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 |
|---|---|---|---|---|
| Iron stain peripheral blood CPT 85536 | $81.06 | $135.10 | $5.78 – $121.59 | 29 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $187.06 | $311.77 | $0.25 – $149.16 | 23 |
| Irradiation of blood product each unit reference CPT 86945 | $127.49 | $212.48 | $12.00 – $191.23 | 29 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $192.35 | $320.59 | $48.09 – $801.00 | 29 |
| Irrigation syringe HCPCS A4322 | $3.60 | $6.00 | $0.90 – $5.40 | 21 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | $171.26 | $285.43 | $42.81 – $256.89 | 29 |
| Island pedicle flap graft CPT 15740 | $2,363.04 | $3,938.40 | $71.00 – $4,517.58 | 29 |
| Ivc venogram s&i CPT 75825 | $3,469.82 | $5,783.04 | $114.28 – $7,896.23 | 29 |
| IV Fluids (each additional hour) CPT 96361 | $200.22 | $333.70 | $41.34 – $300.33 | 29 |
| IV Fluids (first hour) CPT 96360 | $558.06 | $930.10 | $116.45 – $837.09 | 29 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $240.85 | $401.41 | $60.21 – $361.27 | 22 |
| IV inj ra drug dx study CPT 78808 | $748.44 | $1,247.40 | $187.11 – $1,122.66 | 29 |
| IV Medicine Infusion (additional drug) CPT 96367 | $243.30 | $405.50 | $60.83 – $364.95 | 29 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $208.30 | $347.16 | $44.69 – $312.44 | 29 |
| IV Medicine Infusion (first hour) CPT 96365 | $506.74 | $844.57 | $126.69 – $760.11 | 29 |
| IV njx tst vasc flo flap/grf CPT 15860 | $196.94 | $328.23 | $49.23 – $987.04 | 29 |
| IV Push Injection (each additional drug) CPT 96375 | $240.88 | $401.46 | $44.69 – $361.31 | 29 |
| IV Push Injection (first drug) CPT 96374 | $304.45 | $507.42 | $76.11 – $530.97 | 29 |
| Ivp w/nephrotomography CPT 74415 | $673.90 | $1,123.16 | $151.36 – $1,010.84 | 29 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $823.10 | $1,371.84 | $135.33 – $1,234.66 | 29 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $10,695.32 | $17,825.54 | $125.95 – $5,377.66 | 29 |
| Jak2 targeted sequence analysis CPT 81279 | $378.30 | $630.50 | $36.00 – $500.40 | 29 |
| Jaw arthroscopy/surgery CPT 29800 | $4,913.60 | $8,189.33 | $71.00 – $8,018.48 | 29 |
| Jaw arthroscopy/surgery CPT 29804 | $5,669.53 | $9,449.22 | $71.00 – $8,504.30 | 29 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $268.76 | $447.94 | $53.13 – $403.15 | 29 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $361.61 | $602.68 | $43.78 – $542.41 | 29 |
| Jejunstmy tube plcmt CPT 44372 | $1,938.30 | $3,230.50 | $71.00 – $4,713.77 | 29 |
| John cunningham antibody CPT 86711 | $184.84 | $308.07 | $11.25 – $67.50 | 29 |
| Keratoprosthesis CPT 65770 | $9,103.00 | $15,171.66 | $71.00 – $30,711.02 | 29 |
| Ketogenic steroids fract CPT 83582 | $92.66 | $154.43 | $12.00 – $138.99 | 29 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $75.73 | $126.22 | $6.86 – $50.40 | 29 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $29.52 | $49.20 | $0.32 – $5.45 | 29 |
| Kidney endoscopy CPT 50551 | $1,737.34 | $2,895.56 | $71.00 – $12,818.21 | 29 |
| Kidney endoscopy CPT 50553 | $4,065.97 | $6,776.61 | $71.00 – $12,818.21 | 29 |
| Kidney endoscopy CPT 50570 | $949.04 | $1,581.74 | $71.00 – $8,636.11 | 29 |
| Kidney endoscopy CPT 50575 | $4,751.59 | $7,919.31 | $71.00 – $12,818.21 | 29 |
| Kidney endoscopy & biopsy CPT 50555 | $3,850.20 | $6,417.00 | $71.00 – $22,821.27 | 29 |
| Kidney endoscopy & biopsy CPT 50574 | $821.69 | $1,369.49 | $71.00 – $8,636.11 | 29 |
| Kidney endoscopy & treatment CPT 50557 | $4,100.26 | $6,833.76 | $71.00 – $22,821.27 | 29 |
| Kidney endoscopy & treatment CPT 50561 | $4,965.89 | $8,276.49 | $71.00 – $12,818.21 | 29 |
| Kidney endoscopy & treatment CPT 50576 | $4,565.45 | $7,609.08 | $71.00 – $22,821.27 | 29 |
| Kidney endoscopy & treatment CPT 50580 | $3,505.24 | $5,842.07 | $71.00 – $12,818.21 | 29 |
| Kidney function study CPT 78725 | $746.54 | $1,244.23 | $97.56 – $1,119.81 | 29 |
| Kidney imaging (3d) CPT 78710 | $1,263.94 | $2,106.57 | $315.99 – $1,895.91 | 22 |
| Kidney imaging morphology CPT 78700 | $997.30 | $1,662.17 | $157.04 – $1,495.95 | 29 |
| Kidney imag w/bld flow multi CPT 78709 | $1,293.28 | $2,155.46 | $332.13 – $1,939.91 | 29 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,465.10 | $2,441.83 | $212.84 – $2,197.65 | 29 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $673.36 | $1,122.26 | $99.77 – $1,010.03 | 29 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $537.62 | $896.03 | $59.81 – $806.43 | 29 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,585.18 | $15,975.30 | $2,396.30 – $14,377.77 | 21 |
| Kit gene analys d816 variant CPT 81273 | $420.00 | $700.00 | $36.00 – $455.14 | 29 |
| Kit hfx iq ipg bundle HCPCS C1822 | $50,985.00 | $84,975.00 | $8,905.04 – $53,430.24 | 20 |
| Kit lead specify 5-6-5 HCPCS C1778 | $20,394.00 | $33,990.00 | $0.00 – $0.01 | 20 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,867.64 | $3,112.73 | $190.81 – $1,144.84 | 20 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $288.32 | $480.54 | $17.68 – $186.89 | 28 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $10,653.60 | $17,756.00 | $1,910.70 – $11,464.20 | 21 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,541.00 | $4,235.00 | $629.61 – $3,777.65 | 20 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | $4,712.46 | $7,854.10 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/drainage CPT 29871 | $6,051.53 | $10,085.88 | $71.00 – $9,077.29 | 29 |
| Knee arthroscopy dx CPT 29870 | $3,980.03 | $6,633.38 | $71.00 – $8,018.48 | 29 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | $5,896.44 | $9,827.40 | $71.00 – $8,844.66 | 29 |
| Knee arthroscopy/surgery CPT 29850 | $2,834.77 | $4,724.62 | $71.00 – $5,132.00 | 29 |
| Knee arthroscopy/surgery CPT 29851 | $2,974.01 | $4,956.68 | $71.00 – $5,132.00 | 29 |
| Knee arthroscopy/surgery CPT 29873 | $4,741.58 | $7,902.64 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29874 | $5,782.54 | $9,637.56 | $71.00 – $8,673.80 | 29 |
| Knee arthroscopy/surgery CPT 29875 | $3,816.80 | $6,361.34 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29876 | $4,823.89 | $8,039.82 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29879 | $4,058.94 | $6,764.90 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29880 | $5,706.11 | $9,510.18 | $71.00 – $8,559.16 | 29 |
| Knee arthroscopy/surgery CPT 29882 | $6,045.65 | $10,076.08 | $71.00 – $9,068.47 | 29 |
| Knee arthroscopy/surgery CPT 29883 | $5,189.18 | $8,648.64 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29884 | $3,989.60 | $6,649.34 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29886 | $3,346.10 | $5,576.84 | $71.00 – $8,018.48 | 29 |
| Knee arthroscopy/surgery CPT 29887 | $3,543.86 | $5,906.44 | $71.00 – $17,722.46 | 29 |
| Knee arthroscopy/surgery CPT 29888 | $6,243.34 | $10,405.56 | $71.00 – $17,722.46 | 29 |
| Knee arthroscopy/surgery CPT 29889 | $10,477.98 | $17,463.30 | $71.00 – $32,603.53 | 29 |
| Knee control full kneecap HCPCS L2795 | $224.86 | $374.76 | $26.30 – $157.79 | 21 |
| Knee MRI (with and without contrast) CPT 73723 | $3,008.26 | $5,013.76 | $332.94 – $4,512.38 | 29 |
| Knee MRI (with contrast) CPT 73722 | $2,201.09 | $3,668.48 | $323.44 – $3,301.63 | 29 |
| Knee MRI (without contrast) CPT 73721 | $2,159.09 | $3,598.48 | $208.84 – $3,238.63 | 29 |
| Knee orth pos locking joint HCPCS L1831 | $233.52 | $389.20 | $54.86 – $329.17 | 21 |
| Knee X-ray CPT 73564 | $500.23 | $833.72 | $47.45 – $750.35 | 29 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $277.32 | $462.20 | $34.41 – $415.98 | 29 |
| Knee X-ray (3 views, both knees) CPT 73562 | $347.83 | $579.71 | $41.10 – $521.74 | 29 |
| Knee X-ray (standing, both knees) CPT 73565 | $289.34 | $482.23 | $40.10 – $434.01 | 29 |
| Ko elastic w/joints pre ots HCPCS L1812 | $166.35 | $277.25 | $41.59 – $249.53 | 21 |
| Ko single upright pre cst HCPCS L1843 | $522.58 | $870.97 | $130.65 – $783.87 | 21 |
| Kras gene addl variants CPT 81276 | $342.22 | $570.36 | $36.00 – $463.80 | 29 |
| Kras gene variants exon 2 CPT 81275 | $570.29 | $950.49 | $12.00 – $463.80 | 29 |
| Kyleena, 19.5 mg HCPCS J7296 | not published | not published | not published | 0 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $1,949.45 | $3,249.09 | $27.29 – $163.72 | 22 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $1,949.45 | $3,249.09 | $22.01 – $132.07 | 22 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $39.60 | $66.00 | $0.16 – $1.06 | 23 |
| Labioplasty 56800 CPT 56800 | $3,905.53 | $6,509.21 | $71.00 – $7,744.80 | 29 |
| Lab pathology consultation CPT 80500 | $52.32 | $87.20 | $12.00 – $78.48 | 22 |
| Lab pathology consultation CPT 80502 | $80.21 | $133.69 | $12.00 – $120.32 | 22 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $260.98 | $434.97 | $9.00 – $54.00 | 22 |
| Lactate dehydrogenase (ldh) CPT 83615 | $59.42 | $99.03 | $5.07 – $18.79 | 29 |
| Lactated ringers intravenous solution HCPCS J7120 | $56.23 | $93.72 | $2.86 – $33.75 | 23 |
| Lactation class HCPCS S9443 | $111.20 | $185.34 | $27.80 – $166.81 | 22 |
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.