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 simple repair over 30 cm - 12007 CPT 12007 | $1,120.75 | $1,120.75 | $184.51 – $1,187.00 | 3 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $1,120.75 | $1,120.75 | $184.51 – $1,187.00 | 3 |
| Ghs sleep study unattended CPT 95800 | $1,759.19 | $1,759.19 | $177.38 – $433.81 | 2 |
| Ghs somatosensory testing lower extremit CPT 95926 | $1,859.99 | $1,859.99 | $139.83 – $433.81 | 2 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $5,296.71 | $5,296.71 | $418.50 – $1,725.31 | 2 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $72.64 – $95.46 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | $1,485.22 | $1,485.22 | $75.46 – $1,187.00 | 3 |
| Ghs spont nystagmus CPT 92541 | $712.35 | $712.35 | $149.48 – $267.31 | 2 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $467.74 | $467.74 | $152.18 – $199.70 | 2 |
| Ghs st - eval for alt comm CPT 92567 | $263.40 | $263.40 | $45.83 – $75.04 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $1,289.72 | $1,289.72 | $115.14 – $1,187.00 | 3 |
| Ghs st - re-eval for alt comm CPT 92597 | $768.25 | $768.25 | $101.78 – $145.70 | 2 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $387.21 | $387.21 | $21.74 – $94.08 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $598.01 | $598.01 | $231.73 – $427.34 | 2 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $3,841.84 | $3,841.84 | $524.85 – $1,484.88 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $4,371.49 | $4,371.49 | $337.40 – $1,187.00 | 3 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $8,243.52 | $8,243.52 | $1,424.90 – $3,117.31 | 3 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $29.45 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $1,417.66 | $1,417.66 | $227.72 – $1,187.00 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $1,320.65 | $1,320.65 | $227.72 – $1,187.00 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $98.21 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $234.47 | $234.47 | $14.71 – $58.96 | 5 |
| Ghs vaginal delivery only CPT 59409 | $7,559.96 | $7,559.96 | $2,637.99 – $6,503.75 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,985.83 | $1,985.83 | $665.77 – $749.72 | 2 |
| Ghs windowing of cast CPT 29730 | $906.69 | $906.69 | $34.30 – $1,187.00 | 3 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $48.14 | 5 |
| Giardia lamblia antibody CPT 86674 | $178.42 | $178.42 | $14.72 – $58.96 | 5 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $479.38 – $536.46 | 2 |
| Gi inhouse confirmation CPT 87045 | $157.76 | $157.76 | $9.44 – $38.30 | 5 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $353.66 – $13,172.00 | 3 |
| Gi protein loss CPT 78282 | not published | not published | $803.19 – $813.85 | 2 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $1,044.03 – $2,761.00 | 3 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $1,868.39 – $1,942.98 | 2 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $1,044.03 – $2,761.00 | 3 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $1,616.19 – $2,761.00 | 3 |
| Gjb2 gene full sequence CPT 81252 | $861.91 | $861.91 | $101.12 – $276.66 | 4 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $168.32 | 4 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $95.76 | 4 |
| Glassia injection HCPCS J0257 | not published | not published | $6.65 – $11.28 | 3 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $58.11 – $78.06 | 2 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $58.31 – $75.04 | 2 |
| Glaucoma surgery CPT 66150 | not published | not published | $4,032.16 – $8,304.52 | 3 |
| Glaucoma surgery CPT 66155 | not published | not published | $4,032.16 – $8,304.52 | 3 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,135.08 – $4,781.00 | 3 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,135.08 – $4,781.00 | 3 |
| Glove finger flexion right lg xl HCPCS L3912 | $697.94 | $697.94 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $109.33 – $376.53 | 3 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $238.60 – $297.98 | 3 |
| Glucagon plasma - sendout CPT 82943 | $87.50 | $87.50 | $14.29 – $57.95 | 5 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $46.07 – $172.93 | 5 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $50.50 – $172.93 | 5 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.77 – $60.90 | 5 |
| Glucose 1 hr post dose CPT 82950 | $161.03 | $161.03 | $4.75 – $18.68 | 5 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $6.05 – $24.57 | 5 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $40.50 | $40.50 | $3.28 – $9.81 | 5 |
| Glucose blood quantitative CPT 82947 | $240.12 | $240.12 | $3.93 – $15.72 | 5 |
| Glucose body fluid CPT 82945 | $114.14 | $114.14 | $3.93 – $15.72 | 5 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $77.08 – $118.52 | 2 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $226.00 | $226.00 | $12.87 – $52.04 | 5 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $82.64 | $82.64 | $3.92 – $15.72 | 5 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $54.00 | $54.00 | $0.90 – $0.90 | 1 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $19.22 – $19.22 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $1,683.67 | $1,683.67 | $22.08 – $46.77 | 3 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $393.73 | $393.73 | $18.58 – $74.65 | 5 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $148.41 – $477.39 | 5 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $455.18 | $455.18 | $18.52 – $74.65 | 5 |
| Gonioscopy CPT 92020 | not published | not published | $149.48 – $267.31 | 2 |
| Goniotomy CPT 65820 | not published | not published | $4,032.16 – $8,304.52 | 3 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $773.12 – $1,467.33 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $45.22 – $250.02 | 2 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,890.75 – $9,098.00 | 3 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $46.69 – $250.02 | 2 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $1,354.29 – $1,354.29 | 1 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $70.17 – $250.02 | 2 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,202.62 – $9,124.00 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $659.21 | $659.21 | $60.47 – $250.02 | 2 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $11.25 – $11.25 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.70 – $0.70 | 1 |
| Granulocyte pheresis ea unit HCPCS P9050 | $5,039.08 | $5,039.08 | $1,387.82 – $1,387.82 | 1 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,601.36 – $14,578.56 | 3 |
| Great toe with reduction 28495 CPT 28495 | $1,320.65 | $1,320.65 | $115.06 – $1,187.00 | 3 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,713.61 – $4,145.37 | 3 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,144.02 – $9,098.00 | 3 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,144.02 – $9,098.00 | 3 |
| Ground mileage HCPCS A0425 | $41.87 | $41.87 | not published | 0 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $22.24 – $24.68 | 2 |
| Growth hormone antibody CPT 86277 | not published | not published | $15.74 – $63.84 | 5 |
| Growth hormone panel CPT 80428 | not published | not published | $66.70 – $264.26 | 5 |
| Growth hormone panel CPT 80430 | not published | not published | $129.33 – $264.26 | 5 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $62.37 – $151.20 | 4 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | $294.41 | $294.41 | $37.46 – $75.28 | 2 |
| Grp adapt bhv tx by tech CPT 97154 | $294.41 | $294.41 | $37.46 – $75.28 | 2 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,123.98 – $9,124.00 | 2 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $1,392.90 – $13,172.00 | 2 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,789.08 – $9,124.00 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,982.79 – $9,124.00 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,316.40 – $9,124.00 | 2 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,644.61 – $4,781.00 | 3 |
| G-tube reposition CPT 43761 | $2,125.27 | $2,125.27 | $248.05 – $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.