Quick answers Does Methodist Southlake Medical Center have an emergency room? Yes. Medicare (CMS) data lists emergency services at Methodist Southlake Medical Center. In a medical emergency, call 911. Where is Methodist Southlake Medical Center? 421 E State Highway 114, Southlake, TX 76092, in Tarrant County, Texas. What is the phone number of Methodist Southlake Medical Center? (878) 654-4400, as listed by Medicare (CMS). What is the Medicare star rating of Methodist Southlake Medical 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. Cardiac catheterization lab emergency care Angioplasty and stenting Atherectomy Implantable pacemakers and defibrillators Minimally invasive treatment for DVT and embolism Total knee replacement Total hip replacement Shoulder replacement Ankle replacement Casting, bracing and splinting Limb-lengthening procedures Mastectomy Breast reconstruction DIEP flap procedure Breast implants Robotic-assisted gynecologic surgery Myomectomy Hysterectomy Endometrial ablation Bladder resuspension Fertility treatments Electrical stimulation with biofeedback Tubal ligation Colectomy Colostomy Hemorrhoidectomy Ileal pouch anal anastomosis (J-pouch) Rectopexy Gallbladder surgery Appendix surgery Minimally invasive surgery Surgical oncology Tonsillectomy and adenoidectomy Ear tube placement (myringotomy) Cleft lip and cleft palate surgery Thyroid and parathyroid surgery Sinus surgery Balloon sinuplasty Balloon septoplasty Microlaryngoscopy vocal injections Bronchoscopy Show all 41 Coronary CT angiogram Cardiac stress test Echocardiogram Duplex ultrasound SPECT imaging Coronary calcium score X-ray CT scan MRI MRA Nuclear medicine imaging Fluoroscopy Colonoscopy Upper endoscopy (EGD) Endoscopic retrograde cholangiopancreatography (ERCP) Capsule endoscopy Flexible sigmoidoscopy Ambulatory pH monitoring (BRAVO) Sentinel lymph node biopsy Axillary lymph node dissection Lumpectomy Excisional breast biopsy Wire localization excisional biopsy Mediport placement Oncoplastic tissue rearrangement Laparoscopy for gynecologic conditions Gynecologic oncology surgery Endoscopic surgery Inflammatory bowel disease surgery Internal sphincterotomy Show all 30 Programs and centers[13] [16] OrthoCare joint replacement program Methodist Digestive Institute (MDI) - Southlake Visiting and practical information Interpreters and languages Language Assistance Services page available on the site [4]
Joint Commission Gold Seal - Primary Heart Attack Center Accreditation Joint Commission Gold Seal of Approval for Primary Heart Attack Center Accreditation Doctors and clinicians (147) 147 doctors and other clinicians list Methodist Southlake Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.
Main specialties Doctors with a page on this site (147) Adam H. Miller, MD Emergency Medicine Adam J. Patrick, CNA Certified Registered Nurse Anesthetist (CRNA) Ahmed S. Qadir, MD Pulmonary Disease Alandra R. Love, NP Nurse Practitioner Alyssa Morrish, NP Nurse Practitioner Amanda L. Rowe, CNA Certified Registered Nurse Anesthetist (CRNA) Amber N. Fluitt, NP Nurse Practitioner Amy K. Mettman, MD Otolaryngology Anand Patel, MD General Surgery Anas Alomar, MD Interventional Cardiology Andrea L. King, MD Anesthesiology Andrew C. Murphy, MD Emergency Medicine Angela E. Seda, MD Surgical Oncology Aqeel K. Kamal, DO Anesthesiology Arash Malekzadeh, MD Anesthesiology Archana Govindan, MD Internal Medicine Arif A. Khan, MD Pain Management Arshad Asghar, MD Nephrology Arun V. Raghavan, MD Emergency Medicine Ashley M. Chandler, PA Physician Assistant Ashlyn R. Terrell, DO Anesthesiology Bantoo Sehgal, MD Orthopedic Surgery Benjamin L. Singer, PA Physician Assistant Benjamin W. Covington, MD Family Practice And 123 more: the button below opens the full list.
See all 147 clinicians Other emergency rooms nearby Hospitals that list emergency services, by straight-line distance (not driving distance).
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 Methodist Southlake Medical 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.
What patients said (patient survey) What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.
Summary star rating (all survey topics) ★★★★★ 5 of 5 stars Overall rating of the hospital 5 of 5 stars Would recommend the hospital 5 of 5 stars Nurses communicated well 5 of 5 stars Doctors communicated well 5 of 5 stars Staff explained medicines 4 of 5 stars Information about recovery at home 5 of 5 stars Room and bathroom kept clean 4 of 5 stars Quiet at night 5 of 5 stars Rated the hospital 9 or 10 out of 10 90% National average: 72% Would definitely recommend the hospital 90% National average: 71% Nurses “always” communicated well 88% National average: 80% Doctors “always” communicated well 86% National average: 80% Staff “always” explained medicines before giving them 70% National average: 62% Were given information about recovery at home 93% National average: 86% Room and bathroom “always” clean 82% National average: 74% Area around the room “always” quiet at night 69% National average: 60% Completed surveys 111Response rate: 28%
Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.
Infections caught in the hospital What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.
Central line bloodstream infections (CLABSI) Not reported to Medicare Catheter-associated urinary tract infections (CAUTI) Not reported to Medicare Surgical site infections after colon surgery Not reported to Medicare Surgical site infections after abdominal hysterectomy Not reported to Medicare MRSA bloodstream infections Not reported to Medicare Clostridioides difficile (C. diff) intestinal infections 0 No different from the national benchmark
Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.
Complications and deaths What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.
Deaths within 30 days: heart attack patients Too few cases to report Deaths within 30 days: heart failure patients Too few cases to report Deaths within 30 days: pneumonia patients Too few cases to report Deaths within 30 days: COPD patients Too few cases to report Deaths within 30 days: stroke patients Too few cases to report Deaths within 30 days: coronary bypass surgery (CABG) Not reported to Medicare Serious complications (patient safety indicator PSI-90) 0.97 No different from the national rate Complications after hip or knee replacement Too few cases to report
Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2024.
Return visits to the hospital (readmissions) What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.
Returned to any hospital within 30 days (all patients) Not reported to Medicare Readmitted within 30 days: heart attack Too few cases to report Readmitted within 30 days: heart failure 21% Readmitted within 30 days: pneumonia Too few cases to report Readmitted within 30 days: COPD Too few cases to report Readmitted within 30 days: coronary bypass surgery Not reported to Medicare Readmitted within 30 days: hip or knee replacement Too few cases to report
Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.
Emergency room times and sepsis care What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.
Emergency room volume (patients per year) Low (under 20,000) Average (median) time patients spent in the emergency room before leaving (OP-18b) 140 minutes National average: 162 minutes Patients who left the emergency room before being seen (OP-22) 0% National average: 2% Sepsis patients who got all the recommended early care (SEP-1) 86% National average: 65%
Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.
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 53 common services exactly as Methodist Southlake Medical 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 Service Hospital charge Cash price Insurance rates (lowest – highest) New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: HC Pt Visit New Level III $422 $126.60 $211 – $422 New patient office visit (about 30–44 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $117.40 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $236.32 AETNA [3000] — MHS HB AETNA CVS MSMC : $115.26 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $115.26 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $274.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $240.54 New patient office visit (about 30–44 minutes) CPT 99203 · Inpatient or outpatient In the file: HC Urgent Care New Level III $422 $126.60 $211 – $422 New patient office visit (about 30–44 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $117.40 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $236.32 AETNA [3000] — MHS HB AETNA CVS MSMC : $115.26 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $115.26 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $274.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $240.54 New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: HC Pt Visit New Level IV $642 $192.60 $321 – $642 New patient office visit (about 45–59 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $192.16 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $359.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $188.67 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $188.67 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $417.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $365.94 New patient office visit (about 45–59 minutes) CPT 99204 · Inpatient or outpatient In the file: HC Urgent Care New Level IV $642 $192.60 $321 – $642 New patient office visit (about 45–59 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $192.16 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $359.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $188.67 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $188.67 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $417.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $365.94 New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC Pt Visit New Level V $735 $220.50 $367.50 – $735 New patient office visit (about 60–74 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $263.24 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $411.60 AETNA [3000] — MHS HB AETNA CVS MSMC : $258.45 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $258.45 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $477.75 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $418.95 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $396.90 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $418.95 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $396.90 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $418.95 New patient office visit (about 60–74 minutes) CPT 99205 · Inpatient or outpatient In the file: HC Urgent Care New Level V $735 $220.50 $367.50 – $735 New patient office visit (about 60–74 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $263.24 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $411.60 AETNA [3000] — MHS HB AETNA CVS MSMC : $258.45 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $258.45 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $477.75 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $418.95 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $396.90 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $418.95 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $396.90 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $418.95 Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC Pt Visit Est Level III $422 $126.60 $211 – $422 Established patient office visit (about 20–29 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $94.66 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $236.32 AETNA [3000] — MHS HB AETNA CVS MSMC : $92.94 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $92.94 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $274.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $240.54 Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC Urgent Care Est Level III $422 $126.60 $211 – $422 Established patient office visit (about 20–29 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $94.66 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $236.32 AETNA [3000] — MHS HB AETNA CVS MSMC : $92.94 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $92.94 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $274.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $240.54 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $227.88 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $240.54 Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC OP Newborn Exam $642 $192.60 $321 – $642 Established patient office visit (about 30–39 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $139.18 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $359.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $136.65 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $136.65 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $417.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $365.94 Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC Pt Visit Est Level IV $642 $192.60 $321 – $642 Established patient office visit (about 30–39 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $139.18 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $359.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $136.65 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $136.65 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $417.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $365.94 Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient In the file: HC Urgent Care Est Level IV $642 $192.60 $321 – $642 Established patient office visit (about 30–39 minutes): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $139.18 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $359.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $136.65 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $136.65 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $417.30 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $365.94 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $346.68 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $365.94 Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC Sane Em Lvl 99283 W/O Photo $233 $69.90 $116.50 – $233 Emergency room visit (moderate): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $453.21 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $130.48 AETNA [3000] — MHS HB AETNA CVS MSMC : $444.97 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $444.97 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $2,102 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,892 Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER Level III 99283 $1,956 $586.80 $978 – $1,956 Emergency room visit (moderate): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $453.21 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,095.36 AETNA [3000] — MHS HB AETNA CVS MSMC : $444.97 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $444.97 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $2,102 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,892 Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER OB Level III 99283 $1,956 $586.80 $978 – $1,956 Emergency room visit (moderate): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $453.21 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,095.36 AETNA [3000] — MHS HB AETNA CVS MSMC : $444.97 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $444.97 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $2,102 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,892 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,786 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,892 Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER OB Level IV 99284 $2,582 $774.60 $1,291 – $2,582 Emergency room visit (moderately high): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $692.76 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,445.92 AETNA [3000] — MHS HB AETNA CVS MSMC : $680.16 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $680.16 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $3,915 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,523 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $3,328 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,523 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $3,328 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $3,523 Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER Level IV 99284 $2,582 $774.60 $1,291 – $2,582 Emergency room visit (moderately high): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $692.76 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,445.92 AETNA [3000] — MHS HB AETNA CVS MSMC : $680.16 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $680.16 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $3,915 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,523 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $3,328 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,523 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $3,328 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $3,523 Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER OB Level V 99285 $3,549 $1,064.70 $1,774.50 – $3,549 Emergency room visit (high): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $988.73 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,987.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $970.75 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $970.75 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $4,378 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $3,941 Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER Level V 99285 $3,549 $1,064.70 $1,774.50 – $3,549 Emergency room visit (high): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $988.73 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,987.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $970.75 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $970.75 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $4,378 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $3,941 Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC Sane Em Lvl 99285 W/O Photo $233 $69.90 $116.50 – $233 Emergency room visit (high): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $988.73 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $130.48 AETNA [3000] — MHS HB AETNA CVS MSMC : $970.75 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $970.75 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $4,378 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $3,941 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $3,722 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $3,941
Lab tests Service Hospital charge Cash price Insurance rates (lowest – highest) Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Basic Metabolic Panel $699 $209.70 $349.50 – $699 Basic metabolic panel (blood test): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $13.96 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $391.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $13.71 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $13.71 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $36.63 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $32.97 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $30.53 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $32.97 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $30.53 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $32.97 Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehensive Metabolic Panel $810 $243 $405 – $810 Comprehensive metabolic panel (blood test): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $17.42 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $453.60 AETNA [3000] — MHS HB AETNA CVS MSMC : $17.11 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $17.11 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $45.71 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $41.15 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $38.10 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $41.15 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $38.10 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $41.15 Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: HC Lipid Panel $494 $148.20 $247 – $494 Cholesterol panel (lipid panel): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $22.09 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $276.64 AETNA [3000] — MHS HB AETNA CVS MSMC : $21.69 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $21.69 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $57.90 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $52.11 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $48.26 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $52.11 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $48.26 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $52.11 Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel $774 $232.20 $387 – $774 Kidney function panel: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $14.32 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $433.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $14.06 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $14.06 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $37.56 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $33.81 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $31.31 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $33.81 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $31.31 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $33.81 Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Function Panel $576 $172.80 $288 – $576 Liver function panel: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $13.48 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $322.56 AETNA [3000] — MHS HB AETNA CVS MSMC : $13.24 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $13.24 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $35.33 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $31.80 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $29.45 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $31.80 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $29.45 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $31.80 Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC Urinalysis With Microscopy $234 $70.20 $117 – $234 Urine test (automated, with microscope): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $5.23 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $131.04 AETNA [3000] — MHS HB AETNA CVS MSMC : $5.14 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $5.14 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $13.70 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12.33 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $11.42 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12.33 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $11.42 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $12.33 Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Ua Visual $86 $25.80 $43 – $86 Urine test (manual, without microscope): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $5.74 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $48.16 AETNA [3000] — MHS HB AETNA CVS MSMC : $5.64 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $5.64 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $15.07 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $13.56 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $12.56 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $13.56 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $12.56 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $13.56 Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis Chemical $94 $28.20 $47 – $94 Urine test (automated, without microscope): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $3.71 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $52.64 AETNA [3000] — MHS HB AETNA CVS MSMC : $3.65 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $3.65 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $9.73 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $8.76 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $8.11 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $8.76 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $8.11 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $8.76 Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Hemoglobin Urine $4 $1.20 $2 – $4 Urine test (automated, without microscope): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $3.71 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2.24 AETNA [3000] — MHS HB AETNA CVS MSMC : $3.65 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $3.65 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $9.73 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $8.76 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $8.11 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $8.76 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $8.11 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $8.76 PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Prostate Specific Antigen $332 $99.60 $166 – $332 PSA (prostate specific antigen) blood test: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $30.34 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $14 AETNA [3000] — MHS HB AETNA CVS MSMC : $29.79 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $29.79 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $79.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $71.58 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $66.29 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $71.58 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $66.29 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $71.58 PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Assay of Prostate Specific Antigen Total $34 $10.20 $17 – $34 PSA (prostate specific antigen) blood test: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $30.34 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $19.04 AETNA [3000] — MHS HB AETNA CVS MSMC : $29.79 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $29.79 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $79.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $71.58 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $66.29 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $71.58 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $66.29 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $71.58 Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Thyroid Stimulatin Hormone-Tsh $690 $207 $345 – $690 Thyroid stimulating hormone (TSH) test: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $27.72 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $386.40 AETNA [3000] — MHS HB AETNA CVS MSMC : $27.22 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $27.22 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $72.68 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $65.42 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $60.58 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $65.42 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $60.58 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $65.42 Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Complete Blood Count Cbc $313 $93.90 $156.50 – $313 Complete blood count (CBC) with differential: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $12.82 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $175.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $12.59 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $12.59 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $33.60 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $30.24 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $28.01 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $30.24 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $28.01 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $30.24 Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Pt W Inr $64 $19.20 $32 – $64 Blood clotting time test (prothrombin time, PT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $7.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $35.84 AETNA [3000] — MHS HB AETNA CVS MSMC : $6.95 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $6.95 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $18.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $16.68 Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Prothrombin Time $234 $70.20 $117 – $234 Blood clotting time test (prothrombin time, PT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $7.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $131.04 AETNA [3000] — MHS HB AETNA CVS MSMC : $6.95 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $6.95 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $18.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $16.68 Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Lupus Anticoagulant Inr Protim $17 $5.10 $8.50 – $17 Blood clotting time test (prothrombin time, PT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $7.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $9.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $6.95 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $6.95 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $18.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16.68 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $15.45 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $16.68 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Activated Part Thrombo Time $234 $70.20 $117 – $234 Blood clotting test (partial thromboplastin time, PTT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $9.92 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $131.04 AETNA [3000] — MHS HB AETNA CVS MSMC : $9.74 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $9.74 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $26.03 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $23.43 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Lupus Anticoagulant Aptt $17 $5.10 $8.50 – $17 Blood clotting test (partial thromboplastin time, PTT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $9.92 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $9.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $9.74 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $9.74 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $26.03 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $23.43 Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Factor Inhibitor Ptt $63 $18.90 $31.50 – $63 Blood clotting test (partial thromboplastin time, PTT): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $9.92 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $35.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $9.74 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $9.74 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $26.03 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $23.43 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $21.70 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $23.43
Imaging (X-ray, CT, MRI, ultrasound, mammogram) Service Hospital charge Cash price Insurance rates (lowest – highest) CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: HC CT Head Brain Woc $3,578 $1,073.40 $1,789 – $3,578 CT scan of the head or brain, without contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $173.57 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2,003.68 AETNA [3000] — MHS HB AETNA CVS MSMC : $170.42 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $170.42 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,445 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,300 MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MRI Head Wowc $6,042 $1,812.60 $3,021 – $6,042 MRI of the brain, before and after contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $579.22 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $3,383.52 AETNA [3000] — MHS HB AETNA CVS MSMC : $568.69 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $568.69 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,489 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,340 Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC Chest 2 Views $649 $194.70 $324.50 – $649 Chest X-ray, 2 views: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $144.48 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $363.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $141.86 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $141.86 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $108.80 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $97.93 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $82.54 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $97.93 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $82.54 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $97.93 X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC Spinelumbosacral Minimum 4 Views $1,062 $318.60 $531 – $1,062 X-ray of the lower spine, at least 4 views: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $173.57 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $594.72 AETNA [3000] — MHS HB AETNA CVS MSMC : $170.42 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $170.42 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $183.35 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $165.04 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $139.10 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $165.04 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $139.10 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $165.04 MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MRI Spinal Canal Lumbar Woc $4,910 $1,473 $2,455 – $4,910 MRI of the lower back (lumbar spine), without contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $396.14 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2,749.60 AETNA [3000] — MHS HB AETNA CVS MSMC : $388.94 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $388.94 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,489 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,340 CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT Pelvis WC $4,503 $1,350.90 $2,251.50 – $4,503 CT scan of the pelvis, with contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $291.21 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2,521.68 AETNA [3000] — MHS HB AETNA CVS MSMC : $285.91 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $285.91 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,445 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,300 MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI Extremity Lwr Joint Woc $4,878 $1,463.40 $2,439 – $4,878 MRI of a leg joint (such as the knee), without contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $396.14 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2,731.68 AETNA [3000] — MHS HB AETNA CVS MSMC : $388.94 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $388.94 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,489 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,340 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,241 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,340 CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT Abd Pelvis WC $8,670 $2,601 $4,335 – $8,670 CT scan of the abdomen and pelvis, with contrast: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $579.22 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $4,855.20 AETNA [3000] — MHS HB AETNA CVS MSMC : $568.69 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $568.69 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,445 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,300 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,204 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,300 Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US Abdomen Complete $1,566 $469.80 $783 – $1,566 Ultrasound of the abdomen, complete: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $173.57 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $876.96 AETNA [3000] — MHS HB AETNA CVS MSMC : $170.42 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $170.42 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $378.60 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $340.79 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $287.23 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $340.79 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $287.23 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $340.79 Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US OB >14 Wks Single Gestation $1,134 $340.20 $567 – $1,134 Pregnancy ultrasound (after the first trimester): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $173.57 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $635.04 AETNA [3000] — MHS HB AETNA CVS MSMC : $170.42 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $170.42 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $419.84 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $377.91 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $318.52 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $377.91 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $318.52 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $377.91 Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC US Transvaginal $1,323 $396.90 $661.50 – $1,323 Transvaginal ultrasound: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $173.57 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $740.88 AETNA [3000] — MHS HB AETNA CVS MSMC : $170.42 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $170.42 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $416.67 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $375.06 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $316.11 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $375.06 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $316.11 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $375.06 Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Diag Mammoomputer-Aided Detcj Uni $938 $281.40 $469 – $938 Diagnostic mammogram, one breast: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $203.76 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $525.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $200.05 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $200.05 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $415.08 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $373.63 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $314.91 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $373.63 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $314.91 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $373.63 Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Diag Mammocomputer-Aided Detcj Bi $1,160 $348 $580 – $1,160 Diagnostic mammogram, both breasts: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $258.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $649.60 AETNA [3000] — MHS HB AETNA CVS MSMC : $253.38 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $253.38 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $529.36 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $476.50 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $401.61 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $476.50 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $401.61 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $476.50 Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Screening Mammo Bi 2-View Breast Inc Cad $762 $228.60 $381 – $762 Screening mammogram, both breasts: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $207.64 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $426.72 AETNA [3000] — MHS HB AETNA CVS MSMC : $203.86 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $203.86 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $525 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $468 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $447 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $468 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $447 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $473 Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Screening Mammo Bi 2-View Breast Inc Cad/Uni $671 $201.30 $335.50 – $671 Screening mammogram, both breasts: 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $207.64 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $375.76 AETNA [3000] — MHS HB AETNA CVS MSMC : $203.86 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $203.86 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $525 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $468 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $447 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $468 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $447 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $473
Heart tests and sleep study Service Hospital charge Cash price Insurance rates (lowest – highest) Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) In the file: HC Ecg Routine Ecg W/Least 12 Lds W/I&R $669 $200.70 $334.50 – $669 Electrocardiogram (ECG/EKG) with reading: 10 of 47 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $25.21 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $374.64 AETNA [3000] — MHS HB AETNA CVS MSMC : $24.75 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $24.75 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $40.16 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $35.49 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $33.47 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $35.49 AMBETTER SUPERIOR [3051] — MHS HB AMBETTER SUPERIOR MSMC : $26.13 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $50.17 Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient In the file: HC Heart Cath Lt W Intra Inj $17,388 $5,216.40 $8,694 – $17,388 Left heart catheterization (diagnostic): 10 of 93 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $5,382.42 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $9,737.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $5,284.55 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $5,284.55 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $17,864 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16,077 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $16,077 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $16,077 AETNA MEDICARE MANAGED CARE [7000] — MHS HB AETNA GOLDEN MSMC : $3,262.07 ALLIED NATIONAL [2031] — MHS HB 90 DEGREE MSMC : $5,382.42 Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient In the file: HC Eps Comp Eval WO Arrhy Ra/Rv $8,838 $2,651.40 $4,419 – $8,838 Heart rhythm study (electrophysiology evaluation): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $12,949.39 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $4,949.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $12,713.95 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $12,713.95 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $13,792 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12,413 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $12,413 Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient In the file: HC Eps W Arrhy Afib Abl W Pvi $55,582 $16,674.60 $27,791 – $55,582 Heart rhythm study with ablation for atrial fibrillation: 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $43,395.37 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $31,125.92 AETNA [3000] — MHS HB AETNA CVS MSMC : $42,606.37 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $42,606.37 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $13,792 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12,413 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $12,413 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $12,413 Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: HC Polysomnography $7,469 $2,240.70 $3,734.50 – $7,469 Sleep study (overnight, in a sleep lab): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $1,425.72 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $4,182.64 AETNA [3000] — MHS HB AETNA CVS MSMC : $1,399.80 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $1,399.80 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,684.07 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,487.98 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,403.39 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,487.98 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,403.39 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,487.98 Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: HC Sleep Polysomnagram $7,469 $2,240.70 $3,734.50 – $7,469 Sleep study (overnight, in a sleep lab): 10 of 95 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $1,425.72 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $4,182.64 AETNA [3000] — MHS HB AETNA CVS MSMC : $1,399.80 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $1,399.80 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,684.07 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,487.98 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,403.39 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,487.98 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,403.39 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,487.98
Physical therapy and mental health Service Hospital charge Cash price Insurance rates (lowest – highest) Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Therapeutic Rx Each 15 Min $224 $67.20 $112 – $224 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $48.25 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $125.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $47.37 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $47.37 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Therapeutic Treatment $224 $67.20 $112 – $224 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $48.25 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $125.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $47.37 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $47.37 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Therapeutic Exercise Ea 15 Min $224 $67.20 $112 – $224 Physical therapy: therapeutic exercise (each 15 minutes): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $48.25 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $125.44 AETNA [3000] — MHS HB AETNA CVS MSMC : $47.37 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $47.37 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: HC Pt Eval Complexity Low $891 $267.30 $445.50 – $891 Physical therapy evaluation (low complexity): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $162.67 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $498.96 AETNA [3000] — MHS HB AETNA CVS MSMC : $159.72 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $159.72 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: HC Pt Eval Complexity Mod $927 $278.10 $463.50 – $927 Physical therapy evaluation (moderate complexity): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $162.67 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $519.12 AETNA [3000] — MHS HB AETNA CVS MSMC : $159.72 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $159.72 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: HC Pt Eval Complexity High $963 $288.90 $481.50 – $963 Physical therapy evaluation (high complexity): 10 of 91 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $162.67 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $539.28 AETNA [3000] — MHS HB AETNA CVS MSMC : $159.72 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $159.72 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $337 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $303 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $279 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $303 Psychotherapy, 30 minutes CPT 90832 · Inpatient or outpatient In the file: HC Psytx W Pt 30 Min $312 $93.60 $156 – $312 Psychotherapy, 30 minutes: 10 of 21 insurance plan rates AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $174.72 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $202.80 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $177.84 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $168.48 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $177.84 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $168.48 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $177.84 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $168.48 BCBS [3001] — MHS HB BCBS HIGH PERFORMANCE NETWORK MSMC : $162.24 BCBS [3001] — MHS HB BCBS HMO MSMC : $171.60 Psychotherapy, 60 minutes CPT 90837 · Inpatient or outpatient In the file: HC Psytx W Pt 60 Minutes $345 $103.50 $172.50 – $345 Psychotherapy, 60 minutes: 10 of 21 insurance plan rates AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $193.20 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $224.25 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $196.65 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $186.30 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $196.65 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $186.30 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $196.65 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $186.30 BCBS [3001] — MHS HB BCBS HIGH PERFORMANCE NETWORK MSMC : $179.40 BCBS [3001] — MHS HB BCBS HMO MSMC : $189.75
Procedures and surgery Service Hospital charge Cash price Insurance rates (lowest – highest) Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Inj Ther Dx Drug Lumb Sacr Img $2,215 $664.50 $1,107.50 – $2,215 Spinal injection, lower back (epidural), with imaging guidance: 10 of 38 insurance plan rates AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,240.40 AETNA [3000] — MHS HB AETNA CVS MSMC : $1,041.05 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $1,041.05 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,439.75 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,262.55 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,196.10 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,262.55 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,196.10 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,262.55 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $1,196.10 Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Tr Foram Epidur Lumbar $2,227 $668.10 $1,113.50 – $2,227 Nerve root injection, lower back, with imaging guidance: 10 of 38 insurance plan rates AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $1,247.12 AETNA [3000] — MHS HB AETNA CVS MSMC : $1,046.69 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $1,046.69 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $1,447.55 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,269.39 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $1,202.58 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $1,269.39 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $1,202.58 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $1,269.39 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $1,202.58 Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: HC Carpal Tunnel Surgery $4,071 $1,221.30 $2,035.50 – $4,071 Carpal tunnel release: 10 of 38 insurance plan rates AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $2,279.76 AETNA [3000] — MHS HB AETNA CVS MSMC : $1,913.37 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $1,913.37 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $2,646.15 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $2,320.47 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $2,198.34 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $2,320.47 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $2,198.34 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $2,320.47 BCBS [3001] — MHS HB BCBS CITY OF DALLAS MSMC : $2,198.34
Hospital stays (whole stay, MS-DRG) Service Hospital charge Cash price Insurance 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 CATHETERIZATION WITH MCC $349,070.47 $104,721.14 $174,535.24 – $526,637.25 Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 87 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $115,609.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $226,895.81 AETNA [3000] — MHS HB AETNA CVS MSMC : $113,507.10 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $113,507.10 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $166,288.03 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $147,642.53 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $139,448.74 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $147,642.53 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $139,448.74 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $147,642.53 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 MCC $60,642.51 $18,192.75 $28,229.13 – $88,071.50 Hip or knee replacement (major joint of the leg), without major complications: 10 of 87 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $22,794.95 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $28,111.79 AETNA [3000] — MHS HB AETNA CVS MSMC : $22,380.49 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $22,380.49 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $32,787.44 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $28,844.38 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $27,243.59 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $28,844.38 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $27,243.59 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $28,844.38 Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC $99,241.19 $29,772.36 $40,965.43 – $99,241.19 Neck (cervical) spinal fusion, without complications: 10 of 87 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $28,850.27 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $35,579.51 AETNA [3000] — MHS HB AETNA CVS MSMC : $28,325.72 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $28,325.72 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $41,497.22 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $36,216.49 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $34,206.56 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $36,216.49 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $34,206.56 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $36,216.49 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 $30,451.54 $9,135.46 $15,225.77 – $38,429.28 Uterus and ovary surgery (not for cancer), without complications: 10 of 87 insurance plan rates 90 DEGREE BENEFIT [3057] — MHS HB 90 DEGREE MSMC : $14,662.08 AETNA [3000] — MHS HB AETNA BAYLOR SCOTT AND WHITE MSMC : $18,081.96 AETNA [3000] — MHS HB AETNA CVS MSMC : $14,395.50 AETNA [3000] — MHS HB AETNA EXCHANGE MSMC : $14,395.50 AETNA [3000] — MHS HB AETNA HMO PPO MSMC : $21,089.42 AETNA COMMERCIAL [2042] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $18,337.71 AETNA COMMERCIAL [2042] — MHS HB AETNA TX PREF PLUS II MSMC : $17,320.02 AETNA MANAGED CARE [2068] — MHS HB AETNA TEXAS ADVANTAGE MSMC : $18,337.71 AETNA MANAGED CARE [2068] — MHS HB AETNA TX PREF PLUS II MSMC : $17,320.02 AETNA MANAGED CARE [2068] — MHS HB AETNA WHOLE HEALTH MSMC : $18,337.71
Source: Methodist Southlake Medical Center’s standard charges file (methodisthealthsystem.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 23, 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.