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 |
|---|---|---|---|---|
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | $70.84 | $118.07 | $17.71 – $106.26 | 29 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | $58.93 | $98.22 | $14.73 – $88.40 | 29 |
| Osteoplasty humerus CPT 24420 | not published | not published | $2,763.00 – $17,722.46 | 16 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $2,661.59 – $10,897.47 | 14 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $598.63 – $7,441.00 | 4 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | $6,063.98 | $10,106.64 | $71.00 – $10,897.47 | 28 |
| Osteot humerus w/wo int fixj CPT 24400 | $5,886.74 | $9,811.23 | $71.00 – $17,722.46 | 29 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | $4,975.12 | $8,291.86 | $71.00 – $17,722.46 | 29 |
| Other bone graft microvasc CPT 20962 | not published | not published | $4,359.03 – $10,897.47 | 14 |
| Other immunoelectrophoresis CPT 86325 | $126.10 | $210.17 | $12.00 – $189.15 | 29 |
| Oth resp proc, group HCPCS G0239 | $156.25 | $260.42 | $35.64 – $234.38 | 29 |
| Oth resp proc, indiv HCPCS G0238 | $134.53 | $224.22 | $27.61 – $201.80 | 29 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $135.00 | $225.00 | $33.75 – $202.50 | 23 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $71.98 | $119.97 | $18.00 – $107.97 | 18 |
| Otoplasty 69300 CPT 69300 | $2,524.28 | $4,207.14 | $71.00 – $7,975.81 | 29 |
| Ot re-evaluation patient/family CPT 97168 | $229.21 | $382.02 | $57.30 – $343.82 | 23 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $106.40 | $177.33 | $26.60 – $159.60 | 23 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $110.05 | $183.42 | $27.51 – $165.08 | 23 |
| Ovarian cystectomy 58925 CPT 58925 | $5,900.51 | $9,834.18 | $71.00 – $12,321.66 | 29 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $289.20 | $482.00 | $0.09 – $304.20 | 23 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $50.40 | $84.00 | $0.38 – $2.27 | 22 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $48,945.60 | $81,576.00 | $12,236.40 – $73,418.40 | 21 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $222.51 | $370.85 | $0.16 – $333.76 | 23 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $2,874.11 | $4,790.18 | $5.72 – $4,311.16 | 29 |
| Palb2 gene full gene seq CPT 81307 | $290.46 | $484.10 | $36.00 – $1,623.60 | 29 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $6,191.26 | $10,318.76 | $414.91 – $4,920.28 | 29 |
| Palonosetron hcl HCPCS J2469 | $540.00 | $900.00 | $0.71 – $135.00 | 23 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $50.47 | $84.12 | $12.62 – $75.71 | 23 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $12,452.74 | $20,754.56 | $165.67 – $4,703.53 | 29 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $18.27 | $30.45 | $4.57 – $27.41 | 22 |
| Papaverin hcl injection HCPCS J2440 | $149.08 | $248.46 | $18.00 – $108.00 | 22 |
| Parathormone (pth) intact CPT 83970 | $200.23 | $333.72 | $12.00 – $300.35 | 29 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,081.21 | $3,468.68 | $518.17 – $3,121.81 | 29 |
| Parathyroid autotransplantation 60512 CPT 60512 | $4,846.47 | $8,077.45 | $71.00 – $7,269.70 | 22 |
| Parathyroid planar imaging CPT 78070 | $1,435.33 | $2,392.22 | $265.30 – $2,153.00 | 29 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,317.94 | $2,196.57 | $314.75 – $1,976.91 | 29 |
| Paravaginal defect repair 57284 CPT 57284 | $7,150.85 | $11,918.09 | $71.00 – $12,321.66 | 29 |
| Parial mast w/lymph removal 19302 CPT 19302 | $5,509.55 | $9,182.58 | $71.00 – $16,154.42 | 29 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $300.87 | $501.45 | $71.00 – $495.95 | 29 |
| Parotid duct diversion CPT 42507 | $5,286.68 | $8,811.13 | $71.00 – $14,507.25 | 29 |
| Parotid duct diversion CPT 42509 | not published | not published | $1,954.22 – $14,507.25 | 16 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | $7,553.59 | $12,589.32 | $71.00 – $17,722.46 | 29 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | $3,162.10 | $5,270.17 | $71.00 – $7,744.80 | 29 |
| Partial exc bone humerus CPT 24140 | $4,298.11 | $7,163.52 | $71.00 – $8,018.48 | 29 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | $4,711.25 | $7,852.09 | $71.00 – $8,018.48 | 29 |
| Partial excision of lip CPT 40500 | $4,464.27 | $7,440.45 | $71.00 – $7,975.81 | 29 |
| Partial hip replacement CPT 27125 | not published | not published | $1,850.78 – $19,281.30 | 14 |
| Partial hysterectomy CPT 58180 | not published | not published | $1,549.76 – $7,441.00 | 4 |
| Partial removal finger bone CPT 26235 | $2,852.32 | $4,753.87 | $71.00 – $4,463.00 | 29 |
| Partial removal finger bone CPT 26236 | $3,448.48 | $5,747.47 | $71.00 – $5,172.72 | 29 |
| Partial removal foot fascia CPT 28060 | $3,433.72 | $5,722.86 | $71.00 – $8,018.48 | 29 |
| Partial removal leg bone(s) CPT 27360 | $5,160.97 | $8,601.62 | $71.00 – $8,018.48 | 29 |
| Partial removal of bladder CPT 51550 | not published | not published | $1,578.62 – $7,441.00 | 4 |
| Partial removal of eye fluid CPT 67005 | $2,525.16 | $4,208.60 | $71.00 – $5,772.91 | 29 |
| Partial removal of eye fluid CPT 67010 | $3,766.37 | $6,277.29 | $71.00 – $5,772.91 | 29 |
| Partial removal of fibula CPT 27641 | $3,714.10 | $6,190.16 | $71.00 – $8,018.48 | 29 |
| Partial removal of foot bone CPT 28288 | $3,973.21 | $6,622.01 | $71.00 – $8,018.48 | 29 |
| Partial removal of hand bone CPT 26230 | $3,668.02 | $6,113.36 | $71.00 – $8,018.48 | 29 |
| Partial removal of lip CPT 40530 | $4,552.70 | $7,587.84 | $71.00 – $7,975.81 | 29 |
| Partial removal of nose CPT 30150 | $6,603.11 | $11,005.18 | $71.00 – $14,507.25 | 29 |
| Partial removal of penis CPT 54120 | $6,301.67 | $10,502.79 | $71.00 – $9,452.51 | 29 |
| Partial removal of pharynx 42890 CPT 42890 | $5,416.89 | $9,028.15 | $71.00 – $14,507.25 | 29 |
| Partial removal of radius CPT 25151 | $4,566.00 | $7,610.00 | $71.00 – $8,018.48 | 29 |
| Partial removal of radius CPT 25230 | $3,275.98 | $5,459.96 | $71.00 – $8,018.48 | 29 |
| Partial removal of rib CPT 21600 | $6,743.11 | $11,238.52 | $71.00 – $17,722.46 | 29 |
| Partial removal of thyroid CPT 60220 | $7,774.24 | $12,957.06 | $71.00 – $14,293.73 | 29 |
| Partial removal of thyroid CPT 60225 | $10,483.20 | $17,472.00 | $71.00 – $15,724.80 | 29 |
| Partial removal of tibia CPT 27640 | $4,599.50 | $7,665.84 | $71.00 – $8,018.48 | 29 |
| Partial removal of toe CPT 28160 | $3,402.43 | $5,670.72 | $71.00 – $8,018.48 | 29 |
| Partial removal of tongue CPT 41120 | $5,978.70 | $9,964.50 | $71.00 – $14,507.25 | 29 |
| Partial removal of tongue CPT 41130 | not published | not published | $2,155.19 – $7,441.00 | 4 |
| Partial removal of ulna CPT 25119 | $5,831.70 | $9,719.50 | $71.00 – $8,747.55 | 29 |
| Partial removal of ulna CPT 25150 | $3,803.90 | $6,339.83 | $71.00 – $8,018.48 | 29 |
| Partial removal of ulna CPT 25240 | $3,842.97 | $6,404.95 | $71.00 – $8,018.48 | 29 |
| Partial removal of vaginal wall 57106 CPT 57106 | $3,905.53 | $6,509.21 | $71.00 – $7,744.80 | 29 |
| Partial thyroid excision CPT 60210 | $6,049.87 | $10,083.12 | $71.00 – $14,293.73 | 29 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | $9,285.92 | $15,476.53 | $71.00 – $14,293.73 | 29 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $10.10 | $16.83 | $2.10 – $12.60 | 22 |
| Part removal of metatarsal CPT 28110 | $3,579.58 | $5,965.97 | $71.00 – $8,018.48 | 29 |
| Part removal of metatarsal CPT 28113 | $4,278.32 | $7,130.54 | $71.00 – $8,018.48 | 29 |
| Part removal of metatarsal 28112 CPT 28112 | $3,650.84 | $6,084.73 | $71.00 – $8,018.48 | 29 |
| Passy muir valve metal trach HCPCS L8501 | $339.37 | $565.61 | $65.85 – $395.10 | 21 |
| Path clin consltj high 41-60 CPT 80505 | $186.77 | $311.28 | $12.00 – $423.12 | 29 |
| Path clin consltj mod 21-40 CPT 80504 | $211.79 | $352.99 | $12.00 – $423.12 | 29 |
| Path clin consltj prolng svc CPT 80506 | $118.57 | $197.62 | $12.00 – $232.91 | 22 |
| Path clin consltj sf 5-20 CPT 80503 | $70.57 | $117.62 | $12.00 – $134.24 | 29 |
| Pca3/klk3 antigen CPT 81313 | $695.40 | $1,159.00 | $36.00 – $1,043.10 | 29 |
| Pdgfra gene CPT 81314 | $1,302.83 | $2,171.38 | $36.00 – $926.10 | 29 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | $294.77 | $491.29 | $71.00 – $495.95 | 29 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | $3,243.67 | $5,406.12 | $71.00 – $4,865.51 | 29 |
| Pedicle enel/ntroral 15576 CPT 15576 | $3,589.99 | $5,983.31 | $71.00 – $5,384.98 | 29 |
| Pegaspargase injection HCPCS J9266 | $33,512.48 | $55,854.14 | $8,378.12 – $50,268.73 | 29 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $11,569.18 | $19,281.97 | $121.01 – $17,353.77 | 29 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $7,531.80 | $12,553.00 | $129.10 – $11,297.70 | 29 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $3,774.30 | $6,290.50 | $75.53 – $5,661.45 | 29 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,890.36 | $3,150.60 | $167.39 – $2,835.54 | 29 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,177.28 | $3,628.80 | $167.39 – $3,265.92 | 29 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,456.33 | $2,427.22 | $99.77 – $2,184.50 | 29 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,382.76 | $5,637.93 | $332.94 – $5,074.14 | 29 |
| Pelvic MRI (with contrast) CPT 72196 | $1,989.01 | $3,315.01 | $276.66 – $2,983.51 | 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.