BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA
5330 Overpass Road, Suite 110, TX · Baylor Scott & White Health · · NPI 1144781501
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 |
|---|---|---|---|---|
| Listeria monocytogenes CPT 86723 | $96.88 | $161.46 | $11.08 – $121.09 | 18 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | $699.00 | $1,165.00 | $139.80 – $873.75 | 14 |
| Lithium therapeutic drug level CPT 80178 | $95.88 | $159.80 | $5.55 – $119.85 | 18 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $12,380.88 | $20,634.80 | $2,476.18 – $15,476.10 | 14 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $660.00 | $1,100.00 | $36.00 – $751.09 | 18 |
| Liver elastography 91200 CPT 91200 | $193.01 | $321.68 | $31.93 – $386.96 | 18 |
| Liver Function Test CPT 80076 | $161.95 | $269.91 | $6.86 – $202.43 | 18 |
| Liver image (3d) with flow CPT 78206 | $1,505.81 | $2,509.69 | $282.83 – $1,767.71 | 14 |
| Liver imaging CPT 78201 | $1,328.66 | $2,214.44 | $175.43 – $1,660.83 | 18 |
| Liver imaging (3d) CPT 78205 | $1,216.54 | $2,027.56 | $243.31 – $1,520.67 | 14 |
| Liver imag w/vasclr flow CPT 78202 | $1,498.22 | $2,497.04 | $194.80 – $1,872.78 | 18 |
| Liver/spleen imag static only CPT 78215 | $1,123.50 | $1,872.50 | $180.10 – $1,404.38 | 18 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,246.79 | $2,077.98 | $135.99 – $1,558.48 | 18 |
| Lmtd oph exam general anes CPT 92019 | $2,163.60 | $3,606.00 | $113.00 – $5,788.85 | 15 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $4,529.22 | $7,548.70 | $71.00 – $8,018.48 | 18 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $161.06 | $268.44 | $1.27 – $85.87 | 15 |
| Loop ostmy bridg ster HCPCS A4421 | $46.32 | $77.20 | $9.26 – $57.90 | 14 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $12.92 | $21.53 | $0.14 – $1.83 | 15 |
| Loudness balance test CPT 92562 | $169.90 | $283.17 | $33.98 – $777.56 | 18 |
| Low back disk surgery CPT 63030 | $11,779.73 | $19,632.89 | $71.00 – $17,722.46 | 18 |
| Low cost skin substitute app HCPCS C5271 | $860.50 | $1,434.16 | $71.00 – $2,975.00 | 15 |
| Low cost skin substitute app HCPCS C5273 | $3,422.28 | $5,703.80 | $71.00 – $8,649.00 | 15 |
| Low cost skin substitute app HCPCS C5275 | $1,339.33 | $2,232.21 | $71.00 – $2,975.00 | 15 |
| Low cost skin substitute app HCPCS C5277 | $1,067.65 | $1,779.41 | $71.00 – $2,975.00 | 15 |
| Low cost skin substitute app HCPCS C5272 | $22.30 | $37.16 | $4.46 – $71.00 | 14 |
| Low cost skin substitute app HCPCS C5274 | $39.97 | $66.62 | $7.99 – $71.00 | 14 |
| Low cost skin substitute app HCPCS C5276 | $20.99 | $34.98 | $4.20 – $71.00 | 14 |
| Low cost skin substitute app HCPCS C5278 | $53.17 | $88.61 | $10.63 – $71.00 | 14 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $240.33 | $400.55 | $99.77 – $1,841.00 | 18 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,677.35 | $2,795.59 | $167.39 – $2,096.69 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,381.40 | $3,969.00 | $173.75 – $2,976.75 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,655.02 | $2,758.37 | $99.77 – $2,068.78 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,167.94 | $5,279.90 | $329.13 – $3,959.93 | 18 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,446.79 | $4,077.99 | $279.00 – $3,058.49 | 18 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,065.69 | $3,442.81 | $197.14 – $2,582.11 | 18 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $474.69 | $791.15 | $40.10 – $593.36 | 18 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $626.63 | $1,044.39 | $52.13 – $783.29 | 18 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $626.63 | $1,044.39 | $61.48 – $783.29 | 18 |
| Lower jaw bone graft CPT 21215 | $5,095.16 | $8,491.94 | $71.00 – $14,507.25 | 18 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $342.47 | $570.78 | $31.74 – $428.08 | 18 |
| Lsh uterus 250 g or less CPT 58541 | $9,184.73 | $15,307.88 | $71.00 – $25,500.18 | 18 |
| Lsh uterus above 250 g CPT 58543 | $11,886.69 | $19,811.15 | $71.00 – $25,500.18 | 18 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $10,984.04 | $18,306.73 | $71.00 – $25,500.18 | 18 |
| Lsh w/t/o uterus above 250 g CPT 58544 | $12,000.38 | $20,000.63 | $71.00 – $25,500.18 | 18 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $152.40 | $254.00 | $30.48 – $203.20 | 14 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $785.09 | $1,308.48 | $37.19 – $247.95 | 14 |
| Lso s/c shell/panel custom HCPCS L0640 | $984.60 | $1,641.00 | $196.92 – $1,312.80 | 14 |
| Lso s/c shell/panel prefab HCPCS L0639 | $792.33 | $1,320.55 | $158.47 – $1,056.44 | 14 |
| L/s ratio fetal lung CPT 83661 | $220.97 | $368.29 | $12.00 – $276.22 | 18 |
| Lumbar diskogram s&i CPT 72295 | $5,618.23 | $9,363.71 | $111.60 – $7,022.78 | 18 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $10,629.07 | $17,715.11 | $71.00 – $46,166.33 | 18 |
| Lumizyme injection HCPCS J0221 | $1,735.97 | $2,893.29 | $190.05 – $1,891.44 | 18 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $786.77 | $1,311.28 | $142.57 – $983.46 | 18 |
| Lung function test (mbc/mvv) CPT 94200 | $192.29 | $320.49 | $38.46 – $240.37 | 18 |
| Lung Function Test (Spirometry) CPT 94010 | $600.80 | $1,001.33 | $120.16 – $751.00 | 18 |
| Lung perfusion imaging CPT 78580 | $1,100.39 | $1,833.98 | $213.51 – $1,375.48 | 18 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $21,365.20 | $35,608.66 | $39.34 – $8,916.19 | 18 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,455.60 | $2,426.00 | $145.53 – $970.20 | 14 |
| Lymphatics/lymph node imaging CPT 78195 | $1,526.38 | $2,543.96 | $317.76 – $1,907.97 | 18 |
| Lymphocyte culture mixed CPT 86821 | $579.32 | $965.54 | $12.00 – $724.15 | 18 |
| Lymphocyte transformation mitogen CPT 86353 | $463.13 | $771.88 | $12.00 – $414.75 | 18 |
| Lymphocytotoxicity assay CPT 86805 | $399.82 | $666.36 | $12.00 – $499.77 | 18 |
| Lymph vessel x-ray arm/leg CPT 75801 | $984.85 | $1,641.41 | $71.00 – $1,556.23 | 18 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,288.81 | $2,148.02 | $299.60 – $3,967.42 | 18 |
| Lymph vessel x-ray trunk CPT 75805 | $2,494.49 | $4,157.49 | $71.00 – $7,896.23 | 18 |
| Lymph vessel x-ray trunk CPT 75807 | $2,643.68 | $4,406.13 | $146.54 – $7,896.23 | 18 |
| Lysis intranasal synechia 30560 CPT 30560 | $833.97 | $1,389.95 | $71.00 – $3,421.00 | 18 |
| Lysis of labial adhesions CPT 56441 | $2,847.40 | $4,745.66 | $71.00 – $7,744.80 | 18 |
| Lysis penil circumic lesion CPT 54162 | $4,173.43 | $6,955.71 | $71.00 – $5,216.78 | 18 |
| Macro exam dissect molec study ea CPT 88387 | $41.98 | $69.97 | $8.40 – $52.48 | 14 |
| Macroscopic exam arthropod CPT 87168 | $45.36 | $75.60 | $3.59 – $56.70 | 18 |
| Macroscopic exam parasite CPT 87169 | $52.64 | $87.74 | $3.62 – $65.81 | 18 |
| Magnesium CPT 83735 | $116.29 | $193.82 | $5.63 – $19.41 | 18 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $58.32 | $97.20 | $0.47 – $5.35 | 15 |
| Magnetic image bone marrow CPT 77084 | $1,592.64 | $2,654.40 | $227.71 – $2,149.00 | 18 |
| Makena, 10 mg HCPCS J1726 | $1,445.40 | $2,409.00 | $18.96 – $1,806.75 | 15 |
| Malaria antibody CPT 86750 | $110.87 | $184.79 | $11.08 – $138.59 | 18 |
| Male sling procedure CPT 53440 | $8,465.18 | $14,108.64 | $71.00 – $31,800.16 | 18 |
| Mammosite ced HCPCS C1728 | $6,369.00 | $10,615.00 | $0.00 – $0.01 | 14 |
| Manipulate finger w/anesth CPT 26340 | $1,417.44 | $2,362.40 | $71.00 – $3,981.46 | 18 |
| Manipulate wrist w/anesthes CPT 25259 | $1,998.19 | $3,330.31 | $71.00 – $4,463.00 | 18 |
| Manipulation of hip joint CPT 27275 | $2,994.00 | $4,990.00 | $71.00 – $3,981.46 | 18 |
| Manipulation of spine CPT 22505 | $2,852.63 | $4,754.38 | $71.00 – $3,981.46 | 18 |
| Manipulat palm cord post inj CPT 26341 | $492.74 | $821.23 | $66.72 – $2,975.00 | 18 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $17.82 | $29.70 | $3.56 – $22.27 | 14 |
| Manual diff wbc count b-coat CPT 85009 | $44.14 | $73.56 | $4.26 – $55.17 | 18 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $741.11 | $1,235.18 | $148.22 – $926.38 | 14 |
| Mapping io sentinel lymph node CPT 38900 | $505.67 | $842.78 | $71.00 – $632.09 | 14 |
| Map tachycard site(s) CPT 93609 | $1,726.09 | $2,876.81 | $345.22 – $2,157.61 | 14 |
| Marker biop eviva buckle ss HCPCS A4648 | $6,369.00 | $10,615.00 | $7.97 – $53.11 | 14 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,753.29 | $2,922.15 | $350.66 – $2,337.72 | 17 |
| Mask full face lg af531 HCPCS A7030 | $116.62 | $194.37 | $23.32 – $145.78 | 14 |
| Mastectomy form HCPCS L8020 | $224.40 | $374.00 | $4.85 – $32.34 | 14 |
| Mastectomy partial CPT 19301 | $5,127.80 | $8,546.34 | $71.00 – $9,442.65 | 18 |
| Mast mod rad CPT 19307 | $8,079.05 | $13,465.08 | $71.00 – $16,154.42 | 18 |
| Mastoidectomy CPT 69501 | $6,260.10 | $10,433.50 | $71.00 – $14,507.25 | 18 |
| Mastoidectomy complete 69502 CPT 69502 | $6,969.40 | $11,615.67 | $71.00 – $14,507.25 | 18 |
| Mastoids complete CPT 70130 | $235.84 | $393.06 | $62.15 – $294.80 | 18 |
| Mastoid surgery revision CPT 69603 | $7,337.51 | $12,229.18 | $71.00 – $14,507.25 | 18 |
| Mastopexy CPT 19316 | $5,774.26 | $9,623.76 | $71.00 – $16,154.42 | 18 |
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.