BAYLOR SCOTT & WHITE MEDICAL CENTER � PFLUGERVILLE
Acute Care Hospitals
Procedure Prices at BAYLOR SCOTT & WHITE MEDICAL CENTER � PFLUGERVILLE
HC SA-VENIPUNCTURE, COLLECTION OF BLOOD
CPT 36415
$0.01
HC COMPLETE CBC W/AUTO WBC DIFF
CPT 85025
$18.25
HC COMPREHENSIVE METABOLIC PANEL
CPT 80053
$24.83
Mechanical Traction
CPT 97012
$46.35
Therapeutic Activities
CPT 97530
$64.58
HC VIDEO VISIT, E&M LEVEL 3
CPT 99213
$66
Therapeutic Exercises
CPT 97110
$74.26
Screening Mammogram (bilateral)
CPT 77067
$119.26
Diagnostic Mammogram (unilateral)
CPT 77065
$124.94
Diagnostic Mammogram (bilateral)
CPT 77066
$153.65
Chest X-Ray (2 views)
CPT 71046
$180.59
Chest X-Ray (1 view)
CPT 71045
$180.83
EKG Tracing
CPT 93005
$186.58
Thoracic Spine X-Ray
CPT 72072
$225.49
Echocardiogram
CPT 93307
$246.16
OB Ultrasound
CPT 76805
$319.64
CT Chest
CPT 71250
$355.26
Retroperitoneal Ultrasound
CPT 76770
$372.57
Abdominal Ultrasound — Limited
CPT 76705
$391.87
Abdominal Ultrasound
CPT 76700
$414.6
ER Visit — Low-Moderate Complexity
CPT 99283
$488.14
Echocardiogram w/ Doppler
CPT 93306
$571.15
MRI Brain w/ Contrast
CPT 70553
$624.36
ER Visit — Moderate Complexity
CPT 99284
$720.67
HC SNRB TRANS LUMB/SAC SNGL LV BI
CPT 64483
$727.26
MRI Joint of Lower Extremity
CPT 73721
$847.74
MRI Brain w/o Contrast
CPT 70551
$990.56
CT Abdomen & Pelvis
CPT 74177
$1,111.66
ER Visit — High Complexity
CPT 99285
$1,120.24
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.