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 |
|---|---|---|---|---|
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,564.00 | $5,128.00 | $98.00 – $1,484.49 | 63 |
| Echocardiography doppler color flow mapping CPT 93325 | $788.00 | $1,576.00 | $50.63 – $60.75 | 5 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $1,088.00 | $2,176.00 | $18.79 – $648.23 | 66 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $690.50 | $1,381.00 | $44.90 – $156.27 | 6 |
| Echo exam uterus 76831- CPT 76831 | $705.50 | $1,411.00 | $110.78 – $648.23 | 66 |
| Echo guidance radiotherapy CPT 76965 | $1,319.00 | $2,638.00 | $42.64 – $123.07 | 6 |
| Echo guide for amniocentesis CPT 76946 | $328.00 | $656.00 | $22.53 – $65.90 | 6 |
| Echo guide for artery repair CPT 76936 | $825.00 | $1,650.00 | $217.26 – $1,115.21 | 66 |
| Echo stress CPT 93350 | $1,959.00 | $3,918.00 | $67.08 – $1,484.49 | 66 |
| Echo tee guidance CPT 93355 | $1,929.00 | $3,858.00 | $208.87 – $939.57 | 3 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,059.50 | $4,119.00 | $62.79 – $1,484.49 | 66 |
| Echo transesophageal CPT 93313 | $490.50 | $981.00 | $10.48 – $1,484.49 | 66 |
| Echo transesophageal intraop CPT 93318 | $1,578.00 | $3,156.00 | $98.71 – $1,484.49 | 66 |
| Echo transthoracic CPT 93303 | $1,834.00 | $3,668.00 | $91.81 – $1,484.49 | 66 |
| Echo transthoracic CPT 93304 | $1,834.00 | $3,668.00 | $7.85 – $1,484.49 | 66 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,088.00 | $2,176.00 | $128.56 – $648.23 | 66 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $994.50 | $1,989.00 | $26.88 – $586.61 | 60 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $660.00 | $1,320.00 | $4.05 – $1,013.78 | 60 |
| Eeg during surgery CPT 95955 | $628.50 | $1,257.00 | $287.09 – $287.09 | 1 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $660.00 | $1,320.00 | $62.79 – $586.61 | 60 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $1,680.00 | $3,360.00 | $217.26 – $1,045.86 | 60 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $660.00 | $1,320.00 | $5.23 – $586.61 | 60 |
| Eeg recording awake and asleep CPT 95819 | $660.00 | $1,320.00 | $23.93 – $586.61 | 60 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $335.00 | $670.00 | $217.26 – $586.61 | 60 |
| Eeg without vid ea 12-26hr cont CPT 95710 | $643.00 | $1,286.00 | $320.50 – $1,013.78 | 60 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | $643.00 | $1,286.00 | $320.50 – $1,013.78 | 60 |
| E equine encephalitis igg CPT 86652 | $34.00 | $68.00 | $7.74 – $57.03 | 71 |
| Egfr gene com variants CPT 81235 | $345.00 | $690.00 | $138.60 – $1,404.15 | 71 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $33.50 | $67.00 | $14.74 – $151.77 | 71 |
| EKG (Electrocardiogram) CPT 93000 | $334.50 | $669.00 | $16.35 – $41.26 | 24 |
| Electroconvulsive therapy 90870 CPT 90870 | $1,427.00 | $2,854.00 | $506.91 – $2,333.00 | 59 |
| Electrode stimulation brain CPT 95961 | $751.50 | $1,503.00 | $71.96 – $2,333.00 | 60 |
| Electrolyte panel CPT 80051 | $247.00 | $494.00 | $4.12 – $30.35 | 71 |
| Electron microscopy diagnostic CPT 88348 | $2,110.50 | $4,221.00 | $83.93 – $2,188.85 | 75 |
| Electrophysiology evaluation CPT 93619 | $4,419.00 | $8,838.00 | $3,884.57 – $21,189.91 | 63 |
| Electrophysiology evaluation CPT 93620 | $6,805.50 | $13,611.00 | $7,249.37 – $21,189.91 | 63 |
| Electrophysiology evaluation CPT 93621 | $6,540.00 | $13,080.00 | $123.68 – $13,792.00 | 6 |
| Electrophysiology evaluation CPT 93622 | $4,861.00 | $9,722.00 | $216.45 – $13,792.00 | 6 |
| Electrophysiology evaluation CPT 93641 | $3,076.00 | $6,152.00 | $12,413.00 – $13,792.00 | 6 |
| Electrophysiology evaluation CPT 93642 | $4,065.50 | $8,131.00 | $294.94 – $13,792.00 | 63 |
| Electrophysiology evaluation CPT 93644 | $4,065.50 | $8,131.00 | $13,487.28 – $13,487.28 | 1 |
| Electrophys map 3d add-on CPT 93613 | $9,071.00 | $18,142.00 | $3,884.57 – $3,884.57 | 1 |
| Embolization s&i CPT 75894 | $2,447.00 | $4,894.00 | $125.47 – $4,263.85 | 6 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $258.50 | $517.00 | $42.58 – $361.46 | 60 |
| Emg 3 ext w-w/o paraspinal area 95863 CPT 95863 | $308.50 | $617.00 | $50.42 – $349.58 | 60 |
| Emg cranial nerve bilateral CPT 95868 | $258.50 | $517.00 | $38.29 – $586.61 | 60 |
| Emg needle test 1-extremity CPT 95860 | $236.00 | $472.00 | $91.31 – $361.46 | 60 |
| Emg needle test 4-extremities CPT 95864 | $458.00 | $916.00 | $91.31 – $349.58 | 60 |
| Emg thor paraspinal without t1/t2 CPT 95869 | $239.00 | $478.00 | $49.00 – $586.61 | 60 |
| Encephalitis, california igg/igm CPT 86651 | $33.50 | $67.00 | $7.74 – $57.03 | 71 |
| Encephalitis, st louis igg/igm CPT 86653 | $75.00 | $150.00 | $7.74 – $57.03 | 71 |
| Encephalitis, western equine igg/igm CPT 86654 | $34.00 | $68.00 | $7.74 – $57.03 | 71 |
| Endo cath bile duct s&i CPT 74328 | $895.00 | $1,790.00 | $61.52 – $246.44 | 6 |
| Endo cath panc duct s&i CPT 74329 | $895.00 | $1,790.00 | $61.52 – $195.54 | 6 |
| Endoluminl ivus oct c 1st CPT 92978 | $2,988.50 | $5,977.00 | $47.81 – $47.81 | 1 |
| Endoluminl ivus oct c ea CPT 92979 | $755.50 | $1,511.00 | $14.98 – $14.98 | 1 |
| Endoscopy swallow (fees) vid CPT 92612 | $433.00 | $866.00 | $28.07 – $146.34 | 56 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $73.37 | $146.75 | $2.48 – $8.75 | 6 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | $14.50 | $29.00 | $7.04 – $51.84 | 71 |
| Enzyme cell activity ra CPT 82658 | $112.50 | $225.00 | $10.60 – $190.49 | 71 |
| Enzyme histochemistry CPT 88319 | $379.50 | $759.00 | $4.95 – $2,188.85 | 75 |
| Ep & ablate supravent arrhyt CPT 93653 | $20,958.50 | $41,917.00 | $12,413.00 – $71,010.61 | 63 |
| Ep & ablate ventric tachy CPT 93654 | $26,706.50 | $53,413.00 | $12,413.00 – $71,010.61 | 63 |
| Ep induct arrhy by elect pacing CPT 93618 | $4,034.00 | $8,068.00 | $109.65 – $13,792.00 | 63 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $31.75 | $63.50 | $46.36 – $57.84 | 6 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $182.37 | $364.75 | $201.96 – $566.43 | 6 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $30.62 | $61.25 | $17.14 – $60.71 | 6 |
| Epstein barr early antigen antibody CPT 86663 | $9.00 | $18.00 | $7.70 – $56.74 | 71 |
| Epstein barr nuclear antigen antibody CPT 86664 | $10.50 | $21.00 | $8.98 – $66.12 | 71 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $77.00 | $154.00 | $10.65 – $78.44 | 71 |
| Ercp biliary & pancreas CPT 74330 | $895.00 | $1,790.00 | $78.57 – $357.76 | 6 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $84.00 | $168.00 | $28.31 – $161.18 | 6 |
| ER Visit (level 1, minor) CPT 99281 | $262.00 | $524.00 | $84.12 – $229.09 | 59 |
| ER Visit (level 2) CPT 99282 | $463.00 | $926.00 | $151.29 – $417.14 | 59 |
| ER Visit (level 3) CPT 99283 | $978.00 | $1,956.00 | $264.53 – $741.62 | 59 |
| ER Visit (level 4) CPT 99284 | $1,291.00 | $2,582.00 | $406.81 – $1,133.61 | 59 |
| ER Visit (level 5, high severity) CPT 99285 | $1,774.50 | $3,549.00 | $585.73 – $1,617.92 | 59 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $367.50 | $735.00 | $31.15 – $177.82 | 6 |
| Esophageal dilat s&i CPT 74360 | $1,015.00 | $2,030.00 | $48.72 – $391.94 | 6 |
| Esophagus motility study CPT 91010 | $1,043.00 | $2,086.00 | $93.71 – $6,261.00 | 63 |
| Esoph balloon distension tst CPT 91040 | $773.50 | $1,547.00 | $94.19 – $1,013.78 | 60 |
| Esoph imped funct test > 1hr CPT 91038 | $674.00 | $1,348.00 | $375.48 – $1,013.78 | 60 |
| Established Patient Office Visit (level 1) CPT 99211 | $184.50 | $369.00 | $8.22 – $214.34 | 60 |
| Established Patient Office Visit (level 2) CPT 99212 | $195.00 | $390.00 | $33.14 – $214.34 | 60 |
| Established Patient Office Visit (level 3) CPT 99213 | $211.00 | $422.00 | $61.39 – $214.34 | 60 |
| Established Patient Office Visit (level 4) CPT 99214 | $321.00 | $642.00 | $26.40 – $227.75 | 60 |
| Established Patient Office Visit (level 5) CPT 99215 | $367.50 | $735.00 | $48.76 – $338.39 | 60 |
| Estradiol total CPT 82670 | $25.00 | $50.00 | $16.40 – $120.84 | 71 |
| Ethylene glycol -sendout CPT 82693 | $24.50 | $49.00 | $8.74 – $64.46 | 71 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $433.00 | $866.00 | $46.15 – $332.45 | 56 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $325.00 | $650.00 | $38.07 – $424.45 | 71 |
| Evaluation heart device CPT 93640 | $887.50 | $1,775.00 | $12,413.00 – $13,792.00 | 6 |
| Evaluation of speech fluency 92521 CPT 92521 | $433.00 | $866.00 | $7.13 – $362.69 | 56 |
| Evaluation psychiatric diagnostic CPT 90791 | $197.00 | $394.00 | not published | 0 |
| Event monitor CPT 93270 | $43.00 | $86.00 | $6.10 – $101.39 | 66 |
| Evoked oa emissions ltd CPT 92587 | $193.00 | $386.00 | $82.54 – $586.61 | 60 |
| Evoked potentials upper limbs CPT 95925 | $1,439.50 | $2,879.00 | $33.30 – $586.61 | 60 |
| Evoked potential visual not glaucoma CPT 95930 | $942.50 | $1,885.00 | $22.12 – $586.61 | 60 |
| Ewho w/joint(s) cf HCPCS L3764 | $107.50 | $215.00 | $855.35 – $2,309.45 | 53 |
| Exam of vagina w/scope 57420 CPT 57420 | $144.00 | $288.00 | $290.61 – $827.88 | 59 |
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.