BAYLOR SCOTT & WHITE MEDICAL CENTER - PLANO
4700 Alliance Blvd., Plano, TX · Baylor Scott & White Health · · NPI 1649273434
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 |
|---|---|---|---|---|
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $919.19 | $1,531.99 | $0.96 – $1,083.56 | 26 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1,202.05 | $2,003.41 | $0.33 – $946.97 | 26 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $11,135.12 | $18,558.54 | $51.32 – $9,678.65 | 20 |
| Filter vena cava fem denali HCPCS C1880 | $3,416.00 | $5,693.33 | $64.15 – $427.68 | 19 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,081.52 | $1,802.54 | $194.07 – $1,742.94 | 26 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $1,162.97 | $1,938.28 | $232.59 – $1,647.54 | 20 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $210.73 | $351.21 | $42.15 – $298.53 | 20 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $1,031.75 | $1,719.59 | $206.35 – $1,461.65 | 20 |
| Fine needle asp without image guide 10021 CPT 10021 | $547.53 | $912.55 | $51.77 – $987.79 | 26 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $6,338.45 | $10,564.09 | $465.51 – $3,103.41 | 19 |
| Finger X-ray (both hands) CPT 73140 | $218.03 | $363.38 | $38.43 – $272.54 | 26 |
| Fixation of knee joint CPT 27570 | $1,776.24 | $2,960.40 | $593.04 – $3,981.46 | 26 |
| Fix g/colon tube w/device CPT 49460 | $761.49 | $1,269.15 | $334.95 – $2,245.59 | 26 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $3,967.08 | $6,611.80 | $1,088.27 – $8,018.48 | 26 |
| Flecainide (tambocor)-sendout CPT 80181 | $433.44 | $722.40 | $10.00 – $541.80 | 26 |
| Fl exam g/colon tube w contrast CPT 49465 | $627.02 | $1,045.04 | $111.00 – $783.78 | 26 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $130.67 – $3,693.00 | 16 |
| Flow cytometry interp 16 or more CPT 88189 | $300.00 | $500.00 | $29.03 – $215.45 | 20 |
| Flow cytometry marker each additional CPT 88185 | $541.20 | $902.00 | $5.35 – $60.68 | 20 |
| Flow cytometry one marker technical component CPT 88184 | $1,230.08 | $2,050.13 | $5.35 – $890.45 | 26 |
| Floweramnioflo, 0.1 cc HCPCS Q4177 | $407.88 | $679.80 | $56.08 – $397.26 | 20 |
| #flow interp 9 - 15 markers CPT 88188 | $564.24 | $940.40 | $10.77 – $160.92 | 20 |
| Flt3 gene CPT 81245 | $484.98 | $808.30 | $10.00 – $397.22 | 26 |
| Flt3 gene analysis CPT 81246 | $183.75 | $306.25 | $10.00 – $208.13 | 26 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $70.32 | $117.20 | $4.20 – $29.75 | 21 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $764.08 | $1,273.46 | $152.82 – $1,082.44 | 21 |
| Fluid pressure muscle 20950 CPT 20950 | $738.87 | $1,231.45 | $257.60 – $1,742.94 | 26 |
| Fluorescent antibody titer dna CPT 86256 | $315.00 | $525.00 | $10.00 – $43.12 | 26 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $766.31 | $1,277.18 | $137.66 – $1,085.60 | 20 |
| Fluoroguide needle placement CPT 77002 | $567.67 | $946.11 | $113.53 – $804.19 | 20 |
| Fluoro polarize fetal lung CPT 83663 | $190.72 | $317.86 | $10.00 – $238.40 | 26 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $463.80 | $773.00 | $42.78 – $607.02 | 26 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $136.92 | $228.20 | $2.26 – $70.81 | 21 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $41.84 | $69.74 | $6.14 – $59.28 | 21 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | $5,265.00 | $8,775.00 | $1,053.00 – $6,581.25 | 25 |
| Fmri brain by tech CPT 70554 | $987.52 | $1,645.86 | $227.71 – $2,149.00 | 26 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,727.84 | $2,879.73 | $257.60 – $2,159.80 | 26 |
| Fna bx w/ct gdn ea addl CPT 10010 | $579.00 | $965.00 | $115.80 – $820.25 | 20 |
| Folic acid CPT 82746 | $143.70 | $239.50 | $10.00 – $35.28 | 26 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $151.39 | $252.32 | $0.06 – $136.17 | 21 |
| Follow-up angiography CPT 75898 | $1,939.14 | $3,231.90 | $133.71 – $7,896.23 | 26 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,928.54 | $3,214.23 | $6.21 – $2,218.50 | 26 |
| Fondaparinux sodium HCPCS J1652 | $174.74 | $291.24 | $0.88 – $141.51 | 21 |
| Foot insert plastazote or eq HCPCS L3002 | $365.48 | $609.13 | $70.56 – $470.43 | 19 |
| Foot plate molded stirrup at HCPCS L2250 | $541.52 | $902.54 | $108.30 – $722.03 | 19 |
| Foot X-ray CPT 73630 | $365.31 | $608.85 | $34.41 – $456.64 | 26 |
| Foot X-ray (2 views, both feet) CPT 73620 | $287.92 | $479.87 | $28.74 – $359.90 | 26 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | $42.66 | $71.10 | $7.98 – $53.21 | 19 |
| Forearm X-ray (both sides) CPT 73090 | $317.62 | $529.37 | $29.40 – $397.03 | 26 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $740.71 | $1,234.52 | $110.15 – $925.89 | 26 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $221.89 | $369.81 | $0.12 – $153.00 | 21 |
| Foscarnet sodium injection HCPCS J1455 | $1,299.00 | $2,165.00 | $9.19 – $1,840.25 | 21 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $86.40 | $144.00 | $1.26 – $101.25 | 26 |
| Fracture assessment via dxa CPT 77086 | $267.91 | $446.52 | $33.75 – $334.89 | 26 |
| _fragile x methylation-sendout CPT 81244 | $391.65 | $652.75 | $35.00 – $489.56 | 26 |
| Fragmenting of kidney stone CPT 50590 | $13,091.90 | $21,819.84 | $1,142.90 – $12,306.00 | 25 |
| Free omental flap microvasc CPT 49906 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $162.45 | $270.75 | $32.49 – $203.06 | 26 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $164.16 | $273.60 | $32.83 – $207.90 | 26 |
| Fresh frozen plasma thawing ea un CPT 86927 | $114.35 | $190.58 | $10.00 – $423.12 | 26 |
| Fructosamine glycated protein CPT 82985 | $78.73 | $131.22 | $10.00 – $98.42 | 26 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Ftl cgen abnor four anal CPT 81511 | $119.34 | $198.90 | $23.87 – $368.40 | 26 |
| Full field erg w/i&r CPT 92273 | $574.20 | $957.00 | $114.84 – $777.56 | 26 |
| Full mouth x-ray of teeth CPT 70320 | $204.53 | $340.89 | $53.46 – $607.02 | 26 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $464.96 | $774.93 | $70.50 – $581.20 | 26 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $3,873.67 | $6,456.12 | $709.01 – $4,842.09 | 26 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $709.01 – $4,517.58 | 17 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $1,003.75 | $1,672.92 | $585.52 – $4,517.58 | 26 |
| Fundus photography with i&r 92250 CPT 92250 | $209.46 | $349.10 | $41.89 – $316.45 | 26 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $43.20 | $72.00 | $0.02 – $15.30 | 21 |
| Fusion of big toe joint CPT 28750 | not published | not published | $3,410.00 – $17,722.46 | 17 |
| Fusion of foot bones CPT 28740 | not published | not published | $3,410.00 – $17,722.46 | 17 |
| G0180 home health certification HCPCS G0180 | $128.18 | $213.64 | $25.64 – $181.59 | 20 |
| G6pd full gene sequence CPT 81249 | $1,974.30 | $3,290.50 | $35.00 – $1,440.00 | 26 |
| G6pd gene alys cmn variant CPT 81247 | $243.00 | $405.00 | $35.00 – $419.54 | 26 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $6,300.00 | $10,500.00 | $47.15 – $7,875.00 | 25 |
| Gabapentin non-blood CPT 80355 | $125.07 | $208.45 | $3.92 – $8.25 | 19 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $248.73 | $414.55 | $1.59 – $222.46 | 21 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $135.08 | $225.14 | $10.00 – $168.85 | 26 |
| Galactokinase - sendout CPT 82759 | $204.97 | $341.62 | $10.00 – $256.21 | 26 |
| Galectin-3 CPT 82777 | $132.87 | $221.45 | $10.00 – $166.09 | 26 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,760.38 | $2,933.97 | $290.70 – $2,200.48 | 26 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,900.64 | $3,167.73 | $390.26 – $2,375.80 | 26 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Gamma globulin 1 cc inj HCPCS J1460 | $1,243.58 | $2,072.63 | $46.50 – $1,554.47 | 26 |
| Gammaglobulin iga CPT 82784 | $109.53 | $182.55 | $7.81 – $22.32 | 26 |
| Gammaglobulin ige CPT 82785 | $127.31 | $212.18 | $6.00 – $39.50 | 26 |
| Gamma glutamyltransferase CPT 82977 | $82.46 | $137.44 | $6.05 – $46.88 | 26 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $197.40 | $329.00 | $37.45 – $279.65 | 21 |
| Gardner vag dna quant CPT 87512 | $65.33 | $108.88 | $10.00 – $100.22 | 26 |
| Gastric analy w/ph ea spec CPT 82930 | $23.01 | $38.35 | $5.64 – $28.76 | 26 |
| Gastric emptying imag study CPT 78265 | $2,536.50 | $4,227.50 | $353.51 – $3,170.62 | 26 |
| Gastric motility studies CPT 91020 | not published | not published | $356.12 – $1,327.77 | 15 |
| Gastrin test CPT 82938 | $61.80 | $103.00 | $10.00 – $77.25 | 26 |
| Gastroesophageal reflux study CPT 78262 | $493.75 | $822.91 | $223.20 – $1,021.72 | 26 |
| Gastroesophageal reflux test CPT 91034 | $1,393.53 | $2,322.55 | $278.71 – $1,741.91 | 24 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $336.40 | $560.66 | $3.56 – $99.21 | 21 |
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.