Medical emergency?Emergency? Call 911. Nearest emergency roomsNearest ERs

Psychiatric Hospital

Medical City Mental Health and Wellness Center

Fort Worth, Texas · Tarrant County

Summary

Medical City Mental Health and Wellness Center is a psychiatric hospital in Fort Worth, Texas. Medicare data does not list emergency services. Its official website lists 35 services, specialties and programs. Source: CMS Hospital General Information, data updated 2026-07-22.

What is a psychiatric hospital?

A hospital for mental and behavioral health, such as depression, anxiety, crisis care or addiction treatment. More about hospital types

Compare

Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-10-29). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

Not listedEmergency services
Not ratedNot rated by CMSMedicare rating
88Beds (hospital website)
35Services listed

Quick answers

Does Medical City Mental Health and Wellness Center have an emergency room?
Medicare (CMS) data does not list emergency services at Medical City Mental Health and Wellness Center. The closest hospitals that do: Medical City Alliance (0.4 mi), Texas Health Harris Methodist Hospital Alliance (2.0 mi) and Medical City North Hills (7.9 mi). In a medical emergency, call 911.
Where is Medical City Mental Health and Wellness Center?
3100 Alliance Town Center, Fort Worth, TX 76177, in Tarrant County, Texas.
What is the phone number of Medical City Mental Health and Wellness Center?
(409) 938-5166, as listed by Medicare (CMS).
What is the Medicare star rating of Medical City Mental Health and Wellness Center?
CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas[5]

  • Mental Health and Wellness
  • Adult Mental Health and Wellness
  • Inpatient Mental Health Care
  • Outpatient Mental Health Care
  • Senior Mental Health

Conditions treated[4][6][7][8][10]

  • Anxiety
  • Depression
  • Mood disorders
  • Panic attacks
  • Post-traumatic stress disorder (PTSD)
  • Psychosis
  • Self-injury
  • Severe disruptive behavior
  • Sudden mood changes
  • Suicidal thoughts
  • Trauma
  • Attention deficit/hyperactivity disorder
  • Personality disorders
  • Psychotic disorders
  • Suicide prevention

Treatments[4][7][8][11]

Programs and centers[4][7][8][11]

  • Inpatient mental health program
  • Outpatient mental health programs (daytime and evening)
  • Outpatient programs
  • Adult partial hospitalization program (PHP)
  • Adult intensive outpatient program (IOP)
  • Senior inpatient services

Visiting and practical information

VisitingFamily/friends may visit 4:15-5:15pm Tue, Thu, Sat, Sun; reservation required; max two visitors[9]
Interpreters and languagesFree translator/interpreter services available on request, per the patient rights policy[12]

Nearest emergency rooms

Hospitals that list emergency services, by straight-line distance (not driving distance).

Other hospitals nearby

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Medical City Mental Health and Wellness Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

Not reported to Medicare. The latest Medicare release has no patient survey, infection, complication, readmission or emergency room results for this hospital. This is common for small, specialty and psychiatric hospitals.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 70 common services exactly as Medical City Mental Health and Wellness Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,555
Emergency room visit (moderate): rates for 9 insurance plans
  • Aetna — COMM: $1,100
  • Aetna — Meritain: $1,100
  • Aetna — NewBusiness: $1,030
  • Aetna — OON: $1,301
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — PPO: $1,555
  • BCBS — Traditional: 79.2% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Inpatient (hospital stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,386 – $1,555
Emergency room visit (moderate): rates for 7 insurance plans
  • BCBS — BlueAdvantageHMO: $1,386
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — MyBlueHealth: $1,386
  • BCBS — PPO: $1,555
  • BCBS — Traditional: 79.2% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,386 – $1,555
Emergency room visit (moderately high): 10 of 11 insurance plan rates
  • Aetna — COMM: $3,200
  • Aetna — Meritain: $3,200
  • Aetna — NewBusiness: $2,995
  • Aetna — OON: $3,786
  • BCBS — BlueAdvantageHMO: $1,386
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — MyBlueHealth: $1,386
  • BCBS — PPO: $1,555
Emergency room visit (moderately high) CPT 99284 · Inpatient (hospital stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,386 – $1,555
Emergency room visit (moderately high): rates for 7 insurance plans
  • BCBS — BlueAdvantageHMO: $1,386
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — MyBlueHealth: $1,386
  • BCBS — PPO: $1,555
  • BCBS — Traditional: 79.2% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,386 – $1,555
Emergency room visit (high): 10 of 11 insurance plan rates
  • Aetna — COMM: $5,800
  • Aetna — Meritain: $5,800
  • Aetna — NewBusiness: $5,429
  • Aetna — OON: $6,861
  • BCBS — BlueAdvantageHMO: $1,386
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — MyBlueHealth: $1,386
  • BCBS — PPO: $1,555
Emergency room visit (high) CPT 99285 · Inpatient (hospital stay) In the file: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination Not listed in the file Not listed in the file $1,386 – $1,555
Emergency room visit (high): rates for 7 insurance plans
  • BCBS — BlueAdvantageHMO: $1,386
  • BCBS — BlueEssentials: $1,555
  • BCBS — BlueEssentialsAccess: $1,555
  • BCBS — EPOSOA: $1,555
  • BCBS — MyBlueHealth: $1,386
  • BCBS — PPO: $1,555
  • BCBS — Traditional: 79.2% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Ch $337.98 $337.98 $9.22
Basic metabolic panel (blood test): 10 of 15 insurance plan rates
  • Aetna — COMM: $10.21
  • Aetna — MCR: $8.53
  • Aetna — Meritain: $10.21
  • Aetna — NewBusiness: $9.55
  • Aetna — OON: $12.09
  • BCBS — MGMCRHMO: $8.46
  • Humana — MGMCR: $8.46
  • Molina — MCR: $9.22
  • Molina — MME: $9.22
  • Molina — MMP: $9.22
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) In the file: BMP TOTAL CALCIUM $337.98 $337.98 $170.68 – $202.79
Basic metabolic panel (blood test): rates for 3 insurance plans
  • Aetna — ASA: $170.68
  • Magellan BH — Pinnacle: $202.79
  • Magellan BH — Summit: $202.79
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon $432.76 $432.76 $11.51
Comprehensive metabolic panel (blood test): 10 of 15 insurance plan rates
  • Aetna — COMM: $12.74
  • Aetna — MCR: $10.65
  • Aetna — Meritain: $12.74
  • Aetna — NewBusiness: $11.92
  • Aetna — OON: $15.09
  • BCBS — MGMCRHMO: $10.56
  • Humana — MGMCR: $10.56
  • Molina — MCR: $11.51
  • Molina — MME: $11.51
  • Molina — MMP: $11.51
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) In the file: COMP METABOLIC PANEL $432.76 $432.76 $218.54 – $259.66
Comprehensive metabolic panel (blood test): rates for 3 insurance plans
  • Aetna — ASA: $218.54
  • Magellan BH — Pinnacle: $259.66
  • Magellan BH — Summit: $259.66
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) In the file: Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or Not listed in the file Not listed in the file $52.11
Obstetric blood test panel: 10 of 15 insurance plan rates
  • Aetna — COMM: $57.67
  • Aetna — MCR: $48.22
  • Aetna — Meritain: $57.67
  • Aetna — NewBusiness: $53.94
  • Aetna — OON: $68.28
  • BCBS — MGMCRHMO: $47.81
  • Humana — MGMCR: $47.81
  • Molina — MCR: $52.11
  • Molina — MME: $52.11
  • Molina — MMP: $52.11
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholester $318.61 $318.61 $14.60
Cholesterol panel (lipid panel): 10 of 15 insurance plan rates
  • Aetna — COMM: $16.14
  • Aetna — MCR: $13.50
  • Aetna — Meritain: $16.14
  • Aetna — NewBusiness: $15.10
  • Aetna — OON: $19.11
  • BCBS — MGMCRHMO: $13.39
  • Humana — MGMCR: $13.39
  • Molina — MCR: $14.60
  • Molina — MME: $14.60
  • Molina — MMP: $14.60
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) In the file: LIPID PANEL $318.61 $318.61 $160.90 – $191.17
Cholesterol panel (lipid panel): rates for 3 insurance plans
  • Aetna — ASA: $160.90
  • Magellan BH — Pinnacle: $191.17
  • Magellan BH — Summit: $191.17
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chlo $310.69 $310.69 $9.46
Kidney function panel: 10 of 15 insurance plan rates
  • Aetna — COMM: $10.47
  • Aetna — MCR: $8.75
  • Aetna — Meritain: $10.47
  • Aetna — NewBusiness: $9.79
  • Aetna — OON: $12.40
  • BCBS — MGMCRHMO: $8.68
  • Humana — MGMCR: $8.68
  • Molina — MCR: $9.46
  • Molina — MME: $9.46
  • Molina — MMP: $9.46
Kidney function panel CPT 80069 · Outpatient (no overnight stay) In the file: RENAL FUNCTION PANEL $310.69 $310.69 $156.90 – $186.41
Kidney function panel: rates for 3 insurance plans
  • Aetna — ASA: $156.90
  • Magellan BH — Pinnacle: $186.41
  • Magellan BH — Summit: $186.41
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase $563.99 $563.99 $8.91
Liver function panel: 10 of 15 insurance plan rates
  • Aetna — COMM: $9.85
  • Aetna — MCR: $8.24
  • Aetna — Meritain: $9.85
  • Aetna — NewBusiness: $9.21
  • Aetna — OON: $11.66
  • BCBS — MGMCRHMO: $8.17
  • Humana — MGMCR: $8.17
  • Molina — MCR: $8.91
  • Molina — MME: $8.91
  • Molina — MMP: $8.91
Liver function panel CPT 80076 · Outpatient (no overnight stay) In the file: HEPATIC FUNCTION PANEL $563.99 $563.99 $284.81 – $338.39
Liver function panel: rates for 3 insurance plans
  • Aetna — ASA: $284.81
  • Magellan BH — Pinnacle: $338.39
  • Magellan BH — Summit: $338.39
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $221.92 $221.92 $3.46
Urine test (automated, with microscope): 10 of 15 insurance plan rates
  • Aetna — COMM: $3.82
  • Aetna — MCR: $3.20
  • Aetna — Meritain: $3.82
  • Aetna — NewBusiness: $3.57
  • Aetna — OON: $4.52
  • BCBS — MGMCRHMO: $3.17
  • Humana — MGMCR: $3.17
  • Molina — MCR: $3.46
  • Molina — MME: $3.46
  • Molina — MMP: $3.46
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) In the file: UA W MICRO AUTO $221.92 $221.92 $112.07 – $133.15
Urine test (automated, with microscope): rates for 3 insurance plans
  • Aetna — ASA: $112.07
  • Magellan BH — Pinnacle: $133.15
  • Magellan BH — Summit: $133.15
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, Not listed in the file Not listed in the file $3.79
Urine test (manual, without microscope): 10 of 15 insurance plan rates
  • Aetna — COMM: $4.20
  • Aetna — MCR: $3.51
  • Aetna — Meritain: $4.20
  • Aetna — NewBusiness: $3.93
  • Aetna — OON: $4.97
  • BCBS — MGMCRHMO: $3.48
  • Humana — MGMCR: $3.48
  • Molina — MCR: $3.79
  • Molina — MME: $3.79
  • Molina — MMP: $3.79
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, $82.35 $82.35 $2.45
Urine test (automated, without microscope): 10 of 15 insurance plan rates
  • Aetna — COMM: $2.71
  • Aetna — MCR: $2.27
  • Aetna — Meritain: $2.71
  • Aetna — NewBusiness: $2.54
  • Aetna — OON: $3.21
  • BCBS — MGMCRHMO: $2.25
  • Humana — MGMCR: $2.25
  • Molina — MCR: $2.45
  • Molina — MME: $2.45
  • Molina — MMP: $2.45
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) In the file: UA W O MICRO AUTO $82.35 $82.35 $41.59 – $49.41
Urine test (automated, without microscope): rates for 3 insurance plans
  • Aetna — ASA: $41.59
  • Magellan BH — Pinnacle: $49.41
  • Magellan BH — Summit: $49.41
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) In the file: Prostate specific antigen (PSA); total Not listed in the file Not listed in the file $20.05
PSA (prostate specific antigen) blood test: 10 of 15 insurance plan rates
  • Aetna — COMM: $22.17
  • Aetna — MCR: $18.55
  • Aetna — Meritain: $22.17
  • Aetna — NewBusiness: $20.74
  • Aetna — OON: $26.25
  • BCBS — MGMCRHMO: $18.39
  • Humana — MGMCR: $18.39
  • Molina — MCR: $20.05
  • Molina — MME: $20.05
  • Molina — MMP: $20.05
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: Thyroid stimulating hormone (TSH) $302.42 $302.42 $16.80 – $44.02
Thyroid stimulating hormone (TSH) test: 10 of 15 insurance plan rates
  • Aetna — COMM: $20.26
  • Aetna — MCR: $16.94
  • Aetna — Meritain: $20.26
  • Aetna — NewBusiness: $18.95
  • Aetna — OON: $23.99
  • BCBS — MGMCRHMO: $16.80
  • Humana — MGMCR: $16.80
  • Molina — MCR: $18.31
  • Molina — MME: $18.31
  • Molina — MMP: $18.31
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) In the file: TSH $302.42 $302.42 $152.72 – $181.45
Thyroid stimulating hormone (TSH) test: rates for 3 insurance plans
  • Aetna — ASA: $152.72
  • Magellan BH — Pinnacle: $181.45
  • Magellan BH — Summit: $181.45
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count Not listed in the file Not listed in the file $8.47
Complete blood count (CBC) with differential: 10 of 15 insurance plan rates
  • Aetna — COMM: $9.37
  • Aetna — MCR: $7.84
  • Aetna — Meritain: $9.37
  • Aetna — NewBusiness: $8.76
  • Aetna — OON: $11.09
  • BCBS — MGMCRHMO: $7.77
  • Humana — MGMCR: $7.77
  • Molina — MCR: $8.47
  • Molina — MME: $8.47
  • Molina — MMP: $8.47
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) $501.94 $501.94 $7.05
Complete blood count (CBC), automated: 10 of 15 insurance plan rates
  • Aetna — COMM: $7.80
  • Aetna — MCR: $6.52
  • Aetna — Meritain: $7.80
  • Aetna — NewBusiness: $7.29
  • Aetna — OON: $9.23
  • BCBS — MGMCRHMO: $6.47
  • Humana — MGMCR: $6.47
  • Molina — MCR: $7.05
  • Molina — MME: $7.05
  • Molina — MMP: $7.05
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) In the file: CBC AUTOMATED $501.94 $501.94 $253.48 – $301.16
Complete blood count (CBC), automated: rates for 3 insurance plans
  • Aetna — ASA: $253.48
  • Magellan BH — Pinnacle: $301.16
  • Magellan BH — Summit: $301.16
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: Prothrombin time; $123.45 $123.45 $4.68
Blood clotting time test (prothrombin time, PT): 10 of 15 insurance plan rates
  • Aetna — COMM: $5.17
  • Aetna — MCR: $4.33
  • Aetna — Meritain: $5.17
  • Aetna — NewBusiness: $4.83
  • Aetna — OON: $6.12
  • BCBS — MGMCRHMO: $4.29
  • Humana — MGMCR: $4.29
  • Molina — MCR: $4.68
  • Molina — MME: $4.68
  • Molina — MMP: $4.68
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) In the file: PROTIME $123.45 $123.45 $62.34 – $74.07
Blood clotting time test (prothrombin time, PT): rates for 3 insurance plans
  • Aetna — ASA: $62.34
  • Magellan BH — Pinnacle: $74.07
  • Magellan BH — Summit: $74.07
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: Thromboplastin time, partial (PTT); plasma or whole blood $289.30 $289.30 $6.55
Blood clotting test (partial thromboplastin time, PTT): 10 of 15 insurance plan rates
  • Aetna — COMM: $7.26
  • Aetna — MCR: $6.06
  • Aetna — Meritain: $7.26
  • Aetna — NewBusiness: $6.79
  • Aetna — OON: $8.59
  • BCBS — MGMCRHMO: $6.01
  • Humana — MGMCR: $6.01
  • Molina — MCR: $6.55
  • Molina — MME: $6.55
  • Molina — MMP: $6.55
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) In the file: PTT $289.30 $289.30 $146.10 – $173.58
Blood clotting test (partial thromboplastin time, PTT): rates for 3 insurance plans
  • Aetna — ASA: $146.10
  • Magellan BH — Pinnacle: $173.58
  • Magellan BH — Summit: $173.58

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) In the file: Computed tomography, head or brain; without contrast material Not listed in the file Not listed in the file $801 – $1,013
CT scan of the head or brain, without contrast: rates for 4 insurance plans
  • Aetna — COMM: $856
  • Aetna — Meritain: $856
  • Aetna — NewBusiness: $801
  • Aetna — OON: $1,013
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furth Not listed in the file Not listed in the file $1,046 – $1,321
MRI of the brain, before and after contrast: rates for 4 insurance plans
  • Aetna — COMM: $1,117
  • Aetna — Meritain: $1,117
  • Aetna — NewBusiness: $1,046
  • Aetna — OON: $1,321
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) In the file: CHEST XRAY 2 V $569.20 $569.20 $287.45 – $341.52
Chest X-ray, 2 views: rates for 3 insurance plans
  • Aetna — ASA: $287.45
  • Magellan BH — Pinnacle: $341.52
  • Magellan BH — Summit: $341.52
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, chest; 2 views $569.20 $569.20 $53.12 – $67.15
Chest X-ray, 2 views: rates for 4 insurance plans
  • Aetna — COMM: $56.74
  • Aetna — Meritain: $56.74
  • Aetna — NewBusiness: $53.12
  • Aetna — OON: $67.15
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · modifier TC In the file: Radiologic examination, spine, lumbosacral; minimum of 4 views Not listed in the file Not listed in the file $89.51 – $113.16
X-ray of the lower spine, at least 4 views: rates for 4 insurance plans
  • Aetna — COMM: $95.62
  • Aetna — Meritain: $95.62
  • Aetna — NewBusiness: $89.51
  • Aetna — OON: $113.16
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Not listed in the file Not listed in the file $1,046 – $1,321
MRI of the lower back (lumbar spine), without contrast: rates for 4 insurance plans
  • Aetna — COMM: $1,117
  • Aetna — Meritain: $1,117
  • Aetna — NewBusiness: $1,046
  • Aetna — OON: $1,321
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) In the file: Computed tomography, pelvis; with contrast material(s) Not listed in the file Not listed in the file $801 – $1,013
CT scan of the pelvis, with contrast: rates for 4 insurance plans
  • Aetna — COMM: $856
  • Aetna — Meritain: $856
  • Aetna — NewBusiness: $801
  • Aetna — OON: $1,013
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) In the file: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material Not listed in the file Not listed in the file $1,046 – $1,321
MRI of a leg joint (such as the knee), without contrast: rates for 4 insurance plans
  • Aetna — COMM: $1,117
  • Aetna — Meritain: $1,117
  • Aetna — NewBusiness: $1,046
  • Aetna — OON: $1,321
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) In the file: Computed tomography, abdomen and pelvis; with contrast material(s) Not listed in the file Not listed in the file $801 – $1,013
CT scan of the abdomen and pelvis, with contrast: rates for 4 insurance plans
  • Aetna — COMM: $856
  • Aetna — Meritain: $856
  • Aetna — NewBusiness: $801
  • Aetna — OON: $1,013
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) In the file: US ABDOMEN COMPLETE $1,592.02 $1,592.02 $803.97 – $955.21
Ultrasound of the abdomen, complete: rates for 3 insurance plans
  • Aetna — ASA: $803.97
  • Magellan BH — Pinnacle: $955.21
  • Magellan BH — Summit: $955.21
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, abdominal, real time with image documentation; complete $1,592.02 $1,592.02 $184.84 – $233.67
Ultrasound of the abdomen, complete: rates for 4 insurance plans
  • Aetna — COMM: $197.44
  • Aetna — Meritain: $197.44
  • Aetna — NewBusiness: $184.84
  • Aetna — OON: $233.67
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 day Not listed in the file Not listed in the file $204.97 – $259.12
Pregnancy ultrasound (after the first trimester): rates for 4 insurance plans
  • Aetna — COMM: $218.94
  • Aetna — Meritain: $218.94
  • Aetna — NewBusiness: $204.97
  • Aetna — OON: $259.12
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · modifier TC In the file: Ultrasound, transvaginal Not listed in the file Not listed in the file $203.42 – $257.17
Transvaginal ultrasound: rates for 4 insurance plans
  • Aetna — COMM: $217.29
  • Aetna — Meritain: $217.29
  • Aetna — NewBusiness: $203.42
  • Aetna — OON: $257.17
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral Not listed in the file Not listed in the file $92.57
Diagnostic mammogram, one breast: 10 of 11 insurance plan rates
  • Aetna — MCR: $85.65
  • BCBS — MGMCRHMO: $84.93
  • Humana — MGMCR: $84.93
  • Molina — MCR: $92.57
  • Molina — MME: $92.57
  • Molina — MMP: $92.57
  • Molina Healthcare — HIX: $222.52
  • Superior — EPO: $190.24
  • Superior — HMO: $190.24
  • Superior — ValueHMO: $152.02
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral Not listed in the file Not listed in the file $202.65 – $256.19
Diagnostic mammogram, one breast: rates for 4 insurance plans
  • Aetna — COMM: $216.46
  • Aetna — Meritain: $216.46
  • Aetna — NewBusiness: $202.65
  • Aetna — OON: $256.19
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Not listed in the file Not listed in the file $118.73
Diagnostic mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — MCR: $109.86
  • BCBS — MGMCRHMO: $108.93
  • Humana — MGMCR: $108.93
  • Molina — MCR: $118.73
  • Molina — MME: $118.73
  • Molina — MMP: $118.73
  • Molina Healthcare — HIX: $285.40
  • Superior — EPO: $244
  • Superior — HMO: $244
  • Superior — ValueHMO: $194.98
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · modifier TC In the file: Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Not listed in the file Not listed in the file $258.44 – $326.72
Diagnostic mammogram, both breasts: rates for 4 insurance plans
  • Aetna — COMM: $276.06
  • Aetna — Meritain: $276.06
  • Aetna — NewBusiness: $258.44
  • Aetna — OON: $326.72
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Not listed in the file Not listed in the file $97.96
Screening mammogram, both breasts: 10 of 11 insurance plan rates
  • Aetna — MCR: $90.63
  • BCBS — MGMCRHMO: $89.87
  • Humana — MGMCR: $89.87
  • Molina — MCR: $97.96
  • Molina — MME: $97.96
  • Molina — MMP: $97.96
  • Molina Healthcare — HIX: $235.46
  • Superior — EPO: $201.31
  • Superior — HMO: $201.31
  • Superior — ValueHMO: $160.87
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier TC In the file: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Not listed in the file Not listed in the file $213.49 – $269.89
Screening mammogram, both breasts: rates for 4 insurance plans
  • Aetna — COMM: $228.04
  • Aetna — Meritain: $228.04
  • Aetna — NewBusiness: $213.49
  • Aetna — OON: $269.89

Heart tests and sleep study

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report Not listed in the file Not listed in the file $1,198 – $1,514
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans
  • Aetna — COMM: $1,280
  • Aetna — Meritain: $1,280
  • Aetna — NewBusiness: $1,198
  • Aetna — OON: $1,514
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) In the file: Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when pe Not listed in the file Not listed in the file $16,633 – $21,022
Left heart catheterization (diagnostic): rates for 5 insurance plans
  • Aetna — COMM: $17,770
  • Aetna — Meritain: $17,770
  • Aetna — NewBusiness: $16,633
  • Aetna — OON: $21,022
  • Aetna — ASA: 50.5% (a percentage in the contract, not a dollar amount)
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recor Not listed in the file Not listed in the file Not listed in the file
Heart rhythm study (electrophysiology evaluation): rates for 4 insurance plans
  • Aetna — COMM: 24.5% (a percentage in the contract, not a dollar amount)
  • Aetna — Meritain: 24.5% (a percentage in the contract, not a dollar amount)
  • Aetna — NewBusiness: 22.9% (a percentage in the contract, not a dollar amount)
  • Aetna — OON: 29% (a percentage in the contract, not a dollar amount)
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) In the file: Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, Not listed in the file Not listed in the file Not listed in the file
Heart rhythm study with ablation for atrial fibrillation: rates for 4 insurance plans
  • Aetna — COMM: 24.5% (a percentage in the contract, not a dollar amount)
  • Aetna — Meritain: 24.5% (a percentage in the contract, not a dollar amount)
  • Aetna — NewBusiness: 22.9% (a percentage in the contract, not a dollar amount)
  • Aetna — OON: 29% (a percentage in the contract, not a dollar amount)
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) In the file: Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist Not listed in the file Not listed in the file $796 – $1,006
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans
  • Aetna — COMM: $850
  • Aetna — Meritain: $850
  • Aetna — NewBusiness: $796
  • Aetna — OON: $1,006

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) In the file: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexib Not listed in the file Not listed in the file $31.57
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 11 insurance plan rates
  • Aetna — MCR: $29.21
  • BCBS — MGMCRHMO: $28.96
  • Humana — MGMCR: $28.96
  • Molina — MCR: $31.57
  • Molina — MME: $31.57
  • Molina — MMP: $31.57
  • Molina Healthcare — HIX: $75.88
  • Superior — EPO: $64.87
  • Superior — HMO: $64.87
  • Superior — ValueHMO: $51.84
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GO In the file: THER EXERCISES 15 MIN OT $131.18 $131.18 $66.25 – $78.71
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans
  • Aetna — ASA: $66.25
  • Magellan BH — Pinnacle: $78.71
  • Magellan BH — Summit: $78.71
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · modifier GP In the file: THER EXERCISES 15 MIN PT $192.47 $192.47 $97.20 – $115.48
Physical therapy: therapeutic exercise (each 15 minutes): rates for 3 insurance plans
  • Aetna — ASA: $97.20
  • Magellan BH — Pinnacle: $115.48
  • Magellan BH — Summit: $115.48
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $485.76 $485.76 $106.43
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $98.47
  • BCBS — MGMCRHMO: $97.64
  • Humana — MGMCR: $97.64
  • Molina — MCR: $106.43
  • Molina — MME: $106.43
  • Molina — MMP: $106.43
  • Molina Healthcare — HIX: $255.82
  • Superior — EPO: $218.71
  • Superior — HMO: $218.71
  • Superior — ValueHMO: $174.78
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact $485.76 $485.76 $93.66
Physical therapy evaluation (low complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $86.65
  • BCBS — MGMCRHMO: $85.92
  • Humana — MGMCR: $85.92
  • Molina — MCR: $93.66
  • Molina — MME: $93.66
  • Molina — MMP: $93.66
  • Molina Healthcare — HIX: $225.12
  • Superior — EPO: $192.47
  • Superior — HMO: $192.47
  • Superior — ValueHMO: $153.80
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT LOW COMPLEX $485.76 $485.76 $245.31 – $291.46
Physical therapy evaluation (low complexity): rates for 3 insurance plans
  • Aetna — ASA: $245.31
  • Magellan BH — Pinnacle: $291.46
  • Magellan BH — Summit: $291.46
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $700.88 $700.88 $106.43
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $98.47
  • BCBS — MGMCRHMO: $97.64
  • Humana — MGMCR: $97.64
  • Molina — MCR: $106.43
  • Molina — MME: $106.43
  • Molina — MMP: $106.43
  • Molina Healthcare — HIX: $255.82
  • Superior — EPO: $218.71
  • Superior — HMO: $218.71
  • Superior — ValueHMO: $174.78
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or $700.88 $700.88 $93.66
Physical therapy evaluation (moderate complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $86.65
  • BCBS — MGMCRHMO: $85.92
  • Humana — MGMCR: $85.92
  • Molina — MCR: $93.66
  • Molina — MME: $93.66
  • Molina — MMP: $93.66
  • Molina Healthcare — HIX: $225.12
  • Superior — EPO: $192.47
  • Superior — HMO: $192.47
  • Superior — ValueHMO: $153.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT MOD COMPLEX $700.88 $700.88 $353.94 – $420.53
Physical therapy evaluation (moderate complexity): rates for 3 insurance plans
  • Aetna — ASA: $353.94
  • Magellan BH — Pinnacle: $420.53
  • Magellan BH — Summit: $420.53
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,045.99 $1,045.99 $97.64 – $255.82
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $98.47
  • BCBS — MGMCRHMO: $97.64
  • Humana — MGMCR: $97.64
  • Molina — MCR: $106.43
  • Molina — MME: $106.43
  • Molina — MMP: $106.43
  • Molina Healthcare — HIX: $255.82
  • Superior — EPO: $218.71
  • Superior — HMO: $218.71
  • Superior — ValueHMO: $174.78
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP|CQ In the file: Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/o $1,045.99 $1,045.99 $93.66
Physical therapy evaluation (high complexity): 10 of 11 insurance plan rates
  • Aetna — MCR: $86.65
  • BCBS — MGMCRHMO: $85.92
  • Humana — MGMCR: $85.92
  • Molina — MCR: $93.66
  • Molina — MME: $93.66
  • Molina — MMP: $93.66
  • Molina Healthcare — HIX: $225.12
  • Superior — EPO: $192.47
  • Superior — HMO: $192.47
  • Superior — ValueHMO: $153.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · modifier GP In the file: EVAL PT HIGH COMPLEX $1,045.99 $1,045.99 $528.22 – $627.59
Physical therapy evaluation (high complexity): rates for 3 insurance plans
  • Aetna — ASA: $528.22
  • Magellan BH — Pinnacle: $627.59
  • Magellan BH — Summit: $627.59
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) In the file: INDIV SESSION 45MIN $411.92 $411.92 $80.74 – $247.15
Psychotherapy, 45 minutes: rates for 7 insurance plans
  • Aetna — ASA: $208.02
  • Aetna — COMM: $86.09
  • Aetna — Meritain: $86.09
  • Aetna — NewBusiness: $80.74
  • Aetna — OON: $101.74
  • Magellan BH — Pinnacle: $247.15
  • Magellan BH — Summit: $247.15
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) In the file: FAM W PT 50 MIN $763.39 $763.39 $149.62 – $458.03
Family psychotherapy, with the patient: rates for 7 insurance plans
  • Aetna — ASA: $385.51
  • Aetna — COMM: $159.55
  • Aetna — Meritain: $159.55
  • Aetna — NewBusiness: $149.62
  • Aetna — OON: $188.56
  • Magellan BH — Pinnacle: $458.03
  • Magellan BH — Summit: $458.03
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) In the file: IOP PSY GRP (NOT FAMILY) $763.39 $763.39 $385.51 – $458.03
Group psychotherapy: rates for 3 insurance plans
  • Aetna — ASA: $385.51
  • Magellan BH — Pinnacle: $458.03
  • Magellan BH — Summit: $458.03

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) In the file: Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19 Not listed in the file Not listed in the file $7,050 – $8,910
Removal of breast growth (open surgery): rates for 4 insurance plans
  • Aetna — COMM: $7,532
  • Aetna — Meritain: $7,532
  • Aetna — NewBusiness: $7,050
  • Aetna — OON: $8,910
Total hip replacement CPT 27130 · Outpatient (no overnight stay) In the file: Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft Not listed in the file Not listed in the file $14,000 – $69,513
Total hip replacement: rates for 5 insurance plans
  • Aetna — COMM: $58,760
  • Aetna — Meritain: $58,760
  • Aetna — NewBusiness: $54,999
  • Aetna — OON: $69,513
  • Humana — MGMCR: $14,000
Total knee replacement CPT 27447 · Outpatient (no overnight stay) In the file: Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) Not listed in the file Not listed in the file $14,000 – $69,513
Total knee replacement: rates for 5 insurance plans
  • Aetna — COMM: $58,760
  • Aetna — Meritain: $58,760
  • Aetna — NewBusiness: $54,999
  • Aetna — OON: $69,513
  • Humana — MGMCR: $14,000
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) In the file: Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) rele Not listed in the file Not listed in the file $24,430 – $30,876
Shoulder arthroscopy: shaving of shoulder bone: rates for 4 insurance plans
  • Aetna — COMM: $26,100
  • Aetna — Meritain: $26,100
  • Aetna — NewBusiness: $24,430
  • Aetna — OON: $30,876
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) In the file: Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articula Not listed in the file Not listed in the file $24,430 – $30,876
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 4 insurance plans
  • Aetna — COMM: $26,100
  • Aetna — Meritain: $26,100
  • Aetna — NewBusiness: $24,430
  • Aetna — OON: $30,876
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) In the file: Tonsillectomy and adenoidectomy; younger than age 12 Not listed in the file Not listed in the file $7,050 – $8,910
Removal of tonsils and adenoids (under age 12): rates for 4 insurance plans
  • Aetna — COMM: $7,532
  • Aetna — Meritain: $7,532
  • Aetna — NewBusiness: $7,050
  • Aetna — OON: $8,910
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (sep Not listed in the file Not listed in the file $3,838 – $4,850
Upper GI endoscopy (diagnostic): rates for 4 insurance plans
  • Aetna — COMM: $4,100
  • Aetna — Meritain: $4,100
  • Aetna — NewBusiness: $3,838
  • Aetna — OON: $4,850
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) In the file: Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Not listed in the file Not listed in the file $4,568 – $5,773
Upper GI endoscopy with biopsy: rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Not listed in the file Not listed in the file $4,568 – $5,773
Colonoscopy (diagnostic): rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with biopsy, single or multiple Not listed in the file Not listed in the file $4,568 – $5,773
Colonoscopy with biopsy: rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Not listed in the file Not listed in the file $4,568 – $5,773
Colonoscopy with removal of polyps (snare): rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) In the file: Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and Not listed in the file Not listed in the file $4,568 – $5,773
Ultrasound of the lower bowel by endoscope: rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) In the file: Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk Not listed in the file Not listed in the file $4,568 – $5,773
Screening colonoscopy (not high risk): rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical; cholecystectomy Not listed in the file Not listed in the file $9,220 – $11,653
Gallbladder removal by laparoscope: rates for 4 insurance plans
  • Aetna — COMM: $9,850
  • Aetna — Meritain: $9,850
  • Aetna — NewBusiness: $9,220
  • Aetna — OON: $11,653
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) In the file: Repair initial inguinal hernia, age 5 years or older; reducible Not listed in the file Not listed in the file $8,812 – $11,138
Groin (inguinal) hernia repair, age 5 or older: rates for 4 insurance plans
  • Aetna — COMM: $9,415
  • Aetna — Meritain: $9,415
  • Aetna — NewBusiness: $8,812
  • Aetna — OON: $11,138
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) In the file: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; Not listed in the file Not listed in the file $9,220 – $11,653
Prostate removal by laparoscope (radical prostatectomy): rates for 4 insurance plans
  • Aetna — COMM: $9,850
  • Aetna — Meritain: $9,850
  • Aetna — NewBusiness: $9,220
  • Aetna — OON: $11,653
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) In the file: Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C Not listed in the file Not listed in the file $7,778 – $9,831
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans
  • Aetna — COMM: $8,310
  • Aetna — Meritain: $8,310
  • Aetna — NewBusiness: $7,778
  • Aetna — OON: $9,831
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) In the file: Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neur Not listed in the file Not listed in the file $3,838 – $4,850
Spinal injection, lower back (epidural), with imaging guidance: rates for 4 insurance plans
  • Aetna — COMM: $4,100
  • Aetna — Meritain: $4,100
  • Aetna — NewBusiness: $3,838
  • Aetna — OON: $4,850
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) In the file: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, sing Not listed in the file Not listed in the file $3,838 – $4,850
Nerve root injection, lower back, with imaging guidance: rates for 4 insurance plans
  • Aetna — COMM: $4,100
  • Aetna — Meritain: $4,100
  • Aetna — NewBusiness: $3,838
  • Aetna — OON: $4,850
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) In the file: Neuroplasty and/or transposition; median nerve at carpal tunnel Not listed in the file Not listed in the file $4,568 – $5,773
Carpal tunnel release: rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) In the file: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or Not listed in the file Not listed in the file $4,568 – $5,773
Laser treatment of clouding after cataract surgery: rates for 4 insurance plans
  • Aetna — COMM: $4,880
  • Aetna — Meritain: $4,880
  • Aetna — NewBusiness: $4,568
  • Aetna — OON: $5,773
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) In the file: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irriga Not listed in the file Not listed in the file $14,630 – $18,490
Cataract removal with lens implant: rates for 4 insurance plans
  • Aetna — COMM: $15,630
  • Aetna — Meritain: $15,630
  • Aetna — NewBusiness: $14,630
  • Aetna — OON: $18,490

Hospital stays (whole stay, MS-DRG)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Not listed in the file Not listed in the file $135,158 – $172,646.85
Heart valve or major heart-chest surgery with heart catheterization, with major complications: rates for 7 insurance plans
  • Aetna — COMM: $144,400
  • Aetna — Meritain: $144,400
  • Aetna — NewBusiness: $135,158
  • Aetna — OON: $170,825
  • Molina Healthcare — HIX: $172,646.85
  • Magellan BH — Pinnacle: 60% (a percentage in the contract, not a dollar amount)
  • Magellan BH — Summit: 60% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Not listed in the file Not listed in the file $34,041.23 – $90,500
Hip or knee replacement (major joint of the leg), without major complications: rates for 7 insurance plans
  • Aetna — COMM: $76,500
  • Aetna — Meritain: $76,500
  • Aetna — NewBusiness: $71,604
  • Aetna — OON: $90,500
  • Molina Healthcare — HIX: $34,041.23
  • Magellan BH — Pinnacle: 60% (a percentage in the contract, not a dollar amount)
  • Magellan BH — Summit: 60% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC Not listed in the file Not listed in the file $43,084.06 – $90,890
Neck (cervical) spinal fusion, without complications: rates for 7 insurance plans
  • Aetna — COMM: $76,830
  • Aetna — Meritain: $76,830
  • Aetna — NewBusiness: $71,913
  • Aetna — OON: $90,890
  • Molina Healthcare — HIX: $43,084.06
  • Magellan BH — Pinnacle: 60% (a percentage in the contract, not a dollar amount)
  • Magellan BH — Summit: 60% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Not listed in the file Not listed in the file $15,912 – $21,895.87
Uterus and ovary surgery (not for cancer), without complications: rates for 7 insurance plans
  • Aetna — COMM: $17,000
  • Aetna — Meritain: $17,000
  • Aetna — NewBusiness: $15,912
  • Aetna — OON: $20,111
  • Molina Healthcare — HIX: $21,895.87
  • Magellan BH — Pinnacle: 60% (a percentage in the contract, not a dollar amount)
  • Magellan BH — Summit: 60% (a percentage in the contract, not a dollar amount)

Source: Medical City Mental Health and Wellness Center’s standard charges file (stctrprodsnsvc00455826e6.blob.core.windows.net, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on September 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typePsychiatric Hospital
Address3100 Alliance Town Center, Fort Worth, TX 76177
CountyTarrant County
StateTexas
Phone(409) 938‑5166
Emergency servicesNot listed
OwnershipProprietary
Medicare overall ratingNot rated by CMS
CMS Certification Number454079
Name in Medicare recordsMEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER
Profile levelMedicare data + hospital website
Main phone on the hospital’s website(940) 371‑3000[4][5]
Name on the hospital’s websiteMedical City Mental Health and Wellness Center Alliance
Official websitemedicalcityhealthcare.com
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-29.

  1. Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  2. Specialties - Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  3. Inpatient mental health care | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  4. Outpatient mental health care | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  5. Mental health and wellness | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  6. For Visitors | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  7. Adult mental health and wellness | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  8. Senior Mental Health | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com
  9. Patient Rights & Responsibilities | Medical City Mental Health and Wellness Center Alliance — medicalcityhealthcare.com