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 |
|---|---|---|---|---|
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,210.00 | $6,420.00 | $166.31 – $716.35 | 58 |
| Cta neck without &/or w/contrast CPT 70498 | $2,883.00 | $5,766.00 | $166.31 – $716.35 | 58 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,607.50 | $9,215.00 | $348.10 – $1,499.39 | 58 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $2,835.50 | $5,671.00 | $166.31 – $716.35 | 58 |
| CT Angiogram of the Head CPT 70496 | $2,824.50 | $5,649.00 | $166.31 – $716.35 | 58 |
| CT angio hrt w/3d image CPT 75574 | $1,130.00 | $2,260.00 | $166.31 – $946.25 | 58 |
| CT angio pelvis CPT 72191 | $2,808.50 | $5,617.00 | $166.31 – $716.35 | 58 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,730.50 | $7,461.00 | $166.31 – $716.35 | 58 |
| CT cerebral perf w cont & prcssng CPT 70473 | $1,783.00 | $3,566.00 | $176.20 – $475.74 | 55 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $129.00 | $258.00 | $82.25 – $354.29 | 58 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $1,130.00 | $2,260.00 | $166.31 – $946.25 | 58 |
| CT hrt w/3d image CPT 75572 | $1,130.00 | $2,260.00 | $166.31 – $946.25 | 58 |
| CT limited or localized follow-up study CPT 76380 | $1,422.50 | $2,845.00 | $82.25 – $354.29 | 58 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,092.50 | $4,185.00 | $162.84 – $701.41 | 58 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,819.50 | $3,639.00 | $99.51 – $428.64 | 58 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,365.00 | $4,730.00 | $166.31 – $716.35 | 58 |
| CT neck soft tissue w/contrast CPT 70491 | $2,257.00 | $4,514.00 | $166.31 – $716.35 | 58 |
| CT neck soft tissue without contrast CPT 70490 | $1,962.50 | $3,925.00 | $99.51 – $428.64 | 58 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,552.00 | $5,104.00 | $166.31 – $716.35 | 58 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,316.50 | $4,633.00 | $166.31 – $716.35 | 58 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $2,049.50 | $4,099.00 | $166.31 – $716.35 | 58 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,782.00 | $3,564.00 | $99.51 – $428.64 | 58 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $5,006.00 | $10,012.00 | $332.67 – $1,432.94 | 58 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,335.00 | $8,670.00 | $296.48 – $1,277.03 | 58 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,769.50 | $7,539.00 | $178.70 – $769.75 | 58 |
| CT thoracic spine w/contrast CPT 72129 | $2,577.00 | $5,154.00 | $166.01 – $715.08 | 58 |
| CT thoracic spine without contrast CPT 72128 | $2,240.50 | $4,481.00 | $99.51 – $428.64 | 58 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $170.50 | $341.00 | $99.51 – $428.64 | 58 |
| CT t-spine w /wo contrast CPT 72130 | $2,912.50 | $5,825.00 | $166.31 – $716.35 | 58 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,925.50 | $3,851.00 | $196.17 – $946.25 | 58 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,675.00 | $3,350.00 | $99.51 – $428.64 | 58 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,177.00 | $4,354.00 | $166.31 – $716.35 | 58 |
| Culture aerobic additional method definitive id each CPT 87077 | $188.00 | $376.00 | $6.45 – $27.78 | 60 |
| Culture afb any source CPT 87116 | $33.50 | $67.00 | $8.62 – $37.11 | 60 |
| Culture anaerobic additional method definitive id each CPT 87076 | $188.00 | $376.00 | $6.45 – $27.78 | 60 |
| Culture anaerobic except blood CPT 87075 | $333.50 | $667.00 | $7.55 – $32.53 | 60 |
| Culture bact stool aero addl path ea CPT 87046 | $101.00 | $202.00 | $7.53 – $32.45 | 60 |
| Culture body fluid CPT 87070 | $195.50 | $391.00 | $6.88 – $29.63 | 60 |
| Culture fungi definitive id mold CPT 87107 | $195.50 | $391.00 | $8.24 – $35.48 | 60 |
| Culture fungi definitive id yeast CPT 87106 | $188.00 | $376.00 | $8.24 – $35.48 | 60 |
| Culture fungi other (except blood) CPT 87102 | $186.00 | $372.00 | $6.71 – $28.89 | 60 |
| Culture fungi skin/hair/nail CPT 87101 | $186.00 | $372.00 | $6.16 – $26.52 | 60 |
| Culture mycoplasma any source CPT 87109 | $18.00 | $36.00 | $12.28 – $52.91 | 60 |
| Culture quantitative aerobic other source CPT 87071 | $201.00 | $402.00 | $7.89 – $34.00 | 60 |
| Culture screening strep group a CPT 87081 | $101.00 | $202.00 | $5.29 – $22.79 | 60 |
| Culture typing added method CPT 87158 | $54.00 | $108.00 | $6.18 – $26.60 | 60 |
| Culture typing immunologic CPT 87147 | $195.50 | $391.00 | $4.13 – $17.80 | 60 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $165.00 | $330.00 | $28.01 – $120.63 | 60 |
| Culture urine each isolate CPT 87088 | $43.00 | $86.00 | $6.46 – $27.83 | 60 |
| Cyclic citrullinated peptide antibody CPT 86200 | $12.00 | $24.00 | $10.34 – $44.52 | 60 |
| Cyclosporine 2 hour CPT 80158 | $711.00 | $1,422.00 | $14.40 – $62.03 | 60 |
| Cygnus matrix, per sq cm HCPCS Q4199 | $60.94 | $121.88 | $125.01 – $337.53 | 54 |
| Cyp2c19 gene com variants CPT 81225 | $169.00 | $338.00 | $232.50 – $1,001.48 | 60 |
| Cyp2c9 gene com variants CPT 81227 | $60.00 | $120.00 | $139.50 – $600.87 | 60 |
| Cyp3a4 gene common variants CPT 81230 | $240.00 | $480.00 | $174.81 – $471.99 | 56 |
| Cystatin c CPT 82610 | $55.50 | $111.00 | $14.78 – $63.67 | 60 |
| Cystic fibrosis cftr CPT 81223 | $900.00 | $1,800.00 | $398.20 – $1,715.20 | 60 |
| Cystine urine quantitative CPT 82131 | $12.50 | $25.00 | $18.34 – $78.98 | 60 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $536.00 | $1,072.00 | $39.37 – $946.25 | 59 |
| Cystometrogram w/up 51727 CPT 51727 | $774.00 | $1,548.00 | $700.47 – $1,891.28 | 56 |
| Cytogenetics 25-99 CPT 88274 | $78.00 | $156.00 | $33.82 – $145.68 | 60 |
| Cytogenomic neo microra alys CPT 81277 | $1,050.00 | $2,100.00 | $1,160.00 – $3,132.00 | 56 |
| Cytogenom microarray copy nmbr var CPT 81228 | $971.50 | $1,943.00 | $900.00 – $2,430.00 | 56 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $103.00 | $206.00 | $11.49 – $49.47 | 60 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $84.50 | $169.00 | $13.44 – $57.90 | 60 |
| Cyto/molecular report CPT 88291 | $346.00 | $692.00 | $25.91 – $111.59 | 60 |
| Cytopath c/v auto in fluid CPT 88174 | $24.50 | $49.00 | $20.24 – $87.20 | 60 |
| Cytopath c/v thin layer redo CPT 88143 | $32.50 | $65.00 | $18.38 – $79.18 | 60 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $99.00 | $198.00 | $51.55 – $222.03 | 60 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $66.00 | $132.00 | $21.23 – $91.46 | 60 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $32.50 | $65.00 | $16.17 – $69.65 | 60 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $247.50 | $495.00 | $37.52 – $229.68 | 60 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $117.50 | $235.00 | $37.52 – $262.50 | 60 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $447.50 | $895.00 | $22.60 – $97.35 | 4 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $447.50 | $895.00 | $42.77 – $462.09 | 60 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $406.00 | $812.00 | $52.35 – $562.20 | 60 |
| Cytopath smear oth prep screen & interp CPT 88161 | $124.00 | $248.00 | $29.06 – $275.64 | 60 |
| Cytopath tbs c/v manual CPT 88164 | $9.50 | $19.00 | $12.73 – $61.05 | 60 |
| Cytotoxic antibody screening CPT 86807 | $166.50 | $333.00 | $62.77 – $270.36 | 60 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $345.00 | $690.00 | $171.15 – $1,330.06 | 60 |
| Dch pulmonary stress test CPT 94621 | $984.50 | $1,969.00 | $374.86 – $1,012.12 | 56 |
| Dch validity tests CPT 81002 | $43.00 | $86.00 | $2.77 – $11.95 | 60 |
| Deamidated gliadin antibody iga CPT 86258 | $10.50 | $21.00 | $9.61 – $41.41 | 59 |
| Decalcification CPT 88311 | $292.00 | $584.00 | $15.49 – $66.74 | 4 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $148.50 | $297.00 | $219.97 – $593.93 | 56 |
| Dermapure 1 square cm HCPCS Q4152 | $185.62 | $371.25 | $125.01 – $337.53 | 54 |
| Design mlc device for imrt CPT 77338 | $3,679.50 | $7,359.00 | $376.14 – $1,015.57 | 56 |
| Desoxycorticosterone CPT 82633 | $80.00 | $160.00 | $24.72 – $106.47 | 60 |
| Detect agent nos dna dir CPT 87797 | $153.00 | $306.00 | $23.97 – $103.24 | 60 |
| Devel tst phys/qhp 1st hr CPT 96112 | $432.50 | $865.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $16.50 | $33.00 | $17.74 – $76.40 | 60 |
| Diabetes (HbA1c) Test CPT 83036 | $79.00 | $158.00 | $7.75 – $33.39 | 60 |
| Diab manage trn ind/group HCPCS G0109 | $87.50 | $175.00 | $16.03 – $43.28 | 56 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $135.00 | $270.00 | $40.37 – $64.59 | 27 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $74.00 | $148.00 | $40.37 – $64.59 | 27 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $580.00 | $1,160.00 | $156.41 – $422.31 | 56 |
| Diagnostic Mammogram (one breast) CPT 77065 | $469.00 | $938.00 | $123.49 – $333.42 | 56 |
| Dialysis one evaluation CPT 90945 | $3,632.50 | $7,265.00 | $419.16 – $1,131.74 | 56 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $6,267.25 | $12,534.50 | $5,166.99 – $13,950.88 | 54 |
| Digoxin total therapeutic drug level CPT 80162 | $292.00 | $584.00 | $10.60 – $45.67 | 60 |
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.