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 |
|---|---|---|---|---|
| Manipulat palm cord post inj CPT 26341 | $492.74 | $821.23 | $66.72 – $2,975.00 | 29 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $17.82 | $29.70 | $4.46 – $26.73 | 22 |
| Manual diff wbc count b-coat CPT 85009 | $44.14 | $73.56 | $4.26 – $66.20 | 29 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $705.82 | $1,176.37 | $176.46 – $1,058.73 | 22 |
| Mapping io sentinel lymph node CPT 38900 | $459.03 | $765.05 | $71.00 – $688.54 | 22 |
| Map tachycard site(s) CPT 93609 | $2,126.98 | $3,544.96 | $531.74 – $3,190.46 | 22 |
| Marker biop eviva buckle ss HCPCS A4648 | $6,369.00 | $10,615.00 | $9.96 – $59.75 | 20 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,753.29 | $2,922.15 | $438.32 – $2,629.93 | 22 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,855.87 – $7,441.00 | 4 |
| Mask full face lg af531 HCPCS A7030 | $88.85 | $148.09 | $22.21 – $133.28 | 22 |
| Mastectomy form HCPCS L8020 | $224.40 | $374.00 | $6.06 – $36.39 | 21 |
| Mastectomy partial CPT 19301 | $4,306.52 | $7,177.53 | $71.00 – $9,442.65 | 29 |
| Mast mod rad CPT 19307 | $7,638.37 | $12,730.62 | $71.00 – $16,154.42 | 29 |
| Mastoidectomy CPT 69501 | $6,260.10 | $10,433.50 | $71.00 – $14,507.25 | 29 |
| Mastoidectomy complete 69502 CPT 69502 | $6,969.40 | $11,615.67 | $71.00 – $14,507.25 | 29 |
| Mastoids complete CPT 70130 | $245.27 | $408.78 | $62.15 – $367.90 | 29 |
| Mastoid surgery revision CPT 69603 | $7,337.51 | $12,229.18 | $71.00 – $14,507.25 | 29 |
| Mastopexy CPT 19316 | $5,494.31 | $9,157.19 | $71.00 – $16,154.42 | 29 |
| Mast simple complete CPT 19303 | $5,872.32 | $9,787.20 | $71.00 – $16,154.42 | 29 |
| Matrion 1 sq cm HCPCS Q4201 | $361.00 | $601.66 | $23.63 – $541.49 | 28 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $6,522.00 | $10,870.00 | $3.64 – $186.89 | 28 |
| M.avium-intra dna amp prob CPT 87561 | $288.75 | $481.25 | $12.00 – $337.50 | 29 |
| Maxillofacial fixation CPT 21100 | $5,164.84 | $8,608.07 | $71.00 – $14,507.25 | 29 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $124.73 | $207.89 | $12.00 – $187.10 | 29 |
| Mayo aathr protein s free CPT 85306 | $181.16 | $301.94 | $12.00 – $60.75 | 29 |
| Mayo activated protein c resistance assay CPT 85307 | $149.84 | $249.73 | $12.00 – $153.85 | 29 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $645.00 | $1,075.00 | $12.00 – $967.50 | 29 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $144.89 | $241.48 | $11.31 – $208.37 | 21 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $95.97 | $159.95 | $9.42 – $50.40 | 21 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $77.77 | $129.62 | $12.00 – $40.05 | 29 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $94.61 | $157.68 | $12.00 – $45.00 | 21 |
| Mayo alpha 1 antitrypsin CPT 82103 | $120.67 | $201.11 | $11.29 – $181.00 | 29 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $129.43 | $215.71 | $12.00 – $194.14 | 29 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $156.82 | $261.36 | $10.92 – $69.75 | 21 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $144.00 | $240.00 | $2.92 – $9.10 | 21 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $467.34 | $778.90 | $36.00 – $450.00 | 29 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $481.34 | $802.23 | $12.00 – $281.25 | 29 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,171.25 | $3,618.75 | $12.00 – $2,784.00 | 29 |
| Mayo androstenedione CPT 82157 | $187.47 | $312.45 | $12.00 – $281.20 | 29 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $149.51 | $249.19 | $6.75 – $35.04 | 29 |
| Mayo antithrombin iii antigen CPT 85301 | $121.20 | $202.00 | $9.08 – $181.80 | 29 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $91.13 | $151.89 | $3.29 – $36.12 | 29 |
| Mayo avwpr vw factor activity CPT 85397 | $232.54 | $387.56 | $12.00 – $255.38 | 29 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $174.00 | $290.00 | $12.00 – $114.37 | 29 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $86.83 | $144.71 | $2.92 – $9.80 | 21 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $62.64 | $104.40 | $8.55 – $93.96 | 29 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $693.60 | $1,156.00 | $36.00 – $347.62 | 29 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $138.91 | $231.52 | $36.00 – $515.09 | 29 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $93.65 | $156.09 | $9.06 – $30.96 | 29 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $113.33 | $188.88 | $2.92 – $9.44 | 21 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $87.40 | $145.67 | $11.08 – $58.50 | 29 |
| Mayo brcmg brucella antibody igm CPT 86622 | $74.93 | $124.88 | $7.50 – $28.02 | 29 |
| Mayo c1 esterase inhibitor CPT 83883 | $135.42 | $225.70 | $11.42 – $56.25 | 29 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $4,339.50 | $7,232.50 | $11.27 – $87.75 | 21 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $180.00 | $300.00 | $12.00 – $226.19 | 29 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $212.33 | $353.88 | $9.82 – $64.27 | 29 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $463.87 | $773.11 | $12.00 – $293.33 | 29 |
| Mayo ceruloplasmin CPT 82390 | $100.02 | $166.70 | $9.02 – $37.84 | 29 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $334.35 | $557.25 | $11.86 – $73.06 | 29 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $403.50 | $672.50 | $10.82 – $49.57 | 29 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $101.28 | $168.80 | $7.40 – $28.37 | 29 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $96.45 | $160.75 | $7.40 – $30.43 | 29 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $585.00 | $975.00 | $12.00 – $348.75 | 29 |
| Mayo chromium CPT 82495 | $128.84 | $214.73 | $12.00 – $193.26 | 29 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $162.00 | $270.00 | $10.25 – $84.02 | 21 |
| Mayo coccidioides antibody CPT 86635 | $123.75 | $206.25 | $9.06 – $27.53 | 29 |
| Mayo cocou cortisone urine CPT 82542 | $442.20 | $737.00 | $12.00 – $57.82 | 29 |
| Mayo cortisol free CPT 82530 | $149.69 | $249.48 | $12.00 – $100.22 | 29 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $77.63 | $129.38 | $12.00 – $101.11 | 29 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $75.00 | $125.00 | $10.18 – $112.50 | 29 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $59.03 | $98.38 | $2.92 – $19.35 | 21 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $247.50 | $412.50 | $2.92 – $13.38 | 21 |
| Mayo cyanide CPT 82600 | $113.38 | $188.97 | $12.00 – $170.07 | 29 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $809.09 | $1,348.48 | $36.00 – $1,121.34 | 29 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $97.80 | $163.00 | $11.13 – $146.70 | 29 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $165.38 | $275.63 | $12.00 – $248.07 | 29 |
| Mayo dihydrotestosterone CPT 82642 | $192.63 | $321.05 | $12.00 – $288.94 | 29 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | $135.63 | $226.05 | $8.10 – $203.44 | 29 |
| Mayo efpo chloride stool CPT 82438 | $61.92 | $103.20 | $3.94 – $12.00 | 29 |
| Mayo estriol CPT 82677 | $125.48 | $209.13 | $12.00 – $188.22 | 29 |
| Mayo estrone CPT 82679 | $127.80 | $213.00 | $12.00 – $191.70 | 29 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $138.43 | $230.72 | $12.00 – $207.65 | 29 |
| Mayo everolimus therapeutic drug level CPT 80169 | $162.35 | $270.59 | $11.53 – $181.65 | 29 |
| Mayo factor ii CPT 85210 | $163.97 | $273.29 | $10.90 – $245.96 | 29 |
| Mayo factor v CPT 85220 | $221.11 | $368.52 | $12.00 – $331.67 | 29 |
| Mayo factor vii CPT 85230 | $275.12 | $458.54 | $12.00 – $412.69 | 29 |
| Mayo factor viii vw factor antigen CPT 85246 | $194.23 | $323.72 | $12.00 – $55.06 | 29 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $228.83 | $381.38 | $12.00 – $343.24 | 29 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $230.74 | $384.56 | $12.00 – $55.06 | 29 |
| Mayo factor x CPT 85260 | $229.82 | $383.04 | $12.00 – $344.74 | 29 |
| Mayo factor xi CPT 85270 | $255.02 | $425.04 | $12.00 – $382.54 | 29 |
| Mayo fat/lipids feces quantitative CPT 82710 | $163.29 | $272.15 | $12.00 – $90.97 | 29 |
| Mayo fbl culture fungi blood CPT 87103 | $135.99 | $226.65 | $12.00 – $203.99 | 29 |
| Mayo fdp/fsp paracoagulation CPT 85366 | $128.87 | $214.78 | $12.00 – $193.30 | 29 |
| Mayo ffspg allergen clam igg CPT 86001 | $98.45 | $164.08 | $6.57 – $39.94 | 29 |
| Mayo fibrinogen antigen CPT 85385 | $121.26 | $202.10 | $12.00 – $69.44 | 29 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $110.15 | $183.59 | $12.00 – $165.23 | 29 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $7,487.95 | $12,479.92 | $0.00 – $132.61 | 22 |
| Mayo hemosiderin qualitative urine CPT 83070 | $50.40 | $84.00 | $3.99 – $75.60 | 29 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $460.20 | $767.00 | $12.00 – $150.75 | 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.