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 |
|---|---|---|---|---|
| Cath plc art ang/grft lt/rt hr CPT 93461 | $11,902.50 | $23,805.00 | $3,072.83 – $17,864.00 | 63 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $11,858.00 | $23,716.00 | $3,072.83 – $17,864.00 | 63 |
| Cath plc art/grft/angio right hrt CPT 93457 | $12,358.00 | $24,716.00 | $3,072.83 – $17,864.00 | 63 |
| Cath ptca pcltxl agent 3x20mm HCPCS C9610 | $3,814.00 | $7,628.00 | $1,063.27 – $2,898.45 | 56 |
| Cath right heart w/o2 sat & card CPT 93451 | $3,709.00 | $7,418.00 | $3,072.83 – $17,864.00 | 63 |
| Cath stripping venous s&i CPT 75901 | $446.50 | $893.00 | $301.48 – $1,030.16 | 6 |
| Cath symplicity spyral HCPCS C1735 | $10,584.00 | $21,168.00 | $2,950.82 – $8,043.84 | 58 |
| Cdna analysis for variants CPT 81403 | $300.00 | $600.00 | $77.78 – $801.18 | 71 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $23.25 | $46.50 | $1.82 – $2.94 | 6 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $35.62 | $71.25 | $2.66 – $8.22 | 6 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $12.00 | $24.00 | $7.33 – $10.54 | 6 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $8.37 | $16.75 | $4.53 – $8.03 | 6 |
| Ceftazidime and avibactam HCPCS J0714 | $775.00 | $1,550.00 | $100.73 – $857.53 | 62 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $80.50 | $161.00 | $1.44 – $12.09 | 6 |
| Cell count w differential body fluid CPT 89051 | $69.00 | $138.00 | $3.23 – $24.23 | 71 |
| Cell enumeration & id CPT 86152 | $395.50 | $791.00 | $5.34 – $1,084.89 | 68 |
| Cell function assay w/stim CPT 86352 | $161.50 | $323.00 | $40.87 – $587.76 | 71 |
| Cell marker study CPT 88182 | $79.00 | $158.00 | $14.62 – $549.44 | 75 |
| Cerebrospinal fld flw imag CPT 78645 | $692.00 | $1,384.00 | $285.37 – $1,475.12 | 66 |
| #cf-97variants CPT 81220 | $512.00 | $1,024.00 | $233.77 – $2,407.85 | 71 |
| Cftr gene dup/delet variants CPT 81222 | $401.50 | $803.00 | $182.73 – $1,882.10 | 71 |
| Chemo adm cns w/lmbr punct CPT 96450 | $729.00 | $1,458.00 | $18.79 – $897.37 | 63 |
| Chemo ia push tecnique CPT 96420 | $2,179.00 | $4,358.00 | $18.79 – $897.37 | 63 |
| Chemotherapy injection 96542 CPT 96542 | $367.00 | $734.00 | $35.20 – $897.37 | 63 |
| Chest 2 vws w oblique CPT 71048 | $373.00 | $746.00 | $43.49 – $284.03 | 66 |
| Chest apical lordotic proj CPT 71047 | $348.50 | $697.00 | $40.32 – $236.43 | 66 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,547.50 | $5,095.00 | $166.31 – $748.12 | 62 |
| Chest CT scan (with contrast) CPT 71260 | $2,252.50 | $4,505.00 | $163.15 – $733.93 | 62 |
| Chest CT scan (without contrast) CPT 71250 | $1,959.50 | $3,919.00 | $99.51 – $447.65 | 62 |
| Chest X-ray CPT 71046 | $324.50 | $649.00 | $32.06 – $236.43 | 66 |
| Chest X-ray (single view) CPT 71045 | $300.50 | $601.00 | $24.44 – $236.43 | 66 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $442.50 | $885.00 | $104.43 – $476.52 | 66 |
| Chimerism anal no cell selec CPT 81267 | $516.50 | $1,033.00 | $118.87 – $897.50 | 71 |
| Chimerism anal w/cell select CPT 81268 | $649.00 | $1,298.00 | $149.43 – $1,128.15 | 71 |
| Chlamydia culture CPT 87110 | $43.50 | $87.00 | $11.50 – $84.79 | 71 |
| Chlamydia type CPT 87140 | $43.50 | $87.00 | $3.27 – $24.08 | 71 |
| Chloride CPT 82435 | $117.00 | $234.00 | $2.70 – $19.90 | 71 |
| Chloride 24 hour urine CPT 82436 | $105.50 | $211.00 | $2.95 – $24.87 | 71 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $297.62 | $595.25 | $89.83 – $343.47 | 6 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $60.75 | $121.50 | $36.72 – $49.76 | 6 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $338.50 | $677.00 | $31.67 – $111.32 | 6 |
| Cholesterol CPT 82465 | $134.00 | $268.00 | $2.55 – $18.82 | 71 |
| Cholesterol body fluid CPT 84999 | $416.00 | $832.00 | $2.13 – $2.13 | 10 |
| Cholesterol (Lipid) Test CPT 80061 | $247.00 | $494.00 | $7.86 – $57.90 | 71 |
| Cholinesterase CPT 82480 | $8.00 | $16.00 | $4.62 – $34.03 | 71 |
| Chrom analysis CPT 88273 | $102.00 | $204.00 | $18.85 – $150.62 | 71 |
| Chromatography CPT 83021 | $21.50 | $43.00 | $10.60 – $78.16 | 71 |
| Chromo high res and frag x - sendout CPT 81243 | $79.00 | $158.00 | $23.96 – $246.73 | 71 |
| Chromosome analys amniotic CPT 88269 | $222.00 | $444.00 | $97.60 – $751.28 | 71 |
| Chromosome analysis 100 CPT 88249 | $397.00 | $794.00 | $101.62 – $749.12 | 71 |
| Chromosome analysis 15-20 cell count CPT 88262 | $169.00 | $338.00 | $73.14 – $542.84 | 71 |
| Chromosome analysis 20-25 CPT 88245 | $203.50 | $407.00 | $87.35 – $749.12 | 71 |
| Chromosome analysis 45 CPT 88263 | $222.00 | $444.00 | $88.19 – $650.13 | 71 |
| Chylomicron screen, bf - sendout CPT 82664 | $34.00 | $68.00 | $20.16 – $266.05 | 71 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $13.12 | $26.25 | $6.18 – $7.50 | 6 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $450.00 | $900.00 | $138.39 – $1,425.49 | 71 |
| Cllr miami j sm HCPCS L0174 | $21.50 | $43.01 | $315.67 – $852.31 | 53 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $65.87 | $131.75 | $26.62 – $32.38 | 6 |
| Clot factor fletcher fact CPT 85292 | $115.00 | $230.00 | $11.11 – $81.91 | 71 |
| Clot factor wght kininogen CPT 85293 | $94.50 | $189.00 | $11.11 – $81.91 | 71 |
| Clot factor xii hageman CPT 85280 | $34.00 | $68.00 | $11.36 – $83.71 | 71 |
| Clot factor xiii fibrin scrn CPT 85291 | $25.00 | $50.00 | $5.22 – $39.44 | 71 |
| Clot factor xiii fibrin stab CPT 85290 | $139.00 | $278.00 | $9.59 – $70.66 | 71 |
| C motor evoked lwr limbs CPT 95929 | $1,439.50 | $2,879.00 | $264.74 – $1,013.78 | 60 |
| C motor evoked uppr limbs CPT 95928 | $1,439.50 | $2,879.00 | $201.47 – $2,333.00 | 60 |
| C motor evoked upr&lwr limbs CPT 95939 | $2,880.00 | $5,760.00 | $111.08 – $2,333.00 | 60 |
| #cmvcul-virus inoculation shell CPT 87254 | $49.50 | $99.00 | $11.47 – $84.65 | 71 |
| Cmv pcr-sendout CPT 87496 | $90.00 | $180.00 | $20.60 – $151.77 | 71 |
| Co2 monitor per day CPT 94681 | $789.00 | $1,578.00 | $30.92 – $1,013.78 | 60 |
| Coagulation time activated teg CPT 85347 | $144.00 | $288.00 | $2.50 – $18.53 | 71 |
| Cold agglutinin screen (arc) CPT 86156 | $45.00 | $90.00 | $3.93 – $34.90 | 71 |
| Cold agglutinin titer CPT 86157 | $100.00 | $200.00 | $4.73 – $34.90 | 71 |
| Collagen based wound filler HCPCS A6010 | $975.00 | $1,950.00 | $21.23 – $21.23 | 1 |
| Collar cerv ascend 172 reg HCPCS L0172 | $42.85 | $85.71 | $161.96 – $437.29 | 53 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $283.50 | $567.00 | $123.15 – $12,040.00 | 63 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $283.50 | $567.00 | $123.15 – $12,040.00 | 63 |
| Collection of venous blood by venipuncture CPT 36415 | $8.50 | $17.00 | $1.26 – $25.22 | 64 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $116.50 | $233.00 | $192.19 – $549.25 | 59 |
| Colposcopy vulva 56820 CPT 56820 | $93.00 | $186.00 | $192.19 – $549.25 | 59 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $157.50 | $315.00 | $8.58 – $462.86 | 75 |
| Compatibility test each unit electronic CPT 86923 | $115.50 | $231.00 | $9.23 – $462.86 | 75 |
| Compatibility test each unit immediate spin technique CPT 86920 | $121.00 | $242.00 | $8.58 – $462.86 | 75 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $762.50 | $1,525.00 | $637.67 – $1,894.40 | 59 |
| Complement antigen each component c3 CPT 86160 | $159.50 | $319.00 | $7.05 – $51.91 | 71 |
| Complex uroflowmetry (electronic) 51741 CPT 51741 | $49.50 | $99.00 | $217.26 – $586.61 | 59 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $1,783.00 | $3,566.00 | $351.04 – $1,279.58 | 55 |
| Concentration infection agents any type CPT 87015 | $28.50 | $57.00 | $3.92 – $28.91 | 71 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $720.00 | $1,440.00 | $382.91 – $1,057.75 | 62 |
| Consultation pathology during surgery CPT 88329 | $124.00 | $248.00 | $4.95 – $160.27 | 72 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $124.00 | $248.00 | $11.38 – $2,188.85 | 72 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $211.00 | $422.00 | $4.95 – $187.35 | 19 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $1,046.00 | $2,092.00 | $10.36 – $462.86 | 75 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $531.50 | $1,063.00 | $14.62 – $141.57 | 72 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $531.50 | $1,063.00 | $4.95 – $366.05 | 72 |
| Consult comp w/report rfrd material CPT 88325 | $531.50 | $1,063.00 | $14.62 – $592.23 | 72 |
| Contrast baths charges CPT 97034 | $112.00 | $224.00 | $14.09 – $38.04 | 56 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $3,583.00 | $7,166.00 | $120.31 – $8,578.16 | 66 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $3,490.00 | $6,980.00 | $114.90 – $15,117.44 | 66 |
| Contrast x-ray of ankle CPT 73615 | $452.00 | $904.00 | $121.89 – $947.81 | 66 |
| Contrast x-ray of brain CPT 70015 | $564.00 | $1,128.00 | $158.08 – $2,129.73 | 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.