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 |
|---|---|---|---|---|
| Warde 3016000 west nile virus antibody igg CPT 86789 | $12.50 | $25.00 | $8.45 – $62.22 | 71 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $38.50 | $77.00 | $7.19 – $52.99 | 71 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $23.00 | $46.00 | $5.22 – $38.50 | 71 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $23.00 | $46.00 | $10.55 – $77.80 | 71 |
| Warde 3400683 amplification rna markers infectious disease bacterial vaginosis CPT 81513 | $83.00 | $166.00 | $59.90 – $617.03 | 71 |
| Warde 3400852 arsenic CPT 82175 | $179.50 | $359.00 | $11.13 – $82.05 | 71 |
| Warde 3708165 mercury urine CPT 83825 | $39.00 | $78.00 | $9.54 – $70.37 | 71 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $26.50 | $53.00 | $7.73 – $79.60 | 71 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $10.50 | $21.00 | $4.84 – $49.89 | 71 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $90.00 | $180.00 | $4.10 – $35.04 | 71 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $16.00 | $32.00 | $22.67 – $167.06 | 71 |
| Warde aldolase CPT 82085 | $6.50 | $13.00 | $5.70 – $42.03 | 71 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $72.50 | $145.00 | $9.90 – $72.97 | 71 |
| Warde amiodarone therapeutic drug level CPT 80151 | $14.50 | $29.00 | $7.83 – $80.61 | 71 |
| Warde analysis gene hfe common variants CPT 81256 | $94.00 | $188.00 | $37.45 – $282.78 | 71 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $199.00 | $398.00 | $93.95 – $709.32 | 71 |
| Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites CPT 80339 | $94.00 | $188.00 | $0.06 – $183.09 | 44 |
| Warde anti-mullerian hormone CPT 82166 | $49.00 | $98.00 | $16.22 – $167.06 | 71 |
| Warde apolipoprotein b CPT 82172 | $11.50 | $23.00 | $9.09 – $91.21 | 71 |
| Warde bile acids CPT 82239 | $10.00 | $20.00 | $10.05 – $74.05 | 71 |
| Warde cadmium blood CPT 82300 | $33.00 | $66.00 | $13.58 – $102.24 | 71 |
| Warde calcitonin CPT 82308 | $18.50 | $37.00 | $15.71 – $115.86 | 71 |
| Warde calculus (stone) infrared CPT 82365 | $10.50 | $21.00 | $7.56 – $55.81 | 71 |
| Warde clozapine therapeutic drug level CPT 80159 | $13.50 | $27.00 | $10.60 – $87.17 | 71 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $142.00 | $284.00 | $12.89 – $95.03 | 71 |
| Warde collagen cross links c-telopeptide CPT 82523 | $71.50 | $143.00 | $10.97 – $80.82 | 71 |
| Warde complement total hemolytic CPT 86162 | $211.00 | $422.00 | $11.92 – $87.89 | 71 |
| Warde copper CPT 82525 | $149.50 | $299.00 | $7.28 – $53.71 | 71 |
| Warde cryoglobulin CPT 82595 | $5.50 | $11.00 | $3.80 – $27.97 | 71 |
| Warde erythropoietin CPT 82668 | $19.50 | $39.00 | $11.03 – $81.26 | 71 |
| Warde estrogen fractionated CPT 82671 | $30.00 | $60.00 | $18.95 – $139.73 | 71 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $20.00 | $40.00 | $5.08 – $52.27 | 71 |
| Warde folic acid rbc CPT 82747 | $14.00 | $28.00 | $10.16 – $76.35 | 71 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $15.00 | $30.00 | $5.69 – $41.96 | 71 |
| Warde gastrin CPT 82941 | $14.00 | $28.00 | $10.35 – $76.28 | 71 |
| Warde growth hormone (hgh) CPT 83003 | $12.50 | $25.00 | $9.78 – $72.10 | 71 |
| Warde haloperidol therapeutic drug level CPT 80173 | $22.50 | $45.00 | $8.54 – $68.28 | 71 |
| Warde helminth antibody strongyloides igg CPT 86682 | $78.00 | $156.00 | $7.63 – $56.31 | 71 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $21.50 | $43.00 | $7.56 – $55.66 | 71 |
| Warde hepatitis a antibody CPT 86708 | $173.50 | $347.00 | $7.27 – $53.57 | 71 |
| Warde hepatitis be antibody CPT 86707 | $10.50 | $21.00 | $6.79 – $50.04 | 71 |
| Warde hepatitis delta agent antibody CPT 86692 | $66.50 | $133.00 | $10.07 – $74.26 | 71 |
| Warde immunofixation electrophoresis urine CPT 86335 | $407.00 | $814.00 | $17.22 – $126.97 | 71 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $9.50 | $19.00 | $6.76 – $49.89 | 71 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $522.50 | $1,045.00 | $151.07 – $1,113.73 | 71 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $169.00 | $338.00 | $11.61 – $101.95 | 71 |
| Warde lipoprotein (a) CPT 83695 | $14.50 | $29.00 | $7.60 – $61.93 | 71 |
| Warde lipoprotein-associated phospholipase a2 CPT 83698 | $94.00 | $188.00 | $19.92 – $200.37 | 71 |
| Warde mitochondrial antibody each CPT 86381 | $23.50 | $47.00 | $10.69 – $110.10 | 71 |
| Warde neutralization rabies CPT 86382 | $58.00 | $116.00 | $9.92 – $73.18 | 71 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $18.00 | $36.00 | $7.60 – $57.32 | 71 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $76.50 | $153.00 | $9.65 – $99.35 | 71 |
| Warde protein c antigen CPT 85302 | $11.50 | $23.00 | $7.06 – $51.98 | 71 |
| Warde sex hormone binding globulin CPT 84270 | $15.00 | $30.00 | $12.75 – $94.02 | 71 |
| Warde somatomedin CPT 84305 | $14.50 | $29.00 | $12.47 – $92.00 | 71 |
| Warde sugars single qualitative each specimen stool CPT 84376 | $15.00 | $30.00 | $3.23 – $23.79 | 71 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $83.50 | $167.00 | $9.25 – $68.21 | 71 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $91.00 | $182.00 | $29.84 – $220.05 | 71 |
| Warde topiramate therapeutic drug level CPT 80201 | $40.00 | $80.00 | $7.00 – $51.55 | 71 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $77.50 | $155.00 | $15.30 – $112.76 | 71 |
| Warde viscosity CPT 85810 | $20.50 | $41.00 | $6.85 – $50.47 | 71 |
| Warde vitamin a CPT 84590 | $12.00 | $24.00 | $6.80 – $50.25 | 71 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $17.50 | $35.00 | $12.46 – $91.86 | 71 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $20.50 | $41.00 | $16.49 – $121.56 | 71 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $19.50 | $39.00 | $5.80 – $42.76 | 71 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $27.50 | $55.00 | $22.59 – $166.55 | 71 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $11.50 | $23.00 | $8.32 – $61.36 | 71 |
| Warde zinc CPT 84630 | $16.00 | $32.00 | $6.68 – $49.24 | 71 |
| Wbc automated CPT 85048 | $60.00 | $120.00 | $1.49 – $10.96 | 71 |
| Western blot test CPT 84181 | $160.50 | $321.00 | $10.00 – $73.69 | 71 |
| Whole blood for transfusion HCPCS P9010 | $550.00 | $1,100.00 | $189.84 – $512.57 | 59 |
| Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit HCPCS P9054 | $394.00 | $788.00 | $242.44 – $716.01 | 59 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $452.00 | $904.00 | $32.11 – $1,104.41 | 60 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $562.00 | $1,124.00 | $27.59 – $1,104.41 | 60 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $483.50 | $967.00 | $23.55 – $545.08 | 60 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $483.50 | $967.00 | $25.69 – $1,104.41 | 60 |
| Wrist X-ray CPT 73110 | $311.00 | $622.00 | $39.37 – $236.43 | 66 |
| Xcellistem, 1 mg HCPCS A2004 | $1.16 | $2.33 | $5.59 – $5.59 | 1 |
| Xm archive tissue molec anal CPT 88363 | $447.50 | $895.00 | $4.64 – $84.43 | 68 |
| X-ray abdomen 1 view CPT 74018 | $303.50 | $607.00 | $28.88 – $236.43 | 66 |
| X-ray abdomen 2 views CPT 74019 | $391.00 | $782.00 | $34.91 – $284.03 | 66 |
| X-ray abdomen >=3 views CPT 74021 | $478.50 | $957.00 | $40.95 – $284.03 | 66 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $478.50 | $957.00 | $47.62 – $284.03 | 66 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $351.50 | $703.00 | $27.63 – $236.43 | 66 |
| X-ray ankle 2 views (both sides) CPT 73600 | $282.50 | $565.00 | $30.79 – $236.43 | 66 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $416.00 | $832.00 | $125.39 – $947.81 | 66 |
| X-ray bone age studies CPT 77072 | $269.00 | $538.00 | $24.76 – $284.03 | 66 |
| X-ray bone length studies CPT 77073 | $491.00 | $982.00 | $43.17 – $284.03 | 66 |
| X-ray bone survey complete CPT 77075 | $1,170.50 | $2,341.00 | $94.91 – $426.92 | 66 |
| X-ray bone survey infant CPT 77076 | $629.50 | $1,259.00 | $99.51 – $447.65 | 66 |
| X-ray cervical spine 2-3 views CPT 72040 | $467.00 | $934.00 | $37.77 – $236.43 | 66 |
| X-ray cervical spine 4-5 views CPT 72050 | $706.00 | $1,412.00 | $51.11 – $284.03 | 66 |
| X-ray cervical spine >= 6 views CPT 72052 | $1,080.00 | $2,160.00 | $59.67 – $284.03 | 66 |
| X-ray clavicle complete (both sides) CPT 73000 | $269.00 | $538.00 | $31.11 – $236.43 | 66 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $588.50 | $1,177.00 | $146.02 – $656.84 | 66 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $814.00 | $1,628.00 | $166.31 – $799.23 | 66 |
| X-ray elbow 2 views (both sides) CPT 73070 | $324.00 | $648.00 | $27.93 – $236.43 | 66 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $154.50 | $309.00 | $31.43 – $236.43 | 66 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $442.50 | $885.00 | $92.68 – $476.52 | 66 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $531.00 | $1,062.00 | $75.55 – $339.87 | 66 |
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.