Methodist Southlake Medical Center
421 E State Hwy 114, Souhtlake, TX · Methodisthealthsystem · · NPI 1568818417
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 |
|---|---|---|---|---|
| Hepatitis b core antibody igm CPT 86705 | $263.00 | $526.00 | $6.90 – $50.90 | 71 |
| Hepatitis b core antibody total CPT 86704 | $263.00 | $526.00 | $7.07 – $52.13 | 71 |
| Hepatitis b surface antibody CPT 86706 | $173.50 | $347.00 | $6.30 – $46.43 | 71 |
| Hepatitis d quantification CPT 87523 | $169.00 | $338.00 | $17.99 – $185.30 | 71 |
| Hepatobiliary system imaging CPT 78226 | $1,162.50 | $2,325.00 | $287.91 – $1,295.13 | 66 |
| Herpes simplex type 1 antibody igg CPT 86695 | $15.50 | $31.00 | $7.74 – $57.03 | 71 |
| Herpes simplex type 2 antibody igg CPT 86696 | $15.50 | $31.00 | $11.36 – $83.71 | 71 |
| Herpes simplex virus isolation CPT 87255 | $21.50 | $43.00 | $19.87 – $146.51 | 71 |
| Heterophile antibodies screening CPT 86308 | $84.00 | $168.00 | $3.04 – $22.42 | 71 |
| Hexa gene CPT 81255 | $47.50 | $95.00 | $21.61 – $222.57 | 71 |
| Hhv-6 dna quant CPT 87533 | $148.50 | $297.00 | $24.50 – $180.68 | 71 |
| Hip X-ray CPT 73502 | $418.00 | $836.00 | $45.39 – $236.43 | 66 |
| Histamine CPT 83088 | $19.00 | $38.00 | $17.33 – $127.76 | 71 |
| Histochemical stains add-on CPT 88314 | $61.50 | $123.00 | $4.95 – $351.05 | 19 |
| Hla class i high defin qual CPT 86832 | $968.00 | $1,936.00 | $73.25 – $1,400.54 | 71 |
| Hla class ii high defin qual CPT 86833 | $919.00 | $1,838.00 | $66.59 – $1,409.41 | 71 |
| Hla class i/ii antibody qual CPT 86829 | $919.00 | $1,838.00 | $17.14 – $277.66 | 71 |
| Hla class ii phenotype qual CPT 86831 | $112.50 | $225.00 | $39.95 – $354.23 | 71 |
| Hla class ii semiquant panel CPT 86835 | $4,846.50 | $9,693.00 | $186.45 – $1,397.15 | 71 |
| Hla class i semiquant panel CPT 86834 | $4,846.50 | $9,693.00 | $206.43 – $1,546.83 | 71 |
| Hla i & ii typing lr CPT 81370 | $3,863.00 | $7,726.00 | $230.41 – $1,739.56 | 71 |
| Hla ii typing 1 loc hr CPT 81382 | $779.50 | $1,559.00 | $70.87 – $535.05 | 71 |
| Hla ii typing ag equiv lr CPT 81375 | $1,559.00 | $3,118.00 | $126.48 – $954.89 | 71 |
| Hla i typing 1 locus hr CPT 81380 | $184.00 | $368.00 | $101.56 – $766.78 | 71 |
| Hla i typing complete hr CPT 81379 | $465.00 | $930.00 | $192.17 – $1,450.87 | 71 |
| Hla i typing complete lr CPT 81372 | $3,788.50 | $7,577.00 | $126.57 – $1,745.90 | 71 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $195.00 | $390.00 | $54.19 – $734.99 | 71 |
| Hla i typing low res one locus ea CPT 81373 | $415.00 | $830.00 | $63.81 – $551.28 | 71 |
| Hla typing a b or c CPT 86813 | $238.50 | $477.00 | $34.03 – $250.91 | 71 |
| Hla x-math non-cytotoxic CPT 86825 | $1,207.50 | $2,415.00 | $48.32 – $473.62 | 71 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $123.75 | $247.50 | $54.49 – $54.49 | 1 |
| Homocysteine CPT 83090 | $452.00 | $904.00 | $9.90 – $77.51 | 71 |
| Homogenization tissue CPT 87176 | $103.50 | $207.00 | $3.45 – $25.45 | 71 |
| Homovanillic acid (hva) CPT 83150 | $9.50 | $19.00 | $11.36 – $96.97 | 71 |
| Hpa-15 genotyping CPT 81112 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpa-1 genotyping CPT 81105 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpa-3 genotyping CPT 81107 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpa-4 genotyping CPT 81108 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpa-5 genotyping CPT 81109 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpa-6 genotyping CPT 81110 | $71.50 | $143.00 | $63.37 – $528.71 | 71 |
| Hpv types 16 & 18 only CPT 87625 | $44.00 | $88.00 | $20.06 – $175.42 | 71 |
| H pylori (c-13) breath CPT 83013 | $56.50 | $113.00 | $39.53 – $291.43 | 71 |
| Hrdtry perph neurphy panel CPT 81448 | $1,800.00 | $3,600.00 | $303.28 – $2,530.28 | 68 |
| Htt gene detc abnor alleles CPT 81271 | $112.50 | $225.00 | $57.54 – $592.66 | 68 |
| Human epididymis protein 4 (he4) CPT 86305 | $135.00 | $270.00 | $12.52 – $90.05 | 71 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $103.87 | $207.75 | $84.92 – $132.65 | 6 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $32.87 | $65.75 | $6.78 – $15.49 | 6 |
| Hydration IV infusion each additional hour CPT 96361 | $171.50 | $343.00 | $44.08 – $127.21 | 60 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $434.50 | $869.00 | $14.03 – $577.87 | 60 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $42.25 | $84.50 | $23.76 – $38.99 | 6 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $31.50 | $63.00 | $0.09 – $1.23 | 10 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $12.00 | $24.00 | not published | 0 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $33.50 | $67.00 | $10.28 – $77.44 | 71 |
| Hysterosalpingography s&i CPT 74740 | $673.00 | $1,346.00 | $63.49 – $648.23 | 66 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $341.25 | $682.50 | $403.22 – $403.22 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | $96.50 | $193.00 | $7.04 – $58.04 | 71 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $73.00 | $146.00 | $20.60 – $151.77 | 71 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $60.50 | $121.00 | $19.02 – $326.11 | 71 |
| Idh1 common variants CPT 81120 | $285.00 | $570.00 | $81.17 – $836.00 | 71 |
| Idh2 common variants CPT 81121 | $427.50 | $855.00 | $124.23 – $1,279.56 | 71 |
| Igh gene rearrang dir probe CPT 81262 | $111.50 | $223.00 | $25.01 – $296.55 | 71 |
| Igh gene rearrange amp meth CPT 81261 | $282.00 | $564.00 | $113.45 – $856.48 | 71 |
| Igh@ var region somatic mutation analy CPT 81263 | $371.50 | $743.00 | $168.75 – $1,274.08 | 71 |
| Igk rearrangeabn clonal pop CPT 81264 | $250.00 | $500.00 | $85.56 – $747.24 | 71 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $67.50 | $135.00 | $19.22 – $330.13 | 19 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $56.50 | $113.00 | $32.29 – $973.82 | 75 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $168.50 | $337.00 | $14.62 – $462.86 | 75 |
| Ikbkap gene CPT 81260 | $36.00 | $72.00 | $16.51 – $170.08 | 71 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,625.50 | $3,251.00 | $22.06 – $22.06 | 1 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | $36.00 | $72.00 | $37.50 – $101.47 | 59 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $62.39 | $124.79 | $132.02 – $356.45 | 53 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $14.80 | $29.61 | $63.18 – $170.59 | 53 |
| Immune complex assay CPT 86332 | $16.50 | $33.00 | $14.30 – $105.41 | 71 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $2,200.12 | $4,400.25 | $46.46 – $2,226.52 | 62 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $173.50 | $347.00 | $12.21 – $90.05 | 71 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $263.00 | $526.00 | $12.21 – $90.05 | 71 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $8.50 | $17.00 | $7.04 – $51.84 | 71 |
| Immunofixation electrophoresis serum CPT 86334 | $407.00 | $814.00 | $13.11 – $96.61 | 71 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $315.50 | $631.00 | $18.35 – $403.26 | 19 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $557.50 | $1,115.00 | $14.62 – $530.73 | 75 |
| Immunoglobulin assay CPT 86023 | $516.00 | $1,032.00 | $7.31 – $53.93 | 71 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $41.50 | $83.00 | $56.02 – $303.69 | 62 |
| Infect ag drug suscept pheno predict CPT 87900 | $264.50 | $529.00 | $76.49 – $563.89 | 71 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $544.00 | $1,088.00 | $148.63 – $1,113.73 | 71 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $278.00 | $556.00 | $148.63 – $1,113.73 | 71 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $427.50 | $855.00 | $76.08 – $556.90 | 71 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $262.50 | $525.00 | $151.07 – $1,113.73 | 71 |
| Infect ag ia optc obs influenza CPT 87804 | $193.50 | $387.00 | $7.04 – $71.60 | 71 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $96.50 | $193.00 | $7.04 – $51.84 | 71 |
| Infect ag if hep delta agent CPT 87380 | $94.00 | $188.00 | $9.63 – $79.45 | 71 |
| Infect ag if influenza a CPT 87276 | $96.50 | $193.00 | $7.04 – $69.50 | 71 |
| Infect ag if influenza b CPT 87275 | $96.50 | $193.00 | $7.04 – $52.99 | 71 |
| Infect ag if legionella pneumophila CPT 87278 | $28.00 | $56.00 | $7.04 – $67.49 | 71 |
| Infect ag if nos ea CPT 87299 | $96.50 | $193.00 | $7.04 – $69.65 | 71 |
| Infect ag if pneumocystis carinii CPT 87281 | $65.50 | $131.00 | $7.04 – $51.84 | 71 |
| Infect ag na herpes simplex quant CPT 87530 | $105.00 | $210.00 | $25.14 – $185.30 | 71 |
| Infect ag na hpv high-risk types CPT 87624 | $65.50 | $131.00 | $20.06 – $151.77 | 71 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $205.00 | $410.00 | $50.30 – $414.43 | 71 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $32.00 | $64.00 | $21.49 – $369.95 | 71 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $612.00 | $1,224.00 | $240.62 – $1,803.00 | 71 |
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.