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 |
|---|---|---|---|---|
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $9,054.07 | $9,054.07 | $1,713.61 – $4,145.37 | 3 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $433.70 | $433.70 | $1,187.00 – $1,187.00 | 1 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $1,291.63 | $1,291.63 | $248.05 – $1,187.00 | 3 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $507.70 | $507.70 | $52.25 – $94.08 | 2 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $857.73 | $857.73 | $450.00 – $450.00 | 1 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $674.29 | $674.29 | $450.00 – $450.00 | 1 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $674.29 | $674.29 | $450.00 – $450.00 | 1 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $28.90 | $28.90 | $326.94 – $1,187.00 | 3 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $1,134.49 | $1,134.49 | $115.14 – $1,187.00 | 3 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $5,804.01 | $5,804.01 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $2,360.39 | $2,360.39 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $2,394.57 | $2,394.57 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $2,211.02 | $2,211.02 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $2,194.80 | $2,194.80 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $2,211.02 | $2,211.02 | $170.49 – $1,187.00 | 3 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $3,272.65 | $3,272.65 | $524.85 – $1,484.88 | 3 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $3,297.53 | $3,297.53 | $524.85 – $1,484.88 | 3 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $2,360.82 | $2,360.82 | $337.40 – $1,187.00 | 3 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $3,297.53 | $3,297.53 | $337.40 – $2,265.00 | 3 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $7,084.27 | $7,084.27 | $1,713.61 – $4,145.37 | 3 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $601.46 | $601.46 | $8.60 – $34.38 | 5 |
| Ghs low level laser therapy CPT 97039 | not published | not published | $15.31 – $15.31 | 1 |
| Ghs mbp CPT 83873 | $316.74 | $316.74 | $17.20 – $69.73 | 5 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $1,081.36 | $1,081.36 | $35.58 – $35.58 | 1 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $984.35 | $984.35 | $125.50 – $125.50 | 1 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $983.20 | $983.20 | $110.68 – $110.68 | 1 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $983.20 | $983.20 | $14.82 – $14.82 | 1 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $983.20 | $983.20 | $89.92 – $89.92 | 1 |
| Ghs musc test done w/n test comp CPT 95886 | $492.03 | $492.03 | $67.19 – $67.19 | 1 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $379.44 | $379.44 | $58.80 – $58.80 | 1 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $423.33 | $423.33 | $61.76 – $61.76 | 1 |
| Ghs myocardial strain img spckl track CPT 93356 | $744.76 | $744.76 | $28.20 – $28.20 | 1 |
| Ghs nailbed repair/nail removal CPT 11760 | $726.86 | $726.86 | $524.85 – $1,484.88 | 3 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $2,107.76 | $2,107.76 | $857.52 – $2,265.00 | 3 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,096.42 | $1,096.42 | $660.05 – $2,265.00 | 3 |
| Ghs nerve block axillary nerve CPT 64417 | $5,444.80 | $5,444.80 | $857.52 – $2,265.00 | 3 |
| Ghs nerve block brachial plexus CPT 64415 | $2,877.26 | $2,877.26 | $857.52 – $2,265.00 | 3 |
| Ghs nerve block celiac plexus CPT 64530 | $4,518.81 | $4,518.81 | $857.52 – $2,265.00 | 3 |
| Ghs nerve block interscaline CPT 64510 | $1,304.56 | $1,304.56 | $857.52 – $2,265.00 | 3 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $4,292.83 | $4,292.83 | $857.52 – $2,265.00 | 3 |
| Ghs nerve block sciatic nerve CPT 64445 | $4,518.81 | $4,518.81 | $94.51 – $2,265.00 | 3 |
| Ghs nerve block suprascapular CPT 64418 | $3,434.54 | $3,434.54 | $45.74 – $2,265.00 | 3 |
| Ghs ng placement w fluoro guidance CPT 43752 | $960.91 | $960.91 | $383.95 – $1,187.00 | 3 |
| Ghs o2 saturation CPT 82810 | $499.81 | $499.81 | $9.77 – $35.35 | 5 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $189.68 – $258.52 | 2 |
| Ghs o2 uptake rest & indirect CPT 94690 | $347.93 | $347.93 | $45.83 – $118.52 | 2 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $52.25 – $94.08 | 2 |
| Ghs opcc repair cvp without subq port CPT 36575 | $2,772.47 | $2,772.47 | $665.82 – $2,265.00 | 3 |
| Ghs opcc repair cvp w subq port CPT 36576 | $8,122.48 | $8,122.48 | $1,722.47 – $3,162.66 | 3 |
| Ghs optokenetic CPT 92544 | $883.07 | $883.07 | $3.95 – $258.52 | 2 |
| Ghs oscillating trac CPT 92545 | $1,663.95 | $1,663.95 | $3.95 – $433.81 | 2 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $83.27 | $83.27 | $33.62 – $43.38 | 2 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $83.27 | $83.27 | $33.62 – $43.38 | 2 |
| Ghs ot dds rom CPT 95851 | $146.21 | $146.21 | $10.87 – $13.36 | 2 |
| Ghs ot group caregiver training CPT 97552 | $55.64 | $55.64 | $18.66 – $31.12 | 2 |
| Ghs ot prosthetic training/15 min CPT 97761 | not published | not published | $57.32 – $80.84 | 2 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $180.12 | $180.12 | $59.79 – $121.10 | 2 |
| Ghs ot work hardening-additional hours CPT 97546 | $320.59 | $320.59 | $64.72 – $64.72 | 1 |
| Ghs pacing - transcutaneous CPT 92953 | $2,277.52 | $2,277.52 | $566.50 – $2,265.00 | 3 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $1,380.76 | $1,380.76 | $1,187.00 – $1,187.00 | 1 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,579.01 | $1,579.01 | $1,187.00 – $1,187.00 | 1 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $308.64 | $308.64 | $26.35 – $63.10 | 4 |
| Ghs peritonsillar abscess i andd CPT 42700 | $1,615.31 | $1,615.31 | $215.04 – $1,187.00 | 3 |
| Ghs phenylketonurid CPT 84030 | $212.91 | $212.91 | $5.50 – $22.60 | 5 |
| Ghs picc line insert < 5 CPT 36568 | $7,388.14 | $7,388.14 | $665.82 – $3,162.66 | 3 |
| Ghs plngl fx pm cl CPT 26725 | $1,705.16 | $1,705.16 | $115.06 – $1,187.00 | 3 |
| Ghs plt ct-manual CPT 85032 | $35.30 | $35.30 | $4.31 – $17.69 | 5 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $6,281.84 | $6,281.84 | $1,090.47 – $1,725.31 | 2 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $149.48 – $267.31 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | $173.07 | $173.07 | $14.95 – $58.11 | 5 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $118.27 | $118.27 | $9.66 – $39.30 | 5 |
| Ghs protein, misc fluid CPT 84160 | $98.61 | $98.61 | $5.61 – $20.62 | 5 |
| Ghs protoporphyrins fract CPT 84202 | $217.51 | $217.51 | $14.35 – $57.95 | 5 |
| Ghs pr without cont pulse ox CPT 94625 | $618.60 | $618.60 | $27.17 – $118.52 | 2 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $107.10 | $107.10 | $12.25 – $49.10 | 5 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $635.22 | $635.22 | $128.46 – $128.46 | 1 |
| Ghs quinidine CPT 80194 | not published | not published | $14.60 – $58.96 | 5 |
| Ghs refill of implantable pump CPT 95990 | $751.67 | $751.67 | $129.45 – $1,187.00 | 3 |
| Ghs removal intranasal foreign body CPT 30300 | $778.33 | $778.33 | $115.14 – $1,187.00 | 3 |
| Ghs removal pharyngeal foreign body CPT 42809 | $949.45 | $949.45 | $383.95 – $1,187.00 | 3 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | not published | not published | $1,431.29 – $3,230.64 | 3 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $31,980.12 | $31,980.12 | $2,890.75 – $9,098.00 | 3 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $15.89 – $52.04 | 5 |
| Ghs reticulocyte count CPT 85044 | $155.59 | $155.59 | $4.31 – $17.69 | 5 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $500.19 | $500.19 | $13.91 – $48.14 | 5 |
| Ghs sedimentation rate CPT 85651 | $136.64 | $136.64 | $4.27 – $14.73 | 5 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $12.31 – $48.14 | 5 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $36.35 | 5 |
| Ghs sensitivity (per antimicro) CPT 87184 | $361.54 | $361.54 | $7.48 – $27.53 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $2,229.95 | $2,229.95 | $337.40 – $1,187.00 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $2,215.89 | $2,215.89 | $337.40 – $1,187.00 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $2,211.02 | $2,211.02 | $337.40 – $1,187.00 | 3 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $1,338.15 | $1,338.15 | $184.51 – $1,187.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $1,120.75 | $1,120.75 | $184.51 – $1,187.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $1,482.00 | $1,482.00 | $184.51 – $1,187.00 | 3 |
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.