Visits & medical services prices at White Rock Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $5,127.20 $7,540 0.7×
Aep threshold estimation mlt frequencies i&r (92652) $1,202.92 $1,769 5.5×
Airway inhalation treatment (94640) $115.60 $170 0.5×
Analyze Neurostim Complex (95972) $409.26 $601.86 4.3×
Assessment of aphasia (96105) $337.28 $496 3.5×
Behavioral and qualitative analysis of voice and resonance (92524) $354.28 $521 3.2×
Bfb training 1st 15 min (90912) $275.71 $405.46 3.4×
Bfb training ea addl 15 min (90913) $125.80 $185 3.8×
Biofeedback training any modality (90901) $304.64 $448 7.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $471.92 $694 1.3×
Bundle of his recording (93600) $4,641 $6,825 0.6×
Car seat/bed test 60 min (94780) $46.24 $68 1.2×
Cardiac Stress Tst,Tracing Only (93017) $1,748.28 $2,571 8.1×
Cardiopulmonary resuscitation (92950) $782 $1,150 3.6×
Cardioversion (92960) $926.84 $1,363 1.4×
Cath Cath Place/Coronary Angio, Img Super/Interp, Bypass Angio (93455) $14,392.20 $21,165 4.4×
Cath Cath Place/Coronary Angio, Img Super/Interp,W Right Heart Cath (93456) $16,092.88 $23,666 4.9×
Cath Place/Coron Angio, Img Super/Interp, Bypass Angio,W L Hrt Ventric (93459) $15,486.32 $22,774 4.8×
Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) $14,698.20 $21,615 4.5×
Cbt 1st hour (94644) $325.04 $478 2.4×
Chemother, IV infusion, 1 hr (96413) $377.40 $555 1.1×
Chemother, IV infusion, ea add hr (96415) $84.32 $124 1.2×
Color/duplex Doppler, complete (93975) $1,654.44 $2,433 6.9×
Color/duplex Doppler, limited (93976) $1,270.24 $1,868 12.1×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $255.68 $376 1.4×
Continuous Glucose Monitoring (95250) $104.04 $153 0.8×
Coronary artery angio s&i (93454) $13,141 $19,325 4.0×
Cpap initiation and management (94660) $475.32 $699 2.2×
Cpt initial (94667) $153 $225 1.1×
Critical care (99291) $2,451.40 $3,605 3.0×
Debridement Open Wound 20 Sq Cm< (97597) $540.46 $794.80 2.7×
Demo &/or eval,pt use,aerosol device (94664) $28.56 $42 0.1×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $1,697.22 $2,495.91 4.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $662.32 $974 2.8×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $452.88 $666 4.3×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $1,181.84 $1,738 4.9×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $945.88 $1,391 9.0×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $1,697.96 $2,497 7.1×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $1,323.28 $1,946 12.6×
Dup-scan xtr veins unilateral/limited study (93971) $1,296.08 $1,906 12.3×
Duplex hemodialysis access (93990) $539.24 $793 5.1×
Duplex scan extracranial art compl bi study (93880) $2,255.56 $3,317 9.4×
Ear and throat examination (92502) $1,884.55 $2,771.40 3.5×
Echo Heart Xthoracic,Limited (93308) $1,032.24 $1,518 4.3×
Echo transesophageal (93312) $2,182.80 $3,210 4.0×
Echo Transthoracic - Congenital Tte Complete (93303) $1,664.64 $2,448 3.0×
Echo Transthoracic - Congenital Tte Limited (93304) $1,144.44 $1,683 2.1×
EEG awake asleep (95819) $1,400.12 $2,059 6.5×
EEG awake drowsy (95816) $1,297.44 $1,908 6.0×
EEG cerebral death evaluation (95824) $824.16 $1,212 2.2×
EEG cont rec w/video by tech min 8 channels (95700) $973.42 $1,431.50 4.5×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $2,807.69 $4,128.96 7.5×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $2,142 $3,150 5.7×
EKG (93005) $476 $700 8.0×
EKG rhythm strip (93041) $157.16 $231.12 2.7×
Ep & ablate supravent arrhyt (93653) $16,234.32 $23,874 0.6×
Ep & ablate ventric tachy (93654) $19,065.84 $28,038 0.7×
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $6,968.64 $10,248 0.9×
Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) $5,127.20 $7,540 0.7×
Ep Electrophysiologic F/U Study (93624) $5,135.36 $7,552 0.7×
Ep Right Ventricular Recording (93603) $1,455.20 $2,140 1.2×
Er level 1 (99281) $255 $375 3.0×
Er level ii (99282) $518.16 $762 3.4×
Er level iii (99283) $1,056.72 $1,554 3.9×
Er level IV (99284) $1,439.56 $2,117 3.4×
Er level v (99285) $2,067.20 $3,040 3.5×
Ergonovine provocation test (93024) $1,801.32 $2,649 4.0×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $408.78 $601.14 5.7×
Evaluation of speech fluency (92521) $314.16 $462 2.4×
Evaluation of speech sound production (92522) $247.52 $364 2.2×
Evaluation of swallowing function (92610) $304.64 $448 3.6×
Evaluation with prescription of speech-generating alternative (92607) $310.76 $457 2.5×
Exhaled Air Analysis (94690) $371.28 $546 6.3×
External Ecg Scanning Analysis Report (93226) $701.08 $1,031 11.8×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $410.04 $603 2.1×
Flexible ndsc eval swlng&laryn sens c/v rec (92616) $483.48 $711 2.1×
Flow volume loop (94375) $244.80 $360 1.1×
Group Therapeutic Procedures (97150) $129.88 $191 7.2×
Health Behavior Assessment/Re-Assessment (96156) $328.44 $483 3.2×
Health behavior ivntj indiv f2f 1st 30 min (96158) $261.80 $385 1.5×
Hemodialysis (90935) $1,861.24 $2,737.12 2.7×
Immunization Admin (90471) $84.32 $124 1.2×
Initial normal newborn care, same day discharge (99463) $350.53 $515.48 2.6×
Injection intra arterial (96373) $244.80 $360 1.1×
Ins swan ganz bedside (93503) $3,377.56 $4,967 2.1×
Intra-atrial pacing (93610)
likely a partial charge, not the full procedure
$2,174.64 $3,198 0.3×
IV infusion hydration each additional hour (96361) $170.68 $251 3.6×
IV infusion hydration initial 31 min-1 hour (96360) $575.96 $847 2.7×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $119 $175 1.6×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $204 $300 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $104.04 $153 2.2×
IV push initial (96374) $244.80 $360 1.1×
L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) $8,444.87 $12,418.92 2.6×
Laryngoscopic Sensory Test (92614) $439.28 $646 2.9×
Low frequency non-thermal us (97610) $540.46 $794.80 2.7×
Manual therapy 15 min (97140) $92.48 $136 3.3×
Massage 15 min (97124) $97.74 $143.74 3.3×
Mechanical traction (97012) $123.76 $182 8.6×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $69.36 $102 2.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $81.60 $120 2.2×
Mnt Group Ea 30 Min (97804) $38.08 $56 2.2×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $344.08 $506 3.8×
Multiple sleep latency test (95805) $2,118.20 $3,115 2.5×
Neg press wnd tx </=50 sq cm (97607) $467.84 $688 1.1×
Neg press wound tx >50 cm (97608) $1,086.72 $1,598.12 2.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $540.46 $794.80 2.7×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $272 $400 0.7×
Neurobehavioral Status Exam (96116) $358.36 $527 1.7×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $489.60 $720 3.7×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $1,073.72 $1,579 5.0×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $573.24 $843 1.5×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $119 $175 2.6×
Ot eval high complex 60 min (97167) $261.12 $384 2.6×
Ot eval low complex 30 min (97165) $129.88 $191 1.3×
Ot eval mod complex 45 min (97166) $195.84 $288 1.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $137.36 $202 2.7×
Ot Prosthetic Training, Each 15 Min (97761) $111.18 $163.50 2.8×
Ot re-eval est plan care (97168) $123.08 $181 1.8×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $237.32 $349 1.8×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $197.88 $291 1.5×
Paraffin bath (97018) $96.56 $142 16.1×
Peripheral arterial disease rehab per session (93668) $111.52 $164 1.9×
Phy/qhp op pulm rhb w/mntr (94626) $38.66 $56.85 0.7×
Phy/qhp op pulm rhb w/o mntr (94625) $38.25 $56.25 0.6×
Plethysmography (94726) $358.36 $527 1.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $4,392.12 $6,459 5.1×
Prq card revasc chronic 1vsl (92943) $12,019.68 $17,676 1.0×
Prq Card Stent W/Angio 1 Vsl (92928) $9,757.32 $14,349 0.8×
Prq trluml coronary angio/atherect one art/brnch (92924) $30,846.35 $45,362.28 2.7×
Prq trluml coronary angioplasty one art/branch (92920) $5,562.40 $8,180 1.0×
Psychiatric diagnostic evaluation (90791) $326.40 $480 1.8×
Psycl tst eval phys/qhp 1st (96130) $358.36 $527 1.7×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $192.44 $283 1.4×
Pt Aquatic Therapy/Exercises (97113) $93.16 $137 2.5×
Pt Electric Current Therapy (97033) $75.48 $111 4.0×
Pt Electrical Stimulation (97032) $94.52 $139 6.4×
Pt eval high complex 45 min (97163) $195.84 $288 2.0×
Pt eval low complex 20 min (97161) $86.36 $127 0.9×
Pt Gait Training Therapy (97116) $104.04 $153 3.6×
Pt Infrared Therapy (97026) $27.88 $41 4.2×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $87.72 $129 2.7×
Pt Physical Performance Test (97750) $187 $275 5.5×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $129.88 $191 1.3×
Pt re-evaluation (97164) $86.36 $127 1.3×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $85 $125 2.6×
Pt Ultrasound Therapy (97035) $74.80 $110 5.2×
Pure Tone Audiometry, Air (92552) $350.61 $515.60 2.6×
R & l hrt cath w/njx l ventriculog img s&i (93453) $9,143.28 $13,446 2.8×
R & L Hrt Cath Winjx Hrt Art& L Ventr Img (93460) $17,156.40 $25,230 5.3×
R hrt art/grft angio (93457) $15,524.40 $22,830 4.8×
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $18,241.73 $26,826.07 5.6×
Rem mntr physiol param 1st dev supply ea 30 days (99454) $124.44 $183 3.3×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $387.60 $570 2.9×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $355.44 $522.71 9.5×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $828.24 $1,218 2.7×
Right heart cath (93451) $5,095.92 $7,494 1.6×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $243.44 $358 1.2×
Rt Chest Wall Manipulation,Subsequent (94668) $91.80 $135 0.7×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $61.88 $91 1.3×
Sensory Integration Ea 15 Min (97533) $125.97 $185.25 2.1×
Smoking cessation > 10 min (99407) $65.96 $97 1.8×
Speech group therapy (92508) $68.52 $100.77 2.8×
Speech sound lang comprehen (92523) $269.28 $396 1.2×
Spirometry (94010) $200.60 $295 0.9×
Standardized Cognitive Performance Testing (96125) $369.92 $544 3.6×
Stress echo (93350) $1,891.76 $2,782 3.4×
Stress Tte Complete (93351) $2,033.88 $2,991 3.7×
Surfactant Admin Thru Tube (94610) $119.68 $176 0.5×
Temp transcutaneous pacing (92953) $922.68 $1,356.88 1.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $154.68 $227.47 6.9×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $154.68 $227.47 7.4×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $248.88 $366 2.4×
Ther/Proph/Diag Inj Sc/Im (96372) $190.40 $280 2.6×
Therapeutic Activities (97530) $127.84 $188 3.6×
Therapeutic phlebotomy (99195) $180.20 $265 1.3×
Tilt Table Eval (93660) $951.32 $1,399 2.5×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $36.04 $53 1.0×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $1,026.12 $1,509 4.3×
Transcranial Doppler Limited (93888) $673.88 $991 6.4×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $3,214.36 $4,727 5.9×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $2,713.88 $3,991 11.3×
Tx atrial fib pulm vein isol (93656) $23,689.84 $34,838 0.9×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $221.68 $326 2.9×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $189.72 $279 2.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $224.40 $330 4.8×
Ultraviolet Light Therapy (96900) $97.24 $143 2.6×
Unlisted Cardiovascular Service/Procedure (93799) $76.84 $113 0.6×
Vasc Duplex Extrem Venous,Bilat (93970) $1,938 $2,850 8.1×
Vasc Duplex Scan Extracranial,Limited (93882) $909.84 $1,338 8.7×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $3,952.24 $5,812.12 10.5×
Veeg Ea 12-26 Hr Unmntr (95714) $2,835.52 $4,169.88 7.6×
Ventilation assist & mgmt inpatient 1st day (94002) $2,608.48 $3,836 4.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $1,931.88 $2,841 3.1×
Visual Evoked Potential Test (95930) $847.96 $1,247 3.9×
Vital capacity total (94150) $189.04 $278 1.5×
Wheelchair Mgmt Ea 15 Min (97542) $107.44 $158 3.5×