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 |
|---|---|---|---|---|
| H pylori (c-13) breath CPT 83013 | $240.52 | $400.86 | $12.00 – $360.77 | 29 |
| H pylori drug admin CPT 83014 | $31.99 | $53.31 | $6.60 – $47.98 | 29 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | $2,250.00 | $3,750.00 | $36.00 – $3,375.00 | 29 |
| Hrdtry cardmypy gene panel CPT 81439 | $4,425.00 | $7,375.00 | $36.00 – $6,637.50 | 29 |
| Hrdtry perph neurphy panel CPT 81448 | $4,500.00 | $7,500.00 | $36.00 – $1,403.76 | 29 |
| Htt gene detc abnor alleles CPT 81271 | $600.00 | $1,000.00 | $36.00 – $573.76 | 29 |
| Human epididymis protein 4 (he4) CPT 86305 | $169.75 | $282.92 | $12.00 – $162.99 | 29 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $57.60 | $96.00 | $4.95 – $34.70 | 23 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | $326.23 | $543.72 | $81.56 – $489.35 | 22 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $150.66 | $251.10 | $0.40 – $225.99 | 23 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $152.86 | $254.76 | $3.46 – $20.79 | 23 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $428.14 | $713.57 | $6.43 – $38.61 | 23 |
| Hydrogel drg <= 16 in w/bdr HCPCS A6245 | $58.60 | $97.66 | $14.65 – $87.89 | 22 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $279.00 | $465.00 | $0.11 – $6.21 | 23 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $294.92 | $491.54 | $73.73 – $442.39 | 22 |
| Hydromorphone injection HCPCS J1170 | $85.79 | $142.98 | $21.45 – $128.68 | 22 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $111.13 | $185.22 | $0.41 – $16.68 | 23 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $121.09 | $201.82 | $12.00 – $114.19 | 29 |
| Hymenotomy CPT 56442 | $1,644.90 | $2,741.50 | $71.00 – $7,744.80 | 29 |
| Hyoid myotomy & suspension CPT 21685 | $3,334.72 | $5,557.86 | $71.00 – $14,507.25 | 29 |
| Hyperthermia gen intrcv prb CPT 77620 | $1,880.11 | $3,133.52 | $470.03 – $2,820.17 | 29 |
| Hyperthermia ntrstl prb>5 CPT 77615 | $659.02 | $1,098.36 | $164.75 – $1,458.26 | 29 |
| Hypnotherapy CPT 90880 | $154.52 | $257.53 | $38.63 – $231.78 | 29 |
| Hypothermia ill neonate CPT 99184 | $1,291.16 | $2,151.93 | $322.79 – $1,936.74 | 22 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $1,454.71 – $7,441.00 | 4 |
| Hysterosalpingography s&i CPT 74740 | $908.52 | $1,514.20 | $66.83 – $1,362.78 | 29 |
| Hysteroscopy ablation CPT 58563 | $5,913.07 | $9,855.12 | $71.00 – $12,321.66 | 29 |
| Hysteroscopy biopsy CPT 58558 | $4,753.18 | $7,921.97 | $71.00 – $7,744.80 | 29 |
| Hysteroscopy dx sep proc CPT 58555 | $4,977.38 | $8,295.63 | $71.00 – $7,744.80 | 29 |
| Hysteroscopy lysis CPT 58559 | $3,113.21 | $5,188.68 | $71.00 – $12,321.66 | 29 |
| Hysteroscopy remove fb CPT 58562 | $4,502.48 | $7,504.14 | $71.00 – $7,744.80 | 29 |
| Hysteroscopy remove myoma CPT 58561 | $3,289.45 | $5,482.42 | $71.00 – $12,321.66 | 29 |
| Hysteroscopy resect septum CPT 58560 | $4,023.33 | $6,705.55 | $71.00 – $12,321.66 | 29 |
| Hysterotomy abdominal 59100 CPT 59100 | $4,258.45 | $7,097.41 | $71.00 – $12,321.66 | 29 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $159.34 | $265.56 | $12.00 – $239.00 | 29 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $102.11 | $170.19 | $12.00 – $153.17 | 29 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $949.32 | $1,582.20 | $9.96 – $1,423.98 | 23 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | $9,377.40 | $15,629.00 | $36.00 – $7,653.38 | 29 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $987.93 | $1,646.55 | $201.35 – $1,208.12 | 29 |
| Icatibant injection HCPCS J1744 | $20,065.49 | $33,442.49 | $331.04 – $30,098.22 | 23 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $64,074.00 | $106,790.00 | $43.97 – $263.83 | 21 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $54,763.80 | $91,273.00 | $3,997.73 – $23,986.40 | 21 |
| Icd crtp serena MRI HCPCS C2621 | $50,985.00 | $84,975.00 | $65.35 – $21,668.62 | 22 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $15,300.60 | $25,501.00 | $16.05 – $682.22 | 21 |
| Icg angiography i&r uni/bi CPT 92240 | $788.39 | $1,313.98 | $197.10 – $1,182.58 | 29 |
| Icut allergy test-delayed CPT 95028 | $64.87 | $108.11 | $3.00 – $99.35 | 29 |
| Icut allergy test drug/bug CPT 95024 | $58.63 | $97.71 | $3.00 – $151.53 | 29 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | $2,462.23 | $4,103.72 | $71.00 – $7,975.81 | 29 |
| Idarubicin hcl injection HCPCS J9211 | $474.69 | $791.15 | $43.73 – $378.52 | 23 |
| I&d/bursa/foot 28001 CPT 28001 | $2,539.51 | $4,232.51 | $71.00 – $4,016.35 | 29 |
| Identify sperm tissue CPT 89264 | $380.95 | $634.92 | $12.00 – $571.43 | 29 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $2,539.68 | $4,232.80 | $71.00 – $8,018.48 | 29 |
| Idh1 common variants CPT 81120 | $641.36 | $1,068.93 | $36.00 – $463.80 | 29 |
| Idh2 common variants CPT 81121 | $981.65 | $1,636.08 | $36.00 – $709.90 | 29 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | $2,147.18 | $3,578.63 | $939.93 – $6,955.62 | 27 |
| I&d lacrimal gland CPT 68400 | $551.57 | $919.28 | $137.89 – $2,508.06 | 29 |
| I&d lacrimal sac CPT 68420 | $3,205.90 | $5,343.16 | $71.00 – $5,788.85 | 29 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $3,371.02 | $5,618.36 | $71.00 – $7,039.11 | 29 |
| I & d vag hematoma non-ob 57023 CPT 57023 | $3,325.14 | $5,541.90 | $71.00 – $7,039.11 | 29 |
| I&d vag hemtma obst/postpart CPT 57022 | $1,606.08 | $2,676.80 | $71.00 – $7,039.11 | 29 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $320.36 | $533.93 | $27.15 – $243.40 | 23 |
| Igh gene rearrang dir probe CPT 81262 | $82.26 | $137.10 | $36.00 – $164.52 | 29 |
| Igh gene rearrange amp meth CPT 81261 | $583.33 | $972.22 | $12.00 – $475.18 | 29 |
| Igh@ var region somatic mutation analy CPT 81263 | $993.40 | $1,655.67 | $36.00 – $1,012.50 | 29 |
| Igk rearrangeabn clonal pop CPT 81264 | $369.03 | $615.05 | $12.00 – $450.00 | 29 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $153.27 | $255.45 | $24.71 – $333.52 | 22 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $276.19 | $460.31 | $36.00 – $890.45 | 29 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $351.07 | $585.11 | $28.12 – $423.12 | 29 |
| Ikbkap gene CPT 81260 | $476.25 | $793.75 | $33.02 – $262.76 | 29 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,300.58 | $2,167.64 | $325.15 – $1,950.88 | 20 |
| Iliac revasc add-on 37222 CPT 37222 | $7,719.48 | $12,865.80 | $71.00 – $11,579.22 | 22 |
| Img rta detcj/mntr ds staff CPT 92227 | $197.42 | $329.04 | $49.36 – $296.14 | 26 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | $44.93 | $74.89 | $11.23 – $99.35 | 26 |
| Img rta detc/mntr ds poc aly CPT 92229 | $85.70 | $142.83 | $21.42 – $151.53 | 26 |
| Immob elbow child sm HCPCS L3762 | $168.02 | $280.03 | $42.00 – $252.03 | 21 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $54.00 | $90.00 | $13.50 – $81.00 | 21 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $382.08 | $636.80 | $6.44 – $38.63 | 21 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $299.33 | $498.89 | $8.65 – $51.89 | 21 |
| Immobilizer shldr sling med HCPCS L3660 | $19.27 | $32.12 | $4.82 – $28.91 | 21 |
| Immt breast prosthesis 19340 CPT 19340 | $3,849.50 | $6,415.84 | $71.00 – $16,154.42 | 29 |
| Immune complex assay CPT 86332 | $174.76 | $291.26 | $12.00 – $186.06 | 29 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $6,106.32 | $10,177.20 | $46.63 – $691.96 | 29 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $4,040.28 | $6,733.80 | $76.38 – $3,032.91 | 29 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $139.88 | $233.14 | $12.00 – $112.50 | 29 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $132.86 | $221.44 | $12.00 – $199.30 | 29 |
| Immunoassay tumor qual CPT 86294 | $86.69 | $144.48 | $12.00 – $130.03 | 29 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $134.46 | $224.10 | $3.29 – $28.75 | 29 |
| Immunodiffusion nes CPT 86329 | $109.79 | $182.99 | $11.80 – $125.61 | 29 |
| Immunofixation electrophoresis serum CPT 86334 | $346.24 | $577.07 | $12.00 – $201.69 | 29 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $1,007.00 | $1,678.33 | $12.18 – $251.52 | 22 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $1,007.00 | $1,678.33 | $12.18 – $423.12 | 29 |
| Immunoglobulin assay CPT 86023 | $68.89 | $114.82 | $10.47 – $64.75 | 29 |
| Immunology procedure CPT 86849 | $321.98 | $536.63 | $12.00 – $114.31 | 22 |
| Impedence cardiogram CPT 93701 | $80.11 | $133.52 | $20.03 – $316.45 | 29 |
| Impl absrb msh/prsth dly cls CPT 15778 | not published | not published | $647.30 – $7,441.00 | 4 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $5,000.40 | $8,334.00 | $337.50 – $2,025.00 | 21 |
| Implantation iris prosthesis CPT 66683 | not published | not published | $15,709.05 – $24,721.08 | 13 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $11,811.60 | $19,686.00 | $68.16 – $408.97 | 20 |
| Implant cochlear device CPT 69930 | $20,433.28 | $34,055.46 | $71.00 – $83,073.64 | 29 |
| Implant cochlear osia osi300 HCPCS L8690 | $21,892.96 | $36,488.27 | $677.28 – $4,063.71 | 20 |
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.