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 |
|---|---|---|---|---|
| Galactose transferase test CPT 82776 | $34.93 | $58.22 | $9.86 – $52.40 | 29 |
| Galectin-3 CPT 82777 | $150.89 | $251.49 | $12.00 – $226.34 | 29 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,754.98 | $2,924.97 | $290.70 – $2,632.47 | 29 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,968.94 | $3,281.57 | $390.26 – $2,953.41 | 29 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,888.85 – $14,293.73 | 15 |
| Gamma globulin 1 cc inj HCPCS J1460 | $1,243.58 | $2,072.63 | $46.50 – $1,865.37 | 29 |
| Gammaglobulin iga CPT 82784 | $109.53 | $182.55 | $4.81 – $22.32 | 29 |
| Gammaglobulin ige CPT 82785 | $124.16 | $206.94 | $4.47 – $39.50 | 29 |
| Gamma glutamyltransferase CPT 82977 | $65.89 | $109.81 | $6.05 – $56.25 | 29 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $197.40 | $329.00 | $37.45 – $296.10 | 23 |
| Gardner vag dna amp probe CPT 87511 | $57.36 | $95.60 | $12.00 – $86.04 | 29 |
| Gastric analy w/ph ea spec CPT 82930 | $27.67 | $46.11 | $5.64 – $41.50 | 29 |
| Gastric emptying imag study CPT 78265 | $1,391.99 | $2,319.99 | $353.51 – $2,087.99 | 29 |
| Gastric emptying imag study CPT 78266 | $1,770.81 | $2,951.35 | $397.61 – $2,656.22 | 29 |
| Gastric motility studies CPT 91020 | $1,487.86 | $2,479.76 | $356.12 – $2,231.78 | 29 |
| Gastrin test CPT 82938 | $119.11 | $198.52 | $12.00 – $178.67 | 29 |
| Gastroesophageal reflux study CPT 78262 | $1,120.86 | $1,868.10 | $223.20 – $1,681.29 | 29 |
| Gastroesophageal reflux test CPT 91034 | $1,323.71 | $2,206.19 | $330.93 – $1,985.57 | 27 |
| Gastrostomy open neonatal CPT 43831 | $1,132.14 | $1,886.90 | $283.04 – $5,388.00 | 27 |
| Gated heart multiple CPT 78473 | $1,405.04 | $2,341.73 | $262.96 – $2,107.56 | 29 |
| Gba gene CPT 81251 | $291.87 | $486.45 | $36.00 – $437.81 | 29 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | $90.00 | $150.00 | $22.50 – $135.00 | 21 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $336.40 | $560.66 | $3.56 – $105.05 | 23 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $17,843.81 | $29,739.68 | $218.85 – $26,765.71 | 29 |
| Generator barostim neo2 2014 HCPCS C1767 | $54,677.39 | $91,128.98 | $3,995.10 – $23,970.60 | 20 |
| Generator emblem MRI sicd subq HCPCS C1722 | $43,578.00 | $72,630.00 | $381.15 – $2,286.90 | 21 |
| Genetic tstg severe inh cond CPT 81443 | $8,289.90 | $13,816.50 | $12.00 – $5,876.54 | 29 |
| Genioplasty augmentation CPT 21120 | $4,401.73 | $7,336.22 | $71.00 – $14,507.25 | 29 |
| Geniop sldg osteot 1 CPT 21121 | $2,903.97 | $4,839.95 | $71.00 – $7,975.81 | 29 |
| Gen, neuro, clo loop, rechg HCPCS C1826 | $50,985.00 | $84,975.00 | $10,197.00 – $61,182.00 | 20 |
| Genome sequence analysis CPT 81425 | $7,500.00 | $12,500.00 | $36.00 – $12,074.88 | 29 |
| Genome sequence analysis CPT 81426 | $3,900.00 | $6,500.00 | $36.00 – $6,503.88 | 29 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $122.95 | $204.92 | $2.12 – $26.10 | 23 |
| Gentamicin peak therapeutic drug level CPT 80170 | $119.90 | $199.83 | $12.00 – $179.85 | 29 |
| G-esoph reflx tst w/electrod CPT 91035 | $1,877.99 | $3,129.98 | $268.83 – $1,612.98 | 27 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $2,959.00 – $7,441.00 | 2 |
| Ghs abscess perianal iandd CPT 46050 | $1,849.64 | $3,082.74 | $328.50 – $2,774.47 | 29 |
| Ghs abscess postoperative iandd complex CPT 10180 | $4,458.69 | $7,431.15 | $71.00 – $7,039.11 | 29 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $85.02 | $141.70 | $8.24 – $33.88 | 29 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $127.35 | $212.25 | $12.00 – $191.03 | 29 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $620.57 | $1,034.28 | $12.00 – $930.85 | 29 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $262.35 | $437.25 | $65.59 – $393.52 | 29 |
| Ghs antibodies (torch) igm CPT 86694 | $100.40 | $167.33 | $9.48 – $34.54 | 29 |
| Ghs aspiration bladder - needle CPT 51100 | $590.84 | $984.74 | $36.54 – $886.27 | 29 |
| Ghs bladder cath - complex-foley CPT 51703 | $312.34 | $520.56 | $57.79 – $468.50 | 29 |
| Ghs bleeding time (ivy) CPT 85002 | $53.82 | $89.70 | $4.05 – $80.73 | 29 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,318.23 | $2,197.05 | $61.74 – $1,977.35 | 29 |
| Ghs central line insert < age 5, failed CPT 36555 | $2,519.49 | $4,199.15 | $71.00 – $7,896.23 | 29 |
| Ghs change cysto/gastrost CPT 43762 | $625.78 | $1,042.97 | $110.15 – $938.67 | 29 |
| Ghs chemo >8 hrs CPT 96416 | $832.40 | $1,387.34 | $208.10 – $1,248.61 | 29 |
| Ghs chemo infusion >8 hrs CPT 96425 | $503.81 | $839.69 | $125.95 – $838.97 | 29 |
| Ghs chemo IV push, ea addtl CPT 96411 | $369.86 | $616.43 | $68.71 – $801.00 | 29 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $169.49 | $282.49 | $12.00 – $254.24 | 29 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $678.16 | $1,130.27 | $71.00 – $1,017.24 | 29 |
| Ghs closed reduction ankle dislocation CPT 27840 | $615.82 | $1,026.37 | $71.00 – $923.73 | 29 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,230.18 | $2,050.30 | $71.00 – $3,981.46 | 29 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $513.59 | $855.98 | $71.00 – $770.38 | 29 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $3,374.87 | $5,624.79 | $71.00 – $5,062.31 | 29 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $4,798.35 | $7,997.25 | $71.00 – $7,197.52 | 29 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $616.87 | $1,028.12 | $71.00 – $2,975.00 | 29 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $2,653.27 | $4,422.12 | $71.00 – $3,981.46 | 29 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $3,047.36 | $5,078.93 | $71.00 – $4,571.04 | 29 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $720.73 | $1,201.22 | $71.00 – $1,081.10 | 29 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $760.78 | $1,267.97 | $71.00 – $1,141.17 | 29 |
| Ghs community re-entry 15 minutes CPT 97537 | $104.88 | $174.80 | $26.22 – $157.32 | 23 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $345.89 | $576.49 | $71.00 – $987.04 | 29 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $376.96 | $628.27 | $71.00 – $565.44 | 29 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $381.91 | $636.51 | $71.00 – $987.04 | 29 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $287.87 | $479.78 | $71.00 – $431.80 | 29 |
| Ghs cricothyroidotomy CPT 31605 | $1,943.30 | $3,238.84 | $71.00 – $2,914.96 | 29 |
| Ghs cutdown placement age 1 and over CPT 36425 | $92.77 | $154.61 | $23.19 – $987.04 | 29 |
| Ghs cutdown placement under 1 yr CPT 36420 | $272.23 | $453.72 | $68.06 – $408.35 | 29 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $116.25 | $193.75 | $12.00 – $174.38 | 29 |
| Ghs dislocation elbow closed treatment CPT 24600 | $560.12 | $933.53 | $71.00 – $840.18 | 29 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $1,001.03 | $1,668.39 | $71.00 – $2,245.59 | 29 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $351.46 | $585.77 | $31.56 – $665.29 | 29 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $809.98 | $1,349.96 | $262.86 – $2,975.00 | 27 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $455.21 | $758.69 | $113.80 – $682.82 | 29 |
| Ghs electrostagmgraphy CPT 92537 | $484.67 | $807.79 | $28.30 – $727.01 | 29 |
| Ghs elect torsion swing CPT 92546 | $519.74 | $866.23 | $122.80 – $779.61 | 29 |
| Ghs elect vertical elct CPT 92547 | $44.64 | $74.40 | $11.16 – $66.96 | 22 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | $438.47 | $730.79 | $71.00 – $987.79 | 29 |
| Ghs excision ingrown nail CPT 11765 | $376.93 | $628.22 | $71.00 – $987.79 | 29 |
| Ghs eye exam CPT 92002 | $172.26 | $287.10 | $43.06 – $327.47 | 27 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $687.50 | $1,145.84 | $71.00 – $1,031.26 | 29 |
| Ghs fb removal foot - deep - left CPT 28192 | $4,011.33 | $6,685.55 | $71.00 – $6,016.99 | 29 |
| Ghs fb removal from muscle - complicated CPT 20525 | $2,782.37 | $4,637.28 | $71.00 – $7,039.11 | 29 |
| Ghs fb removal - incisional CPT 10121 | $3,520.49 | $5,867.49 | $71.00 – $5,280.74 | 29 |
| Ghs fb removal - non-incisional CPT 20520 | $1,305.06 | $2,175.10 | $71.00 – $4,016.35 | 29 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $51.99 | $86.65 | $5.86 – $77.98 | 29 |
| Ghs fish cytogen CPT 88271 | $1,521.15 | $2,535.25 | $9.59 – $51.41 | 29 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $492.77 | $821.28 | $22.91 – $122.86 | 29 |
| Ghs flow volume loop CPT 94375 | $404.04 | $673.40 | $101.01 – $777.56 | 29 |
| Ghs gastric intub aspiration lavage CPT 43753 | $227.28 | $378.80 | $56.82 – $777.56 | 29 |
| Ghs hcv amplificaiton CPT 87521 | $261.94 | $436.57 | $12.00 – $392.91 | 29 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | $27.56 | $45.94 | $12.00 – $55.13 | 29 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $423.75 | $706.25 | $0.00 – $37.18 | 29 |
| Ghs hgb stability-thal CPT 83068 | $114.74 | $191.24 | $7.95 – $157.26 | 29 |
| Ghs histoplasma antigen CPT 87385 | $197.32 | $328.86 | $11.13 – $101.25 | 29 |
| Ghs HIV antibody CPT 86703 | $148.23 | $247.05 | $2.19 – $32.90 | 29 |
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.