Supplies, drugs & other prices at Texas Health Presbyterian Hospital Dallas
Dallas, TX · every code in this section with a posted price and a Medicare benchmark.
77 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) | $1,375.05 | $2,291.75 | 1.7× |
| 2d tte w or w/o fol w/con,co (C8923) | $1,691.40 | $2,819 | 2.1× |
| 2d tte w or w/o fol w/con,fu (C8924) | $1,375.05 | $2,291.75 | 3.9× |
| 3d anat seg imaging preop (C8001) | $1,067.10 | $1,778.50 | 8.3× |
| Admin influenza virus vac (G0008) | $113.70 | $189.50 | 2.4× |
| Admin pneumococcal vaccine (G0009) | $113.70 | $189.50 | 2.4× |
| Catheterize for urine spec (P9612) | $148.80 | $248 | 15.9× |
| Diab manage trn per indiv (G0108) | $144.60 | $241 | 2.6× |
| Diab manage trn ind/group (G0109) | $84 | $140 | 5.2× |
| Direct refer hospital observ (G0379) | $304.35 | $507.25 | 0.5× |
| Drug test def 1-7 classes (G0480) | $113.70 | $189.50 | 1.0× |
| Drug test def 15-21 classes (G0482) | $442.80 | $738 | 2.2× |
| Drug test def 8-14 classes (G0481) | $405.90 | $676.50 | 2.6× |
| Elec stim other than wound (G0283) | $93.90 | $156.50 | 7.4× |
| Esd endoscopy or colonoscopy (C9779) | $3,689.40 | $6,149 | 1.0× |
| Hbot, full body chamber, 30m (G0277) | $362.40 | $604 | 2.6× |
| Hep c screen high risk/other (G0472) | $225.45 | $375.75 | 4.9× |
| Inj for sacroiliac jt anesth (G0260) | $2,255.55 | $3,759.25 | 3.2× |
| Insertion of substernal implantable defibrillator electrode (0572T) | $16,627.35 | $27,712.25 | 2.0× |
| Insertion perm ccm-d system pulse generator only (0916T) | $47,137.05 | $78,561.75 | 2.1× |
| Insj Perm Ccm-D Sys 1 Transvns Lead Only (0917T) | $17,379.60 | $28,966 | 2.1× |
| Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) | $17,379.60 | $28,966 | 2.1× |
| Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) | $67,329.45 | $112,215.75 | 2.1× |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) | $36,434.85 | $60,724.75 | 1.2× |
| Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) | $8,920.35 | $14,867.25 | 1.1× |
| Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) | $17,379.60 | $28,966 | 2.1× |
| Mnt subs tx for change dx (G0270) | $90 | $150 | 2.8× |
| Mra w/cont, abd (C8900) | $2,394.15 | $3,990.25 | 6.8× |
| Mra w/cont, chest (C8909) | $2,939.25 | $4,898.75 | 8.4× |
| Mra w/cont, pelvis (C8918) | $2,929.95 | $4,883.25 | 8.4× |
| Mra w/o cont, abd (C8901) | $2,274.45 | $3,790.75 | 9.5× |
| Mra w/o cont, chest (C8910) | $2,939.25 | $4,898.75 | 12.3× |
| Mra w/o cont, lwr ext (C8913) | $3,082.65 | $5,137.75 | 12.9× |
| Mra w/o cont, pelvis (C8919) | $3,047.25 | $5,078.75 | 12.7× |
| Mra w/o fol w/cont, abd (C8902) | $2,394.15 | $3,990.25 | 6.8× |
| Mra w/o fol w/cont, chest (C8911) | $2,939.25 | $4,898.75 | 8.4× |
| Mra w/o fol w/cont, lwr ext (C8914) | $3,023.32 | $5,038.88 | 8.6× |
| Mra w/o fol w/cont, pelvis (C8920) | $3,047.25 | $5,078.75 | 8.7× |
| Mri w/cont, breast, bi (C8906) | $2,574.45 | $4,290.75 | 7.3× |
| Mri w/cont, breast, uni (C8903) | $2,479.35 | $4,132.25 | 14.1× |
| Mri w/o fol w/cont, breast, (C8908) | $3,209.55 | $5,349.25 | 9.2× |
| Mri w/o fol w/cont, brst, un (C8905) | $2,610.75 | $4,351.25 | 7.4× |
| Neuro csf detcj prion prtn quakg conf conv qual (0035U) | $409.50 | $682.50 | 0.8× |
| Njx dx/ther paraver fct jt w/us cer/thor 1 lvl (0213T) | $1,278.90 | $2,131.50 | 1.4× |
| Oth resp proc, group (G0239) | $79.95 | $133.25 | 2.1× |
| Oth resp proc, indiv (G0238) | $76.80 | $128 | 2.6× |
| Perc d-e cor revasc chro sin (C9607) | $18,808.65 | $31,347.75 | 1.0× |
| Perc d-e cor revasc t cabg s (C9604) | $18,808.65 | $31,347.75 | 1.6× |
| Perc d-e cor stent ather s (C9602) | $18,808.65 | $31,347.75 | 1.0× |
| Perc drug-el cor stent sing (C9600) | $18,808.65 | $31,347.75 | 1.6× |
| Perq Sacral Augmt Bilat Inj (0201T) | $6,284.40 | $10,474 | 0.9× |
| Perq Sacral Augmt Unilat Inj (0200T) | $4,580.70 | $7,634.50 | 0.6× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) | $18,228 | $30,380 | 1.6× |
| Place device/marker, non pro (C9728) | $2,385.75 | $3,976.25 | 1.7× |
| Pre 3d mdl w/ccta and/or mri (C9793) | $1,904.25 | $3,173.75 | 2.2× |
| Psa screening (G0103) | $154.95 | $258.25 | 8.0× |
| Rbc DNA gnotyp 10 bld groups (0084U) | $680.55 | $1,134.25 | 0.9× |
| Removal Cardiac Modulj Sys Transvenous Electrode (0413T) | $3,841.05 | $6,401.75 | 1.0× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $5,837.10 | $9,728.50 | 1.6× |
| Revasc intra lithotrip-ather (C9766) | $18,808.65 | $31,347.75 | 1.0× |
| Revasc intra lithotrip-stent (C9765) | $18,808.65 | $31,347.75 | 1.0× |
| Revasc intravasc lithotripsy (C9764) | $9,041.40 | $15,069 | 0.8× |
| Revasc lithotrip tibi/perone (C9772) | $18,808.65 | $31,347.75 | 1.6× |
| Revasc lithotrip-stent-ather (C9767) | $18,808.65 | $31,347.75 | 1.0× |
| Rmvl substernal implantable defibrillator eltrd (0573T) | $8,726.55 | $14,544.25 | 2.3× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $8,182.80 | $13,638 | 2.2× |
| Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) | $44,127.45 | $73,545.75 | 2.0× |
| Therapeutic procd strg endur (G0237) | $79.95 | $133.25 | 2.8× |
| Tomosynthesis, mammo (G0279) | $71.40 | $119 | 5.6× |
| Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) | $17,591.70 | $29,319.50 | 1.5× |
| Trauma respons w/hosp criti (G0390) | $6,074.40 | $10,124 | 4.5× |
| Trim nail(s) (G0127) | $111.30 | $185.50 | 1.9× |
| Trluml peripheral atherectomy iliac artery ea (0238T) | $17,591.70 | $29,319.50 | 1.0× |
| Tte w or w/o contr, cont ecg (C8930) | $1,802.10 | $3,003.50 | 2.3× |
| Tte w or w/o fol w/con,stres (C8928) | $1,375.35 | $2,292.25 | 1.7× |
| Tte w or wo fol wcon,doppler (C8929) | $1,859.40 | $3,099 | 2.4× |
| Unsched dialysis esrd pt hos (G0257) | $2,127.45 | $3,545.75 | 3.1× |