Supplies, drugs & other prices at Texas Health Hospital Mansfield

Mansfield, TX · every code in this section with a posted price and a Medicare benchmark.

94 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,co (C8923) $7,528.72 $7,528.72 9.6×
Adm tocilizu covid-19 1st (M0249) $396.70 $396.70 0.9×
Adm tocilizu covid-19 2nd (M0250) $1,878.14 $1,878.14 4.2×
Admin hepatitis b vaccine (G0010) $391.84 $391.84 8.3×
Admin influenza virus vac (G0008) $447.17 $447.17 9.5×
Bia whole body composition assessment w/i&r (0358T) $223.90 $223.90 7.7×
Ca screen;pelvic/breast exam (G0101) $679.66 $679.66 6.7×
Catheterize for urine spec (P9612) $430.96 $430.96 46.1×
Chemo extend iv infus w/pump (G0498) $10.48 $10.48 0.0×
Colon ca scrn not hi rsk ind (G0121) $8,175.65 $8,175.65 8.8×
Diab manage trn per indiv (G0108) $331.30 $331.30 5.9×
Diab manage trn ind/group (G0109) $100.82 $100.82 6.3×
Direct refer hospital observ (G0379) $196.31 $196.31 0.3×
Drug test def 1-7 classes (G0480) $454.84 $454.84 4.0×
Eia hiv-1/hiv-2 screen (G0432) $235.49 $235.49 12.0×
Ekg tracing for initial prev (G0404) $223.90 $223.90 7.7×
Electrophysiologic eval icds w/ss electrode (0577T) $5,508.78 $5,508.78 4.5×
Hep c screen high risk/other (G0472) $557.73 $557.73 12.0×
Home sleep test/type 2 porta (G0398) $759.92 $759.92 3.5×
Home sleep test/type 3 porta (G0399) $759.92 $759.92 3.5×
Home sleep test/type 4 porta (G0400) $858.90 $858.90 4.0×
Infectious disease (bacterial and fungal), organism identification, blood culture, using rRNA FISH, 6 or more organism… (0086U) $1,787.54 $1,787.54 8.9×
Init/sub psych care m 1st 30 (G2214) $216.96 $216.96 2.1×
Inj for sacroiliac jt anesth (G0260) $5,573.77 $5,573.77 7.9×
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that… (0216T) $7,314.86 $7,314.86 8.2×
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial… (0526T) $26,420.24 $26,420.24 3.2×
Insertion/replacement complete iims (0525T) $30,861.36 $30,861.36 1.6×
Insertion/replacement iims implantable mntr only (0527T) $26,420.24 $26,420.24 3.2×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $58,205.95 $58,205.95 1.8×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $6,188.04 $6,188.04 0.7×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $6,188.04 $6,188.04 0.7×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $16,099.84 $16,099.84 0.7×
Intens cardiac rehab no exer (G0423) $676 $676 5.2×
Intens cardiac rehab w/exerc (G0422) $676 $676 5.2×
Interro Device Evaluation Cardiac Modulj System (0418T) $101.09 $101.09 2.7×
Interrog dev eval iims ip (0529T) $474.97 $474.97 12.7×
Mnt subs tx for change dx (G0270) $156.56 $156.56 4.9×
Mra w/o fol w/cont, abd (C8902) $4,407.33 $4,407.33 12.6×
Mra w/o fol w/cont, chest (C8911) $3,940.20 $3,940.20 11.2×
Mra w/o fol w/cont, lwr ext (C8914) $3,827.47 $3,827.47 10.9×
Mra w/o fol w/cont, pelvis (C8920) $4,025.49 $4,025.49 11.5×
Mra, w/o&w/dye, spinal canal (C8933) $785.42 $785.42 2.2×
Mra, w/o&w/dye, upper extr (C8936) $3,857.77 $3,857.77 11.0×
Mri w/cont, breast, bi (C8906) $1,831.25 $1,831.25 5.2×
Mri w/cont, breast, uni (C8903) $5,239.30 $5,239.30 29.7×
Neuro csf detcj prion prtn quakg conf conv qual (0035U) $3,855.10 $3,855.10 7.1×
Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) $7,314.86 $7,314.86 8.2×
Njx pltlt plasma w/img harvest/preparation (0232T) $2,836.54 $2,836.54 6.3×
Obtaining screen pap smear (Q0091) $132.22 $132.22 4.5×
Onc merkel cell carc detcj antb serum reprtd +/- (0059U) $1,614.80 $1,614.80 5.0×
Onc Merkel Cll Carc Srm Quan (0058U) $3,638 $3,638 11.3×
Oth resp proc, group (G0239) $222.57 $222.57 5.9×
Oth resp proc, indiv (G0238) $294.84 $294.84 10.1×
Pathogen test for platelets (P9100) $465.78 $465.78 7.9×
Perc d-e cor revasc chro sin (C9607) $43,192.99 $43,192.99 2.3×
Perc d-e cor revasc t cabg s (C9604) $35,780.96 $35,780.96 3.1×
Perc d-e cor stent ather s (C9602) $53,543.48 $53,543.48 2.9×
Perc drug-el cor stent sing (C9600) $35,780.96 $35,780.96 3.1×
Perq Sacral Augmt Bilat Inj (0201T) $33,703.39 $33,703.39 4.6×
Perq Sacral Augmt Unilat Inj (0200T) $21,223.75 $21,223.75 2.9×
Pne flu hepb cov home admin (M0201) $443.49 $443.49 12.2×
Prgrmg dev eval iims ip (0528T) $474.97 $474.97 12.7×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $101.09 $101.09 2.7×
Prostate biopsy, any mthd (G0416) $640.52 $640.52 1.8×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $2,344.21 $2,344.21 1.1×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $6,450.40 $6,450.40 1.7×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $6,450.40 $6,450.40 1.7×
Removal complete iims (0530T) $26,420.24 $26,420.24 7.0×
Removal iims electrode only (0531T) $26,420.24 $26,420.24 7.0×
Removal iims implt mntr only (0532T) $26,420.24 $26,420.24 7.0×
Repos Cardiac Modulj Transvenous Electrode (0415T) $1,385.22 $1,385.22 2.2×
Revasc intra lithotrip-ather (C9766) $30,368.88 $30,368.88 1.6×
Revasc intra lithotrip-stent (C9765) $30,368.88 $30,368.88 1.6×
Revasc intravasc lithotripsy (C9764) $26,082.22 $26,082.22 2.2×
Revasc lith-sten-ath tib/per (C9775) $94,344.72 $94,344.72 5.1×
Revasc lithotr-ather tib/per (C9774) $94,344.72 $94,344.72 5.1×
Revasc lithotr-stent tib/per (C9773) $94,344.72 $94,344.72 5.1×
Revasc lithotrip tibi/perone (C9772) $28,094.28 $28,094.28 2.4×
Revasc lithotrip-stent-ather (C9767) $53,344.74 $53,344.74 2.9×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $16,099.84 $16,099.84 0.7×
Screen pap by tech w md supv (P3000) $130.42 $130.42 7.0×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $33,713.65 $33,713.65 1.7×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) $30,423.33 $30,423.33 5.3×
Therapeutic procd strg endur (G0237) $228.97 $228.97 7.9×
Tomosynthesis, mammo (G0279) $354.68 $354.68 27.9×
Trauma respons w/hosp criti (G0390) $6,682.94 $6,682.94 5.0×
Trgt gen seq alys sld orgn neo DNA 324 genes (0037U) $23,797.61 $23,797.61 6.8×
Trluml Perip Athrc Renal Art (0234T) $72,714.61 $72,714.61 6.3×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $29,517.86 $29,517.86 2.5×
Trluml peripheral atherectomy iliac artery ea (0238T) $58,504.67 $58,504.67 3.2×
Tte w or w/o fol w/con,stres (C8928) $7,528.72 $7,528.72 9.6×
Unsched dialysis esrd pt hos (G0257) $2,605.24 $2,605.24 3.8×
Urine specimen collect mult (P9615) $47.69 $47.69 5.1×
Visit esketamine 56m or less (G2082) $8,126.36 $8,126.36 7.9×