Texas Health Hospital Mansfield
2300 Lone Star Road, Mansfield, TX · AdventHealth · · NPI 1356960132
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 |
|---|---|---|---|---|
| X-ray exam of penis CPT 74445 | $1,385.29 | $1,385.29 | $105.02 – $210.04 | 2 |
| X-ray exam of perineum CPT 74775 | $1,953.64 | $1,953.64 | $239.69 – $479.38 | 2 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $87.42 – $174.84 | 2 |
| X-ray exam of sinuses CPT 70210 | $814.52 | $814.52 | $87.42 – $174.84 | 2 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $239.69 – $479.38 | 2 |
| X-ray exam of teeth CPT 70300 | not published | not published | $87.42 – $174.84 | 2 |
| X-ray exam of teeth CPT 70310 | $1,328.20 | $1,328.20 | $239.69 – $479.38 | 2 |
| X-ray exam si joints CPT 72200 | $561.30 | $561.30 | $105.02 – $210.04 | 2 |
| X-ray exam thorac spine4/>vw CPT 72074 | not published | not published | $105.02 – $210.04 | 2 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $444.60 | $444.60 | $87.42 – $174.84 | 2 |
| X-ray facial bones complete > 3 views CPT 70150 | $751.12 | $751.12 | $105.02 – $210.04 | 2 |
| X-ray fallopian tube CPT 74742 | $1,066.24 | $1,066.24 | $92.56 – $92.56 | 1 |
| X-ray femur >=2 views (both sides) CPT 73552 | $551.45 | $551.45 | $87.42 – $174.84 | 2 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $508.72 | $508.72 | $87.42 – $174.84 | 2 |
| X-ray foot 2 views (both sides) CPT 73620 | $603.99 | $603.99 | $87.42 – $174.84 | 2 |
| X-ray forearm 2 views (both sides) CPT 73090 | $576.10 | $576.10 | $87.42 – $174.84 | 2 |
| X-ray hand 2 views (both sides) CPT 73120 | $581.92 | $581.92 | $105.02 – $210.04 | 2 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $87.42 – $174.84 | 2 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $427.84 | $427.84 | $87.42 – $174.84 | 2 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $932.96 | $932.96 | $105.02 – $210.04 | 2 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $576.67 | $576.67 | $105.02 – $210.04 | 2 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $561.30 | $561.30 | $105.02 – $210.04 | 2 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $1,385.29 | $1,385.29 | $105.02 – $210.04 | 2 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $414.79 | $414.79 | $87.42 – $174.84 | 2 |
| X-ray humerus >= 2 views left CPT 73060 | $561.54 | $561.54 | $87.42 – $174.84 | 2 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $105.02 – $210.04 | 2 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $519.37 | $519.37 | $87.42 – $174.84 | 2 |
| X-ray knee 3 views (both sides) CPT 73562 | $613.10 | $613.10 | $87.42 – $174.84 | 2 |
| X-ray knee ap standing bilateral CPT 73565 | $804.56 | $804.56 | $87.42 – $174.84 | 2 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $431.62 | $431.62 | $87.42 – $174.84 | 2 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $495.22 | $495.22 | $105.02 – $210.04 | 2 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $1,014.59 | $1,014.59 | $105.02 – $210.04 | 2 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $1,136.86 | $1,136.86 | $105.02 – $210.04 | 2 |
| X-ray male genital tract CPT 74440 | not published | not published | $239.69 – $479.38 | 2 |
| X-ray mandible complete > 4 views CPT 70110 | $773.19 | $773.19 | $105.02 – $210.04 | 2 |
| X-ray mandible ltd <4 views CPT 70100 | $456.85 | $456.85 | $87.42 – $174.84 | 2 |
| X-ray nasal bones complete > 3 views CPT 70160 | $469.46 | $469.46 | $87.42 – $174.84 | 2 |
| X-ray neck soft tissue CPT 70360 | $391.99 | $391.99 | $87.42 – $174.84 | 2 |
| X-ray nose to rectum for foreign body child CPT 76010 | $427.79 | $427.79 | $87.42 – $174.84 | 2 |
| X-ray of mammary ducts CPT 77054 | $3,349.47 | $3,349.47 | $239.69 – $479.38 | 2 |
| X-ray optic foramina CPT 70190 | not published | not published | $87.42 – $174.84 | 2 |
| X-ray pelvis 1-2 views CPT 72170 | $495.73 | $495.73 | $105.02 – $210.04 | 2 |
| X-ray pelvis complete > 3 views CPT 72190 | $558.44 | $558.44 | $105.02 – $210.04 | 2 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $513.36 – $513.36 | 1 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $589.11 – $589.11 | 1 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,030.83 | $1,030.83 | $135.70 – $700.93 | 2 |
| X-ray ribs 2 views left CPT 71100 | $700.34 | $700.34 | $87.42 – $174.84 | 2 |
| X-ray ribs 3 views bilateral CPT 71110 | $711.53 | $711.53 | $105.02 – $210.04 | 2 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $823.47 | $823.47 | $105.02 – $210.04 | 2 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $732.90 | $732.90 | $105.02 – $210.04 | 2 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $576.49 | $576.49 | $105.02 – $210.04 | 2 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $713.28 | $713.28 | $87.42 – $174.84 | 2 |
| X-ray scapula complete (both sides) CPT 73010 | $454.75 | $454.75 | $105.02 – $210.04 | 2 |
| X-ray sella turcica CPT 70240 | not published | not published | $87.42 – $174.84 | 2 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $474.71 | $474.71 | $87.42 – $174.84 | 2 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $967.65 | $967.65 | $87.42 – $174.84 | 2 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,677.54 | $1,677.54 | $548.90 – $1,097.81 | 2 |
| X-ray skull < 4 views CPT 70250 | $433.02 | $433.02 | $105.02 – $210.04 | 2 |
| X-ray skull > 4 views complete CPT 70260 | $918.60 | $918.60 | $105.02 – $210.04 | 2 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $1,385.29 | $1,385.29 | $105.02 – $210.04 | 2 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $1,664.46 | $1,664.46 | $176.20 – $352.40 | 2 |
| X-ray small intestine follow-through study CPT 74248 | $2,019.70 | $2,019.70 | $139.91 – $139.91 | 1 |
| X-ray spine single view CPT 72020 | $531.12 | $531.12 | $87.42 – $174.84 | 2 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $280.96 | $280.96 | $87.42 – $174.84 | 2 |
| X-ray sternum > 2 views CPT 71120 | $445.64 | $445.64 | $87.42 – $174.84 | 2 |
| X-ray surgical specimen CPT 76098 | $419.73 | $419.73 | $548.90 – $1,097.81 | 2 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $910.22 | $910.22 | $176.20 – $352.40 | 2 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $786.16 | $786.16 | $87.42 – $174.84 | 2 |
| X-ray thoracic spine 2 views CPT 72070 | $562.32 | $562.32 | $105.02 – $210.04 | 2 |
| X-ray thoracic spine 3 views CPT 72072 | $849.59 | $849.59 | $105.02 – $210.04 | 2 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $329.66 | $329.66 | $87.42 – $174.84 | 2 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $565.79 | $565.79 | $87.42 – $174.84 | 2 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $565.79 | $565.79 | $105.02 – $210.04 | 2 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $584.93 | $584.93 | $87.42 – $174.84 | 2 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $470.95 | $470.95 | $87.42 – $174.84 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $2,019.70 | $2,019.70 | $176.20 – $352.40 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $2,019.70 | $2,019.70 | $176.20 – $352.40 | 2 |
| X-ray wrist 2 views (both sides) CPT 73100 | $536.73 | $536.73 | $87.42 – $174.84 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $1,176.41 | $1,176.41 | $176.20 – $352.40 | 2 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $234.06 – $234.06 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $246.77 – $246.77 | 1 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $52.64 | 5 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.37 – $2.74 | 3 |
| Yersinia antibody CPT 86793 | $158.71 | $158.71 | $13.19 – $53.06 | 5 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $56,824.55 – $128,726.96 | 3 |
| Ziconotide injection HCPCS J2278 | not published | not published | $10.79 – $21.59 | 3 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.51 – $3.03 | 2 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $0.59 – $0.59 | 1 |
| Zika virus dna/rna amp probe CPT 87662 | $280.52 | $280.52 | $51.31 – $205.24 | 4 |
| Zika virus igm antibody CPT 86794 | $202.76 | $202.76 | $16.85 – $67.40 | 4 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $50.25 – $50.25 | 1 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $8.67 – $17.35 | 3 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $296.06 | $296.06 | $13.66 – $13.66 | 1 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $430.23 – $430.23 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $773.00 | 4 |
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.