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 |
|---|---|---|---|---|
| Injection epidural blood patch or clot CPT 62273 | $1,790.34 | $2,983.90 | $262.86 – $2,237.93 | 26 |
| Injection eye drug CPT 67028 | $825.10 | $1,375.17 | $48.45 – $1,031.38 | 26 |
| Injection for arthrography wrist (both sides) CPT 25246 | $521.18 | $868.64 | $104.24 – $738.34 | 20 |
| Injection for bladder x-ray CPT 51600 | $780.00 | $1,300.00 | $156.00 – $1,105.00 | 20 |
| Injection for hip x-ray CPT 27095 | $1,210.53 | $2,017.55 | $242.11 – $1,714.92 | 20 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $514.36 | $857.26 | $102.87 – $728.67 | 20 |
| Injection for spleen x-ray CPT 38200 | $982.72 | $1,637.87 | $196.54 – $1,392.19 | 17 |
| Injection for ureter x-ray CPT 50684 | $841.49 | $1,402.48 | $168.30 – $1,192.11 | 20 |
| Injection for ureter x-ray CPT 50690 | $515.21 | $858.68 | $103.04 – $729.88 | 20 |
| Injection, fulvestrant HCPCS J9395 | $3,520.29 | $5,867.15 | $5.43 – $2,528.75 | 21 |
| Injection, glucarpidase HCPCS C9293 | $74,113.20 | $123,522.00 | $426.64 – $92,641.50 | 25 |
| Injection into brain canal CPT 61055 | $1,090.69 | $1,817.81 | $108.15 – $1,363.36 | 26 |
| Injection into hemorrhoid(s) CPT 46500 | $2,926.20 | $4,877.00 | $210.13 – $3,657.75 | 26 |
| Injection, isavuconazonium HCPCS J1833 | $987.58 | $1,645.97 | $0.96 – $1,234.48 | 26 |
| Injection jaw joint x-ray CPT 21116 | $229.06 | $381.77 | $45.81 – $324.50 | 19 |
| Injection jugular CPT 36299 | $1,048.20 | $1,747.00 | $297.77 – $1,013.26 | 19 |
| Injection of sinus tract CPT 20500 | $1,006.81 | $1,678.02 | $60.63 – $3,777.93 | 26 |
| Injection,onabotulinumtoxina HCPCS J0585 | $1,162.80 | $1,938.00 | $6.01 – $1,453.50 | 26 |
| Injection, peramivir HCPCS J2547 | $857.98 | $1,429.97 | $1.46 – $1,072.48 | 26 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,481.87 | $2,469.78 | $296.37 – $1,852.34 | 26 |
| Injection, renflexis HCPCS Q5104 | $1,356.10 | $2,260.17 | $25.46 – $1,695.13 | 26 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,582.12 | $2,636.87 | $316.42 – $1,977.65 | 26 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $2,618.36 | $4,363.94 | $39.86 – $3,272.95 | 26 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,139.12 | $1,898.54 | $39.31 – $1,713.14 | 26 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,251.00 | $3,751.66 | $340.77 – $2,813.74 | 26 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,131.41 | $1,885.68 | $226.28 – $1,602.83 | 20 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,195.95 | $3,659.91 | $340.77 – $2,744.93 | 26 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $966.32 | $1,610.54 | $193.26 – $1,368.96 | 20 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,165.84 | $3,609.74 | $340.77 – $2,707.30 | 26 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,033.74 | $3,389.57 | $262.86 – $2,542.18 | 26 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,882.52 | $3,137.53 | $262.86 – $2,353.15 | 26 |
| Injection, siltuximab HCPCS J2860 | $8,477.45 | $14,129.09 | $151.74 – $2,677.34 | 26 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $460.94 | $768.23 | $23.54 – $733.72 | 26 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $624.56 | $1,040.94 | $23.26 – $780.71 | 26 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $684.48 | $1,140.80 | $27.13 – $855.60 | 26 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $216.67 | $361.12 | $43.33 – $306.95 | 20 |
| Injection treatment of nerve CPT 64605 | $2,792.73 | $4,654.55 | $659.94 – $4,783.04 | 26 |
| Inject sacroiliac joint CPT 27096 | $950.29 | $1,583.81 | $111.00 – $1,346.24 | 20 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,311.74 | $2,186.24 | $262.86 – $1,713.14 | 26 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,450.84 | $2,418.06 | $262.86 – $2,257.97 | 26 |
| Inj., eravacycline, 1 mg HCPCS J0122 | $300.00 | $500.00 | $1.23 – $211.31 | 26 |
| Inj., evomela, 1 mg HCPCS J9246 | $3,630.00 | $6,050.00 | $18.46 – $4,537.50 | 26 |
| Inj for ext venography CPT 36005 | $1,858.36 | $3,097.26 | $371.67 – $2,632.67 | 20 |
| Inj for mammo ductogram CPT 19030 | $621.62 | $1,036.04 | $124.32 – $880.63 | 20 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | $904.21 | $1,507.01 | $3.54 – $506.81 | 21 |
| Inj givosiran 0.5 mg HCPCS J0223 | $76,708.80 | $127,848.00 | $107.30 – $95,886.00 | 26 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $36.60 | $61.00 | $1.26 – $51.85 | 21 |
| Inj herzuma 10 mg HCPCS Q5113 | $2,554.50 | $4,257.50 | $53.22 – $3,193.12 | 26 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $2,613.24 | $4,355.40 | $522.65 – $13,331.00 | 18 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $2,874.61 | $4,791.01 | $574.92 – $13,331.00 | 18 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $1,960.03 | $3,266.72 | $392.01 – $13,331.00 | 18 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $2,226.93 | $3,711.55 | $445.39 – $13,331.00 | 18 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $1,887.60 | $3,146.00 | $377.52 – $13,331.00 | 18 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $1,478.38 | $2,463.96 | $5.17 – $1,847.97 | 26 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | $1,228.59 | $2,047.65 | $14.24 – $1,740.50 | 21 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | $38.40 | $64.00 | $0.14 – $54.40 | 21 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $1,673.66 | $2,789.44 | $340.77 – $2,257.97 | 26 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $238.77 | $397.95 | $47.75 – $495.95 | 26 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | $24.72 | $41.20 | $1.48 – $30.90 | 26 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $136.62 | $227.70 | $25.40 – $193.54 | 21 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $570.13 | $950.22 | $6.61 – $299.33 | 26 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $48.60 | $81.00 | $0.06 – $0.39 | 20 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $794.70 | $1,324.50 | $158.94 – $1,125.83 | 20 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $1,380.00 | $2,300.00 | $114.64 – $1,725.00 | 26 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $35.21 | $58.68 | $0.18 – $4.10 | 21 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $586.20 | $977.00 | $2.06 – $732.75 | 26 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $8,304.04 | $13,840.07 | $225.36 – $10,380.05 | 26 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $165.60 | $276.00 | $9.62 – $234.60 | 21 |
| Inj multihance HCPCS A9577 | $283.77 | $472.95 | $1.97 – $402.01 | 21 |
| Inj. mycophenolate mofetil HCPCS J7519 | $291.54 | $485.90 | $0.44 – $277.31 | 21 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $1,569.23 | $2,615.39 | $313.85 – $1,961.54 | 26 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $2,058.43 | $3,430.72 | $709.01 – $10,795.00 | 24 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $2,058.43 | $3,430.72 | $709.01 – $10,795.00 | 24 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | $379.08 | $631.80 | $43.95 – $537.03 | 21 |
| Inj ontruzant 10 mg HCPCS Q5112 | $6,706.27 | $11,177.12 | $28.32 – $8,382.84 | 26 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $17,613.00 | $29,355.00 | $90.41 – $22,016.25 | 26 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $7,082.75 | $11,804.59 | $113.66 – $8,853.44 | 26 |
| Inj peritoneal venous shunt CPT 49427 | $329.49 | $549.15 | $65.90 – $466.78 | 20 |
| Inj proc ankle arthr CPT 27648 | $405.31 | $675.51 | $81.06 – $574.18 | 17 |
| Inj proc elbow arthro CPT 24220 | $768.85 | $1,281.41 | $79.60 – $743.22 | 20 |
| Inj proc for lymphang CPT 38790 | $1,848.76 | $3,081.27 | $369.75 – $2,619.08 | 20 |
| Inj proc lumbr disk ea lvl CPT 62290 | $2,015.55 | $3,359.25 | $403.11 – $2,855.36 | 20 |
| Inj proc myelogram lumbar CPT 62284 | $1,267.73 | $2,112.89 | $253.55 – $1,795.96 | 20 |
| Inj proc sialogram CPT 42550 | $419.34 | $698.90 | $83.87 – $594.07 | 20 |
| Inj progesterone per 50 mg HCPCS J2675 | $10.76 | $17.94 | $0.72 – $15.25 | 21 |
| Inj prohance multipack HCPCS A9576 | $283.77 | $472.95 | $1.53 – $402.01 | 21 |
| Inj retro urethrocysto CPT 51610 | $605.02 | $1,008.37 | $121.00 – $857.11 | 20 |
| Inj teclistamab cqyv 0.5 mg HCPCS J9380 | $17,517.56 | $29,195.93 | $32.72 – $4,323.66 | 26 |
| Inj testosterone cypionate HCPCS J1071 | $85.64 | $142.74 | $0.03 – $94.55 | 21 |
| Inj theophylline per 40 mg HCPCS J2810 | $14.40 | $24.00 | $2.88 – $20.40 | 20 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $3,047.17 | $5,078.62 | $609.43 – $4,316.83 | 20 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $1,628.54 | $2,714.24 | $325.71 – $2,307.10 | 20 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $3,525.12 | $5,875.20 | $4.22 – $2,203.20 | 26 |
| Inj, vancomycin hcl (mylan) HCPCS J3371 | $89.83 | $149.72 | $15.07 – $106.76 | 21 |
| Inj vancomycin (xellia) 10mg HCPCS J3375 | $13.80 | $23.00 | $0.18 – $19.55 | 21 |
| Inj, vasopressin (baxter) HCPCS J2601 | $202.50 | $337.50 | $1.45 – $253.12 | 26 |
| Inj w/fluor eval cv device CPT 36598 | $696.14 | $1,160.23 | $79.46 – $870.17 | 26 |
| Ins cath ren art 1st bi CPT 36252 | $6,115.51 | $10,192.52 | $1,223.10 – $7,896.23 | 26 |
| Ins cath ren art 1st uni CPT 36251 | $4,879.64 | $8,132.73 | $975.93 – $7,896.23 | 26 |
| Ins cath ren art 2nd+ bi CPT 36254 | $3,325.60 | $5,542.66 | $665.12 – $7,896.23 | 26 |
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.