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 |
|---|---|---|---|---|
| Photochemotherapy puva CPT 96912 | $238.54 | $397.56 | $56.30 – $357.80 | 29 |
| Photodynamic tx addl 15 min CPT 96571 | $166.19 | $276.99 | $41.55 – $249.29 | 22 |
| Photodynmc tx 30 min add-on CPT 96570 | $191.77 | $319.62 | $47.94 – $287.66 | 22 |
| Phys blood bank serv authrj CPT 86079 | $152.73 | $254.55 | $8.40 – $134.24 | 29 |
| Phys blood bank serv reactj CPT 86078 | $208.73 | $347.89 | $12.00 – $423.12 | 29 |
| Phys blood bank serv xmatch CPT 86077 | $45.01 | $75.01 | $11.25 – $73.76 | 29 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $374.69 | $624.48 | $93.67 – $562.03 | 23 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $304.19 | $506.98 | $76.05 – $456.28 | 23 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $332.36 | $553.94 | $83.09 – $498.55 | 23 |
| Physical Therapy Re-Evaluation CPT 97164 | $205.19 | $341.99 | $51.30 – $307.79 | 23 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $176.28 | $293.80 | $3.47 – $32.40 | 23 |
| Pik3ca gene trgt seq alys CPT 81309 | $585.97 | $976.61 | $36.00 – $878.95 | 29 |
| Pin caspar distraction 12mm HCPCS C1821 | $11,580.00 | $19,300.00 | $28.58 – $171.50 | 20 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | $863.24 | $1,438.73 | $71.00 – $1,555.84 | 29 |
| Pin finger dislocation CPT 26776 | $3,494.18 | $5,823.64 | $71.00 – $8,018.48 | 29 |
| Pin finger fracture each CPT 26756 | $3,910.33 | $6,517.21 | $71.00 – $8,018.48 | 29 |
| Pin hand dislocation CPT 26676 | $3,668.47 | $6,114.11 | $71.00 – $8,018.48 | 29 |
| Pin knuckle dislocation CPT 26706 | $3,152.78 | $5,254.63 | $71.00 – $8,018.48 | 29 |
| Pinworm exam CPT 87172 | $63.05 | $105.09 | $3.59 – $94.58 | 29 |
| Pinworm examinations HCPCS Q0113 | $5.70 | $9.50 | $1.43 – $10.25 | 29 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $399.28 | $665.47 | $1.19 – $32.26 | 23 |
| Place breast cath for rad CPT 19297 | $6,156.73 | $10,261.22 | $71.00 – $9,235.10 | 22 |
| Place breast rad tube/caths CPT 19298 | $6,215.93 | $10,359.89 | $71.00 – $20,696.41 | 29 |
| Place cath intracranial art CPT 36228 | $2,186.53 | $3,644.21 | $71.00 – $5,388.00 | 22 |
| Place cath xtrnl carotid CPT 36227 | $3,196.57 | $5,327.61 | $71.00 – $4,794.85 | 22 |
| Place cecostomy tube perc CPT 49442 | $2,726.45 | $4,544.08 | $71.00 – $5,645.00 | 29 |
| Place device/marker, non pro HCPCS C9728 | $2,039.82 | $3,399.70 | $509.95 – $3,432.55 | 27 |
| Place duod/jej tube perc CPT 49441 | $2,718.99 | $4,531.65 | $71.00 – $4,713.77 | 29 |
| Place endorectal app HCPCS C9725 | $1,438.99 | $2,398.32 | $359.75 – $2,264.11 | 29 |
| Place gastrostomy tube perc CPT 49440 | $2,039.95 | $3,399.92 | $71.00 – $4,713.77 | 29 |
| Placement bile duct support CPT 47801 | $2,131.56 | $3,552.60 | $71.00 – $5,388.00 | 22 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,351.81 | $2,253.02 | $71.00 – $4,016.35 | 30 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $319.48 | $532.46 | $48.72 – $479.21 | 23 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,332.43 | $2,220.72 | $71.00 – $1,998.65 | 30 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $3,752.50 | $6,254.16 | $71.00 – $6,837.00 | 29 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $1,160.65 | $1,934.42 | $71.00 – $1,740.98 | 22 |
| Placement of seton CPT 46020 | $3,645.00 | $6,075.00 | $939.93 – $6,955.62 | 27 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $16,578.05 | $27,630.09 | $71.00 – $27,252.71 | 29 |
| Place ndl musc/tis for right CPT 20555 | $3,383.41 | $5,639.01 | $71.00 – $8,649.00 | 29 |
| Place needles h&n for right CPT 41019 | $4,555.73 | $7,592.89 | $71.00 – $14,507.25 | 29 |
| Place needles pelvic for right CPT 55920 | $3,633.66 | $6,056.10 | $71.00 – $12,321.66 | 29 |
| Place non-slctv cath thoracic arta CPT 36221 | $5,274.33 | $8,790.55 | $71.00 – $7,911.49 | 29 |
| Placental lactogen CPT 83632 | $207.64 | $346.06 | $12.00 – $311.45 | 29 |
| Place po breast cath for rad CPT 19296 | $6,311.93 | $10,519.89 | $71.00 – $23,352.21 | 29 |
| Place right device/marker pros CPT 55876 | $2,195.93 | $3,659.88 | $70.87 – $3,432.55 | 29 |
| Place slctv cath carotd art uni CPT 36224 | $6,942.83 | $11,571.38 | $71.00 – $13,613.39 | 29 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $5,362.43 | $8,937.38 | $71.00 – $8,043.64 | 29 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $6,216.21 | $10,360.35 | $71.00 – $13,613.39 | 29 |
| Place slctv cath subclavian art CPT 36225 | $5,825.33 | $9,708.88 | $71.00 – $8,737.99 | 29 |
| Place slctv cath vertebral art uni CPT 36226 | $7,165.75 | $11,942.92 | $71.00 – $13,613.39 | 29 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $181.01 | $301.68 | $45.25 – $271.51 | 29 |
| Plasma volume multiple CPT 78111 | $1,964.02 | $3,273.36 | $91.89 – $3,517.62 | 29 |
| Plastic surgery neck CPT 15819 | $2,793.57 | $4,655.95 | $71.00 – $4,517.58 | 23 |
| Platelet aggregation each agent teg CPT 85576 | $192.99 | $321.65 | $12.00 – $289.49 | 29 |
| Platelet automated CPT 85049 | $77.50 | $129.17 | $3.76 – $116.25 | 29 |
| Platelet pheresis each unit HCPCS P9034 | $1,260.36 | $2,100.60 | $288.60 – $1,890.54 | 29 |
| Platelets each unit HCPCS P9019 | $259.58 | $432.63 | $49.67 – $389.37 | 29 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $1,673.52 | $2,789.20 | $418.38 – $2,510.28 | 29 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $361.59 | $602.65 | $90.40 – $542.38 | 29 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $391.62 | $652.70 | $97.91 – $599.64 | 29 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,370.40 | $2,284.00 | $317.70 – $1,906.20 | 29 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,481.28 | $2,468.80 | $345.42 – $2,072.52 | 29 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $822.60 | $1,371.00 | $205.65 – $1,433.33 | 29 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $3,407.22 | $5,678.70 | $71.00 – $8,649.00 | 29 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $2,905.23 | $4,842.05 | $71.00 – $4,357.85 | 22 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $4,316.34 | $7,193.90 | $71.00 – $8,649.00 | 29 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $6,804.00 | $11,340.00 | $71.00 – $10,206.00 | 29 |
| Plcmt dlyd xtn pros 1st vsl CPT 34710 | $3,298.61 | $5,497.69 | $824.65 – $5,388.00 | 20 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,331.53 | $2,219.22 | $71.00 – $3,421.00 | 29 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $456.97 | $761.62 | $71.00 – $685.46 | 22 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $199.28 | $332.13 | $49.82 – $298.92 | 23 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $181.95 | $303.25 | $45.49 – $272.93 | 23 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $410.62 | $684.37 | $41.82 – $615.93 | 23 |
| Plerixafor injection HCPCS J2562 | $17,959.33 | $29,932.21 | $19.54 – $26,938.99 | 29 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $429.77 | $716.29 | $107.44 – $777.56 | 29 |
| Plmt access bil tree sm bwl CPT 47541 | $3,537.42 | $5,895.70 | $71.00 – $18,741.87 | 29 |
| Plmt biliary drainage cath CPT 47534 | $4,762.80 | $7,938.00 | $71.00 – $8,649.00 | 29 |
| Plmt nephroureteral catheter CPT 50433 | $3,422.08 | $5,703.46 | $71.00 – $8,636.11 | 29 |
| Plmt ureteral stent prq CPT 50694 | $3,695.02 | $6,158.36 | $71.00 – $8,649.00 | 29 |
| Plug insert indwelling 16f HCPCS L8511 | $149.90 | $249.84 | $37.48 – $224.86 | 22 |
| Pm device progr eval dual CPT 93280 | $309.84 | $516.40 | $35.62 – $917.00 | 29 |
| Pm device progr eval multi CPT 93281 | $338.33 | $563.89 | $35.62 – $917.00 | 29 |
| Pml/raralpha 1 breakpoint CPT 81316 | $307.13 | $511.88 | $36.00 – $497.54 | 29 |
| Pmp22 gene dup/delet CPT 81324 | $1,029.75 | $1,716.25 | $12.00 – $1,820.06 | 29 |
| Pmp22 gene full sequence CPT 81325 | $2,559.68 | $4,266.13 | $12.00 – $3,839.52 | 29 |
| Pmp22 gene known fam variant CPT 81326 | $63.42 | $105.70 | $36.00 – $111.84 | 29 |
| Pm phone r-strip device eval CPT 93293 | $189.72 | $316.20 | $35.62 – $917.00 | 29 |
| Pms2 gene dup/delet variants CPT 81319 | $499.20 | $832.00 | $36.00 – $488.40 | 29 |
| Pms2 gene full seq analysis CPT 81317 | $843.75 | $1,406.25 | $36.00 – $1,623.60 | 29 |
| Pms2 known familial variants CPT 81318 | $397.20 | $662.00 | $36.00 – $794.40 | 29 |
| Pneum full leg splnt pre ots HCPCS L4370 | $52.80 | $88.00 | $13.20 – $79.20 | 21 |
| Pneumothrx tx-intraplrl inj ai CPT 32960 | $852.41 | $1,420.69 | $71.00 – $1,556.23 | 29 |
| #pnh-flow cytometry interp CPT 88187 | $154.14 | $256.90 | $36.00 – $229.12 | 22 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $234.98 | $391.63 | $12.00 – $352.47 | 29 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $32,554.79 | $54,257.99 | $130.37 – $48,832.19 | 29 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $6,277.17 | $10,461.95 | $819.52 – $9,415.75 | 29 |
| Polysom any age 1-3> param CPT 95808 | $3,703.29 | $6,172.15 | $819.52 – $5,554.94 | 29 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $5,236.15 | $8,726.91 | $819.52 – $7,854.22 | 29 |
| Positional change of finger CPT 26555 | $4,915.21 | $8,192.02 | $71.00 – $17,722.46 | 29 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | not published | not published | $2,959.00 – $7,441.00 | 2 |
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.