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 |
|---|---|---|---|---|
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $2,211.02 | $2,211.02 | $170.49 – $1,187.00 | 3 |
| Destruction benign lesions < 14 lesions CPT 17110 | $1,110.31 | $1,110.31 | $184.51 – $1,187.00 | 3 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $857.52 – $2,265.00 | 3 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $1,228.61 | $1,228.61 | $1,187.00 – $1,187.00 | 1 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $6,491.02 | $6,491.02 | $1,815.63 – $4,781.00 | 3 |
| Destruction ciliary body CPT 66700 | not published | not published | $2,135.08 – $4,636.68 | 3 |
| Destruction ciliary body CPT 66720 | not published | not published | $2,043.57 – $4,781.00 | 3 |
| Destruction ciliary body CPT 66740 | not published | not published | $2,043.57 – $4,781.00 | 3 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | $1,120.75 | $1,120.75 | $93.23 – $1,187.00 | 3 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | $14,614.78 | $14,614.78 | $2,475.45 – $5,576.62 | 3 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $92.99 – $4,781.00 | 3 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $137.58 – $1,187.00 | 3 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $155.11 – $1,187.00 | 3 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $139.49 – $1,187.00 | 3 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $153.58 – $1,187.00 | 3 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,713.61 – $4,145.37 | 3 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $2,190.98 | $2,190.98 | $113.95 – $1,187.00 | 3 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,475.45 – $5,576.62 | 3 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $2,637.99 – $6,503.75 | 3 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $96.80 – $6,503.75 | 3 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | $7,084.27 | $7,084.27 | $84.23 – $4,145.37 | 3 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $80.56 | 5 |
| Detect agnt mult dna direc CPT 87800 | $322.37 | $322.37 | $43.67 – $161.10 | 5 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $13.83 – $13.83 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $189.68 – $258.52 | 2 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,202.57 – $1,202.57 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $81.52 – $81.52 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $218.49 | $218.49 | $53.94 – $174.84 | 2 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $178.22 – $205.87 | 2 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.57 – $1.57 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.01 – $0.01 | 1 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $35.08 | $35.08 | $0.03 – $0.03 | 1 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $252.02 – $409.22 | 3 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $0.78 – $1.47 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $126.12 – $250.79 | 3 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $35.10 – $35.10 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $98.42 | $98.42 | $2.22 – $2.22 | 1 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $98.42 | $98.42 | $6.55 – $6.55 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $30.65 | $30.65 | $10.03 – $10.03 | 1 |
| Dextrose 5 % IV bolus HCPCS J7070 | $98.42 | $98.42 | $20.06 – $20.06 | 1 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $272.25 | $272.25 | $22.23 – $89.39 | 5 |
| Diabetes (HbA1c) Test CPT 83036 | $258.48 | $258.48 | $9.71 – $39.30 | 5 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $37.48 – $75.28 | 2 |
| Diab manage trn ind/group HCPCS G0109 | $100.82 | $100.82 | $21.25 – $31.98 | 2 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,510.72 – $3,576.02 | 3 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $5,104.40 – $13,172.00 | 3 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $115.14 – $1,187.00 | 3 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,060.46 – $2,761.00 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $726.86 | $726.86 | $115.14 – $1,187.00 | 3 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $293.04 | $293.04 | $216.53 – $216.53 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $203.52 | $203.52 | $216.53 – $216.53 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $512.84 | $512.84 | $67.84 – $1,187.00 | 3 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $141.21 | $141.21 | $83.53 – $1,187.00 | 3 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $1,071.65 | $1,071.65 | $209.78 – $277.09 | 2 |
| Diagnostic Mammogram (one breast) CPT 77065 | $725.48 | $725.48 | $170.66 – $216.53 | 2 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $174.84 – $183.72 | 2 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $5,366.71 | $5,366.71 | $1,187.00 – $1,187.00 | 1 |
| Dialysis one evaluation CPT 90945 | $3,207.61 | $3,207.61 | $838.33 – $838.33 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $9.88 – $14.54 | 2 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $501.68 | $501.68 | $0.12 – $0.12 | 1 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $64.23 | $64.23 | $8.20 – $8.20 | 1 |
| Dicyclomine injection HCPCS J0500 | $228.46 | $228.46 | $37.15 – $37.15 | 1 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.24 – $0.24 | 1 |
| Diffusing capacity CPT 94729 | $1,431.24 | $1,431.24 | $64.23 – $64.23 | 1 |
| Digital analysis of eeg CPT 95957 | $4,106.67 | $4,106.67 | $230.74 – $230.74 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $34.31 | $34.31 | $5.03 – $5.03 | 1 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $5,055.18 – $10,336.46 | 3 |
| Digoxin total therapeutic drug level CPT 80162 | $217.60 | $217.60 | $13.28 – $53.06 | 5 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $256.82 – $256.82 | 1 |
| Dilate biliary duct/ampulla CPT 47542 | $2,109.39 | $2,109.39 | $1,187.00 – $1,187.00 | 1 |
| Dilate esophagus CPT 43453 | not published | not published | $1,644.61 – $3,855.30 | 3 |
| Dilate esophagus 1/mult pass CPT 43450 | $8,421.06 | $8,421.06 | $829.93 – $2,761.00 | 3 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $374.48 – $9,124.00 | 2 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $187.24 – $9,124.00 | 2 |
| Dilate ic vasospasm init CPT 61640 | $8,592.55 | $8,592.55 | $533.18 – $9,124.00 | 2 |
| Dilate tear duct opening CPT 68801 | not published | not published | $383.95 – $1,187.00 | 3 |
| Dilate urethra stricture CPT 53600 | $928.03 | $928.03 | $41.54 – $1,187.00 | 3 |
| Dilate urethra stricture CPT 53601 | $542.76 | $542.76 | $115.14 – $1,187.00 | 3 |
| Dilate urethra stricture CPT 53605 | not published | not published | $1,870.76 – $7,082.09 | 3 |
| Dilate urethra stricture CPT 53621 | not published | not published | $94.51 – $1,187.00 | 3 |
| Dilation/female urethra/initial 53660 CPT 53660 | $759.92 | $759.92 | $46.50 – $1,187.00 | 3 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,060.46 – $2,761.00 | 3 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $42.68 – $6,503.75 | 3 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,060.46 – $2,761.00 | 3 |
| Dilation of salivary duct CPT 42660 | not published | not published | $79.65 – $1,187.00 | 3 |
| Dilation of urethra CPT 53661 | $542.76 | $542.76 | $115.14 – $1,187.00 | 3 |
| Dilation of urethra CPT 53665 | not published | not published | $1,870.76 – $4,781.00 | 3 |
| Dilation of vagina CPT 57400 | not published | not published | $2,637.99 – $6,503.75 | 3 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $52.21 – $3,117.31 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $92.23 – $2,265.00 | 3 |
| Dilat xst trc ndurlgc px CPT 50436 | $17,953.63 | $17,953.63 | $1,870.76 – $7,082.09 | 3 |
| Dilat xst trc new access rcs CPT 50437 | $20,984.37 | $20,984.37 | $3,187.58 – $9,098.00 | 3 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $74.64 – $117.59 | 2 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $13.27 – $13.27 | 1 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $818.39 – $1,497.69 | 3 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.03 – $0.03 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $27.91 | $27.91 | $0.91 – $0.91 | 1 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $49.69 – $49.69 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $45.83 – $75.04 | 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.