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 |
|---|---|---|---|---|
| Pelvic MRI (without contrast) CPT 72195 | $2,456.13 | $4,093.55 | $227.71 – $3,684.20 | 29 |
| Pelvic ring fracture uni/bil HCPCS G0413 | $2,623.43 | $4,372.38 | $71.00 – $17,722.46 | 29 |
| Pelvic Ultrasound (complete) CPT 76856 | $647.87 | $1,079.78 | $96.28 – $971.80 | 29 |
| Pelvic Ultrasound (limited) CPT 76857 | $483.26 | $805.43 | $50.79 – $724.89 | 29 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $319.22 | $532.03 | $28.06 – $478.83 | 29 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $348.19 | $580.31 | $42.44 – $522.28 | 29 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $10,437.74 | $17,396.24 | $56.42 – $15,656.62 | 29 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $7,307.40 | $12,179.00 | $3.84 – $207.00 | 29 |
| Pemivibart infusion HCPCS M0224 | $520.56 | $867.60 | $130.14 – $1,171.30 | 29 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $826.47 | $1,377.45 | $29.90 – $717.69 | 29 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $182.10 | $303.50 | $0.75 – $62.55 | 23 |
| Penile injection CPT 54235 | $545.38 | $908.96 | $35.16 – $818.06 | 29 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $23,449.80 | $39,083.00 | $0.00 – $0.01 | 20 |
| Penile vascular study CPT 93980 | $942.47 | $1,570.79 | $99.77 – $1,413.71 | 29 |
| Penile vascular study CPT 93981 | $647.15 | $1,078.59 | $70.50 – $1,117.00 | 29 |
| Penis plastic surgery CPT 54360 | $5,770.68 | $9,617.80 | $71.00 – $8,656.02 | 29 |
| Penis study CPT 54240 | $267.65 | $446.09 | $66.91 – $777.56 | 29 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $453.61 | $756.01 | $0.18 – $680.41 | 23 |
| Pentobarbital sodium inj HCPCS J2515 | $4,062.60 | $6,771.00 | $35.00 – $3,267.59 | 28 |
| Perc cryo ablate renal tum CPT 50593 | $11,458.04 | $19,096.74 | $71.00 – $25,500.18 | 29 |
| Perc d-e cor revasc chro add HCPCS C9608 | $0.01 | $0.01 | $0.00 – $10,604.00 | 20 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $25,576.93 | $42,628.22 | $6,394.23 – $43,439.01 | 28 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $0.01 | $0.01 | $0.00 – $10,604.00 | 20 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $22,624.54 | $37,707.57 | $5,656.14 – $33,936.81 | 28 |
| Perc d-e cor stent ather br HCPCS C9603 | $0.01 | $0.01 | $0.00 – $10,604.00 | 20 |
| Perc d-e cor stent ather s HCPCS C9602 | $25,491.77 | $42,486.29 | $6,372.94 – $43,439.01 | 28 |
| Perc drug-el cor stent bran HCPCS C9601 | $0.01 | $0.01 | $0.00 – $10,604.00 | 20 |
| Perc drug-el cor stent sing HCPCS C9600 | $23,696.92 | $39,494.87 | $5,475.60 – $32,853.61 | 28 |
| Perc rf ablate renal tumor CPT 50592 | $7,419.75 | $12,366.25 | $71.00 – $14,293.73 | 29 |
| Percut ablate liver rf CPT 47382 | $7,214.31 | $12,023.85 | $71.00 – $14,293.73 | 29 |
| Percutaneous islet celltrans HCPCS G0341 | $1,729.73 | $2,882.88 | $432.43 – $5,388.00 | 19 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $939.94 | $1,566.57 | $43.95 – $1,409.91 | 23 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $2,513.20 | $4,188.67 | $71.00 – $17,181.00 | 22 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,649.05 | $4,415.09 | $71.00 – $3,973.58 | 29 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | $1,432.75 | $2,387.92 | $358.19 – $2,149.13 | 22 |
| Peri-implt capslc brst compl CPT 19371 | $3,913.07 | $6,521.78 | $71.00 – $9,442.65 | 29 |
| Perineoplasty rpr per nonob CPT 56810 | $4,347.17 | $7,245.28 | $71.00 – $7,744.80 | 29 |
| Peripheral vascular rehab CPT 93668 | $104.71 | $174.51 | $26.18 – $157.06 | 29 |
| Peri-proc device eval icd CPT 93287 | $222.64 | $371.07 | $55.66 – $917.00 | 22 |
| Peri-proc device eval pm CPT 93286 | $200.92 | $334.86 | $50.23 – $917.00 | 22 |
| Peritoneal cath sub q resv per CPT 49419 | $4,497.42 | $7,495.70 | $1,804.00 – $13,613.39 | 27 |
| Peritoneogram rs&i CPT 74190 | $510.85 | $851.42 | $81.04 – $1,366.64 | 29 |
| Perit-vens shunt pat tst CPT 78291 | $661.40 | $1,102.34 | $238.58 – $1,021.72 | 29 |
| Perphenazine 4mg oral HCPCS Q0175 | $2.58 | $4.30 | $0.14 – $0.84 | 22 |
| Perq art m-thrombect &/nfs CPT 61645 | $5,909.22 | $9,848.70 | $71.00 – $8,863.83 | 22 |
| Perq clsr tcat l atr apndge CPT 33340 | $17,513.83 | $29,189.71 | $2,502.00 – $26,270.74 | 21 |
| Perq dev breast 1st mr guide CPT 19287 | $264.37 | $440.62 | $66.09 – $1,742.94 | 30 |
| Perq dev breast 1st strtctc CPT 19283 | $193.51 | $322.51 | $48.38 – $1,742.94 | 30 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | $9,232.63 | $15,387.72 | $71.00 – $22,821.27 | 29 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $7,060.20 | $11,767.00 | $71.00 – $22,821.27 | 29 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $12,403.61 | $20,672.68 | $5,338.09 – $27,252.71 | 28 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $20,071.40 | $33,452.34 | $5,338.09 – $43,439.01 | 28 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $12,403.61 | $20,672.68 | $5,338.09 – $27,252.71 | 28 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $12,403.61 | $20,672.68 | $5,338.09 – $27,252.71 | 28 |
| Perq p-art revsc each addl CPT 33904 | $8,627.68 | $14,379.46 | $2,156.92 – $12,941.51 | 21 |
| Perq plmt bile duct stent CPT 47538 | $9,185.40 | $15,309.00 | $71.00 – $14,293.73 | 29 |
| Perq plmt bile duct stent CPT 47539 | $4,847.95 | $8,079.92 | $71.00 – $14,293.73 | 29 |
| Perq plmt bile duct stent CPT 47540 | $8,439.92 | $14,066.54 | $71.00 – $14,293.73 | 29 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $488.26 | $813.76 | $110.15 – $732.38 | 29 |
| Perq skel fix rad/uln dislc CPT 25671 | $3,603.83 | $6,006.39 | $71.00 – $8,018.48 | 29 |
| Perq skel fix ulnar styld fx CPT 25651 | $3,174.28 | $5,290.46 | $71.00 – $8,018.48 | 29 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | $2,086.27 | $3,477.12 | $71.00 – $3,129.41 | 22 |
| Perq transcath closure each CPT 93592 | $10,244.02 | $17,073.37 | $2,561.01 – $17,181.00 | 21 |
| Perq transcath closure pda CPT 93582 | $26,690.99 | $44,484.99 | $6,672.75 – $43,439.01 | 29 |
| Perq transcath cls aortic CPT 93591 | $20,488.05 | $34,146.75 | $661.87 – $43,439.01 | 29 |
| Perq transcath cls mitral CPT 93590 | $23,414.91 | $39,024.85 | $801.09 – $43,439.01 | 29 |
| Perq transcath septal reduxn CPT 93583 | $1,369.23 | $2,282.05 | $342.31 – $2,144.70 | 21 |
| Perq trluml angp nt/recr coa CPT 33897 | $9,722.63 | $16,204.38 | $954.53 – $14,583.94 | 20 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $3,599.97 | $5,999.95 | $71.00 – $8,018.48 | 29 |
| Perq tx malar fracture CPT 21355 | $7,799.20 | $12,998.67 | $71.00 – $11,698.80 | 29 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | $2,729.48 | $4,549.13 | $71.00 – $14,507.25 | 29 |
| Perq tx nasoethmoid fx CPT 21340 | $6,759.31 | $11,265.51 | $71.00 – $10,138.96 | 29 |
| Pertussis ag if CPT 87265 | $79.09 | $131.81 | $10.06 – $118.63 | 29 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $11,778.22 | $19,630.36 | $15.38 – $17,667.32 | 29 |
| Pet CT skull-mid thgh initial CPT 78815 | $5,602.44 | $9,337.40 | $1,364.64 – $8,403.66 | 29 |
| Pet CT whole body initial CPT 78816 | $5,953.50 | $9,922.50 | $1,364.64 – $8,930.25 | 29 |
| Pet fdg brain metoblic eval sb CPT 78608 | $5,359.28 | $8,932.14 | $1,364.64 – $8,038.93 | 29 |
| Pet image full body CPT 78813 | $4,567.11 | $7,611.85 | $1,364.64 – $6,850.66 | 29 |
| Pet image ltd area CPT 78811 | $3,677.40 | $6,129.00 | $1,235.52 – $5,516.10 | 29 |
| Pet image skull-thigh CPT 78812 | $4,658.45 | $7,764.09 | $1,364.64 – $6,987.68 | 29 |
| Pet image w/ct lmtd CPT 78814 | $4,912.88 | $8,188.14 | $1,364.64 – $7,369.33 | 29 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $50,985.00 | $84,975.00 | $0.00 – $0.01 | 20 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $54.47 | $90.78 | $13.62 – $81.70 | 22 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $92.30 | $153.84 | $23.08 – $138.46 | 22 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $28.98 | $48.30 | $7.25 – $43.47 | 22 |
| Phalangectomy ea toe 28150 CPT 28150 | $3,309.58 | $5,515.97 | $71.00 – $8,018.48 | 29 |
| Ph body fluid CPT 83986 | $56.00 | $93.34 | $3.01 – $23.31 | 29 |
| Phencyclidine (pcp) CPT 83992 | $106.85 | $178.09 | $12.00 – $160.28 | 22 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $184.67 | $307.79 | $23.72 – $142.31 | 23 |
| Phenobarbital therapeutic drug level CPT 80184 | $109.10 | $181.84 | $12.00 – $163.66 | 29 |
| Phentolaine mesylate inj HCPCS J2760 | $1,325.32 | $2,208.87 | $244.58 – $1,696.50 | 29 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $158.10 | $263.50 | $0.00 – $14.40 | 23 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $10.80 | $18.00 | $0.46 – $7.51 | 23 |
| Phenytoin total therapeutic drug level CPT 80185 | $111.27 | $185.45 | $11.13 – $166.91 | 29 |
| Phlebotomy therapeutic CPT 99195 | $238.04 | $396.74 | $59.51 – $357.07 | 29 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $5,923.97 | $9,873.29 | $71.00 – $8,885.96 | 29 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $5,481.30 | $9,135.50 | $71.00 – $8,221.95 | 29 |
| Phosphorus CPT 84100 | $47.81 | $79.68 | $3.98 – $71.71 | 29 |
| Phosphorus 24 hour urine CPT 84105 | $59.55 | $99.25 | $4.86 – $88.20 | 29 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | $217.42 | $362.36 | $54.35 – $326.12 | 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.