Southlake Specialty Hospital LLC
Southlake Specialty Hospital LLC in Southlake, TX publishes cash prices for 34 common procedures listed here, from its own machine-readable price file updated Apr 21, 2026. Click a procedure to compare it with other hospitals nearby.
1545 E Southlake Blvd, Southlake, TX 76092 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS W CONT | $3,920.40 | $6,534.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS W CONT | $3,920.40 | $6,534.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT STROKE ONSET | $2,057.70 | $3,429.50 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT | $2,057.70 | $3,429.50 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT STROKE ONSET | $2,057.70 | $3,429.50 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT | $2,057.70 | $3,429.50 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT | $2,612.85 | $4,354.75 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT | $2,612.85 | $4,354.75 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LWR LT JOINT WO CONT | $3,264.90 | $5,441.50 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LWR RT JOINT WO CONT | $3,264.90 | $5,441.50 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LWR RT JOINT WO CONT | $3,264.90 | $5,441.50 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LWR LT JOINT WO CONT | $3,264.90 | $5,441.50 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LWR LT JOINT W WO CONT | $3,700.05 | $6,166.75 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LWR RT JOINT W WO CONT | $3,700.05 | $6,166.75 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LWR RT JOINT W WO CONT | $3,700.05 | $6,166.75 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LWR LT JOINT W WO CONT | $3,700.05 | $6,166.75 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONT | $2,504.25 | $4,173.75 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONT | $2,504.25 | $4,173.75 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC W/WO CONT | $2,830.05 | $4,716.75 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W WO CONT | $2,830.05 | $4,716.75 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W WO CONT | $2,830.05 | $4,716.75 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC W/WO CONT | $2,830.05 | $4,716.75 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONT | $2,394.15 | $3,990.25 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONT | $2,394.15 | $3,990.25 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE SNGL FETUS | $381.75 | $636.25 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE SNGL FETUS | $381.75 | $636.25 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB | $589.80 | $983.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON-OB | $589.80 | $983.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $785.55 | $1,309.25 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $785.55 | $1,309.25 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR 4 VIEWS MIN | $652.50 | $1,087.50 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR 4 VIEWS MIN | $652.50 | $1,087.50 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL | $255.15 | $425.25 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL | $255.15 | $425.25 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC LIPID PROFILE | $358.50 | $597.50 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $391.80 | $653.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 POC LIPID PROFILE | $358.50 | $597.50 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $391.80 | $653.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC HEMOGRAM W AUTO DIFF | $134.70 | $224.50 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC HEMOGRAM W AUTO DIFF | $134.70 | $224.50 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM W/PLTS | $120.30 | $200.50 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF | $120.30 | $200.50 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF | $120.30 | $200.50 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/PLTS | $120.30 | $200.50 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PNL | $391.80 | $653.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PNL | $391.80 | $653.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PNL | $352.50 | $587.50 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PNL | $352.50 | $587.50 | 40% |
| Liver function blood test panel CPT 80076 LIVER PANEL | $316.20 | $527.00 | 40% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $370.20 | $617.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER PANEL | $316.20 | $527.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE | $370.20 | $617.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $127.05 | $211.75 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $127.05 | $211.75 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $130.65 | $217.75 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $130.65 | $217.75 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME W/INR | $91.05 | $151.75 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $119.10 | $198.50 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME W/INR | $91.05 | $151.75 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $119.10 | $198.50 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCT CASCADE | $161.70 | $269.50 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $324.00 | $540.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCT CASCADE | $161.70 | $269.50 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $324.00 | $540.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS ROUTINE | $107.85 | $179.75 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS ROUTINE | $107.85 | $179.75 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UR PH QL | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UR BLOOD | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UR PROTEIN QL | $30.00 | $50.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS SCRN W RFLX MICRO | $107.85 | $179.75 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS SCREEN ONLY | $107.85 | $179.75 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UR PH QL | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UR BLOOD | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS | $28.80 | $48.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UR PROTEIN QL | $30.00 | $50.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS SCREEN ONLY | $107.85 | $179.75 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS SCRN W RFLX MICRO | $107.85 | $179.75 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 W/BY SNARE (COLON) | $760.95 | $1,268.25 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 W/BY SNARE (COLON) | $760.95 | $1,268.25 | 40% |
| Colonoscopy with tissue sample CPT 45380 W/BIOPSY (COLON) | $760.95 | $1,268.25 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 W/BIOPSY (COLON) | $760.95 | $1,268.25 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $1,899.00 | $3,165.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $1,899.00 | $3,165.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ ANES LUM/SAC EPI W IMG | $1,001.25 | $1,668.75 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ ANES LUM/SAC EPI W IMG | $1,001.25 | $1,668.75 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ ANES LUM/SAC EPI W/O IMG | $1,001.25 | $1,668.75 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ ANES LUM/SAC EPI W/O IMG | $1,001.25 | $1,668.75 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TFRML EPI INJ LUMBAR/SACRAL 1 LEVEL | $1,482.45 | $2,470.75 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TFRML EPI INJ LUMBAR/SACRAL 1 LEVEL | $1,482.45 | $2,470.75 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY W BX (EGD) | $731.70 | $1,219.50 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY W BX (EGD) | $731.70 | $1,219.50 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD | $1,824.75 | $3,041.25 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD | $1,824.75 | $3,041.25 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ORAL MOTOR THERAPY 15 MIN | $123.90 | $206.50 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EX 15M | $123.90 | $206.50 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EX 15M | $123.90 | $206.50 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ORAL MOTOR THERAPY 15 MIN | $123.90 | $206.50 | 40% |