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 |
|---|---|---|---|---|
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $7,499.98 | $21,428.50 | $4,714.27 – $21,428.50 | 22 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $9,702.65 | $27,721.83 | $41.42 – $27,721.83 | 23 |
| Inj, bortezomib freseniuskab HCPCS J9048 | $2,099.22 | $5,997.75 | $1,319.51 – $5,997.75 | 22 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $31.69 | $90.52 | $0.82 – $59.27 | 23 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $26.21 | $74.86 | $16.28 – $73.96 | 22 |
| Inj cefazolin (wg crit care) HCPCS J0687 | $33.94 | $96.97 | $12.79 – $58.10 | 22 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $315.28 | $900.78 | $135.52 – $615.99 | 22 |
| Inj ceftolozane tazobactam HCPCS J0695 | $233.01 | $665.74 | $6.21 – $665.74 | 23 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $55.30 | $158.00 | $12.64 – $158.00 | 19 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $17,124.69 | $48,927.67 | $1,329.80 – $48,927.67 | 23 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | $423.66 | $1,210.43 | $182.79 – $830.84 | 22 |
| Inj, daptomycin (hospira) HCPCS J0877 | $205.21 | $586.30 | $128.99 – $586.30 | 22 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $1,044.16 | $2,983.29 | $656.33 – $2,983.29 | 22 |
| Inj dx for sinogram CPT 20501 | $295.05 | $843.00 | $100.00 – $843.00 | 19 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $386.05 | $1,103.00 | $100.00 – $1,103.00 | 19 |
| Injection, belinostat, 10mg HCPCS J9032 | $5,276.22 | $15,074.90 | $44.26 – $15,074.90 | 23 |
| Injection, cangrelor HCPCS C9460 | $1,303.21 | $3,723.45 | $26.87 – $2,961.27 | 22 |
| Injection, daratumumab 10 mg HCPCS J9145 | $1,907.11 | $5,448.88 | $57.33 – $5,448.88 | 23 |
| Injection, doxercalciferol HCPCS J1270 | $30.62 | $87.48 | $0.54 – $62.73 | 23 |
| Injection during cath supravalvular aortography CPT 93567 | $1,364.30 | $3,898.00 | $100.00 – $3,898.00 | 18 |
| Injection epidural blood patch or clot CPT 62273 | $862.05 | $2,463.00 | $665.01 – $2,463.00 | 16 |
| Injection for arthrography wrist (both sides) CPT 25246 | $158.90 | $454.00 | $100.00 – $454.00 | 19 |
| Injection for bladder x-ray CPT 51600 | $471.80 | $1,348.00 | $100.00 – $1,348.00 | 19 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $503.30 | $1,438.00 | $100.00 – $1,438.00 | 19 |
| Injection for ureter x-ray CPT 50690 | $51.10 | $146.00 | $39.42 – $146.00 | 19 |
| Injection, fulvestrant HCPCS J9395 | $2,550.36 | $7,286.74 | $9.51 – $746.87 | 23 |
| Injection glatiramer acetate HCPCS J1595 | $358.05 | $1,022.99 | $101.90 – $1,022.99 | 23 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $4,940.02 | $14,114.32 | $3,105.16 – $14,114.32 | 22 |
| Injection into brain canal CPT 61026 | not published | not published | $958.00 – $958.00 | 1 |
| Injection into brain canal CPT 61055 | not published | not published | $958.00 – $958.00 | 1 |
| Injection into spinal artery CPT 62294 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Injection into vocal cord CPT 31513 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Injection, isavuconazonium HCPCS J1833 | $482.37 | $1,378.18 | $0.93 – $1,378.18 | 23 |
| Injection,onabotulinumtoxina HCPCS J0585 | $1,691.35 | $4,832.42 | $6.37 – $4,832.42 | 23 |
| Injection, peramivir HCPCS J2547 | $1,418.92 | $4,054.03 | $1.72 – $4,054.03 | 23 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $477.75 | $1,365.00 | $368.55 – $1,365.00 | 19 |
| Injection, renflexis HCPCS Q5104 | $1,205.90 | $3,445.42 | $37.50 – $2,877.86 | 23 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $2,160.20 | $6,172.00 | $958.00 – $6,172.00 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $570.15 | $1,629.00 | $224.64 – $832.00 | 19 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $516.25 | $1,475.00 | $331.83 – $1,229.00 | 19 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $936.25 | $2,675.00 | $722.25 – $2,675.00 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,030.05 | $2,943.00 | $100.00 – $2,943.00 | 19 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $936.25 | $2,675.00 | $722.25 – $2,675.00 | 19 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $256.20 | $732.00 | $100.00 – $732.00 | 19 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $449.05 | $1,283.00 | $346.41 – $1,283.00 | 19 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,877.75 | $5,365.00 | $1,448.55 – $5,365.00 | 16 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $158.55 | $453.00 | $122.31 – $453.00 | 19 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $355.95 | $1,017.00 | $274.59 – $1,017.00 | 19 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $306.60 | $876.00 | $24.73 – $876.00 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $93.45 | $267.00 | $34.73 – $267.00 | 16 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $306.60 | $876.00 | $57.87 – $876.00 | 16 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $306.60 | $876.00 | $88.29 – $876.00 | 16 |
| Injection treatment of eye CPT 66020 | not published | not published | $958.00 – $958.00 | 1 |
| Injection treatment of eye CPT 66030 | not published | not published | $958.00 – $958.00 | 1 |
| Injection treatment of nerve CPT 64605 | not published | not published | $958.00 – $958.00 | 1 |
| Injection treatment of nerve CPT 64610 | not published | not published | $958.00 – $958.00 | 1 |
| Injection treatment of nerve CPT 64681 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Inject/treat eye socket CPT 67500 | $262.15 | $749.00 | $202.23 – $749.00 | 19 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | $38,221.73 | $109,204.93 | $41.35 – $109,204.93 | 40 |
| Inj for ext venography CPT 36005 | $649.95 | $1,857.00 | $100.00 – $1,857.00 | 22 |
| Inj for mammo ductogram CPT 19030 | $87.50 | $250.00 | $67.50 – $250.00 | 19 |
| Inj, fosaprepitant (teva) HCPCS J1456 | $115.36 | $329.58 | $72.51 – $329.58 | 22 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $24.28 | $69.37 | $12.03 – $54.67 | 22 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $12,149.65 | $34,713.28 | $87.45 – $34,713.28 | 23 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $1,691.90 | $4,834.00 | $100.00 – $4,834.00 | 18 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $1,883.00 | $5,380.00 | $100.00 – $5,380.00 | 18 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $2,005.85 | $5,731.00 | $100.00 – $5,731.00 | 18 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $982.45 | $2,807.00 | $100.00 – $2,807.00 | 18 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $941.50 | $2,690.00 | $100.00 – $2,690.00 | 18 |
| Inj human fibrinogen con nos HCPCS J7178 | $126.10 | $360.28 | $1.09 – $360.28 | 40 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $457.80 | $1,308.00 | $2.32 – $1,308.00 | 23 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | $24.52 | $70.04 | $12.55 – $57.02 | 22 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | $115,324.19 | $329,497.66 | $490.25 – $183,886.51 | 23 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $958.00 – $958.00 | 1 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $157.15 | $449.00 | $121.23 – $449.00 | 19 |
| Inj ivig privigen 500 mg HCPCS J1459 | $10,879.50 | $31,084.27 | $52.00 – $3,490.97 | 23 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $1,729.21 | $4,940.60 | $481.30 – $2,187.71 | 22 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $51.76 | $147.86 | $16.63 – $75.59 | 23 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $115.33 | $329.50 | $25.91 – $117.77 | 22 |
| Inj luxturna 1 billion vec g HCPCS J3398 | $159,939.86 | $456,971.02 | $2,445.96 – $456,971.02 | 23 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $390.60 | $1,116.00 | $89.28 – $1,116.00 | 18 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $3,856.04 | $11,017.24 | $190.91 – $3,740.26 | 23 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $1,485.81 | $4,245.16 | $1.44 – $53.83 | 23 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $281.22 | $803.48 | $1.80 – $734.39 | 23 |
| Inj meropenem (wg crit care) HCPCS J2183 | $24.84 | $70.97 | $15.62 – $70.97 | 22 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $54.12 | $154.62 | $12.01 – $154.62 | 23 |
| Inj multihance HCPCS A9577 | $64.28 | $183.63 | $2.35 – $17.00 | 23 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $751.45 | $2,147.00 | $579.69 – $2,147.00 | 16 |
| Inj ogivri 10 mg HCPCS Q5114 | $3,968.67 | $11,339.04 | $74.03 – $4,262.98 | 23 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $22.50 | $64.27 | $14.14 – $64.27 | 22 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $24,790.29 | $70,829.38 | $103.55 – $70,829.38 | 23 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $7,258.20 | $20,737.69 | $35.29 – $20,737.69 | 23 |
| Inj proc ankle arthr CPT 27648 | $86.80 | $248.00 | $19.84 – $248.00 | 22 |
| Inj proc elbow arthro CPT 24220 | $137.55 | $393.00 | $100.00 – $393.00 | 19 |
| Inj proc for lymphang CPT 38790 | $113.40 | $324.00 | $87.48 – $324.00 | 19 |
| Inj proc lumbr disk ea lvl CPT 62290 | $1,165.15 | $3,329.00 | $100.00 – $3,329.00 | 19 |
| Inj proc myelogram lumbar CPT 62284 | $914.55 | $2,613.00 | $100.00 – $2,613.00 | 19 |
| Inj proc sialogram CPT 42550 | $68.60 | $196.00 | $52.92 – $196.00 | 19 |
| Inj progesterone per 50 mg HCPCS J2675 | $19.32 | $55.19 | $1.27 – $55.19 | 23 |
| Inj, releuko 1 mcg HCPCS Q5125 | $326.52 | $932.90 | $48.92 – $222.32 | 22 |
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.