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 |
|---|---|---|---|---|
| Mayo fat/lipids feces quantitative CPT 82710 | $35.35 | $101.00 | $12.10 – $101.00 | 39 |
| Mayo fbl culture fungi blood CPT 87103 | $116.90 | $334.00 | $14.73 – $334.00 | 39 |
| Mayo fibrinogen antigen CPT 85385 | $4.90 | $14.00 | $3.78 – $45.50 | 39 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $60.55 | $173.00 | $15.60 – $173.00 | 39 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $646.10 | $1,846.00 | $37.45 – $1,846.00 | 18 |
| Mayo hemosiderin qualitative urine CPT 83070 | $65.45 | $187.00 | $3.42 – $187.00 | 39 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $200.90 | $574.00 | $25.26 – $574.00 | 39 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $52.15 | $149.00 | $9.93 – $149.00 | 40 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $140.00 | $400.00 | $18.58 – $400.00 | 39 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $111.30 | $318.00 | $6.40 – $318.00 | 40 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $31.50 | $90.00 | $9.73 – $90.00 | 40 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $64.05 | $183.00 | $19.56 – $183.00 | 39 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $198.80 | $568.00 | $12.43 – $568.00 | 39 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $19.60 | $56.00 | $10.79 – $56.00 | 39 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $247.10 | $706.00 | $14.98 – $706.00 | 39 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $96.95 | $277.00 | $14.98 – $277.00 | 39 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $103.95 | $297.00 | $11.57 – $297.00 | 39 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $100.45 | $287.00 | $8.63 – $287.00 | 39 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $150.50 | $430.00 | $25.26 – $430.00 | 39 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $278.95 | $797.00 | $25.26 – $797.00 | 39 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $414.75 | $1,185.00 | $25.26 – $1,185.00 | 39 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $230.65 | $659.00 | $30.84 – $659.00 | 39 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $322.00 | $920.00 | $51.98 – $920.00 | 37 |
| Mayo inhab inhibin a CPT 86336 | $54.95 | $157.00 | $11.22 – $157.00 | 39 |
| Mayo insulin antibodies CPT 86337 | $57.75 | $165.00 | $15.42 – $165.00 | 39 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $24.85 | $71.00 | $9.54 – $71.00 | 39 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $24.15 | $69.00 | $9.21 – $69.00 | 39 |
| Mayo legionella antibody CPT 86713 | $135.80 | $388.00 | $11.02 – $388.00 | 39 |
| Mayo leptospira antibody igm CPT 86720 | $33.25 | $95.00 | $11.66 – $95.00 | 39 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $58.80 | $168.00 | $11.15 – $168.00 | 40 |
| Mayo manganese CPT 83785 | $31.50 | $90.00 | $19.19 – $90.00 | 39 |
| Mayo metanephrines plasma CPT 83835 | $96.95 | $277.00 | $12.20 – $277.00 | 39 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $85.40 | $244.00 | $65.88 – $244.00 | 15 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $64.75 | $185.00 | $10.48 – $185.00 | 39 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $113.05 | $323.00 | $13.42 – $323.00 | 39 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $215.60 | $616.00 | $98.64 – $616.00 | 40 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $291.20 | $832.00 | $133.34 – $832.00 | 37 |
| Mayo myoglobin CPT 83874 | $60.55 | $173.00 | $9.30 – $173.00 | 39 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $44.45 | $127.00 | $15.27 – $127.00 | 39 |
| Mayo oxalate 24 hour urine CPT 83945 | $39.20 | $112.00 | $10.40 – $112.00 | 39 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $179.20 | $512.00 | $8.30 – $512.00 | 39 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $43.40 | $124.00 | $10.82 – $124.00 | 39 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $99.40 | $284.00 | $8.68 – $284.00 | 39 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $58.80 | $168.00 | $12.95 – $168.00 | 40 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $58.80 | $168.00 | $9.91 – $168.00 | 39 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $34.65 | $99.00 | $6.08 – $99.00 | 39 |
| Mayo psaft prostate specific antigen free CPT 84154 | $67.90 | $194.00 | $13.24 – $194.00 | 39 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $168.70 | $482.00 | $13.25 – $482.00 | 39 |
| Mayo receptor assay transferrin soluble CPT 84238 | $69.30 | $198.00 | $26.33 – $198.00 | 39 |
| Mayo renin CPT 84244 | $68.25 | $195.00 | $15.83 – $195.00 | 39 |
| Mayo repu protein electrophoresis urine CPT 84166 | $133.00 | $380.00 | $12.84 – $380.00 | 39 |
| Mayo selenium CPT 84255 | $25.20 | $72.00 | $18.38 – $82.97 | 39 |
| Mayo serotonin CPT 84260 | $66.15 | $189.00 | $22.31 – $189.00 | 39 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $66.85 | $191.00 | $13.93 – $191.00 | 39 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $147.00 | $420.00 | $9.89 – $420.00 | 39 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $173.60 | $496.00 | $3.07 – $496.00 | 40 |
| Mayo tgrp testosterone free CPT 84402 | $98.35 | $281.00 | $18.34 – $281.00 | 39 |
| Mayo tgrp testosterone total CPT 84403 | $128.10 | $366.00 | $18.58 – $366.00 | 39 |
| Mayo thyroglobulin CPT 84432 | $40.95 | $117.00 | $11.56 – $117.00 | 39 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $81.20 | $232.00 | $8.92 – $232.00 | 39 |
| Mayo vasoactive intestinal peptide CPT 84586 | $39.90 | $114.00 | $25.44 – $114.82 | 39 |
| Mayo vitamin b3 (niacin) CPT 84591 | $88.55 | $253.00 | $12.28 – $253.00 | 39 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Measure kidney pressure CPT 50396 | $577.50 | $1,650.00 | $445.50 – $1,650.00 | 16 |
| Measurement post void urine by ultrasound CPT 51798 | $87.50 | $250.00 | $20.00 – $250.00 | 21 |
| Medial canthopexy CPT 21280 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Med physic dos eval rad exps CPT 76145 | $442.05 | $1,263.00 | $140.00 – $1,263.00 | 18 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $90.09 | $257.38 | $0.23 – $88.40 | 23 |
| Melphalan oral 2 mg HCPCS J8600 | $152.81 | $436.60 | $7.66 – $436.60 | 23 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $467.95 | $1,337.00 | $223.30 – $1,015.00 | 22 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $128.18 | $366.21 | $1.98 – $54.40 | 23 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $9,422.50 | $26,921.41 | $30.92 – $26,921.41 | 23 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $41.70 | $119.13 | $0.56 – $55.11 | 23 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | $51,414.28 | $146,897.94 | $54.25 – $11,500.55 | 23 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $289.13 | $826.07 | $2.26 – $385.65 | 23 |
| Metabolic Blood Panel (Basic) CPT 80048 | $380.10 | $1,086.00 | $6.09 – $1,086.00 | 39 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $472.85 | $1,351.00 | $7.60 – $1,351.00 | 39 |
| Methadone injection HCPCS J1230 | $25.78 | $73.63 | $13.19 – $64.82 | 23 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $29.43 | $84.08 | $9.38 – $61.73 | 23 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $0.91 | $2.60 | $0.12 – $0.51 | 23 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $259.16 | $740.44 | $1.30 – $403.33 | 23 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $30,664.20 | $87,612.00 | $1.26 – $72.75 | 23 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $48.37 | $138.19 | $14.89 – $79.92 | 23 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $163.20 | $466.28 | $1.05 – $97.93 | 23 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $0.59 | $1.67 | $0.06 – $0.26 | 23 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $34.47 | $98.46 | $12.83 – $58.30 | 22 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $96.23 | $274.94 | $13.38 – $60.80 | 22 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $21.72 | $62.03 | $1.47 – $54.68 | 23 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $23.55 | $67.27 | $12.49 – $56.75 | 22 |
| Mgmt promoter methylation analysis CPT 81287 | $159.60 | $456.00 | $89.74 – $456.00 | 40 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $294.67 | $841.89 | $0.40 – $90.65 | 23 |
| Microdissection manual CPT 88381 | $210.00 | $600.00 | $147.96 – $600.00 | 18 |
| Microvolt t-wave assess CPT 93025 | $392.35 | $1,121.00 | $100.00 – $1,121.00 | 16 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $369.81 | $1,056.59 | $0.09 – $1.29 | 23 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $19.33 | $55.21 | $12.15 – $55.21 | 22 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $108.42 | $309.76 | $1.87 – $71.10 | 23 |
| Minocycline hydrochloride HCPCS J2265 | $323.57 | $924.47 | $1.77 – $293.75 | 23 |
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.