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 |
|---|---|---|---|---|
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc thigh/knee tum deep <5cm CPT 27328 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $1,082.20 | $3,092.00 | $834.84 – $3,092.00 | 19 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951 CPT 15951 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exc trchntr pr ulc flp clsr CPT 15952 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exc trchntr pr ulc flp ostc CPT 15953 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exc trchntr pr ulc prep flap CPT 15956 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exc trchntr pr ulc prep ostc CPT 15958 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exc trchntr pr ulc prim sutr CPT 15950 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exc vagina lesion 57135 CPT 57135 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exercise w/hemodynamic meas CPT 93464 | $705.25 | $2,015.00 | $100.00 – $2,015.00 | 19 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $7,515.38 | $21,472.50 | $0.21 – $1.00 | 23 |
| Exploration for testis CPT 54550 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exploration maxillary sinus CPT 31030 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exploration maxillary sinus CPT 31256 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exploration of ankle joint CPT 27612 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exploration of chest 39010 CPT 39010 | $5,702.20 | $16,292.00 | $1,303.36 – $16,292.00 | 22 |
| Exploration of foot joint CPT 28020 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exploration of foot joint CPT 28022 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exploration of frontal sinus CPT 31070 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Exploration of frontal sinus CPT 31075 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exploration of knee joint CPT 27310 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Exploration of middle ear CPT 69440 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Exploration of sinuses CPT 31090 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Exploration of toe joint CPT 28024 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Explore/biopsy eye socket CPT 67400 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Explore/biopsy eye socket CPT 67450 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore deep node(s) neck CPT 38542 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Explore/drain eye socket CPT 67405 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Explore/drain eye socket CPT 67440 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore epididymis CPT 54865 | not published | not published | $958.00 – $958.00 | 1 |
| Explore inner ear CPT 69805 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Explore inner ear CPT 69806 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $624.75 | $1,785.00 | $481.95 – $1,785.00 | 19 |
| Explore scrotum CPT 55110 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Explore/treat ankle joint CPT 27620 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Explore/treat eye socket CPT 67412 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore/treat eye socket CPT 67420 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore/treat eye socket CPT 67430 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore/treat eye socket 67413 CPT 67413 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Explore/treat finger joint CPT 26075 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Explore/treat finger joint CPT 26080 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Explore/treat knee joint CPT 27331 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Explore/treat wrist joint CPT 25101 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Explore wound abdomen 20102 CPT 20102 | $1,014.30 | $2,898.00 | $231.84 – $2,898.00 | 24 |
| Explore woundchest 20101 CPT 20101 | $1,014.30 | $2,898.00 | $231.84 – $2,898.00 | 24 |
| Explor not followed by surg repair artery; low extrem 35703 CPT 35703 | $7,783.65 | $22,239.00 | $1,779.12 – $22,239.00 | 19 |
| Explor not followed by surg repair artery; up extrem 35702 CPT 35702 | $7,783.65 | $22,239.00 | $1,779.12 – $22,239.00 | 19 |
| Explr/decompress eye socket CPT 67445 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Expose art endoprosth iliac 34820 CPT 34820 | $238.35 | $681.00 | $49.52 – $619.00 | 22 |
| Expose endoprosth brachial 34834 CPT 34834 | $306.25 | $875.00 | $70.00 – $875.00 | 22 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Extensive ear canal surgery 69150 CPT 69150 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Extensive hand surgery CPT 26250 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Extensive mastoid surgery CPT 69511 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Extensive mastoid surgery CPT 69530 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| External cannula declotting CPT 36860 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| External chromosome analysis 20-25 cells CPT 88264 | $321.30 | $918.00 | $104.12 – $918.00 | 40 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $37.45 | $107.00 | $26.21 – $107.00 | 17 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $647.15 | $1,849.00 | $103.50 – $1,849.00 | 40 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $159.60 | $456.00 | $12.91 – $456.00 | 39 |
| Extraction of lens CPT 66930 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Extraction of lens CPT 66940 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Eye implant band 40 HCPCS C1784 | $9,738.75 | $27,825.00 | $7.56 – $36.00 | 23 |
| F-18 fdg pet diag HCPCS A9552 | $479.15 | $1,369.00 | $100.00 – $1,369.00 | 16 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $4,073.83 | $11,639.49 | $100.00 – $9,263.00 | 18 |
| F-18 fluciclovine per mci HCPCS A9588 | $1,042.30 | $2,978.00 | $383.30 – $2,978.00 | 16 |
| F-18 sodium fluoride HCPCS A9580 | $254.10 | $726.00 | $100.00 – $2,913.00 | 17 |
| Face bone graft CPT 21210 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Facial bones <3 CPT 70140 | $112.35 | $321.00 | $25.68 – $321.00 | 23 |
| Factor ix CPT 85250 | $71.75 | $205.00 | $13.71 – $205.00 | 39 |
| Factor ix alprolix recomb HCPCS J7201 | $131.30 | $375.12 | $2.61 – $375.12 | 40 |
| Factor ix complex HCPCS J7194 | $126.36 | $361.02 | $1.02 – $361.02 | 40 |
| Factor ix recombinant nos HCPCS J7195 | $2,644.25 | $7,554.98 | $1.35 – $338.10 | 40 |
| Factor viii CPT 85240 | $226.10 | $646.00 | $12.89 – $646.00 | 39 |
| Factor viii recombinant nos HCPCS J7192 | $5,557.21 | $15,877.74 | $1.01 – $337.63 | 40 |
| Factor viii recomb novoeight HCPCS J7182 | $3,643.48 | $10,409.93 | $1.09 – $10,409.93 | 40 |
| Factor xiii anti-hem factor HCPCS J7180 | $146.89 | $419.67 | $7.75 – $419.67 | 40 |
| Fallopian tube recnl CPT 58345 | $2,814.70 | $8,042.00 | $2,171.34 – $8,042.00 | 19 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $7,077.64 | $20,221.82 | $29.35 – $20,221.82 | 23 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $1,696.10 | $4,846.00 | $330.12 – $1,572.00 | 20 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $22,811.39 | $65,175.38 | $14,338.59 – $65,175.38 | 22 |
| #fecal-sodium CPT 84302 | $25.20 | $72.00 | $3.50 – $72.00 | 39 |
| Femoral endovas graft add-on 34813 CPT 34813 | $390.60 | $1,116.00 | $89.28 – $1,116.00 | 22 |
| Fem/popl revasc w/stent CPT 37226 | $13,989.15 | $39,969.00 | $10,791.63 – $39,969.00 | 19 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $171.92 | $491.20 | $0.43 – $53.20 | 23 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $1,329.31 | $3,798.01 | $1.52 – $3,798.01 | 23 |
| Ferritin CPT 82728 | $103.95 | $297.00 | $9.81 – $297.00 | 39 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $241.59 | $690.23 | $0.54 – $690.23 | 23 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $492.45 | $1,407.00 | $96.54 – $1,407.00 | 23 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $587.30 | $1,678.00 | $48.94 – $1,678.00 | 19 |
| Fetal fibronectin CPT 82731 | $395.85 | $1,131.00 | $46.38 – $1,131.00 | 40 |
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.