Methodist Midlothian Medical Center
1201 E US-287, Midlothian, TX · Methodisthealthsystem · · NPI 1487271375
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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $133.00 | $266.00 | $28.01 – $120.63 | 60 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $450.00 | $900.00 | $40.95 – $176.37 | 60 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $197.00 | $394.00 | $113.82 – $490.26 | 60 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $227.00 | $454.00 | $113.82 – $490.26 | 60 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $80.50 | $161.00 | $28.01 – $120.63 | 60 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $86.50 | $173.00 | $28.01 – $120.63 | 60 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $16.50 | $33.00 | $70.18 – $189.49 | 56 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $138.00 | $276.00 | $61.27 – $263.89 | 59 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $654.00 | $1,308.00 | $332.60 – $1,432.61 | 60 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $397.50 | $795.00 | $209.86 – $903.96 | 60 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $171.50 | $343.00 | $34.19 – $147.27 | 60 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $102.00 | $204.00 | $34.19 – $147.27 | 60 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $79.00 | $158.00 | $34.19 – $147.27 | 60 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $60.00 | $120.00 | $67.91 – $292.50 | 60 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,192.37 | $2,384.75 | $24.22 – $65.39 | 54 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $157.00 | $314.00 | $219.97 – $593.93 | 56 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,581.50 | $3,163.00 | $219.97 – $593.93 | 56 |
| Inj, bupivacaine liposome HCPCS J0666 | $775.00 | $1,550.00 | $1.44 – $3.88 | 54 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $459.12 | $918.25 | $2.42 – $6.53 | 54 |
| Inj ceftolozane tazobactam HCPCS J0695 | $356.50 | $713.00 | $8.95 – $24.16 | 54 |
| Injection,onabotulinumtoxina HCPCS J0585 | $820.37 | $1,640.75 | $6.51 – $17.58 | 54 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $445.50 | $891.00 | $23.54 – $832.55 | 59 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $230.50 | $461.00 | $47.04 – $127.01 | 56 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $230.50 | $461.00 | $213.67 – $576.92 | 56 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $168.50 | $337.00 | $72.33 – $195.29 | 56 |
| Inject sacroiliac joint CPT 27096 | $1,107.50 | $2,215.00 | $709.10 – $1,134.56 | 27 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | $775.00 | $1,550.00 | $1.57 – $4.24 | 54 |
| Inj, releuko 1 mcg HCPCS Q5125 | $473.25 | $946.50 | $0.34 – $0.91 | 54 |
| Insertion catheter bladder temporary simple CPT 51702 | $190.50 | $381.00 | $133.65 – $360.87 | 56 |
| Insert swan-ganz cath CPT 93503 | $1,855.50 | $3,711.00 | $1,581.33 – $4,269.59 | 56 |
| Insitu hybridization auto CPT 88367 | $155.50 | $311.00 | $83.04 – $972.22 | 60 |
| Insitu hybridization (fish) CPT 88366 | $366.00 | $732.00 | $171.15 – $879.41 | 60 |
| Insitu hybridization manual CPT 88368 | $325.50 | $651.00 | $110.30 – $972.22 | 60 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $154.50 | $309.00 | $98.28 – $423.32 | 4 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $401.50 | $803.00 | $132.55 – $570.96 | 60 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $358.00 | $716.00 | $44.85 – $1,891.28 | 59 |
| Insulin total CPT 83525 | $8.00 | $16.00 | $9.12 – $39.28 | 60 |
| Interrog dev eval icpms ip CPT 93290 | $83.50 | $167.00 | $37.49 – $101.23 | 56 |
| Interrog evl pm/ldls pm ip CPT 93288 | $383.00 | $766.00 | $37.49 – $101.23 | 56 |
| Intra-atrial pacing CPT 93610 | $122.00 | $244.00 | $7,835.21 – $21,155.06 | 56 |
| Intra-atrial recording CPT 93602 | $2,345.00 | $4,690.00 | $7,835.21 – $21,155.06 | 56 |
| Intracranial complete study CPT 93886 | $1,122.00 | $2,244.00 | $229.63 – $989.12 | 59 |
| Intracranial limited study CPT 93888 | $819.00 | $1,638.00 | $101.02 – $435.14 | 59 |
| Intrapul surf admin endo tube CPT 94610 | $95.50 | $191.00 | $219.97 – $593.93 | 56 |
| Intraventricular pacing CPT 93612 | $4,127.00 | $8,254.00 | $7,835.21 – $21,155.06 | 56 |
| Intrinsic factor antibody CPT 86340 | $12.50 | $25.00 | $12.04 – $51.85 | 60 |
| Iron CPT 83540 | $176.00 | $352.00 | $5.16 – $22.22 | 60 |
| Iron binding capacity CPT 83550 | $176.00 | $352.00 | $6.97 – $30.04 | 60 |
| Irradiation of blood product each unit reference CPT 86945 | $47.50 | $95.00 | $37.52 – $101.31 | 56 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $263.00 | $526.00 | $59.26 – $160.00 | 56 |
| Ivc venogram s&i CPT 75825 | $3,066.00 | $6,132.00 | $108.57 – $8,564.05 | 59 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $171.50 | $343.00 | $72.33 – $195.29 | 56 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $171.50 | $343.00 | $47.04 – $127.01 | 56 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $434.50 | $869.00 | $213.67 – $576.92 | 56 |
| IV inj ra drug dx study CPT 78808 | $2,071.50 | $4,143.00 | $401.59 – $1,084.30 | 56 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $756.50 | $1,513.00 | $128.56 – $553.77 | 59 |
| Jak2 targeted sequence analysis CPT 81279 | $131.50 | $263.00 | $147.79 – $636.59 | 59 |
| John cunningham antibody CPT 86711 | $184.00 | $368.00 | $13.95 – $60.07 | 60 |
| Ketamine and metabolite screen - quest CPT 80357 | $82.50 | $165.00 | $9.81 – $183.09 | 31 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $70.00 | $140.00 | $6.52 – $28.07 | 60 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $1.37 | $2.75 | $0.33 – $0.90 | 54 |
| Kidney function study CPT 78725 | $863.00 | $1,726.00 | $107.29 – $1,084.30 | 59 |
| Kidney imaging morphology CPT 78700 | $602.50 | $1,205.00 | $152.67 – $1,084.30 | 59 |
| Kidney imag w/bld flow multi CPT 78709 | $1,047.00 | $2,094.00 | $328.22 – $1,472.70 | 59 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $920.00 | $1,840.00 | $207.60 – $1,472.70 | 59 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $708.00 | $1,416.00 | $99.51 – $428.64 | 59 |
| Kit gene analys d816 variant CPT 81273 | $210.00 | $420.00 | $99.65 – $429.21 | 60 |
| Knee MRI (with and without contrast) CPT 73723 | $3,171.50 | $6,343.00 | $348.10 – $1,499.39 | 58 |
| Knee MRI (with contrast) CPT 73722 | $2,805.50 | $5,611.00 | $307.27 – $2,126.23 | 58 |
| Knee MRI (without contrast) CPT 73721 | $2,439.00 | $4,878.00 | $198.40 – $854.57 | 58 |
| Knee X-ray CPT 73564 | $242.50 | $485.00 | $45.08 – $283.56 | 59 |
| Kras gene variants exon 2 CPT 81275 | $572.50 | $1,145.00 | $154.21 – $664.25 | 60 |
| Lactate dehydrogenase (ldh) CPT 83615 | $176.00 | $352.00 | $4.82 – $20.75 | 60 |
| Lactic acid CPT 83605 | $370.50 | $741.00 | $9.23 – $39.77 | 60 |
| Lactoferrin fecal qualitative CPT 83630 | $51.50 | $103.00 | $15.72 – $67.72 | 60 |
| Laryngeal function studies CPT 92520 | $431.00 | $862.00 | $133.65 – $360.87 | 56 |
| Laryngoscopic sensory vid CPT 92614 | $432.00 | $864.00 | $54.15 – $146.21 | 56 |
| Laryngoscopy telescopic CPT 31579 | $411.50 | $823.00 | $392.90 – $1,060.83 | 56 |
| Lead capillary CPT 83655 | $9.00 | $18.00 | $9.66 – $41.62 | 60 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,714.00 | $3,428.00 | $175.54 – $756.12 | 59 |
| Leishmania antibody CPT 86717 | $29.00 | $58.00 | $9.78 – $42.11 | 60 |
| Leukocyte phagocytosis CPT 86344 | $151.00 | $302.00 | $8.29 – $35.72 | 60 |
| Levetiracetam therapeutic drug level CPT 80177 | $95.00 | $190.00 | $10.57 – $45.54 | 60 |
| Lidocaine therapeutic drug level CPT 80176 | $74.50 | $149.00 | $11.72 – $50.50 | 60 |
| Lipase CPT 83690 | $158.50 | $317.00 | $5.50 – $23.69 | 60 |
| Lipoprotein blood high res frac & quant CPT 83701 | $22.50 | $45.00 | $27.02 – $116.38 | 60 |
| Lipoprotein blood quant CPT 83704 | $37.50 | $75.00 | $27.28 – $117.52 | 60 |
| Lipoprotein direct measurement hdl CPT 83718 | $221.00 | $442.00 | $6.54 – $28.15 | 60 |
| Lipoprotein direct measurement ldl CPT 83721 | $239.00 | $478.00 | $8.38 – $36.09 | 60 |
| Listeria monocytogenes CPT 86723 | $45.50 | $91.00 | $10.53 – $45.34 | 60 |
| Lithium therapeutic drug level CPT 80178 | $275.00 | $550.00 | $5.27 – $22.71 | 60 |
| Liver Function Test CPT 80076 | $288.00 | $576.00 | $6.52 – $28.07 | 60 |
| Liver imaging CPT 78201 | $1,391.50 | $2,783.00 | $170.15 – $1,472.70 | 59 |
| Liver/spleen imag static only CPT 78215 | $892.50 | $1,785.00 | $175.22 – $1,084.30 | 59 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,200.50 | $2,401.00 | $122.21 – $1,084.30 | 59 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,943.00 | $5,886.00 | $166.31 – $716.35 | 58 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,602.00 | $5,204.00 | $165.06 – $946.25 | 58 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,263.00 | $4,526.00 | $99.51 – $428.64 | 58 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,191.50 | $6,383.00 | $312.67 – $1,346.80 | 58 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,824.00 | $5,648.00 | $265.05 – $1,141.67 | 58 |
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.