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 |
|---|---|---|---|---|
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,602.98 – $9,124.00 | 2 |
| Liver imaging CPT 78201 | not published | not published | $405.68 – $1,090.89 | 2 |
| Liver imag w/vasclr flow CPT 78202 | $4,716.89 | $4,716.89 | $427.25 – $1,090.89 | 2 |
| Liver/spleen imag static only CPT 78215 | $3,460.65 | $3,460.65 | $408.17 – $803.19 | 2 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $4,255.71 | $4,255.71 | $240.58 – $803.19 | 2 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,043.57 – $4,781.00 | 3 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $18,080.34 | $18,080.34 | $2,890.75 – $9,098.00 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $43.30 | $43.30 | $0.89 – $0.89 | 1 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $114.47 – $114.47 | 1 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $275.16 – $433.81 | 3 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $32.28 | $32.28 | $0.49 – $0.49 | 1 |
| Loudness balance test CPT 92562 | not published | not published | $189.68 – $433.81 | 2 |
| Low back disk surgery CPT 63030 | not published | not published | $6,316.94 – $16,164.00 | 3 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $524.85 – $1,187.00 | 2 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $1,713.61 – $2,761.00 | 2 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $524.85 – $1,187.00 | 2 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $524.85 – $1,187.00 | 2 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $4,761.56 | $4,761.56 | $352.40 – $614.99 | 2 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $4,112.34 | $4,112.34 | $700.93 – $1,288.74 | 2 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $3,740.70 | $3,740.70 | $210.04 – $378.27 | 2 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $7,256.12 | $7,256.12 | $700.93 – $1,288.74 | 2 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $6,162.86 | $6,162.86 | $700.93 – $1,288.74 | 2 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $5,117.37 | $5,117.37 | $479.38 – $786.51 | 2 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $797.02 | $797.02 | $210.04 – $258.01 | 2 |
| Lower jaw bone graft CPT 21215 | not published | not published | $5,122.16 – $13,172.00 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $239.55 – $403.10 | 2 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $19.85 – $31.80 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $5,104.40 – $21,356.54 | 3 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $8,884.24 – $21,356.54 | 3 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $8,884.24 – $21,356.54 | 3 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $8,884.24 – $21,356.54 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $88.38 | 5 |
| Lumbar diskogram s&i CPT 72295 | $6,771.13 | $6,771.13 | $3,923.25 – $3,957.94 | 2 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $12,567.15 – $35,227.43 | 3 |
| Lumizyme injection HCPCS J0221 | not published | not published | $209.60 – $413.18 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | $105.38 | $105.38 | $75.42 – $118.52 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $1,041.82 | $1,041.82 | $189.68 – $433.81 | 2 |
| Lung perfusion imaging CPT 78580 | $1,838.87 | $1,838.87 | $483.67 – $803.19 | 2 |
| Lung transplant double CPT 32853 | not published | not published | $5,081.41 – $9,124.00 | 2 |
| Lung transplant single CPT 32851 | not published | not published | $3,628.76 – $9,124.00 | 2 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,945.02 – $9,124.00 | 2 |
| Lung transplant with bypass CPT 32854 | not published | not published | $5,393.10 – $9,124.00 | 2 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,617.05 – $9,124.00 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $225.97 – $414.25 | 3 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $45.34 – $83.96 | 3 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $323.47 – $633.97 | 3 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $280.01 – $511.68 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $24.28 – $1,187.00 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $80.56 | 5 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $779.79 – $16,421.27 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $1,319.14 | $1,319.14 | $713.48 – $1,090.89 | 2 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $227.92 | 5 |
| Lymphocyte transformation mitogen CPT 86353 | $391.29 | $391.29 | $49.03 – $197.45 | 5 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $158.95 – $379.02 | 5 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $191.55 | 5 |
| Lymph vessel x-ray arm/leg CPT 75801 | $6,507.96 | $6,507.96 | $1,260.32 – $1,451.43 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | $8,122.48 | $8,122.48 | $2,517.90 – $3,162.66 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | $31,746.42 | $31,746.42 | $2,517.90 – $6,343.74 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | $22,512.70 | $22,512.70 | $6,343.74 – $6,379.49 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | $3,882.25 | $3,882.25 | $466.46 – $1,187.00 | 3 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $2,637.99 – $6,503.75 | 3 |
| Lysis penil circumic lesion CPT 54162 | $10,159.54 | $10,159.54 | $1,870.76 – $4,781.00 | 3 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $23.17 – $30.83 | 2 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $7.22 – $17.31 | 3 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $4.27 – $16.70 | 5 |
| Macroscopic exam parasite CPT 87169 | $221.72 | $221.72 | $4.31 – $16.70 | 5 |
| Magnesium CPT 83735 | $245.82 | $245.82 | $6.70 – $26.52 | 5 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $97.86 | $97.86 | $0.09 – $0.09 | 1 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $479.38 – $778.44 | 2 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $23.75 – $23.75 | 1 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $53.06 | 5 |
| Male sling procedure CPT 53440 | not published | not published | $8,519.73 – $26,507.16 | 3 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $3,349.04 – $9,124.00 | 2 |
| Manipulate finger w/anesth CPT 26340 | $9,636.68 | $9,636.68 | $1,187.00 – $3,230.64 | 3 |
| Manipulate wrist w/anesthes CPT 25259 | $15,118.59 | $15,118.59 | $1,431.29 – $3,230.64 | 3 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $331.74 | $331.74 | $149.48 – $267.31 | 2 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $527.26 | $527.26 | $149.48 – $267.31 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,431.29 – $3,230.64 | 3 |
| Manipulation of spine CPT 22505 | not published | not published | $1,431.29 – $3,230.64 | 3 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $75.46 – $1,187.00 | 3 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $55.83 | $55.83 | $4.06 – $4.06 | 1 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $8.71 – $8.71 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $14.73 | 5 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $124.02 – $124.02 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $1,187.00 – $1,187.00 | 1 |
| Map tachycard site(s) CPT 93609 | $6,583.20 | $6,583.20 | $400.22 – $1,187.00 | 2 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $50,266.77 | $50,266.77 | $54.75 – $104.97 | 3 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $0.48 – $2,508.00 | 2 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,248.28 – $9,124.00 | 2 |
| Mastectomy partial CPT 19301 | not published | not published | $3,199.20 – $7,866.55 | 3 |
| Mast mod rad CPT 19307 | not published | not published | $5,530.58 – $13,340.85 | 3 |
| Mastoidectomy CPT 69501 | not published | not published | $5,122.16 – $13,172.00 | 3 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $4,781.00 – $11,893.61 | 3 |
| Mastoids complete CPT 70130 | $1,385.29 | $1,385.29 | $210.04 – $258.01 | 2 |
| Mastoid surgery revision CPT 69603 | not published | not published | $5,122.16 – $13,172.00 | 3 |
| Mastopexy CPT 19316 | not published | not published | $5,530.58 – $13,340.85 | 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.