SelfPayRates
Hospital Dallas-Fort Worth-Arlington, TX

Texas Health Hospital Mansfield

Texas Health Hospital Mansfield in Mansfield, TX publishes cash prices for 60 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.

2300 Lone Star Road, Mansfield, TX 76063 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT SCAN,ABDOMEN AND PELVIS,W CONTRAST $10,563.14 $10,563.14 —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT SCAN,ABDOMEN AND PELVIS,W CONTRAST $10,563.14 $10,563.14 —
CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL $3,938.02 $3,938.02 —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL $3,938.02 $3,938.02 —
CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST $4,852.76 $4,852.76 —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST $4,852.76 $4,852.76 —
Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $1,071.65 $1,071.65 —
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI $1,071.65 $1,071.65 —
Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $725.48 $725.48 —
Diagnostic mammogram, one breast inpatient CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI $725.48 $725.48 —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT, W/O CONTRAST $4,237.94 $4,237.94 —
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT, W/O CONTRAST $4,237.94 $4,237.94 —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR LOWER EXTREMITY W AND WO IV CONTRAST $4,842.61 $4,842.61 —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR LOWER EXTREMITY W AND WO IV CONTRAST $4,842.61 $4,842.61 —
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN $3,430.49 $3,430.49 —
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN $3,430.49 $3,430.49 —
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO $5,412.37 $5,412.37 —
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO $5,412.37 $5,412.37 —
MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE $5,117.37 $5,117.37 —
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE $5,117.37 $5,117.37 —
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US, OB >/= 14 WKS, SNGL FETUS $2,385.55 $2,385.55 —
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US, OB >/= 14 WKS, SNGL FETUS $2,385.55 $2,385.55 —
Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $1,204.42 $1,204.42 —
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD $1,204.42 $1,204.42 —
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $6,197.13 $6,197.13 —
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $6,197.13 $6,197.13 —
Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL $1,266.72 $1,266.72 —
Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL $1,266.72 $1,266.72 —
Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE $1,617.97 $1,617.97 —
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE $1,617.97 $1,617.97 —
X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW $1,014.59 $1,014.59 —
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY LUMBAR SPINE 4 VW $1,014.59 $1,014.59 —

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL $596.54 $596.54 —
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL $596.54 $596.54 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE CARDIO IQ $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE BY NMR - NMR LIPOMED PROFILE - ARUP $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - BUNDLED CHARGE $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE- LIPOPROTEIN ELECTROPHORESIS - ARUP $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - CARDIO IQ - QWDL $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE BY NMR - NMR LIPOMED PROFILE - ARUP $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - CARDIO IQ - QWDL $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE CARDIO IQ $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE- LIPOPROTEIN ELECTROPHORESIS - ARUP $502.90 $502.90 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - BUNDLED CHARGE $502.90 $502.90 —
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO WBC DIFF $265.15 $265.15 —
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO WBC DIFF $265.15 $265.15 —
Complete blood count (CBC), no differential CPT 85027 HC CBC $223.56 $223.56 —
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC $223.56 $223.56 —
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL - CMP $794.49 $794.49 —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL - CMP $794.49 $794.49 —
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE $449.78 $449.78 —
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE $449.78 $449.78 —
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE $703.20 $703.20 —
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL - BUNDLED CHARGE $703.20 $703.20 —
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL - BUNDLED CHARGE $1,066.40 $1,066.40 —
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL - BUNDLED CHARGE $1,066.40 $1,066.40 —
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE - ARUP $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN, FREE - PSA TOTAL AND FREE $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN, FREE - PSA TOTAL AND FREE $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE - ARUP $191.76 $191.76 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE $260.61 $260.61 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL DIAGNOSTIC $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL HEALTH FAIR $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL - ARUP $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA ULTRASENSITIVE - ARUP $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL SCREENING - ARUP $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA SCREEN $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL SCREENING $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA ULTRA SENSITIVE $332.29 $332.29 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE $260.61 $260.61 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL DIAGNOSTIC $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL HEALTH FAIR $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL - ARUP $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA ULTRASENSITIVE - ARUP $292.39 $292.39 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL SCREENING - ARUP $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA SCREEN $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL SCREENING $300.46 $300.46 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA ULTRA SENSITIVE $332.29 $332.29 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC SPECIAL COAG APTT $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT DIRECT ORAL ANTICOAGULANT (DOAC) MONITORING $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT - ANTIPHOSPHOLIPID SYNDROME REFLEX PANEL - ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) - PT AND PTT PANEL $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) LUPUS SENS-INHIBITOR SCREEN $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT - LUPUS ANTICOAGULANT SCREEN $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT-D HEPARIN REFLEX BILL (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT-D 1:1 MIX BILL (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT, INHIBITOR SCREEN, 1-HOUR (RFLX) (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT - LUPUS ANTICOAGULANT PANEL WITH REFLEX - ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT - INHIBITOR ASSAY PTT WITH REFLEX (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT, HEPZYME TREATED $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT CRRT SYSTEM $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT - PHOSLIPID ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT LUPUS SENSITIVE $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM $303.93 $303.93 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT - ANTIPHOSPHOLIPID SYNDROME REFLEX PANEL - ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT DIRECT ORAL ANTICOAGULANT (DOAC) MONITORING $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) - PT AND PTT PANEL $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT CRRT SYSTEM $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC SPECIAL COAG APTT $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT, HEPZYME TREATED $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT - INHIBITOR ASSAY PTT WITH REFLEX (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT - LUPUS ANTICOAGULANT PANEL WITH REFLEX - ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT, INHIBITOR SCREEN, 1-HOUR (RFLX) (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT-D 1:1 MIX BILL (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT-D HEPARIN REFLEX BILL (ARUP) $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT - LUPUS ANTICOAGULANT SCREEN $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) LUPUS SENS-INHIBITOR SCREEN $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT LUPUS SENSITIVE $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - APTT - PHOSLIPID ARUP $229.48 $229.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM $303.93 $303.93 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY $95.98 $95.98 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR COUMADIN CLINIC $190.00 $190.00 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PT AND PTT PANEL $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME SPECIAL COAGULATION - INHIBITOR SCREEN $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTIME-INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR - SPECIAL COAG $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR - ARUP INHIB SCRN $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR - ARUP PHOSLIPID $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INR - LUPUS ANTICOAGULANT PANEL WITH REFLEX -ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC POC PROTHROMBIN TIME INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME INHIBITOR ASSAY PT WITH REFLEX TO PT 1:1 MIX - ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME -ANTIPHOSPHOLIPID SYNDROME REFLEX PANEL - ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - SURGICAL LAB $234.72 $234.72 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME DILUTION PROTOCOL $234.72 $234.72 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY $95.98 $95.98 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR COUMADIN CLINIC $190.00 $190.00 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME SPECIAL COAGULATION - INHIBITOR SCREEN $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME -ANTIPHOSPHOLIPID SYNDROME REFLEX PANEL - ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR - ARUP INHIB SCRN $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR - SPECIAL COAG $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POC PROTHROMBIN TIME INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR - ARUP PHOSLIPID $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INHIBITOR ASSAY PT WITH REFLEX TO PT 1:1 MIX - ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PT AND PTT PANEL $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTIME-INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME INR - LUPUS ANTICOAGULANT PANEL WITH REFLEX -ARUP $215.56 $215.56 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME DILUTION PROTOCOL $234.72 $234.72 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - SURGICAL LAB $234.72 $234.72 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL - TSH REFLEX FREE T4 $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL - TSH CASCADE $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL 3RD GENERATION - ARUP $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL 30 MINUTES - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL 60 MINUTES - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL BASELINE - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL - ARUP $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH LEVEL 3RD GENERATION $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL BASELINE - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL 3RD GENERATION $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL - ARUP $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL 60 MINUTES - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL - TSH REFLEX FREE T4 $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL - TSH CASCADE $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL 3RD GENERATION - ARUP $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL 30 MINUTES - THYROID RELEASING HORMONE STIMULATION PANEL $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE $470.35 $470.35 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH LEVEL $470.35 $470.35 —
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO WITH MICROSCOPIC $223.25 $223.25 —
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO WITH MICROSCOPIC $223.25 $223.25 —
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS W MICROSCOPIC NON-AUTO $63.33 $63.33 —
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS W MICROSCOPIC NON-AUTO $63.33 $63.33 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO W/O MICROSCPY - SPECIFIC GRAVITY QUAL $86.82 $86.82 —
Urinalysis without microscope exam, automated CPT 81003 HC GLUCOSE URINE QUALITATIVE $104.40 $104.40 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - POCT KETONE, URINE $107.76 $107.76 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - PH $138.84 $138.84 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS DIPSTICK $155.55 $155.55 —
Urinalysis without microscope exam, automated CPT 81003 HC UROBILINOGEN QUALITATIVE URINE $155.55 $155.55 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - SPECIFIC GRAVITY $166.76 $166.76 —
Urinalysis without microscope exam, automated CPT 81003 HC UROBILINOGEN QUALITATIVE $184.18 $184.18 —
Urinalysis without microscope exam, automated CPT 81003 HC BILE URINE $184.18 $184.18 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - OCCULT BLOOD $185.78 $185.78 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS POINT OF CARE $192.52 $192.52 —
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - ALBUMIN $194.74 $194.74 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO W/O MICROSCPY - SPECIFIC GRAVITY QUAL $86.82 $86.82 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC GLUCOSE URINE QUALITATIVE $104.40 $104.40 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - POCT KETONE, URINE $107.76 $107.76 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - PH $138.84 $138.84 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS DIPSTICK $155.55 $155.55 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC UROBILINOGEN QUALITATIVE URINE $155.55 $155.55 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - SPECIFIC GRAVITY $166.76 $166.76 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC BILE URINE $184.18 $184.18 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC UROBILINOGEN QUALITATIVE $184.18 $184.18 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - OCCULT BLOOD $185.78 $185.78 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS POINT OF CARE $192.52 $192.52 —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY - ALBUMIN $194.74 $194.74 —
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - POC $41.88 $41.88 —
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - SPECIFIC GRAVITY $44.71 $44.71 —
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY $49.41 $49.41 —
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - PROTEIN $49.41 $49.41 —
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - ACETONE QUAL $54.74 $54.74 —
Urinalysis without microscope exam, manual CPT 81002 HC PBB URINALYSIS NONAUTO W/O SCOPE $55.34 $55.34 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - POC $41.88 $41.88 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - SPECIFIC GRAVITY $44.71 $44.71 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY $49.41 $49.41 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - PROTEIN $49.41 $49.41 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS, NON-AUTO W/O MICROSCPY - ACETONE QUAL $54.74 $54.74 —
Urinalysis without microscope exam, manual inpatient CPT 81002 HC PBB URINALYSIS NONAUTO W/O SCOPE $55.34 $55.34 —

Surgery and procedures

ProcedureCash price List priceOff list
Cataract surgery with lens implant CPT 66984 HC XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $19,267.03 $19,267.03 —
Cataract surgery with lens implant inpatient CPT 66984 HC XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $19,267.03 $19,267.03 —
Colonoscopy with polyp removal CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $8,895.96 $8,895.96 —
Colonoscopy with polyp removal inpatient CPT 45385 HC COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $8,895.96 $8,895.96 —
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $8,895.96 $8,895.96 —
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $8,895.96 $8,895.96 —
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $8,607.73 $8,607.73 —
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $8,607.73 $8,607.73 —
Gallbladder removal, laparoscopic CPT 47562 HC LAPAROSCOPY SURG CHOLECYSTECTOMY $40,023.07 $40,023.07 —
Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAPAROSCOPY SURG CHOLECYSTECTOMY $40,023.07 $40,023.07 —
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC PBB REPAIR ING HERNIA,5+Y/O,REDUCIBL $22,862.64 $22,862.64 —
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC PBB REPAIR ING HERNIA,5+Y/O,REDUCIBL $22,862.64 $22,862.64 —
Knee arthroscopy with meniscus trim CPT 29881 HC KNEE SCOPE,MED/LAT MENISECTOMY $21,427.02 $21,427.02 —
Knee arthroscopy with meniscus trim inpatient CPT 29881 HC KNEE SCOPE,MED/LAT MENISECTOMY $21,427.02 $21,427.02 —
Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP $17,559.50 $17,559.50 —
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP $17,559.50 $17,559.50 —
Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $1,219.48 $1,219.48 —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $1,219.48 $1,219.48 —
Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $3,280.41 $3,280.41 —
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $3,280.41 $3,280.41 —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL $4,518.81 $4,518.81 —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL $4,518.81 $4,518.81 —
Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE,NEEDLE/PUNCH $2,438.95 $2,438.95 —
Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE,NEEDLE/PUNCH $2,438.95 $2,438.95 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC SHLDR ARTHROSCOP,PART ACROMIOPLAS $8,517.97 $8,517.97 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC SHLDR ARTHROSCOP,PART ACROMIOPLAS $8,517.97 $8,517.97 —
Tonsil and adenoid removal, child under 12 CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O $30,179.24 $30,179.24 —
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 HC REMOVE TONSILS/ADENOIDS,<12 Y/O $30,179.24 $30,179.24 —
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $8,408.35 $8,408.35 —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $8,408.35 $8,408.35 —
Upper endoscopy (EGD), diagnostic CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $7,273.38 $7,273.38 —
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $7,273.38 $7,273.38 —

Doctor visits and therapy

ProcedureCash price List priceOff list
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W/ PT 50 MIN $440.00 $440.00 —
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W/ PT 50 MIN $440.00 $440.00 —
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY, IOP/PHP $526.23 $526.23 —
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY, VIRTUAL/IN-PERSON $617.45 $617.45 —
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY, IOP/PHP $526.23 $526.23 —
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY, VIRTUAL/IN-PERSON $617.45 $617.45 —
New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW PT LOW LVL MDM $695.75 $695.75 —
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW PT LOW LVL MDM $695.75 $695.75 —
New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW PT MOD LVL MDM $955.09 $955.09 —
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW PT MOD LVL MDM $955.09 $955.09 —
New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW PT HIGH LVL MDM $1,170.08 $1,170.08 —
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW PT HIGH LVL MDM $1,170.08 $1,170.08 —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES $281.72 $281.72 —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES $295.82 $295.82 —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES $281.72 $281.72 —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES $295.82 $295.82 —
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES $1,080.42 $1,080.42 —
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES $1,080.42 $1,080.42 —
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES $928.43 $928.43 —
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES $928.43 $928.43 —
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES $901.42 $901.42 —
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/ PT 60 MINUTES $901.42 $901.42 —
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE/OP CONSULT NEW/ESTAB PATIENT 30 MIN $301.72 $301.72 —
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE/OP CONSULT NEW/ESTAB PATIENT 30 MIN $301.72 $301.72 —
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE/OP CONSULT NEW/ESTAB PATIENT 40 MIN $359.53 $359.53 —
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE/OP CONSULT NEW/ESTAB PATIENT 40 MIN $359.53 $359.53 —

Source file: https://HospitalPriceDisclosure.com/download.aspx?pi=8TD412ABjMMB7Z3bph2isQ*-*