BAYLOR EMERGENCY MEDICAL CENTER AT AUBREY

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J3490	Ryanodex Dantrolene Sodium 250 mg injection single-use vial 5mL	$13,849	$8,309	—	—	28
27664	Repair, extensor tendon, leg; primary w/o graft, each tendon	$10,666	$6,399	—	—	42
25270	Rpr Tendon/muscle, Exts FA/Wrist; primary single ea Tendon/muscle	$8,722	$5,233	—	—	42
23931	Bursa I&D - Upper Arm/Elbow	$8,681	$5,208	—	—	42
23930	Deep I&D - Upper Arm/Elbow	$8,681	$5,208	—	—	42
23030	I&D Shoulder; Deep Abscess	$8,681	$5,208	—	—	42
10121	Foreign Body Removal Tissue Cplx	$8,220	$4,932	—	—	42
24620	Clsd Trmt Monteggia FX w/ Manip	$8,088	$4,853	—	—	42
74174	CTA Abd/Pelvis w & w/o contrast	$7,946	$4,768	—	—	41
21320	Clsd Trmt Nasal Bone w/ Stblz	$7,728	$4,637	—	—	42
21315	Clsd Trmt Nasal Bone w/o Stblz	$7,728	$4,637	—	—	42
24605	Posterior Elbow Reduction w/Anes	$7,473	$4,484	—	—	42
41000	I&D Intraoral Lingual Abscess	$7,126	$4,275	—	—	42
74178	CT ABD AND PELVIS W AND W/O CO	$6,807	$4,084	—	—	41
31530	Laryngoscopy, direct, operative, with Foreign Body Removal	$6,753	$4,052	—	—	42
26350	Finger/Hand Flexor Tendon Rpair	$6,088	$3,653	—	—	42
53000	Urethrotomy or urethrostomy, Ext (sep proc); pendulous urethra	$6,076	$3,645	—	—	42
51102	Aspiration of Bladder; w/insertion Suprapubic Catheter	$6,053	$3,632	—	—	42
74177	CT ABDOMEN AND PELVIS W/ CONTR	$5,915	$3,549	—	—	41
10140	I&D Hemat, Seroma, Fluid Collec	$5,800	$3,480	—	—	42
71275	CTA Chest w & w/o contrast	$5,621	$3,373	—	—	41
20525	Removal of FB in muscle or tendon sheath; deep/complicated	$5,398	$3,239	—	—	42
27532	Closed Tx Tib Plat Fx, w/ Traction	$5,377	$3,226	—	—	42
70496	CTA Head w & w/o contrast	$5,332	$3,199	—	—	41
70498	CTA Neck w & w/o contrast	$5,275	$3,165	—	—	41
74176	CT ABDOMEN AND PELVIS W/O CONT	$5,270	$3,162	—	—	41
25690	Closed TX of lunate dislocation, with manipulation	$5,102	$3,061	—	—	42
27842	Clsd TX Ankle Disloc; Req Anest w or w/o Fixation	$5,058	$3,035	—	—	42
99291	Critical Care first 30-74 min	$4,897	$2,938	—	—	46
46945	Hemorrhoidectomy, internal, single, w/o imaging guidance	$4,842	$2,905	—	—	84
26990	I&D Pelvis/Hip Joint, Deep Absc/Hemat	$4,776	$2,866	—	—	42
54001	Slitting of prepuce, dorsal or lateral (sep proc); except newborn	$4,752	$2,851	—	—	42
27825	Closed Tx Pilon/Plafond Fx, w/o Manip	$4,375	$2,625	—	—	42
42330	Sialolithotomy; submand, subling or parotid, uncompl, intraoral	$4,361	$2,617	—	—	42
59414	Delivery Placenta Only	$4,356	$2,614	—	—	42
57200	Suture Vaginal Injury	$4,356	$2,614	—	—	42
74175	CTA Abd w& w/o contrast	$4,296	$2,578	—	—	41
45915	Fecal Disimpaction w/ Anesthesia	$4,283	$2,570	—	—	42
59409	Vaginal Delivery & Method	$4,247	$2,548	—	—	42
64999	Unlisted Procedure, Nervous System	$4,177	$2,506	—	—	42
75635	CTA Runoff	$3,979	$2,387	—	—	41
36573	Insertion of PICC line >/= 5yrs w/ imaging guid	$3,935	$2,361	—	—	42
11044	Debride SQ Bone 20 sq cm/<	$3,786	$2,272	—	—	42
23330	Foreign Body Removal Shoulder	$3,786	$2,272	—	—	42
99285	ER Visit - Level 5	$3,732	$2,239	—	—	46
71270	CT CHEST W AND W/O CONTRAST	$3,702	$2,221	—	—	41
72130	CT SPINE-THORACIC W/WO CONTRAS	$3,685	$2,211	—	—	41
72133	CT SPINE-LUMBAR W AND W/O CONT	$3,685	$2,211	—	—	41
81479	Unlisted molecular pathology procedure	$3,670	$2,202	—	—	28
27232	Clsd TX Femoral Neck FX w/Man	$3,653	$2,192	—	—	42

Showing top 50 of 3,610 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.