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 |
|---|---|---|---|---|
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $12,380.20 | $35,372.00 | $24.48 – $116.55 | 23 |
| Granisetron 1 mg tab HCPCS Q0166 | $1.87 | $5.34 | $0.24 – $1.06 | 23 |
| Granisetron hcl injection HCPCS J1626 | $30.41 | $86.88 | $0.33 – $64.11 | 23 |
| Great toe with reduction 28495 CPT 28495 | $301.00 | $860.00 | $232.20 – $860.00 | 19 |
| G-tube reposition CPT 43761 | $116.20 | $332.00 | $89.64 – $332.00 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,679.30 | $4,798.00 | $119.63 – $4,798.00 | 23 |
| Guided cath fluid drainage 10030 CPT 10030 | $586.95 | $1,677.00 | $452.79 – $1,677.00 | 18 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $6,634.11 | $18,954.60 | $8.64 – $40,285.00 | 19 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $2,229.99 | $6,371.40 | $29.49 – $109.20 | 15 |
| Guid loc target vol rad tx CPT 77387 | $395.15 | $1,129.00 | $172.06 – $1,129.00 | 18 |
| Gw stiffened micro access kit HCPCS C1894 | $27,486.80 | $78,533.70 | $0.27 – $40,285.00 | 19 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $32.39 | $92.52 | $7.93 – $80.48 | 23 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $24.66 | $70.44 | $1.73 – $54.53 | 23 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hand X-ray CPT 73130 | $505.75 | $1,445.00 | $37.09 – $1,445.00 | 23 |
| Haptoglobin quantitative CPT 83010 | $145.60 | $416.00 | $9.06 – $416.00 | 39 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | $251.30 | $718.00 | $100.00 – $718.00 | 16 |
| Hast w/oxygen titrate CPT 94453 | $251.30 | $718.00 | $100.00 – $718.00 | 16 |
| Hbot, full body chamber, 30m HCPCS G0277 | $251.30 | $718.00 | $100.00 – $718.00 | 16 |
| Hcg qualitative CPT 84703 | $133.00 | $380.00 | $5.41 – $380.00 | 40 |
| Hcg quantitative CPT 84702 | $112.35 | $321.00 | $10.84 – $321.00 | 39 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $136.50 | $390.00 | $51.00 – $390.00 | 16 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $958.00 – $958.00 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | $839.65 | $2,399.00 | $166.74 – $2,399.00 | 23 |
| Hc nm kidney imaging with flow CPT 78701 | $1,577.80 | $4,508.00 | $211.18 – $4,508.00 | 23 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $911.05 | $2,603.00 | $264.74 – $2,603.00 | 18 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,523.85 | $7,211.00 | $1,733.30 – $7,211.00 | 18 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $3,228.40 | $9,224.00 | $100.00 – $9,224.00 | 18 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $3,727.85 | $10,651.00 | $339.90 – $10,651.00 | 18 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $6,486.55 | $18,533.00 | $599.84 – $18,533.00 | 18 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $9,692.55 | $27,693.00 | $938.69 – $27,693.00 | 18 |
| Head CT scan (with and without contrast) CPT 70470 | $3,935.05 | $11,243.00 | $175.06 – $11,243.00 | 24 |
| Head CT scan (with contrast) CPT 70460 | $3,358.95 | $9,597.00 | $152.36 – $9,597.00 | 24 |
| Head CT scan (without contrast) CPT 70450 | $2,399.25 | $6,855.00 | $104.75 – $6,855.00 | 24 |
| Heart infarct image CPT 78466 | $738.15 | $2,109.00 | $168.72 – $2,109.00 | 23 |
| Heinz bodies direct CPT 85441 | $23.80 | $68.00 | $3.02 – $68.00 | 39 |
| Helicobacter pylori antibody igm CPT 86677 | $75.60 | $216.00 | $12.13 – $216.00 | 40 |
| Hematocrit CPT 85014 | $77.70 | $222.00 | $1.71 – $222.00 | 40 |
| Hematopoietic nuclear tx CPT 79403 | $786.45 | $2,247.00 | $118.40 – $2,247.00 | 18 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $13,852.74 | $39,579.23 | $24.25 – $39,579.23 | 23 |
| Hemodialysis one evaluation CPT 90935 | $1,450.40 | $4,144.00 | $100.00 – $4,144.00 | 15 |
| Hemoglobin CPT 85018 | $91.00 | $260.00 | $1.71 – $260.00 | 40 |
| Hemoglobin fetal qualitative CPT 83033 | $11.55 | $33.00 | $5.76 – $33.00 | 39 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $57.05 | $163.00 | $5.90 – $163.00 | 39 |
| Hemoglobin plasma CPT 83051 | $38.15 | $109.00 | $5.26 – $109.00 | 39 |
| Hemoglobin urine CPT 83069 | $28.35 | $81.00 | $2.84 – $81.00 | 39 |
| Hemolysins/agglutinins auto CPT 86940 | $53.90 | $154.00 | $6.31 – $154.00 | 39 |
| Hemolysins and agglutinins incubated CPT 86941 | $53.90 | $154.00 | $8.72 – $154.00 | 39 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | $2,403.45 | $6,867.00 | $1,854.09 – $6,867.00 | 16 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $752.85 | $2,151.00 | $580.77 – $2,151.00 | 19 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Hepagam b intravenous, inj HCPCS J1573 | $961.26 | $2,746.44 | $92.48 – $2,746.44 | 23 |
| Heparin assay CPT 85520 | $130.20 | $372.00 | $9.42 – $372.00 | 39 |
| Heparin bolus from bag HCPCS J1644 | $53.24 | $152.09 | $0.15 – $54.12 | 23 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $28.84 | $82.38 | $0.03 – $54.75 | 23 |
| Hepatitis a antibody igm CPT 86709 | $194.60 | $556.00 | $8.11 – $556.00 | 40 |
| Hepatitis b core antibody igm CPT 86705 | $140.00 | $400.00 | $8.47 – $400.00 | 40 |
| Hepatitis b core antibody total CPT 86704 | $156.10 | $446.00 | $8.68 – $446.00 | 40 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,299.38 | $3,712.49 | $83.53 – $379.68 | 23 |
| Hepatitis b surface antibody CPT 86706 | $170.10 | $486.00 | $7.73 – $486.00 | 40 |
| Hepatitis c antibody CPT 86803 | $134.05 | $383.00 | $10.27 – $223.00 | 39 |
| Hepatobiliary system imaging CPT 78226 | $1,521.10 | $4,346.00 | $303.06 – $4,346.00 | 23 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Herpes simplex type 1 antibody igg CPT 86695 | $1,657.25 | $4,735.00 | $9.50 – $4,735.00 | 40 |
| Herpes simplex type 2 antibody igg CPT 86696 | $92.05 | $263.00 | $13.93 – $263.00 | 40 |
| Herpes simplex virus isolation CPT 87255 | $141.75 | $405.00 | $24.38 – $405.00 | 39 |
| Heterophile antibodies screening CPT 86308 | $92.75 | $265.00 | $3.73 – $265.00 | 40 |
| Hhv-6 dna quant CPT 87533 | $67.90 | $194.00 | $30.07 – $194.00 | 39 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Hip X-ray CPT 73502 | $560.70 | $1,602.00 | $47.11 – $1,602.00 | 23 |
| HIV prep, inj, cabotegravir HCPCS J0739 | $9,876.71 | $28,219.17 | $5,247.79 – $23,853.56 | 22 |
| Hla class i high defin qual CPT 86832 | $563.15 | $1,609.00 | $233.10 – $1,609.00 | 39 |
| Hla class ii high defin qual CPT 86833 | $569.10 | $1,626.00 | $234.58 – $1,626.00 | 39 |
| Hla class i&ii antibody qual CPT 86828 | $112.70 | $322.00 | $46.22 – $322.00 | 39 |
| Hla class ii semiquant panel CPT 86835 | $563.15 | $1,609.00 | $232.53 – $1,609.00 | 39 |
| Hla class i semiquant panel CPT 86834 | $619.50 | $1,770.00 | $257.44 – $1,770.00 | 39 |
| Hla i & ii typing lr CPT 81370 | $2,328.90 | $6,654.00 | $289.53 – $6,654.00 | 40 |
| Hla typing a b or c CPT 86813 | $210.35 | $601.00 | $41.76 – $499.00 | 39 |
| Hla x-match noncytotoxc addl CPT 86826 | $274.75 | $785.00 | $26.30 – $785.00 | 39 |
| Hla x-math non-cytotoxic CPT 86825 | $350.00 | $1,000.00 | $78.83 – $1,000.00 | 39 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | $33.91 | $96.88 | $0.28 – $63.60 | 23 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $6.14 | $17.53 | $0.21 – $8.56 | 23 |
| Homocysteine CPT 83090 | $98.35 | $281.00 | $12.90 – $281.00 | 39 |
| Homogenization tissue CPT 87176 | $41.30 | $118.00 | $4.23 – $118.00 | 39 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $64.47 | $184.18 | $40.52 – $184.18 | 23 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | $154.88 | $442.49 | $0.45 – $57.33 | 23 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $88.34 | $252.39 | $0.40 – $252.39 | 23 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $644.76 | $1,842.16 | $5.83 – $51.97 | 23 |
| Hydration IV infusion each additional hour CPT 96361 | $196.35 | $561.00 | $19.99 – $561.00 | 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.