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 |
|---|---|---|---|---|
| Unlisted px male genital sys CPT 55899 | $6,664.68 | $11,107.80 | $238.44 – $2,437.54 | 26 |
| Unlisted px med radj physics CPT 77399 | $376.03 | $626.72 | $75.21 – $470.04 | 26 |
| Unlisted px neck/thorax CPT 21899 | $3,385.58 | $5,642.64 | $226.03 – $3,051.39 | 26 |
| Unlisted px palate uvula CPT 42299 | $243.44 | $405.74 | $101.44 – $605.10 | 26 |
| Unlisted px pelvis/hip joint CPT 27299 | $10,031.98 | $16,719.97 | $235.40 – $4,094.53 | 26 |
| Unlisted px salivry glnd/dux CPT 42699 | $2,838.66 | $4,731.10 | $110.92 – $605.10 | 26 |
| Unlisted px small intestine CPT 44799 | $3,029.95 | $5,049.91 | $59.84 – $2,245.59 | 26 |
| Unlisted px tongue flr mouth CPT 41599 | $243.44 | $405.74 | $98.77 – $605.10 | 26 |
| Unlisted special svc px/rprt CPT 99199 | $210.00 | $350.00 | $18.00 – $127.50 | 20 |
| Unlisted ultrasound procedure CPT 76999 | $2,231.09 | $3,718.48 | $83.05 – $225.11 | 26 |
| Unlstd laps px sprmatic cord CPT 55559 | $3,961.44 | $6,602.40 | $1,650.60 – $14,293.73 | 26 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,951.63 | $3,252.71 | $390.33 – $2,439.53 | 26 |
| Upgrade pm system CPT 33214 | $13,940.67 | $23,234.45 | $6,346.73 – $26,452.82 | 26 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $309.31 | $515.52 | $32.08 – $386.64 | 26 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $2,274.17 | $3,790.29 | $167.39 – $2,842.72 | 26 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $1,890.44 | $3,150.74 | $99.77 – $2,363.05 | 26 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $3,957.73 | $6,596.21 | $330.45 – $4,947.16 | 26 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,853.47 | $3,089.11 | $281.34 – $2,316.83 | 26 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,034.41 | $3,390.69 | $196.14 – $2,543.02 | 26 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $312.80 | $521.34 | $33.08 – $391.00 | 26 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $395.95 | $659.91 | $39.76 – $494.93 | 26 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $334.95 – $3,693.00 | 17 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $334.95 – $4,063.00 | 17 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | $619.49 | $1,032.48 | $123.90 – $825.98 | 19 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $657.77 | $1,096.29 | $139.34 – $822.22 | 26 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $555.04 | $925.06 | $122.96 – $693.79 | 26 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $334.95 – $4,063.00 | 17 |
| Urea nitrogen CPT 84520 | $63.28 | $105.46 | $3.32 – $56.25 | 26 |
| Urea nitrogen 24 hour urine CPT 84540 | $71.51 | $119.19 | $4.67 – $89.39 | 26 |
| Urea nitrogen clearance CPT 84545 | $20.07 | $33.45 | $6.05 – $25.09 | 26 |
| Ureteral embolization/occl CPT 50705 | $3,689.40 | $6,149.00 | $737.88 – $5,226.65 | 20 |
| Ureteral reflux study CPT 78740 | $432.89 | $721.49 | $209.50 – $1,021.72 | 26 |
| Ureter endoscopy & biopsy CPT 50955 | $5,696.72 | $9,494.54 | $1,689.43 – $12,818.21 | 26 |
| Ureteroureterostomy 50760 CPT 50760 | $2,999.40 | $4,999.00 | $599.88 – $7,038.00 | 18 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $615.08 | $1,025.14 | $81.38 – $768.86 | 26 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $3,363.99 – $8,636.11 | 16 |
| Urethrocystography void s&i CPT 74455 | $702.97 | $1,171.61 | $104.25 – $878.71 | 26 |
| Uric acid blood CPT 84550 | $70.34 | $117.24 | $3.80 – $87.93 | 26 |
| Uric acid urine CPT 84560 | $69.30 | $115.50 | $4.27 – $19.39 | 26 |
| Urinalysis microscopic only CPT 81015 | $31.75 | $52.92 | $2.56 – $39.69 | 26 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $46.86 | $78.10 | $1.82 – $42.75 | 26 |
| Urinalysis (with microscopy) CPT 81001 | $77.87 | $129.78 | $2.66 – $97.33 | 26 |
| Urinalysis (without microscopy) CPT 81003 | $96.30 | $160.50 | $1.89 – $62.69 | 26 |
| Urinary bldr retent nuc study CPT 78730 | $309.22 | $515.37 | $61.84 – $438.06 | 20 |
| Urine Culture Test CPT 87086 | $129.30 | $215.50 | $6.78 – $161.62 | 26 |
| Urine pregnancy test CPT 81025 | $97.30 | $162.16 | $7.23 – $112.61 | 26 |
| Urography, antegrade CPT 74425 | $593.37 | $988.95 | $135.99 – $952.69 | 26 |
| Urography inf drip &/or bolus CPT 74410 | $690.85 | $1,151.41 | $142.00 – $863.56 | 26 |
| Use 1st target lesion CPT 76982 | $355.91 | $593.18 | $93.56 – $444.88 | 26 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $3,644.13 | $6,073.55 | $11.04 – $4,555.16 | 26 |
| Vaccine Administration (one shot) CPT 90471 | $77.72 | $129.54 | $15.54 – $174.51 | 26 |
| Vaccine dtap < 7 years im CPT 90700 | $101.02 | $168.37 | $18.04 – $127.80 | 20 |
| Vaccine dtap-ipv/hib im CPT 90698 | $280.15 | $466.92 | $56.03 – $396.88 | 20 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $46.99 | $78.32 | $9.40 – $66.57 | 20 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $225.31 | $375.52 | $45.06 – $319.19 | 21 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $179.89 | $299.81 | $35.98 – $254.84 | 21 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $402.20 | $670.34 | $80.44 – $569.79 | 21 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $103.22 | $172.03 | $20.27 – $143.60 | 21 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $81.00 | $135.00 | $16.20 – $114.75 | 21 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $81.00 | $135.00 | $16.20 – $114.75 | 21 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $27.00 | $45.00 | $5.40 – $38.25 | 21 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $605.69 | $1,009.48 | $121.14 – $858.06 | 20 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $426.43 | $710.71 | $70.92 – $502.35 | 20 |
| Vaccine mmr live subcutaneous CPT 90707 | $254.57 | $424.28 | $49.45 – $350.29 | 20 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $729.93 | $1,216.55 | $145.99 – $1,034.07 | 21 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $1,134.58 | $1,890.96 | $226.92 – $1,607.32 | 20 |
| Vaccine rabies im CPT 90675 | $1,174.89 | $1,958.15 | $205.40 – $1,283.76 | 26 |
| Vaccine tdap >=7 years im CPT 90715 | $167.69 | $279.48 | $33.22 – $235.32 | 21 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $131.77 | $219.61 | $26.35 – $186.66 | 21 |
| Vaccine varicella live subcutaneous CPT 90716 | $495.68 | $826.13 | $99.14 – $702.21 | 20 |
| Vacuum drain bottle/tube kit HCPCS A7048 | $1,617.00 | $2,695.00 | $8.14 – $57.68 | 20 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | $2,541.00 | $4,235.00 | $292.38 – $1,949.20 | 19 |
| Vad cable power module dc input HCPCS Q0478 | $2,808.00 | $4,680.00 | $131.57 – $877.14 | 19 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $15,793.12 | $26,321.86 | $508.80 – $22,373.58 | 20 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $4,773.99 – $12,321.66 | 16 |
| Vag hyst including t/o CPT 58262 | not published | not published | $1,526.99 – $12,321.66 | 16 |
| Vaginal bx CPT 58999 | $3,859.51 | $6,432.52 | $192.94 – $1,585.67 | 26 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | $4,170.07 | $6,950.12 | $834.01 – $7,744.80 | 26 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $1,526.99 – $12,321.66 | 16 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $24.12 | $40.20 | $0.04 – $34.17 | 21 |
| Valproic acid total therapeutic drug level CPT 80164 | $173.37 | $288.95 | $10.00 – $57.88 | 26 |
| Valvuloplasty aortic CPT 92986 | $16,030.65 | $26,717.75 | $3,206.13 – $20,038.31 | 25 |
| Valvuloplasty mitral CPT 92987 | $17,175.83 | $28,626.39 | $3,435.17 – $27,252.71 | 25 |
| Valvuloplasty pulmonary CPT 92990 | $12,700.66 | $21,167.77 | $2,540.13 – $27,252.71 | 25 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | $15,523.12 | $25,871.87 | $2,546.00 – $21,991.09 | 18 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $246.70 | $411.17 | $0.03 – $19.55 | 21 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $89.83 | $149.72 | $0.11 – $86.05 | 21 |
| Vancomycin hcl injection HCPCS J3370 | $589.52 | $982.54 | $6.48 – $45.87 | 20 |
| Vancomycin peak therapeutic drug level CPT 80202 | $182.61 | $304.35 | $10.00 – $228.26 | 26 |
| Vanomycin dna amp probe CPT 87500 | $174.24 | $290.40 | $10.00 – $217.80 | 26 |
| Varicella zoster antibody igg CPT 86787 | $108.99 | $181.65 | $10.00 – $30.91 | 26 |
| Varus/valgus strap padded/li HCPCS L2270 | $136.41 | $227.35 | $27.28 – $181.88 | 19 |
| Vasc emb/occ w/prs cath HCPCS C9797 | $16,060.54 | $26,767.56 | $3,212.11 – $43,439.01 | 24 |
| Vasectomy CPT 55250 | not published | not published | $652.80 – $5,045.72 | 17 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $1,458.00 | $2,430.00 | $0.46 – $309.82 | 21 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $15,599.84 | $25,999.74 | $19.93 – $19,499.81 | 26 |
| Veeg cont 2-12 hrs CPT 95713 | $1,868.14 | $3,113.57 | $356.12 – $2,335.18 | 26 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $4,212.17 | $7,020.29 | $819.52 – $5,265.22 | 26 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $2,338.10 | $3,896.83 | $356.12 – $2,922.62 | 26 |
| Veeg unmon 12-26 hrs CPT 95714 | $2,826.33 | $4,710.55 | $356.12 – $3,532.91 | 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.