Supplies, drugs & other prices at Baylor Scott and White Surgical Hospital Fortworth
Fort Worth, TX · every code in this section with a posted price and a Medicare benchmark.
13 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Admin influenza virus vac (G0008) | $56.40 | $94 | 1.2× |
| Admin pneumococcal vaccine (G0009) | $56.40 | $94 | 1.2× |
| Arthro/shoul surg; w/spacer (C9781) | $8,321.40 | $13,869 | 0.6× |
| Cysto impl 4 or more (C9740) likely a partial charge, not the full procedure |
$932.40 | $1,554 | 0.1× |
| Cysto, litho, vacuum kidney (C9761) | $5,274 | $8,790 | 0.6× |
| Cystoscopy prostatic imp 1-3 (C9739) | $8,786.40 | $14,644 | 1.6× |
| Direct refer hospital observ (G0379) | $204.60 | $341 | 0.3× |
| Drug test def 1-7 classes (G0480) | $148.80 | $248 | 1.3× |
| Inj for sacroiliac jt anesth (G0260) | $1,280.40 | $2,134 | 1.8× |
| Mra, w/dye, upper extremity (C8934) | $3,512.70 | $5,854.50 | 10.0× |
| Prostate biopsy, any mthd (G0416) | $742.20 | $1,237 | 2.1× |
| Spine device implant surgery (C9757) likely a partial charge, not the full procedure |
$3,717 | $6,195 | 0.3× |
| Tte w or wo fol wcon,doppler (C8929) | $2,307 | $3,845 | 2.9× |