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 |
|---|---|---|---|---|
| Intra-atrial recording CPT 93602 | $6,157.90 | $17,594.00 | $4,750.38 – $17,594.00 | 16 |
| Intracard echo interv w/s&i CPT 93662 | $3,977.05 | $11,363.00 | $100.00 – $11,363.00 | 20 |
| Intracran angioplsty w/stent CPT 61635 | $2,704.80 | $7,728.00 | $2,086.56 – $7,728.00 | 19 |
| Intracranial angioplasty CPT 61630 | $2,742.95 | $7,837.00 | $2,115.99 – $7,837.00 | 19 |
| Intracranial complete study CPT 93886 | $549.85 | $1,571.00 | $125.68 – $1,571.00 | 21 |
| Intracranial limited study CPT 93888 | $319.20 | $912.00 | $72.96 – $912.00 | 21 |
| Intranasal reconstruction CPT 30620 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Intrapul surf admin endo tube CPT 94610 | $177.80 | $508.00 | $100.00 – $508.00 | 16 |
| Intraventricular pacing CPT 93612 | $6,157.90 | $17,594.00 | $4,750.38 – $17,594.00 | 16 |
| Intrinsic factor antibody CPT 86340 | $34.30 | $98.00 | $10.86 – $98.00 | 39 |
| Intro cath dialysis circuit CPT 36901 | $5,167.40 | $14,764.00 | $3,986.28 – $14,764.00 | 16 |
| Intro cath dialysis circuit w/pta CPT 36902 | $18,447.80 | $52,708.00 | $14,231.16 – $52,708.00 | 16 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $35,500.15 | $101,429.00 | $27,385.83 – $101,429.00 | 16 |
| Intro catheter aorta CPT 36200 | $1,582.70 | $4,522.00 | $100.00 – $4,522.00 | 22 |
| Intro cath svc/ivc CPT 36010 | $757.75 | $2,165.00 | $100.00 – $2,165.00 | 22 |
| Intro long gi tube CPT 44500 | $720.65 | $2,059.00 | $555.93 – $2,059.00 | 19 |
| Intro long gi tube w/mult fluo CPT 74340 | $388.85 | $1,111.00 | $39.13 – $1,111.00 | 18 |
| Intro windpipe wire/tube CPT 31730 | not published | not published | $958.00 – $958.00 | 1 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,069.90 | $5,914.00 | $100.00 – $5,914.00 | 19 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $1,801.10 | $5,146.00 | $100.00 – $5,146.00 | 19 |
| Intubation endotracheal emergency procedure CPT 31500 | $263.90 | $754.00 | $203.58 – $754.00 | 19 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $871.50 | $2,490.00 | $100.00 – $2,490.00 | 16 |
| Ionm in operatng room 15 min CPT 95940 | $58.10 | $166.00 | $44.82 – $166.00 | 16 |
| Ionm remote/>1 pt or per hr CPT 95941 | $290.50 | $830.00 | $100.00 – $830.00 | 16 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $89.85 | $256.71 | $0.22 – $1.00 | 23 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $163.53 | $467.21 | $0.20 – $1.00 | 23 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $87,854.81 | $251,013.72 | $159.64 – $63,039.03 | 23 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $227.39 | $649.68 | $2.81 – $429.66 | 23 |
| Iron CPT 83540 | $92.05 | $263.00 | $4.66 – $153.00 | 39 |
| Iron binding capacity CPT 83550 | $98.35 | $281.00 | $6.29 – $281.00 | 39 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $31.09 | $88.81 | $14.82 – $88.81 | 23 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $110.58 | $315.94 | $0.33 – $185.29 | 23 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $75.60 | $216.00 | $58.32 – $216.00 | 18 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $9,856.39 | $28,161.11 | $80.90 – $5,914.17 | 23 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Ivc venogram s&i CPT 75825 | $3,316.95 | $9,477.00 | $114.28 – $9,477.00 | 23 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $326.55 | $933.00 | $46.30 – $933.00 | 16 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $316.05 | $903.00 | $31.04 – $903.00 | 16 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $171.15 | $489.00 | $32.09 – $489.00 | 16 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $641.55 | $1,833.00 | $100.00 – $1,833.00 | 16 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $881.30 | $2,518.00 | $135.16 – $2,518.00 | 23 |
| Jak2 targeted sequence analysis CPT 81279 | $291.20 | $832.00 | $133.34 – $832.00 | 37 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Keratoprosthesis CPT 65770 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $51.80 | $148.00 | $5.88 – $148.00 | 39 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $26.86 | $76.74 | $0.20 – $53.86 | 23 |
| Kidney endoscopy CPT 50551 | not published | not published | $958.00 – $958.00 | 1 |
| Kidney endoscopy CPT 50553 | not published | not published | $958.00 – $958.00 | 1 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $958.00 – $958.00 | 1 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $958.00 – $958.00 | 1 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $958.00 – $958.00 | 1 |
| Kidney function study CPT 78725 | $315.70 | $902.00 | $72.16 – $902.00 | 23 |
| Kidney imaging morphology CPT 78700 | $1,206.80 | $3,448.00 | $160.71 – $3,448.00 | 23 |
| Kidney imag w/bld flow multi CPT 78709 | $2,572.15 | $7,349.00 | $345.49 – $7,349.00 | 23 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,631.00 | $4,660.00 | $218.53 – $4,660.00 | 23 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,124.20 | $3,212.00 | $104.75 – $3,212.00 | 23 |
| Kit case 4.2mm spinejack HCPCS C1062 | $13,775.74 | $39,359.25 | $2,982.56 – $13,557.08 | 23 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $17,272.50 | $49,350.00 | $100.00 – $24,373.00 | 15 |
| Kit hfx iq ipg bundle HCPCS C1822 | $95,550.00 | $273,000.00 | $721.35 – $3,435.00 | 23 |
| Kit ipg optimizer smart HCPCS C1824 | $95,550.00 | $273,000.00 | $48,276.27 – $229,887.00 | 23 |
| Kit lead specify 5-6-5 HCPCS C1778 | $36,731.63 | $104,947.50 | $0.27 – $1,021.80 | 23 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $2,701.13 | $7,717.50 | $432.39 – $2,059.00 | 23 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $4,454.10 | $12,726.00 | $164.64 – $784.00 | 23 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Knee MRI (with and without contrast) CPT 73723 | $5,206.60 | $14,876.00 | $366.42 – $14,876.00 | 24 |
| Knee MRI (with contrast) CPT 73722 | $4,225.20 | $12,072.00 | $323.44 – $12,072.00 | 24 |
| Knee MRI (without contrast) CPT 73721 | $2,725.80 | $7,788.00 | $208.84 – $7,788.00 | 24 |
| Knee X-ray CPT 73564 | $579.60 | $1,656.00 | $46.78 – $1,656.00 | 23 |
| Kras gene addl variants CPT 81276 | $303.10 | $866.00 | $139.14 – $866.00 | 39 |
| Kras gene variants exon 2 CPT 81275 | $200.55 | $573.00 | $139.14 – $628.06 | 40 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $25.00 | $71.42 | $11.86 – $53.88 | 22 |
| Labioplasty 56800 CPT 56800 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $166.62 | $476.05 | $0.59 – $56.69 | 22 |
| Lactate dehydrogenase (ldh) CPT 83615 | $62.30 | $178.00 | $4.35 – $178.00 | 39 |
| Lactated ringers intravenous solution HCPCS J7120 | $24.28 | $69.37 | $0.59 – $2.64 | 23 |
| Lactic acid CPT 83605 | $102.90 | $294.00 | $8.33 – $294.00 | 39 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $24,143.75 | $68,982.14 | $64.23 – $57,735.14 | 23 |
| Laparo-asst vag hysterectomy CPT 58550 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Laparo ligate spermatic vein CPT 55550 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Laparo-myomectomy complex CPT 58546 | not published | not published | $5,460.00 – $5,460.00 | 1 |
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.