Supplies, drugs & other prices at William P. Clements Jr. University Hospital (UT Southwestern)

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

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

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ProcedureCash priceGross charge× Medicare
2d tee w or w/o fol w/con,in (C8925) $1,848 $3,696 2.3×
2d tte w or w/o fol w/con,fu (C8924) $1,010 $2,020 2.9×
3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation (0944T) $1,569.50 $3,139 6.5×
Ablation b9 thyroid nodule perq laser w/img gdn (0673T) $2,425 $4,850 1.5×
Ablation mal brst tumor perq crtx unilateral (0581T) $4,802.50 $9,605 1.2×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $7,479.50 $14,959 3.8×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) $11,099 $22,198 1.3×
Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) $7,562.50 $15,125 3.9×
Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including target… (0890T) $6,743.50 $13,487 1.8×
Adm tocilizu covid-19 1st (M0249) $675 $1,350 1.5×
Adm tocilizu covid-19 2nd (M0250) $675 $1,350 1.5×
Admin hepatitis b vaccine (G0010) $76.50 $153 1.6×
Admin influenza virus vac (G0008) $59 $118 1.3×
Admin pneumococcal vaccine (G0009) $59 $118 1.3×
Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical… (0015M) $2,872 $5,744 2.2×
Augmnt alys chest CT data ild w/o CT (0877T) $1,916.50 $3,833 3.0×
Augmnt analys chest CT data ild w/CT (0878T) $1,916.50 $3,833 3.0×
Bioelectrical impedance analysis whole body composition assessment, with interpretation and report (0358T) $160 $320 5.5×
Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing… (0555T) $43 $86 1.5×
Bone strength and fracture risk using finite element analysis of functional data and bone-mineral density utilizing… (0556T) $351 $702 1.5×
Ca screen;flexi sigmoidscope (G0104) $686 $1,372 0.7×
Ca screen;pelvic/breast exam (G0101) $113.50 $227 1.1×
Catheterize for urine spec (P9612) $8.50 $17 0.9×
Complex simulation w/pet-ct (G0562) $5,644 $11,288 2.9×
Covid-19 lab test non-cdc (U0002) $77 $154 1.5×
Direct refer hospital observ (G0379) $467.50 $935 0.8×
Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9,… (0029U) $569 $1,138 0.8×
Drug metabolism (warfarin drug response), targeted sequence analysis (ie, CYP2C9, CYP4F2, VKORC1, rs12777823) Other… (0030U) $614.50 $1,229 4.6×
Electrophysiologic eval icds w/ss electrode (0577T) $599 $1,198 0.5×
Endo outlet restrict w/tube (C9785)
unusually low — confirm this is the full procedure
$4,543.50 $9,087 0.4×
Ephys eval ccm-d ld 1st impl (0930T) $2,959.50 $5,919 2.4×
Ephys eval ccm-d ld separate (0931T) $2,959.50 $5,919 2.4×
Esd endoscopy or colonoscopy (C9779) $3,750 $7,500 1.0×
Hbot, full body chamber, 30m (G0277) $296.50 $593 2.1×
Hep c screen high risk/other (G0472) $202 $404 4.4×
Hepb screen high risk indiv (G0499) $52.50 $105 1.9×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $202 $404 4.7×
Inj for sacroiliac jt anesth (G0260) $637 $1,274 0.9×
Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed,… (0744T) $7,709.50 $15,419 1.4×
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic… (0915T) $65,038.50 $130,077 2.1×
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic… (0917T) $16,768.50 $33,537 2.0×
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic… (0918T) $18,293 $36,586 2.2×
Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic… (0916T) $45,759 $91,518 2.0×
Insertion of substernal implantable defibrillator electrode (0572T) $16,768.50 $33,537 2.0×
Insj/rplc car modulj sys pls gen transvns eltrd (0408T) $33,166 $66,332 1.1×
Insj/rplcmt icds w/substernal electrode (0571T) $65,038.50 $130,077 2.1×
Interrog dev eval impl ccm-d system in person (0927T) $1,569.50 $3,139 41.9×
Ire ablation 1+tumors per organ w/img gdn perq (0600T) $13,358.50 $26,717 1.3×
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin,… (0003M) $2,189.50 $4,379 4.3×
Mri w/cont, breast, bi (C8906) $1,951 $3,902 5.6×
Mri w/cont, breast, uni (C8903) $1,971.50 $3,943 11.2×
Mri w/o fol w/cont, brst, un (C8905) $1,125 $2,250 3.2×
Neuro csf prion prtn qual (0035U) $2,311.50 $4,623 4.3×
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography… (0712T) $545 $1,090 2.5×
Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and… (0898T) $2,724 $5,448 3.2×
Obtaining screen pap smear (Q0091) $44 $88 1.5×
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum,… (0059U) $1,380 $2,760 4.3×
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T… (0058U) $1,254.50 $2,509 3.9×
Oncology (thyroid), DNA and mRNA of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule,… (0026U) $15,658 $31,316 4.3×
Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation,… (0857T) $346 $692 3.3×
Ortho impl mvmt alys pair CT (0946T) $330.50 $661 3.1×
Pathogen test for platelets (P9100) $85.50 $171 1.4×
Pef bronch ablt 3d nav ebus (C8005) $9,625 $19,250 0.6×
Pemivibart infusion (M0224) $1,348.50 $2,697 3.0×
Perc d-e cor revasc chro sin (C9607) $12,238.50 $24,477 0.7×
Perc d-e cor revasc t cabg s (C9604) $12,238.50 $24,477 1.1×
Perc d-e cor stent ather s (C9602) $12,238.50 $24,477 0.7×
Perc drug-el cor stent sing (C9600) $12,238.50 $24,477 1.1×
Perq sac agmntj bi w/wo balo/mchnl dev 2/> ndls (0201T) $3,864 $7,728 0.5×
Perq sac agmntj uni w/wo balo/mchnl dev 1/> ndl (0200T) $3,864 $7,728 0.5×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $14,488 $28,976 1.2×
Personalized target development for accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst… (0889T) $2,848.50 $5,697 3.0×
Place device/marker, non pro (C9728) $1,869 $3,738 1.3×
Place endorectal app (C9725) $1,766.60 $3,533.20 1.9×
Pre 3d mdl w/ccta and/or mri (C9793) $2,882.50 $5,765 3.3×
Programming device eval impl ccm-d sys in person (0926T) $1,569.50 $3,139 41.9×
Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph… (0808T) $449.50 $899 2.1×
Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph… (0807T) $449.50 $899 2.1×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $987.50 $1,975 1.1×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $987.50 $1,975 1.1×
Quan mr tis wo MRI 1orgn (0648T) $1,426 $2,852 1.5×
Quan mr tiss w/MRI 1orgn (0649T) $1,426 $2,852 1.5×
Quantitative computed tomography (CT scan) tissue characterization with interpretation and report and concurrent CT… (0722T) $683 $1,366 1.1×
Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct… (0724T) $1,397.50 $2,795 1.5×
Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct… (0723T) $1,397.50 $2,795 1.5×
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)… (0865T) $1,243 $2,486 5.2×
Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR)… (0866T) $1,243 $2,486 5.2×
Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups,… (0001U) $232 $464 0.3×
Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator (0925T) $3,269.50 $6,539 1.6×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $1,569.50 $3,139 41.9×
Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only (0923T) $45,759 $91,518 2.0×
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and… (0922T) $9,362.50 $18,725 2.5×
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only (0919T) $8,582.50 $17,165 2.3×
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing… (0920T) $8,582.50 $17,165 2.3×
Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous… (0921T) $8,582.50 $17,165 2.3×
Removal of substernal implantable defibrillator pulse generator only (0580T) $8,582.50 $17,165 2.3×
Repos prev impl ss impltbl dfb pacing eltrd (0574T) $8,582.50 $17,165 2.3×
Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s),… (0924T) $2,053.50 $4,107 3.3×
Revasc intra lithotrip-ather (C9766) $19,962.50 $39,925 1.1×
Revasc intra lithotrip-stent (C9765) $17,750 $35,500 1.0×
Revasc intravasc lithotripsy (C9764) $16,037.50 $32,075 1.4×
Revasc lithotrip tibi/perone (C9772) $16,922.50 $33,845 1.5×
Revasc lithotrip-stent-ather (C9767) $26,860 $53,720 1.5×
Rmvl substernal implantable defibrillator eltrd (0573T) $8,582.50 $17,165 2.3×
Rmvl&rplcmt substernal impltbl defibrillator pg (0614T) $45,759 $91,518 2.0×
Sbrt w/positron emission del (G0563) $16,110.50 $32,221 5.0×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $26,730.50 $53,461 1.4×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $26,730.50 $53,461 1.4×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $26,730.50 $53,461 1.4×
Tcat insj perm dual chamber ldls pm compl sys (0795T) $26,730.50 $53,461 1.4×
Tcat rmvl/debulk icar mass suction device perq (0644T) $8,362.50 $16,725 1.5×
Tpmt nudt15 genes (0034U) $341.50 $683 0.7×
Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring,… (0933T) $8,415 $16,830 2.6×
Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter… (0339T) $10,888 $21,776 1.9×
Transplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing… (0088U) $1,925 $3,850 0.6×
Trauma respons w/hosp criti (G0390) $1,490.50 $2,981 1.1×
Trnscth renal symp denrv unl (0338T) $9,980.50 $19,961 1.7×
Tte w or w/o contr, cont ecg (C8930) $1,784.50 $3,569 2.3×
Tte w or w/o fol w/cont, com (C8921) $2,429.50 $4,859 3.1×
Tte w or w/o fol w/cont, f/u (C8922) $1,676.50 $3,353 2.1×
Tte w or wo fol wcon,doppler (C8929) $2,196 $4,392 2.8×
U/s trtmt, not leiomyomata (C9734) $17,481.50 $34,963 1.4×
Unsched dialysis esrd pt hos (G0257) $1,441.50 $2,883 2.1×
Vasc emb/occ w/prs cath (C9797) $33,659.50 $67,319 1.8×
Visit to determ ldct elig (G0296) $104.50 $209 1.0×