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 |
|---|---|---|---|---|
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $2,763.00 – $17,722.46 | 17 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $3,122.54 – $17,722.46 | 17 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $2,620.26 – $14,507.25 | 17 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $2,640.42 – $14,507.25 | 17 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $3,410.00 – $32,603.53 | 17 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $3,410.00 – $46,166.33 | 17 |
| Optx tmprmand dislocation CPT 21490 | $2,635.12 | $4,391.86 | $886.62 – $7,975.81 | 26 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $3,121.14 – $17,722.46 | 16 |
| Oral aprepitant HCPCS J8501 | $410.20 | $683.66 | $2.63 – $200.67 | 21 |
| Oral everolimus HCPCS J7527 | $25.34 | $42.24 | $1.37 – $35.84 | 21 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $1,151.54 – $8,570.48 | 17 |
| Organic acids total quant ea spec CPT 83918 | $231.47 | $385.79 | $10.00 – $289.34 | 26 |
| Oropharyngeal biopsy 42800 CPT 42800 | $1,698.19 | $2,830.32 | $85.54 – $3,777.93 | 26 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $348.29 | $580.48 | $69.66 – $493.41 | 20 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $881.50 | $1,469.16 | $176.30 – $1,175.33 | 19 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $225.00 | $375.00 | $45.00 – $300.00 | 19 |
| Orthopantogram CPT 70355 | $219.22 | $365.36 | $18.38 – $274.02 | 26 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $678.20 | $1,130.34 | $135.64 – $904.27 | 19 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $420.76 | $701.26 | $84.15 – $561.01 | 19 |
| Oscillation chest wall mechanical per session CPT 94669 | $333.90 | $556.50 | $66.78 – $528.37 | 26 |
| Osmolality blood CPT 83930 | $91.31 | $152.18 | $5.55 – $114.14 | 26 |
| Osmolality urine CPT 83935 | $88.31 | $147.19 | $5.73 – $44.29 | 26 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $7,038.00 – $32,603.53 | 16 |
| Osteochondral talus autogrft CPT 28446 | $6,731.17 | $11,218.62 | $3,122.54 – $17,722.46 | 26 |
| Other immunoelectrophoresis CPT 86325 | $173.50 | $289.17 | $10.00 – $216.88 | 26 |
| Oth resp proc, group HCPCS G0239 | $173.23 | $288.71 | $34.65 – $216.53 | 26 |
| Oth resp proc, indiv HCPCS G0238 | $119.59 | $199.31 | $23.92 – $149.48 | 26 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $124.35 | $207.25 | $24.87 – $176.16 | 21 |
| Ot re-evaluation patient/family CPT 97168 | $227.06 | $378.44 | $45.41 – $321.67 | 21 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $115.19 | $191.98 | $23.04 – $163.18 | 21 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $114.69 | $191.15 | $22.94 – $162.48 | 21 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $4,773.99 – $12,321.66 | 16 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $289.20 | $482.00 | $0.09 – $287.30 | 21 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $50.40 | $84.00 | $0.30 – $2.14 | 20 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $48,945.60 | $81,576.00 | $9,789.12 – $65,260.80 | 19 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $222.51 | $370.85 | $0.16 – $315.22 | 21 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $2,874.11 | $4,790.18 | $5.72 – $3,592.64 | 26 |
| Palb2 gene full gene seq CPT 81307 | $290.46 | $484.10 | $35.00 – $1,623.60 | 26 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $6,191.26 | $10,318.76 | $414.91 – $4,100.23 | 26 |
| Palonosetron hcl HCPCS J2469 | $540.00 | $900.00 | $0.71 – $127.50 | 21 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $50.47 | $84.12 | $10.09 – $71.50 | 21 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $2,546.00 – $7,038.00 | 3 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $12,452.74 | $20,754.56 | $165.67 – $3,919.61 | 26 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $18.27 | $30.45 | $3.65 – $25.88 | 20 |
| Papaverin hcl injection HCPCS J2440 | $149.08 | $248.46 | $14.40 – $102.00 | 20 |
| Parathormone (pth) intact CPT 83970 | $269.44 | $449.06 | $10.00 – $336.80 | 26 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,254.06 | $3,756.76 | $450.81 – $2,817.57 | 26 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $1,896.00 – $1,896.00 | 1 |
| Parathyroid planar imaging CPT 78070 | $1,522.84 | $2,538.06 | $265.30 – $1,903.55 | 26 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,873.69 | $3,122.81 | $314.75 – $2,342.11 | 26 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $1,845.21 – $16,154.42 | 17 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $285.93 | $476.55 | $57.19 – $495.95 | 26 |
| Partial exc bone humerus CPT 24140 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Partial removal finger bone CPT 26236 | $2,374.87 | $3,958.11 | $593.04 – $3,981.46 | 26 |
| Partial removal foot fascia CPT 28060 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Partial removal of sternum CPT 21620 | not published | not published | $884.36 – $7,066.86 | 15 |
| Partial removal of thyroid CPT 60220 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Partial removal of tongue CPT 41120 | not published | not published | $1,954.22 – $14,507.25 | 17 |
| Partial removal of ulna CPT 25150 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Partial thyroid excision CPT 60210 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $1,888.85 – $14,293.73 | 16 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $10.10 | $16.83 | $1.70 – $12.05 | 20 |
| Part removal hip bone deep CPT 27071 | not published | not published | $1,624.36 – $7,066.86 | 15 |
| Part removal of metatarsal CPT 28110 | not published | not published | $1,088.27 – $8,018.48 | 17 |
| Passy muir valve metal trach HCPCS L8501 | $339.37 | $565.61 | $52.68 – $351.20 | 19 |
| Path clin consltj high 41-60 CPT 80505 | $177.88 | $296.46 | $10.00 – $423.12 | 26 |
| Path clin consltj mod 21-40 CPT 80504 | $177.88 | $296.46 | $10.00 – $423.12 | 26 |
| Path clin consltj prolng svc CPT 80506 | $118.57 | $197.62 | $10.00 – $167.98 | 20 |
| Path clin consltj sf 5-20 CPT 80503 | $59.27 | $98.78 | $10.00 – $134.24 | 26 |
| Pdgfra gene CPT 81314 | $1,302.83 | $2,171.38 | $35.00 – $790.82 | 26 |
| Pegaspargase injection HCPCS J9266 | $33,512.48 | $55,854.14 | $6,702.50 – $61,111.73 | 26 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $11,569.18 | $19,281.97 | $121.01 – $14,461.48 | 26 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $7,531.80 | $12,553.00 | $129.10 – $9,414.75 | 26 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $3,774.30 | $6,290.50 | $75.53 – $4,717.88 | 26 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,047.67 | $3,412.78 | $167.39 – $2,559.59 | 26 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,199.47 | $3,665.78 | $167.39 – $2,749.34 | 26 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,621.86 | $2,703.10 | $99.77 – $2,027.33 | 26 |
| Pelvic & hip control thigh c HCPCS L1680 | $1,902.39 | $3,170.65 | $380.48 – $2,536.52 | 19 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,742.20 | $6,237.00 | $332.94 – $4,677.75 | 26 |
| Pelvic MRI (with contrast) CPT 72196 | $1,745.15 | $2,908.58 | $276.66 – $2,181.43 | 26 |
| Pelvic MRI (without contrast) CPT 72195 | $2,721.60 | $4,536.00 | $227.71 – $3,402.00 | 26 |
| Pelvic ring fracture uni/bil HCPCS G0413 | $3,091.54 | $5,152.56 | $618.31 – $17,722.46 | 26 |
| Pelvic Ultrasound (complete) CPT 76856 | $761.44 | $1,269.06 | $96.28 – $951.79 | 26 |
| Pelvic Ultrasound (limited) CPT 76857 | $560.25 | $933.75 | $50.79 – $700.31 | 26 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $270.84 | $451.40 | $28.06 – $338.55 | 26 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $355.88 | $593.13 | $42.44 – $444.85 | 26 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $10,437.74 | $17,396.24 | $55.59 – $13,047.18 | 26 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $7,307.40 | $12,179.00 | $3.84 – $172.50 | 26 |
| Pemivibart infusion HCPCS M0224 | $520.56 | $867.60 | $104.11 – $1,171.30 | 26 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $826.47 | $1,377.45 | $29.90 – $598.07 | 26 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $182.10 | $303.50 | $0.75 – $59.08 | 21 |
| Penile injection CPT 54235 | $533.92 | $889.87 | $35.16 – $667.40 | 26 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $23,449.80 | $39,083.00 | $0.00 – $0.01 | 19 |
| Penile vascular study CPT 93980 | $855.79 | $1,426.32 | $99.77 – $1,069.74 | 26 |
| Penile vascular study CPT 93981 | $605.42 | $1,009.03 | $70.50 – $756.77 | 26 |
| Penis plastic surgery CPT 54360 | not published | not published | $1,142.90 – $8,636.11 | 17 |
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.