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 |
|---|---|---|---|---|
| Antibody elution rbc reference CPT 86860 | $157.50 | $315.00 | $8.58 – $462.86 | 75 |
| Antibody htlv/hiv confirm test CPT 86689 | $330.00 | $660.00 | $11.36 – $83.71 | 71 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $395.00 | $790.00 | $10.78 – $79.45 | 71 |
| Antibody id rbc panel CPT 86870 | $347.50 | $695.00 | $7.29 – $973.82 | 75 |
| Antibody influenza virus CPT 86710 | $6.00 | $12.00 | $7.95 – $58.62 | 71 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $13.50 | $27.00 | $7.55 – $55.66 | 71 |
| Antibody screen rbc CPT 86850 | $135.00 | $270.00 | $5.78 – $141.57 | 75 |
| Antibody tetanus CPT 86774 | $66.00 | $132.00 | $8.69 – $64.02 | 71 |
| Antidepressant not specified CPT 80338 | $178.50 | $357.00 | $0.06 – $183.09 | 34 |
| Anti mog serum - sendout CPT 86362 | $133.50 | $267.00 | $5.06 – $52.13 | 71 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $30.00 | $60.00 | $5.06 – $52.13 | 71 |
| Antinuclear antibodies CPT 86038 | $61.00 | $122.00 | $7.09 – $52.27 | 71 |
| Antinuclear antibodies titer CPT 86039 | $48.50 | $97.00 | $6.55 – $48.31 | 71 |
| Antiphosphatidylserine antibody CPT 86148 | $14.50 | $29.00 | $9.42 – $69.50 | 71 |
| Antipsychotics nos 1-3 CPT 80342 | $77.50 | $155.00 | $0.06 – $183.09 | 44 |
| Antistreptolysin o screen CPT 86063 | $84.00 | $168.00 | $3.39 – $24.95 | 71 |
| Antistreptolysin o titer CPT 86060 | $146.00 | $292.00 | $4.28 – $31.58 | 71 |
| Antithrombin iii activity CPT 85300 | $67.50 | $135.00 | $6.95 – $51.26 | 71 |
| Apc gene dup/delet variants CPT 81203 | $234.50 | $469.00 | $84.00 – $865.20 | 71 |
| Apc gene full sequence CPT 81201 | $717.50 | $1,435.00 | $327.60 – $3,374.28 | 71 |
| Apheresis immunoads slctv CPT 36516 | $8,700.00 | $17,400.00 | $1,462.04 – $13,792.00 | 66 |
| Apheresis plasma CPT 36514 | $4,350.00 | $8,700.00 | $564.62 – $6,940.00 | 66 |
| Apheresis platelets CPT 36513 | $5,469.00 | $10,938.00 | $164.30 – $6,940.00 | 66 |
| Apheresis rbc CPT 36512 | $5,096.00 | $10,192.00 | $564.62 – $6,940.00 | 66 |
| Apheresis wbc CPT 36511 | $5,469.00 | $10,938.00 | $564.62 – $6,940.00 | 66 |
| Apl(pml-rara) quant - sendout CPT 81315 | $250.50 | $501.00 | $118.79 – $896.85 | 71 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $112.00 | $224.00 | $6.00 – $16.20 | 56 |
| Apply interstit radiat compl CPT 77778 | $867.00 | $1,734.00 | $662.84 – $2,187.08 | 63 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $350.00 | $700.00 | $5.06 – $135.43 | 71 |
| Aquaporin-4 antibody cba each CPT 86052 | $225.00 | $450.00 | $5.06 – $52.13 | 71 |
| Aquaporin-4 antibody elisa CPT 86051 | $163.00 | $326.00 | $4.84 – $49.89 | 71 |
| Aquatic exercise - group charge CPT 97150 | $112.00 | $224.00 | $18.03 – $48.95 | 56 |
| Artery xray each vessel 7577426 CPT 75774 | $1,369.00 | $2,738.00 | $112.06 – $243.70 | 6 |
| Artery xray of abdomen 75726-26 CPT 75726 | $4,515.50 | $9,031.00 | $161.58 – $15,117.44 | 66 |
| Artery x-rays adrenal gland CPT 75731 | $1,749.50 | $3,499.00 | $146.02 – $8,578.16 | 66 |
| Artery x-rays adrenals CPT 75733 | $1,827.00 | $3,654.00 | $164.11 – $8,578.16 | 66 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $4,886.50 | $9,773.00 | $142.84 – $8,578.16 | 66 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $3,583.00 | $7,166.00 | $154.90 – $8,578.16 | 66 |
| Artery x-rays chest CPT 75756 | $1,749.50 | $3,499.00 | $157.13 – $8,578.16 | 66 |
| Artery x-rays lung CPT 75741 | $1,831.50 | $3,663.00 | $123.48 – $8,578.16 | 66 |
| Artery x-rays lung CPT 75746 | $2,104.00 | $4,208.00 | $128.24 – $8,578.16 | 66 |
| Artery x-rays lungs CPT 75743 | $1,998.50 | $3,997.00 | $140.31 – $8,578.16 | 66 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $3,607.50 | $7,215.00 | $136.50 – $15,117.44 | 66 |
| Artery x-rays spine CPT 75705 | $4,136.50 | $8,273.00 | $238.39 – $15,117.44 | 66 |
| Arthrd si jt perq/min nvas CPT 27279 | $16,475.00 | $32,950.00 | $11,232.00 – $47,635.39 | 63 |
| Arthrd si jt prq wo tfxj dev CPT 27278 | $16,475.00 | $32,950.00 | $11,232.00 – $47,635.39 | 59 |
| Aspa gene CPT 81200 | $43.50 | $87.00 | $19.85 – $204.40 | 71 |
| Assay acid phosphatase CPT 84060 | $7.00 | $14.00 | $4.33 – $33.02 | 71 |
| Assay myeloperoxidase CPT 83876 | $24.50 | $49.00 | $7.94 – $220.05 | 68 |
| Assay of androsterone CPT 82160 | $19.00 | $38.00 | $14.67 – $110.53 | 71 |
| Assay of breath ethanol CPT 82075 | $71.00 | $142.00 | $0.06 – $107.69 | 71 |
| Assay of corticosterone CPT 82528 | $23.00 | $46.00 | $13.21 – $97.41 | 71 |
| Assay of feces porphyrins CPT 84126 | $56.50 | $113.00 | $14.95 – $169.22 | 71 |
| Assay of gdh enzyme CPT 82965 | $11.00 | $22.00 | $4.54 – $56.89 | 71 |
| Assay of interleukin-6 (il-6) CPT 83529 | $16.00 | $32.00 | $7.25 – $74.70 | 71 |
| Assay of lap enzyme CPT 83670 | $20.50 | $41.00 | $5.38 – $42.47 | 71 |
| Assay of leflunomide CPT 80193 | $56.50 | $113.00 | $16.20 – $166.84 | 71 |
| Assay of osteocalcin CPT 83937 | $32.50 | $65.00 | $17.52 – $129.13 | 71 |
| Assay of procainamide w/metab CPT 80192 | $14.00 | $28.00 | $9.83 – $72.46 | 71 |
| Assay of prostaglandin CPT 84150 | $266.50 | $533.00 | $14.65 – $180.68 | 71 |
| Assay of salicylate CPT 80179 | $114.50 | $229.00 | $7.83 – $80.61 | 71 |
| Assay of semen fructose CPT 82757 | $13.50 | $27.00 | $10.18 – $74.98 | 71 |
| Assay of sialic acid CPT 84275 | $14.50 | $29.00 | $7.88 – $58.11 | 71 |
| Assay of somatostatin CPT 84307 | $127.50 | $255.00 | $10.73 – $79.09 | 71 |
| Assay of thiocyanate CPT 84430 | $79.50 | $159.00 | $6.83 – $50.33 | 71 |
| Assay of urine sulfate CPT 84392 | $17.00 | $34.00 | $2.79 – $23.72 | 71 |
| Assay toxin or antitoxin CPT 87230 | $105.50 | $211.00 | $11.59 – $85.37 | 71 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $411.50 | $823.00 | $97.34 – $262.82 | 55 |
| Assess care plan pt w/cog impair 99483 CPT 99483 | $88.50 | $177.00 | $88.37 – $276.00 | 59 |
| Ast/sgot CPT 84450 | $176.00 | $352.00 | $3.03 – $22.42 | 71 |
| Asxl1 full gene sequence CPT 81175 | $1,496.50 | $2,993.00 | $296.95 – $2,926.54 | 68 |
| Atomic absorption CPT 82190 | $56.50 | $113.00 | $8.75 – $68.78 | 71 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $69.00 | $138.00 | $2.99 – $4.81 | 6 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $6.62 | $13.25 | $3.15 – $9.92 | 6 |
| Baclofen eval charges CPT 97750 | $112.00 | $224.00 | $22.84 – $91.58 | 56 |
| Bacterial vaginosis pcr CPT 87801 | $385.50 | $771.00 | $41.19 – $303.69 | 71 |
| #bac vag cand-c. albicans naa CPT 87481 | $31.50 | $63.00 | $20.60 – $151.77 | 71 |
| Bartonella dna pcr-sendout CPT 87471 | $184.00 | $368.00 | $20.60 – $151.77 | 71 |
| B cells total count CPT 86355 | $45.00 | $90.00 | $22.13 – $163.23 | 71 |
| Bckdhb gene CPT 81205 | $57.50 | $115.00 | $39.90 – $410.90 | 71 |
| #_benzodiazconfur CPT 80346 | $144.00 | $288.00 | $0.06 – $183.09 | 44 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $34.00 | $68.00 | $14.93 – $110.10 | 71 |
| Beta-2 microglobulin CPT 82232 | $16.50 | $33.00 | $9.50 – $70.01 | 71 |
| Beta-amyloid 1-42 CPT 82234 | $249.00 | $498.00 | $11.27 – $348.08 | 59 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $102.37 | $204.75 | $53.40 – $66.08 | 6 |
| Bfb train 1st 15min cntct 90912 CPT 90912 | $101.00 | $202.00 | $37.42 – $101.03 | 56 |
| Bfb train ea addl 15 min 90913 CPT 90913 | $101.00 | $202.00 | $21.04 – $60.89 | 56 |
| Bilicheck CPT 88720 | $13.50 | $27.00 | $3.08 – $21.70 | 71 |
| Bilirubin direct CPT 82248 | $105.50 | $211.00 | $2.95 – $21.70 | 71 |
| Bilirubin total CPT 82247 | $134.50 | $269.00 | $2.95 – $21.70 | 71 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $10.55 | $21.10 | $40.36 – $108.97 | 53 |
| Biofeedback, pt CPT 90901 | $222.00 | $444.00 | $16.43 – $116.07 | 56 |
| Biopsy of heart lining CPT 93505 | $1,970.00 | $3,940.00 | $3,007.00 – $17,864.00 | 63 |
| Biotinidase - quest CPT 82261 | $25.00 | $50.00 | $9.90 – $72.97 | 71 |
| Bis xtracell fluid analysis CPT 93702 | $228.00 | $456.00 | $5.47 – $349.58 | 56 |
| Bivalirudin HCPCS J0583 | $269.75 | $539.50 | $61.20 – $824.55 | 6 |
| Bld prd mix CPT 86965 | $157.50 | $315.00 | $8.58 – $462.86 | 72 |
| Blm gene CPT 81209 | $36.00 | $72.00 | $16.51 – $170.08 | 71 |
| Blood Clotting (PT/INR) Test CPT 85610 | $117.00 | $234.00 | $2.31 – $18.53 | 71 |
| Blood Clotting (PTT) Test CPT 85730 | $117.00 | $234.00 | $3.52 – $26.03 | 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.