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 |
|---|---|---|---|---|
| Sialolithotomy 42330 CPT 42330 | $3,283.01 | $5,471.68 | $71.00 – $7,975.81 | 29 |
| Sickling rbc CPT 85660 | $76.70 | $127.83 | $4.63 – $59.35 | 29 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $328.50 – $2,975.00 | 15 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $328.50 – $2,975.00 | 15 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $429.26 – $2,975.00 | 16 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $328.50 – $2,975.00 | 15 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $429.26 – $5,132.00 | 15 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $429.26 – $2,975.00 | 15 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $2,769.50 – $14,118.49 | 15 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $939.93 – $6,955.62 | 15 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $429.26 – $2,975.00 | 16 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $328.50 – $2,975.00 | 16 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $429.26 – $2,975.00 | 16 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $328.50 – $2,975.00 | 16 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $257.47 | $429.11 | $31.74 – $917.00 | 29 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $429.26 – $2,975.00 | 16 |
| Sim ang w/prs cath rad emb HCPCS C8004 | $13,001.06 | $21,668.44 | $3,250.27 – $19,501.60 | 26 |
| Simple cystometrogram 51725 CPT 51725 | $1,030.83 | $1,718.05 | $110.15 – $1,546.24 | 29 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,908.25 | $3,180.42 | $167.39 – $2,862.38 | 29 |
| Sinus CT scan (with contrast) CPT 70487 | $1,930.24 | $3,217.06 | $156.38 – $2,895.35 | 29 |
| Sinus CT scan (without contrast) CPT 70486 | $1,640.48 | $2,734.13 | $99.77 – $2,460.72 | 29 |
| Sinus/juglr venogram s&i CPT 75860 | $2,052.67 | $3,421.11 | $125.64 – $7,896.23 | 29 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | $2,616.15 | $4,360.25 | $71.00 – $7,975.81 | 29 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | $5,181.19 | $8,635.32 | $71.00 – $14,507.25 | 29 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | $4,555.73 | $7,592.89 | $71.00 – $14,507.25 | 29 |
| Sinus X-ray (complete) CPT 70220 | $421.47 | $702.45 | $37.76 – $632.21 | 29 |
| Sinus X-ray (limited) CPT 70210 | $188.79 | $314.65 | $32.41 – $283.19 | 29 |
| Sipuleucel-t - su HCPCS Q2043 | $112,684.50 | $187,807.50 | $28,171.12 – $169,026.75 | 29 |
| Sirolimus, oral HCPCS J7520 | $42.11 | $70.18 | $1.31 – $24.68 | 23 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $252.00 | $420.00 | $11.21 – $298.51 | 21 |
| Skin Biopsy CPT 11102 | $360.34 | $600.56 | $64.23 – $610.51 | 29 |
| Skin full graft 20sq cm less 15200 CPT 15200 | $3,157.10 | $5,261.83 | $71.00 – $4,735.65 | 29 |
| Skin full graft add-on 15241 CPT 15241 | $729.62 | $1,216.04 | $71.00 – $1,094.44 | 22 |
| Skin pedicle flap arms/legs CPT 15572 | $3,040.42 | $5,067.37 | $71.00 – $8,887.48 | 29 |
| Skin pedicle flap trunk CPT 15570 | $2,501.86 | $4,169.77 | $71.00 – $4,517.58 | 29 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $2,711.32 | $4,518.86 | $71.00 – $4,066.97 | 22 |
| Skull X-ray (1 to 3 views) CPT 70250 | $309.63 | $516.05 | $36.09 – $464.44 | 29 |
| Skull X-ray (complete) CPT 70260 | $440.90 | $734.83 | $44.78 – $661.35 | 29 |
| Sleep study attended CPT 95807 | $1,625.75 | $2,709.58 | $356.12 – $2,438.62 | 29 |
| Sleep Study (Polysomnography) CPT 95810 | $4,658.81 | $7,764.68 | $819.52 – $6,988.21 | 29 |
| Sleep study unattended CPT 95806 | $990.34 | $1,650.57 | $206.06 – $2,062.00 | 29 |
| Sleeve fing rolyan med HCPCS L3933 | $197.40 | $329.00 | $49.35 – $296.10 | 21 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $41.10 | $68.50 | $2.00 – $36.36 | 22 |
| Sling suprapubic suburetheral HCPCS C1771 | $16,564.21 | $27,607.02 | $192.97 – $1,157.82 | 20 |
| Slitting of prepuce CPT 54000 | $2,733.23 | $4,555.39 | $71.00 – $8,636.11 | 29 |
| Slitting of prepuce CPT 54001 | $3,659.06 | $6,098.44 | $71.00 – $5,488.60 | 29 |
| Slp pure tone screening CPT 92551 | $95.55 | $159.25 | $23.89 – $143.32 | 22 |
| Slp stdy unatnd w/anal CPT 95801 | $526.81 | $878.02 | $56.30 – $2,062.00 | 29 |
| Small animal inoculation CPT 87003 | $119.41 | $199.01 | $12.00 – $179.11 | 29 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $520.69 | $867.82 | $121.96 – $781.04 | 29 |
| Small bowel endoscopy CPT 44360 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44364 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44366 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44369 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44376 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44378 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy CPT 44382 | not published | not published | $334.95 – $2,975.00 | 16 |
| Small bowel endoscopy CPT 44384 | not published | not published | $1,831.27 – $5,132.00 | 15 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $564.97 – $4,713.77 | 16 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $334.95 – $2,975.00 | 16 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $564.97 – $5,132.00 | 15 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $2,916.94 – $14,118.49 | 16 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $85.55 | $142.58 | $4.53 – $47.37 | 29 |
| Smear gram stain CPT 87205 | $76.01 | $126.68 | $3.59 – $114.01 | 29 |
| Smear nasal eosinophil CPT 89190 | $72.60 | $121.00 | $4.86 – $108.90 | 29 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $94.10 | $156.84 | $5.03 – $141.16 | 29 |
| Smear wet mount CPT 87210 | $68.63 | $114.38 | $4.89 – $102.94 | 29 |
| Smn1 gene full gene sequence CPT 81336 | $1,200.00 | $2,000.00 | $36.00 – $1,800.00 | 29 |
| Smpd1 gene common variants CPT 81330 | $240.00 | $400.00 | $36.00 – $360.00 | 29 |
| Snrpn/ube3a gene CPT 81331 | $206.19 | $343.65 | $12.00 – $309.29 | 29 |
| Sodium 24 hour urine CPT 84300 | $54.37 | $90.62 | $4.25 – $81.56 | 29 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $69.85 | $116.42 | $2.40 – $45.00 | 23 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $30.00 | $50.00 | $1.49 – $45.00 | 23 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $30.00 | $50.00 | $0.77 – $22.95 | 23 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $31.39 | $52.32 | $2.70 – $16.20 | 22 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $131.28 | $218.80 | $2.63 – $196.92 | 23 |
| Sodium serum/plasma/whole blood CPT 84295 | $58.28 | $97.14 | $4.04 – $87.43 | 29 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $156.60 | $261.00 | $0.84 – $234.90 | 28 |
| Soft interface below knee se HCPCS L2820 | $76.20 | $127.00 | $19.05 – $114.30 | 21 |
| Somatosensory testing CPT 95927 | $1,124.38 | $1,873.96 | $206.06 – $1,686.56 | 29 |
| So neo gsap dna/dna&rna CPT 81459 | $2,714.80 | $4,524.66 | $36.00 – $4,469.38 | 28 |
| So neo gsap dna mcrstl ins CPT 81457 | $3,975.00 | $6,625.00 | $36.00 – $2,448.49 | 28 |
| So vest canvas/web pre ots HCPCS L3675 | $347.06 | $578.44 | $37.65 – $225.90 | 21 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $6,309.00 – $7,441.00 | 2 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $2,959.00 – $7,441.00 | 2 |
| Special physics consult CPT 77370 | $799.57 | $1,332.61 | $128.27 – $1,199.35 | 29 |
| Special radiation dosimetry CPT 77331 | $463.21 | $772.01 | $75.89 – $694.81 | 29 |
| Special radiation treatment CPT 77470 | $1,978.89 | $3,298.15 | $101.20 – $2,968.34 | 29 |
| Special supplies phys/qhp CPT 99070 | $60.00 | $100.00 | $7.50 – $45.00 | 22 |
| Special teletx port plan CPT 77321 | $1,346.27 | $2,243.79 | $174.29 – $2,019.41 | 29 |
| Specific gravity body fluid CPT 84315 | $28.32 | $47.20 | $2.76 – $42.48 | 29 |
| Specimen fat stain CPT 89125 | $28.52 | $47.54 | $4.94 – $42.79 | 29 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $505.93 | $843.22 | $112.00 – $758.90 | 23 |
| Speech audiometry complete CPT 92556 | $137.93 | $229.88 | $34.48 – $206.89 | 29 |
| Speech evaluation complex CPT 70371 | $409.97 | $683.28 | $109.60 – $614.95 | 29 |
| Speech recep thresh CPT 92555 | $106.68 | $177.80 | $26.67 – $160.02 | 29 |
| Speech Therapy Session (one-on-one) CPT 92507 | $301.84 | $503.07 | $75.46 – $452.76 | 23 |
| Sperm antibody test CPT 89325 | $74.27 | $123.78 | $10.14 – $111.40 | 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.