BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER
1901 SW HK Dodgen Loop, Temple, TX · Baylor Scott & White Health · · NPI 1477516466
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 |
|---|---|---|---|---|
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $474.05 | $790.08 | $71.00 – $711.07 | 29 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $764.75 | $1,274.58 | $71.00 – $1,147.12 | 29 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $567.08 | $945.13 | $71.00 – $850.62 | 29 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,320.57 | $2,200.95 | $71.00 – $3,981.46 | 29 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $638.99 | $1,064.98 | $71.00 – $958.48 | 29 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,379.01 | $2,298.35 | $71.00 – $3,981.46 | 29 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $387.39 | $645.65 | $71.00 – $2,975.00 | 29 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $657.52 | $1,095.87 | $71.00 – $986.28 | 29 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $650.51 | $1,084.18 | $71.00 – $975.76 | 29 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $593.27 | $988.79 | $71.00 – $2,975.00 | 29 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $1,978.91 | $3,298.18 | $71.00 – $2,968.36 | 29 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $777.86 | $1,296.44 | $71.00 – $4,463.00 | 29 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $439.41 | $732.35 | $71.00 – $659.12 | 29 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $399.04 | $665.07 | $71.00 – $598.56 | 29 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $657.22 | $1,095.37 | $71.00 – $985.83 | 29 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $2,248.36 | $3,747.27 | $71.00 – $8,018.48 | 29 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $522.78 | $871.30 | $71.00 – $784.17 | 29 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $418.20 | $697.00 | $71.00 – $627.30 | 29 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $3,474.95 | $5,791.59 | $71.00 – $7,975.81 | 29 |
| Clsd tx nose fx without manip 21310 CPT 21310 | $323.95 | $539.92 | $71.00 – $485.93 | 22 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $1,947.75 | $3,246.25 | $71.00 – $3,981.46 | 29 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $748.39 | $1,247.32 | $71.00 – $1,122.59 | 29 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $612.52 | $1,020.86 | $71.00 – $918.77 | 29 |
| Clsd tx pelvic ring fx CPT 27197 | $479.44 | $799.06 | $71.00 – $719.15 | 29 |
| Clsd tx pelvic ring fx CPT 27198 | $2,216.99 | $3,694.98 | $71.00 – $3,325.48 | 29 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,870.01 | $4,783.35 | $71.00 – $4,305.02 | 29 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $550.27 | $917.11 | $71.00 – $825.40 | 29 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $517.10 | $861.83 | $71.00 – $775.65 | 29 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,868.38 | $3,113.96 | $71.00 – $3,981.46 | 29 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $629.56 | $1,049.26 | $71.00 – $944.33 | 29 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $2,110.45 | $3,517.42 | $71.00 – $3,981.46 | 29 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $742.58 | $1,237.63 | $71.00 – $3,981.46 | 29 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $3,316.31 | $5,527.19 | $71.00 – $4,974.47 | 29 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $2,086.57 | $3,477.62 | $71.00 – $8,018.48 | 29 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $445.15 | $741.92 | $71.00 – $667.73 | 29 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $662.02 | $1,103.37 | $59.25 – $993.03 | 29 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $735.14 | $1,225.24 | $71.00 – $2,975.00 | 29 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,602.79 | $2,671.32 | $71.00 – $3,981.46 | 29 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $443.43 | $739.05 | $71.00 – $665.14 | 29 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $648.34 | $1,080.56 | $71.00 – $2,975.00 | 29 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $575.05 | $958.42 | $71.00 – $862.58 | 29 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $673.55 | $1,122.58 | $71.00 – $1,010.32 | 29 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $496.61 | $827.68 | $71.00 – $3,421.00 | 29 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $636.49 | $1,060.81 | $71.00 – $954.73 | 29 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $568.81 | $948.01 | $71.00 – $2,975.00 | 29 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $2,635.14 | $4,391.90 | $71.00 – $3,952.71 | 29 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $1,501.09 | $2,501.82 | $71.00 – $3,981.46 | 29 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $2,072.29 | $3,453.82 | $71.00 – $3,981.46 | 29 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $735.14 | $1,225.24 | $71.00 – $2,975.00 | 29 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,877.71 | $3,129.52 | $71.00 – $3,981.46 | 29 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $581.99 | $969.99 | $71.00 – $2,975.00 | 29 |
| Cltx lunate dislc w/mnpj CPT 25690 | $3,367.63 | $5,612.71 | $71.00 – $5,051.44 | 29 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $5,741.68 | $9,569.47 | $71.00 – $14,507.25 | 29 |
| Cltx mndblr fx w/mnpj CPT 21451 | $2,963.90 | $4,939.83 | $71.00 – $4,445.85 | 29 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $4,419.42 | $7,365.70 | $71.00 – $7,975.81 | 29 |
| Cltx palatal/max fx wire fix CPT 21421 | $4,199.49 | $6,999.15 | $71.00 – $7,975.81 | 29 |
| Cltx post ankle fx CPT 27767 | $339.17 | $565.29 | $71.00 – $2,975.00 | 29 |
| Cltx post ankle fx w/mnpj CPT 27768 | $661.84 | $1,103.06 | $71.00 – $3,981.46 | 29 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,271.75 | $2,119.58 | $71.00 – $3,981.46 | 29 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $804.79 | $1,341.32 | $71.00 – $1,207.19 | 29 |
| Cltx thigh fx CPT 27267 | $1,996.56 | $3,327.60 | $71.00 – $8,018.48 | 29 |
| Cltx thigh fx w/mnpj CPT 27268 | $989.98 | $1,649.96 | $247.49 – $2,414.90 | 28 |
| Cltx tmprmand dislc comp CPT 21485 | $4,040.04 | $6,733.40 | $71.00 – $6,060.06 | 29 |
| Cmbn ant pst colprhy CPT 57260 | $5,194.98 | $8,658.30 | $71.00 – $12,321.66 | 29 |
| C motor evoked lwr limbs CPT 95929 | $648.00 | $1,080.00 | $162.00 – $1,327.77 | 29 |
| C motor evoked uppr limbs CPT 95928 | $677.30 | $1,128.84 | $169.33 – $2,590.07 | 29 |
| C motor evoked upr&lwr limbs CPT 95939 | $922.79 | $1,537.99 | $230.70 – $2,590.07 | 29 |
| Cmptr ophth dx img ant segmt CPT 92132 | $144.13 | $240.21 | $36.03 – $216.19 | 29 |
| Cmptr ophth img optic nerve CPT 92133 | $166.21 | $277.02 | $41.55 – $249.32 | 29 |
| #cms hgb-carboxyhemoglobin CPT 82376 | $67.80 | $113.00 | $11.82 – $101.70 | 29 |
| #cms hgb-sulfhemoglobin CPT 83060 | $75.58 | $125.96 | $7.39 – $104.55 | 29 |
| #cmvcul-virus inoculation shell CPT 87254 | $124.00 | $206.67 | $12.00 – $186.00 | 29 |
| Cmv pcr-sendout CPT 87496 | $568.11 | $946.85 | $12.00 – $159.75 | 29 |
| Cnbp gene detc abnor allele CPT 81187 | $7,487.95 | $12,479.92 | $36.00 – $2,823.75 | 29 |
| Co2 monitor per day CPT 94681 | $450.60 | $751.00 | $112.65 – $777.56 | 29 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $26.45 | $44.08 | $2.51 – $39.67 | 29 |
| Coagulation time activated teg CPT 85347 | $84.58 | $140.97 | $3.60 – $126.87 | 29 |
| Coagulation time otr method CPT 85348 | $36.01 | $60.01 | $3.77 – $54.01 | 29 |
| Coch implant headset replace HCPCS L8615 | $1,083.39 | $1,805.65 | $270.85 – $1,625.09 | 21 |
| Coch implant microphone repl HCPCS L8616 | $1,083.39 | $1,805.65 | $270.85 – $1,625.09 | 21 |
| Coch implant tran cable repl HCPCS L8618 | $434.37 | $723.95 | $108.59 – $651.55 | 21 |
| Coch implant trans coil repl HCPCS L8617 | $1,359.90 | $2,266.50 | $339.98 – $2,039.85 | 21 |
| Cochlear implt f/up exam <7 CPT 92601 | $853.70 | $1,422.84 | $122.80 – $1,280.56 | 29 |
| Cochlear implt f/up exam 7/> CPT 92603 | $552.29 | $920.48 | $122.80 – $828.43 | 29 |
| Cocm by rhc/fqhc 60 min mo HCPCS G0512 | $85.42 | $142.36 | $21.35 – $187.21 | 22 |
| Cogenex amnio memb per sq cm HCPCS Q4229 | $0.01 | $0.01 | $0.00 – $186.89 | 28 |
| Cold agglutinin screen (arc) CPT 86156 | $91.12 | $151.87 | $6.78 – $136.68 | 29 |
| Cold agglutinin titer CPT 86157 | $78.30 | $130.50 | $6.77 – $117.45 | 29 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $2,202.14 – $7,441.00 | 4 |
| Colistimethate sodium inj HCPCS J0770 | $103.76 | $172.94 | $15.69 – $155.65 | 23 |
| Collagen based wound filler HCPCS A6010 | $1,096.43 | $1,827.38 | $118.73 – $1,197.30 | 22 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $286.09 | $476.82 | $32.75 – $429.14 | 29 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $97.80 | $163.00 | $3.64 – $21.82 | 21 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $60.00 | $100.00 | $15.00 – $90.00 | 21 |
| Collar cerv ascend 172 reg HCPCS L0172 | $151.61 | $252.69 | $10.01 – $60.05 | 21 |
| Collar cerv patriot adlt HCPCS L0150 | $94.80 | $158.00 | $6.14 – $36.83 | 21 |
| Collar extrication adult univ HCPCS L0200 | $521.40 | $869.00 | $130.35 – $782.10 | 21 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $186.73 | $311.22 | $12.00 – $316.45 | 29 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $170.68 | $284.47 | $12.00 – $316.45 | 29 |
| Colon motility 6 hr study CPT 91117 | $501.82 | $836.37 | $125.46 – $777.56 | 27 |
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.