra-atrial pacing CPT 93610 | $122.00 | $244.00 | $7,533.71 – $21,189.91 | 57 |
| Intra-atrial recording CPT 93602 | $2,345.00 | $4,690.00 | $7,533.71 – $21,189.91 | 57 |
| Intracard echo interv w/s&i CPT 93662 | $5,801.50 | $11,603.00 | $91.31 – $91.31 | 1 |
| Intracranial complete study CPT 93886 | $1,122.00 | $2,244.00 | $92.59 – $1,032.99 | 60 |
| Intracranial limited study CPT 93888 | $819.00 | $1,638.00 | $101.02 – $454.44 | 60 |
| Intrapul surf admin endo tube CPT 94610 | $95.50 | $191.00 | $18.79 – $594.91 | 57 |
| Intraventricular pacing CPT 93612 | $4,127.00 | $8,254.00 | $7,533.71 – $21,189.91 | 57 |
| Intrinsic factor antibody CPT 86340 | $12.50 | $25.00 | $12.04 – $54.15 | 75 |
| Intro long gi tube w/mult fluo CPT 74340 | $608.50 | $1,217.00 | $46.90 – $46.90 | 1 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $1,871.00 | $3,742.00 | $21,525.18 – $21,525.18 | 1 |
| Ionm in operatng room 15 min CPT 95940 | $231.00 | $462.00 | $234.53 – $234.53 | 1 |
| Ionm remote/>1 pt or per hr CPT 95941 | $923.00 | $1,846.00 | $96.33 – $96.33 | 1 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $164.75 | $329.50 | $6.69 – $6.69 | 1 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $390.62 | $781.25 | $11.47 – $11.47 | 1 |
| Iron CPT 83540 | $176.00 | $352.00 | $5.16 – $23.21 | 75 |
| Iron binding capacity CPT 83550 | $176.00 | $352.00 | $6.97 – $31.37 | 75 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $82.25 | $164.50 | $18.08 – $65.01 | 69 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $120.87 | $241.75 | $83.65 – $83.65 | 1 |
| Irradiation of blood product each unit reference CPT 86945 | $47.50 | $95.00 | $37.58 – $101.47 | 57 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $263.00 | $526.00 | $59.26 – $160.27 | 71 |
| Ivc venogram s&i CPT 75825 | $3,066.00 | $6,132.00 | $108.57 – $8,578.16 | 74 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $171.50 | $343.00 | $39.91 – $195.61 | 71 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $171.50 | $343.00 | $12.61 – $12.61 | 1 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $171.50 | $343.00 | $39.91 – $127.21 | 71 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $434.50 | $869.00 | $10.47 – $577.87 | 71 |
| IV inj ra drug dx study CPT 78808 | $2,071.50 | $4,143.00 | $402.25 – $1,086.09 | 57 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $756.50 | $1,513.00 | $128.56 – $578.33 | 74 |
| Jak2 targeted sequence analysis CPT 81279 | $131.50 | $263.00 | $147.79 – $664.83 | 74 |
| John cunningham antibody CPT 86711 | $184.00 | $368.00 | $13.95 – $62.73 | 75 |
| Ketamine and metabolite screen - quest CPT 80357 | $82.50 | $165.00 | $9.81 – $183.09 | 31 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $70.00 | $140.00 | $6.52 – $29.32 | 75 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $6.12 | $12.25 | $0.33 – $0.90 | 69 |
| Kidney function study CPT 78725 | $863.00 | $1,726.00 | $107.29 – $1,086.09 | 74 |
| Kidney imaging morphology CPT 78700 | $602.50 | $1,205.00 | $152.67 – $1,086.09 | 60 |
| Kidney imag w/bld flow multi CPT 78709 | $1,047.00 | $2,094.00 | $328.22 – $1,476.45 | 74 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $920.00 | $1,840.00 | $207.60 – $1,475.12 | 74 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $708.00 | $1,416.00 | $99.51 – $447.65 | 74 |
| Kit gene analys d816 variant CPT 81273 | $210.00 | $420.00 | $99.65 – $448.25 | 61 |
| Knee MRI (with and without contrast) CPT 73723 | $3,171.50 | $6,343.00 | $348.10 – $1,565.90 | 73 |
| Knee MRI (with contrast) CPT 73722 | $2,805.50 | $5,611.00 | $307.27 – $2,444.14 | 73 |
| Knee MRI (without contrast) CPT 73721 | $2,439.00 | $4,878.00 | $198.40 – $892.48 | 73 |
| Knee X-ray CPT 73564 | $242.50 | $485.00 | $45.08 – $284.03 | 74 |
| Kras gene variants exon 2 CPT 81275 | $572.50 | $1,145.00 | $154.21 – $693.72 | 75 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $7.87 | $15.75 | $2.58 – $2.58 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $176.00 | $352.00 | $4.82 – $21.67 | 75 |
| Lactic acid CPT 83605 | $370.50 | $741.00 | $9.23 – $41.54 | 75 |
| Lactoferrin fecal qualitative CPT 83630 | $51.50 | $103.00 | $15.72 – $70.73 | 75 |
| Laryngeal function studies CPT 92520 | $431.00 | $862.00 | $58.04 – $361.46 | 71 |
| Laryngoscopic sensory vid CPT 92614 | $432.00 | $864.00 | $54.15 – $146.21 | 57 |
| Laryngoscopy telescopic CPT 31579 | $411.50 | $823.00 | $393.55 – $1,062.58 | 56 |
| Lead capillary CPT 83655 | $9.00 | $18.00 | $9.66 – $43.46 | 75 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,714.00 | $3,428.00 | $73.97 – $789.66 | 74 |
| Leishmania antibody CPT 86717 | $29.00 | $58.00 | $9.78 – $43.97 | 61 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $42.00 | $84.00 | $6.14 – $6.14 | 1 |
| Leukocyte phagocytosis CPT 86344 | $151.00 | $302.00 | $8.29 – $37.31 | 61 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $7.25 | $14.50 | $13.15 – $13.15 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $95.00 | $190.00 | $10.57 – $47.56 | 75 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $28.62 | $57.25 | $1.20 – $1.20 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $12.50 | $25.00 | $47.80 – $47.80 | 1 |
| Lidocaine therapeutic drug level CPT 80176 | $74.50 | $149.00 | $11.72 – $52.73 | 61 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $121.00 | $242.00 | $103.25 – $103.25 | 1 |
| Lipase CPT 83690 | $158.50 | $317.00 | $5.50 – $24.74 | 75 |
| Lipoprotein blood high res frac & quant CPT 83701 | $22.50 | $45.00 | $27.02 – $121.54 | 61 |
| Lipoprotein blood quant CPT 83704 | $37.50 | $75.00 | $27.28 – $122.73 | 75 |
| Lipoprotein direct measurement hdl CPT 83718 | $221.00 | $442.00 | $6.54 – $29.40 | 61 |
| Lipoprotein direct measurement ldl CPT 83721 | $239.00 | $478.00 | $8.38 – $37.69 | 75 |
| Listeria monocytogenes CPT 86723 | $45.50 | $91.00 | $10.53 – $47.35 | 61 |
| Lithium therapeutic drug level CPT 80178 | $275.00 | $550.00 | $5.27 – $23.72 | 75 |
| Liver Function Test CPT 80076 | $288.00 | $576.00 | $6.52 – $29.32 | 75 |
| Liver imaging CPT 78201 | $1,391.50 | $2,783.00 | $170.15 – $1,475.12 | 74 |
| Liver/spleen imag static only CPT 78215 | $892.50 | $1,785.00 | $175.22 – $1,086.09 | 60 |
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.