BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE
2600 E. Pflugerville Parkway, Suite 100, TX · Baylor Scott & White Health · · NPI 1346729159
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 |
|---|---|---|---|---|
| Derm autograft face/nck/hf/g CPT 15135 | $2,846.00 | $4,743.34 | $71.00 – $8,887.48 | 24 |
| Derm autograft trnk/arm/leg CPT 15130 | $2,984.90 | $4,974.83 | $71.00 – $4,517.58 | 24 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $8,271.10 | $13,785.16 | $1,516.37 – $12,406.64 | 17 |
| Design custom breast implant CPT 19396 | $4,007.21 | $6,678.68 | $71.00 – $9,442.65 | 24 |
| Design mlc device for imrt CPT 77338 | $1,677.86 | $2,796.44 | $307.61 – $2,516.80 | 24 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $1,071.36 | $1,785.60 | $3.75 – $55.51 | 19 |
| Desoxycorticosterone CPT 82633 | $162.50 | $270.83 | $12.00 – $243.75 | 24 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $8,622.16 | $14,370.27 | $1,580.73 – $12,933.24 | 17 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | $307.26 | $512.10 | $56.33 – $495.95 | 24 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | $564.46 | $940.77 | $71.00 – $987.79 | 24 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | $548.06 | $913.43 | $71.00 – $987.79 | 24 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | $332.93 | $554.88 | $71.00 – $499.39 | 24 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | $336.09 | $560.15 | $71.00 – $504.13 | 24 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | $349.15 | $581.92 | $64.01 – $523.73 | 24 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | $319.99 | $533.31 | $58.66 – $495.95 | 24 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | $349.15 | $581.92 | $64.01 – $523.73 | 24 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | $366.07 | $610.11 | $67.11 – $549.10 | 24 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | $401.53 | $669.22 | $71.00 – $602.30 | 24 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $2,579.28 | $4,298.80 | $71.00 – $4,783.04 | 24 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $549.49 | $915.82 | $71.00 – $824.24 | 18 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | $900.53 | $1,500.88 | $130.95 – $5,645.00 | 23 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $203.04 | $338.40 | $37.22 – $495.95 | 24 |
| Destroy vulva lesion extensive 56515 CPT 56515 | $3,666.68 | $6,111.13 | $71.00 – $5,500.02 | 24 |
| Destroy vulva lesion simple 56501 CPT 56501 | $3,785.00 | $6,308.34 | $71.00 – $5,677.51 | 24 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $349.15 | $581.92 | $64.01 – $523.73 | 24 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | $1,066.45 | $1,777.41 | $71.00 – $2,975.00 | 24 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $822.58 | $1,370.97 | $71.00 – $1,233.87 | 24 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | $2,458.77 | $4,097.95 | $71.00 – $4,517.58 | 24 |
| Destruction 2-14 lesions 17003 CPT 17003 | $84.04 | $140.06 | $15.41 – $126.05 | 18 |
| Destruction anal lesion(s) CPT 46910 | $2,772.60 | $4,621.00 | $160.02 – $5,388.00 | 23 |
| Destruction anal lesion(s) CPT 46924 | $3,363.79 | $5,606.32 | $939.93 – $6,955.62 | 23 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $535.46 | $892.44 | $137.87 – $2,975.00 | 23 |
| Destruction benign lesions < 14 lesions CPT 17110 | $261.23 | $435.38 | $47.89 – $495.95 | 24 |
| Destruction by injection tx of nerve 64630 CPT 64630 | $1,626.35 | $2,710.58 | $71.00 – $3,421.00 | 24 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $1,429.57 | $2,382.61 | $71.00 – $2,144.35 | 18 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,812.90 | $4,688.16 | $71.00 – $5,645.00 | 24 |
| Destruction ciliary body CPT 66720 | $3,228.83 | $5,381.38 | $71.00 – $5,788.85 | 24 |
| Destruction ciliary body CPT 66740 | $2,188.86 | $3,648.10 | $71.00 – $5,788.85 | 24 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | $305.03 | $508.38 | $74.34 – $495.95 | 23 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | $2,770.80 | $4,618.00 | $939.93 – $6,955.62 | 23 |
| Destruction les conjunctiva CPT 68135 | $1,901.92 | $3,169.87 | $70.60 – $5,788.85 | 24 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | $639.42 | $1,065.70 | $71.00 – $987.79 | 24 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | $419.85 | $699.75 | $71.00 – $2,975.00 | 24 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | $495.72 | $826.20 | $71.00 – $987.79 | 24 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | $615.05 | $1,025.09 | $71.00 – $2,975.00 | 24 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | $326.34 | $543.90 | $59.83 – $987.79 | 24 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | $3,556.35 | $5,927.25 | $71.00 – $5,334.52 | 24 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $609.45 | $1,015.75 | $97.18 – $987.79 | 20 |
| Destruction rectal tumor 45190 CPT 45190 | $2,998.42 | $4,997.36 | $939.93 – $8,649.00 | 23 |
| Destruction vag lesions complex 57065 CPT 57065 | $3,237.28 | $5,395.47 | $71.00 – $7,744.80 | 24 |
| Destruction vag lesions simple 57061 CPT 57061 | $3,149.41 | $5,249.02 | $71.00 – $7,744.80 | 24 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | $2,236.85 | $3,728.09 | $71.00 – $5,388.00 | 24 |
| Detect agent nos dna dir CPT 87797 | $186.00 | $310.00 | $12.00 – $179.45 | 24 |
| Detect agnt mult dna direc CPT 87800 | $175.12 | $291.87 | $12.00 – $262.68 | 24 |
| Determination venous press CPT 93770 | $167.73 | $279.55 | $25.04 – $251.59 | 18 |
| Determine refractive state CPT 92015 | $5.17 | $8.62 | $0.95 – $59.86 | 18 |
| Devel tst phys/qhp 1st hr CPT 96112 | $79.98 | $133.30 | $14.66 – $417.82 | 24 |
| Device ablt adv novasure HCPCS C1886 | $9,177.30 | $15,295.50 | $177.43 – $1,451.66 | 18 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $5,098.50 | $8,497.50 | $39.57 – $7,647.75 | 18 |
| Device intraute mirena HCPCS J7298 | $2,082.22 | $3,470.37 | $381.74 – $3,123.33 | 18 |
| Device tiss remov myosure reach HCPCS C1782 | $2,541.00 | $4,235.00 | $124.51 – $1,018.71 | 18 |
| Dev interrog remote 1/2/mlt CPT 93295 | $272.69 | $454.49 | $49.99 – $917.00 | 18 |
| Devlopment test interpt&rep HCPCS G0451 | $75.54 | $125.90 | $13.85 – $237.19 | 24 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $203.19 | $338.65 | $37.25 – $304.79 | 18 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $235.55 | $392.58 | $31.74 – $353.32 | 24 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $85.86 | $143.10 | $0.03 – $0.31 | 19 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $27.00 | $45.00 | $0.12 – $10.53 | 19 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,268.38 | $2,113.97 | $47.25 – $951.26 | 24 |
| Dextran 40 infusion HCPCS J7100 | $151.20 | $252.00 | $27.72 – $226.80 | 18 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $28.80 | $48.00 | $0.83 – $6.75 | 19 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $28.80 | $48.00 | $4.62 – $37.80 | 18 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $31.32 | $52.20 | $1.55 – $12.69 | 19 |
| Dextrose 5 % IV bolus HCPCS J7070 | $45.14 | $75.24 | $2.74 – $22.41 | 19 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $150.54 | $250.90 | $12.00 – $225.81 | 24 |
| Diabetes (HbA1c) Test CPT 83036 | $123.97 | $206.61 | $8.16 – $138.13 | 24 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | $35.43 | $59.05 | $6.50 – $71.08 | 20 |
| Diab manage trn ind/group HCPCS G0109 | $69.32 | $115.53 | $12.71 – $103.98 | 18 |
| Diag laparo separate proc 49320 CPT 49320 | $5,649.52 | $9,415.87 | $71.00 – $14,293.73 | 24 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $134.55 | $224.25 | $24.67 – $316.45 | 24 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $117.94 | $196.56 | $21.62 – $316.04 | 18 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $70.70 | $117.84 | $12.96 – $316.04 | 18 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $231.71 | $386.19 | $56.20 – $490.70 | 24 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $485.26 | $808.76 | $68.14 – $727.88 | 24 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $340.20 | $567.00 | $62.37 – $510.30 | 18 |
| Diagnostic Mammogram (one breast) CPT 77065 | $272.16 | $453.60 | $49.90 – $408.24 | 18 |
| Diagnostic radio unlisted proc CPT 76499 | $6,446.54 | $10,744.23 | $83.05 – $3,495.21 | 24 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $2,234.87 | $3,724.78 | $71.00 – $3,352.30 | 18 |
| Dialysis one evaluation CPT 90945 | $1,775.84 | $2,959.74 | $325.57 – $2,663.77 | 24 |
| Dialysis repeated eval CPT 90947 | $1,523.40 | $2,539.00 | $279.29 – $2,285.10 | 18 |
| Dialysis training complete CPT 90989 | $581.47 | $969.12 | $106.60 – $872.21 | 18 |
| Dialysis training incompl CPT 90993 | $290.74 | $484.56 | $53.30 – $436.10 | 18 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $149.04 | $248.40 | $0.08 – $174.96 | 19 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $135.30 | $225.50 | $2.38 – $19.48 | 19 |
| Dicyclomine injection HCPCS J0500 | $229.36 | $382.26 | $0.13 – $10.30 | 19 |
| Diffusing capacity CPT 94729 | $478.63 | $797.72 | $87.75 – $717.95 | 18 |
| Digital analysis of eeg CPT 95957 | $665.39 | $1,108.98 | $121.99 – $998.08 | 18 |
| Digit nerve surgery add-on CPT 64778 | $1,832.59 | $3,054.32 | $71.00 – $2,748.89 | 18 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $371.87 | $619.79 | $1.90 – $15.56 | 19 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $8,613.00 | $14,355.00 | $1,579.05 – $12,919.50 | 24 |
| Digoxin total therapeutic drug level CPT 80162 | $102.07 | $170.12 | $11.16 – $153.11 | 24 |
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.