St. Luke's Health - The Vintage Hospital
20171 Chasewood Park Drive, Houston, TX · CommonSpirit Health · · NPI 1710314141
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Drainage of salivary gland CPT 42320 | not published | not published | $958.00 – $958.00 | 1 |
| Drainage of throat abscess CPT 42725 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drain bladder by trocar/cath CPT 51101 | $3,470.95 | $9,917.00 | $2,677.59 – $9,917.00 | 19 |
| Drain blood from under nail 11740 CPT 11740 | $87.50 | $250.00 | $20.00 – $250.00 | 24 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $1,320.20 | $3,772.00 | $1,018.44 – $3,772.00 | 18 |
| Drain cath image guided visceral pq CPT 49405 | $2,394.00 | $6,840.00 | $1,846.80 – $6,840.00 | 18 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $606.90 | $1,734.00 | $468.18 – $1,734.00 | 16 |
| Drain chest lesion CPT 21502 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drain finger abscess;simple 26010 CPT 26010 | $261.10 | $746.00 | $201.42 – $746.00 | 19 |
| Drain lower leg bursa CPT 27604 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drain ovary abscess open CPT 58820 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drain penis lesion CPT 54015 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drain shoulder lesion CPT 23030 | not published | not published | $958.00 – $958.00 | 1 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,342.90 | $6,694.00 | $1,609.00 – $6,694.00 | 16 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $958.00 – $958.00 | 1 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $115.50 | $330.00 | $89.10 – $330.00 | 16 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $114.45 | $327.00 | $88.29 – $327.00 | 19 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $257.25 | $735.00 | $198.45 – $735.00 | 16 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drng of eyelid abscess 67700 CPT 67700 | $684.95 | $1,957.00 | $528.39 – $1,957.00 | 19 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,336.65 | $3,819.00 | $958.00 – $3,819.00 | 16 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $958.00 – $958.00 | 1 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $958.00 – $958.00 | 1 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Drng of scrotum abscess 55100 CPT 55100 | $834.05 | $2,383.00 | $643.41 – $2,383.00 | 16 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $958.00 – $958.00 | 1 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $958.00 – $958.00 | 1 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1.50 | $4.26 | $0.66 – $2.96 | 23 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $30.05 | $85.84 | $1.82 – $63.87 | 23 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $13,597.50 | $38,850.00 | $228.05 – $1,085.91 | 23 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $55.30 | $158.00 | $12.77 – $158.00 | 23 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $24,696.00 | $70,560.00 | $1,801.80 – $8,190.00 | 22 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $351.75 | $1,005.00 | $20.81 – $1,005.00 | 23 |
| Drug admin & hemodynmic meas CPT 93463 | $528.50 | $1,510.00 | $100.00 – $1,510.00 | 19 |
| Drug of abuse screen urine CPT 80305 | $157.85 | $451.00 | $9.07 – $451.00 | 39 |
| Drug test def 1-7 classes HCPCS G0480 | $239.75 | $685.00 | $37.80 – $371.90 | 40 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $206.15 | $589.00 | $44.74 – $589.00 | 39 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $958.00 – $958.00 | 1 |
| Ductogram sgl duct CPT 77053 | $318.15 | $909.00 | $53.46 – $909.00 | 23 |
| Duplex scan bilateral study 93985 CPT 93985 | $421.40 | $1,204.00 | $245.00 – $1,204.00 | 16 |
| Duplex scan unilateral study 93986 CPT 93986 | $246.75 | $705.00 | $185.98 – $705.00 | 16 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $249.20 | $712.00 | $56.96 – $712.00 | 21 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,293.25 | $3,695.00 | $157.71 – $3,695.00 | 21 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,082.20 | $3,092.00 | $196.14 – $3,092.00 | 21 |
| Dxa bone density axl vrt fx CPT 77085 | $191.45 | $547.00 | $43.76 – $547.00 | 23 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $2,562.70 | $7,322.00 | $1,285.00 – $7,322.00 | 16 |
| Dx bronchoscope/wash 31622 CPT 31622 | $3,105.90 | $8,874.00 | $958.00 – $8,874.00 | 16 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Ear cartilage graft CPT 21235 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Ear irrigation 69209 CPT 69209 | $101.50 | $290.00 | $23.20 – $290.00 | 21 |
| Ecg 12 lead tracing only CPT 93005 | $295.40 | $844.00 | $80.31 – $844.00 | 16 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $72.80 | $208.00 | $56.16 – $208.00 | 16 |
| Ecg external < 48 hours recording CPT 93225 | $286.30 | $818.00 | $100.00 – $818.00 | 16 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $908.95 | $2,597.00 | $100.00 – $2,597.00 | 16 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $68.25 | $195.00 | $49.41 – $195.00 | 16 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $112.35 | $321.00 | $81.26 – $321.00 | 16 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,651.25 | $7,575.00 | $100.00 – $7,575.00 | 16 |
| Echocardiography doppler color flow mapping CPT 93325 | $316.05 | $903.00 | $32.62 – $903.00 | 16 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $3,150.00 | $9,000.00 | $100.00 – $9,000.00 | 16 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $462.00 | $1,320.00 | $98.24 – $1,320.00 | 21 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $462.00 | $1,320.00 | $100.00 – $1,320.00 | 16 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $336.70 | $962.00 | $28.94 – $962.00 | 16 |
| Echo exam uterus 76831- CPT 76831 | $450.45 | $1,287.00 | $102.96 – $1,287.00 | 23 |
| Echo guide for amniocentesis CPT 76946 | $272.30 | $778.00 | $18.80 – $778.00 | 18 |
| Echo guide for artery repair CPT 76936 | $215.60 | $616.00 | $49.28 – $616.00 | 23 |
| Echo tee guidance CPT 93355 | $3,253.25 | $9,295.00 | $100.00 – $9,295.00 | 21 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,565.20 | $4,472.00 | $100.00 – $4,472.00 | 21 |
| Echo transesophageal CPT 93314 | $1,471.40 | $4,204.00 | $100.00 – $4,204.00 | 16 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $526.75 | $1,505.00 | $100.00 – $1,505.00 | 21 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | $6,123.25 | $17,495.00 | $1,399.60 – $17,495.00 | 19 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | $7,594.30 | $21,698.00 | $1,735.84 – $21,698.00 | 19 |
| Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 | $1,624.70 | $4,642.00 | $371.36 – $4,642.00 | 19 |
| Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 | $1,958.25 | $5,595.00 | $447.60 – $5,595.00 | 19 |
| Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 | $1,768.55 | $5,053.00 | $404.24 – $5,053.00 | 19 |
| Ecmo/ecls repos perph cnula 6yrs&older perq 33958 CPT 33958 | $1,965.25 | $5,615.00 | $449.20 – $5,615.00 | 19 |
| Ecp ciliary body destruction CPT 66711 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 | $44.10 | $126.00 | $34.02 – $126.00 | 16 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $693.70 | $1,982.00 | $100.00 – $1,982.00 | 16 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $768.25 | $2,195.00 | $59.45 – $2,195.00 | 16 |
| Eeg during surgery CPT 95955 | $574.35 | $1,641.00 | $100.00 – $1,641.00 | 16 |
| Eeg monitoring/function test CPT 95958 | $786.10 | $2,246.00 | $100.00 – $2,246.00 | 16 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $1,041.25 | $2,975.00 | $100.00 – $2,975.00 | 16 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $720.65 | $2,059.00 | $100.00 – $2,059.00 | 16 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $515.90 | $1,474.00 | $100.00 – $1,474.00 | 16 |
| Eeg recording awake and asleep CPT 95819 | $1,218.35 | $3,481.00 | $100.00 – $3,481.00 | 16 |
| Eeg without vid 2-12hr cont mntr CPT 95707 | $311.85 | $891.00 | $100.00 – $891.00 | 16 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $315.35 | $901.00 | $100.00 – $901.00 | 16 |
| Eeg without vid ea 12-26hr cont CPT 95710 | $531.30 | $1,518.00 | $100.00 – $1,518.00 | 16 |
| Eeg without vid ea 12-26hr intmt CPT 95709 | $531.30 | $1,518.00 | $100.00 – $1,518.00 | 16 |
| Eeg wo vid 2-12hr intmt mntr CPT 95706 | $311.85 | $891.00 | $100.00 – $891.00 | 16 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.