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 |
|---|---|---|---|---|
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $3,158.38 | $9,023.92 | $66.19 – $651.14 | 23 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $433.14 | $1,237.52 | $40.78 – $1,237.52 | 23 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $958.00 – $958.00 | 1 |
| Monitor cable elec vad, rep HCPCS Q0485 | $1,280.30 | $3,658.00 | $768.18 – $3,658.00 | 20 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $18,032.35 | $51,521.00 | $1,266.80 – $6,032.36 | 23 |
| Mopath procedure level 3 CPT 81402 | $235.90 | $674.00 | $108.24 – $674.00 | 40 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $86.76 | $247.87 | $0.08 – $49.86 | 23 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $22.12 | $63.19 | $12.03 – $54.64 | 22 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $491.17 | $1,403.32 | $5.08 – $53.32 | 23 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $362.25 | $1,035.00 | $193.77 – $1,035.00 | 18 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $249.55 | $713.00 | $192.51 – $713.00 | 18 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | $1,682.99 | $4,808.53 | $1,057.88 – $4,808.53 | 22 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $303.80 | $868.00 | $193.77 – $868.00 | 18 |
| MRA chest w IV cont HCPCS C8909 | $1,613.15 | $4,609.00 | $538.41 – $4,609.00 | 19 |
| MRA chest wo IV cont HCPCS C8910 | $1,205.05 | $3,443.00 | $328.59 – $3,443.00 | 19 |
| MRA chest wwo IV cont HCPCS C8911 | $1,943.20 | $5,552.00 | $538.41 – $5,552.00 | 19 |
| MRA pelvis w IV cont HCPCS C8918 | $1,211.35 | $3,461.00 | $538.41 – $3,461.00 | 19 |
| MRA pelvis wo IV cont HCPCS C8919 | $904.75 | $2,585.00 | $328.59 – $2,585.00 | 19 |
| MRA w/cont, abd HCPCS C8900 | $1,509.90 | $4,314.00 | $538.41 – $4,314.00 | 19 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,607.90 | $4,594.00 | $538.41 – $4,594.00 | 19 |
| Mra, w/dye, spinal canal HCPCS C8931 | $316.40 | $904.00 | $244.08 – $1,398.60 | 19 |
| MRA without cont, abd HCPCS C8901 | $1,128.05 | $3,223.00 | $328.59 – $3,223.00 | 19 |
| MRA without cont, lwr ext HCPCS C8913 | $972.65 | $2,779.00 | $328.59 – $2,779.00 | 19 |
| Mra, without dye, spinal canal HCPCS C8932 | $192.85 | $551.00 | $148.77 – $1,398.60 | 19 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,818.95 | $5,197.00 | $538.41 – $5,197.00 | 19 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,830.15 | $5,229.00 | $538.41 – $5,229.00 | 19 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,459.15 | $4,169.00 | $538.41 – $4,169.00 | 19 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $316.40 | $904.00 | $244.08 – $1,398.60 | 19 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $712.60 | $2,036.00 | $538.41 – $2,036.00 | 19 |
| Mr elastography CPT 76391 | $1,811.95 | $5,177.00 | $207.16 – $5,177.00 | 24 |
| MRI breast c- unilateral CPT 77046 | $1,206.80 | $3,448.00 | $340.24 – $3,448.00 | 19 |
| MRI breast c-+ w/cad uni CPT 77048 | $372.40 | $1,064.00 | $287.28 – $1,398.60 | 19 |
| MRI breast without cont bi CPT 77047 | $1,163.05 | $3,323.00 | $340.24 – $3,323.00 | 19 |
| MRI breast w IV cont bi CPT 77049 | $988.75 | $2,825.00 | $427.78 – $2,825.00 | 19 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $1,264.55 | $3,613.00 | $233.47 – $3,613.00 | 24 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $1,453.20 | $4,152.00 | $332.16 – $4,152.00 | 24 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $1,453.20 | $4,152.00 | $332.16 – $4,152.00 | 24 |
| MRI chest without contrast CPT 71550 | $1,548.40 | $4,424.00 | $233.47 – $4,424.00 | 24 |
| MRI chest without & w/contrast CPT 71552 | $2,150.40 | $6,144.00 | $366.42 – $6,144.00 | 24 |
| MRI chest w IV cont CPT 71551 | $1,414.00 | $4,040.00 | $323.20 – $4,040.00 | 24 |
| MRI fetal ea addl gestation CPT 74713 | $576.10 | $1,646.00 | $131.68 – $1,646.00 | 24 |
| MRI fetal sngl/1st gestation CPT 74712 | $1,187.55 | $3,393.00 | $233.47 – $3,393.00 | 24 |
| MRI guid ndl plc s&i CPT 77021 | $1,161.65 | $3,319.00 | $100.00 – $3,319.00 | 19 |
| MRI loex nonjt w IV cont CPT 73719 | $3,427.20 | $9,792.00 | $271.31 – $9,792.00 | 24 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,904.30 | $8,298.00 | $230.21 – $8,298.00 | 24 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $4,385.50 | $12,530.00 | $347.50 – $12,530.00 | 24 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,555.75 | $4,445.00 | $233.23 – $4,445.00 | 24 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,321.90 | $6,634.00 | $349.16 – $6,634.00 | 24 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,069.60 | $3,056.00 | $244.48 – $3,056.00 | 24 |
| MRI tmj CPT 70336 | $673.75 | $1,925.00 | $154.00 – $1,925.00 | 24 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,951.95 | $5,577.00 | $233.47 – $5,577.00 | 24 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,637.60 | $7,536.00 | $366.42 – $7,536.00 | 24 |
| MRI upper extremity w/dye CPT 73219 | $2,136.75 | $6,105.00 | $341.81 – $6,105.00 | 24 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 19 |
| MRI w/cont, breast, uni HCPCS C8903 | $905.10 | $2,586.00 | $256.93 – $2,586.00 | 19 |
| MRI without fol w/cont, breast HCPCS C8908 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 19 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 19 |
| Mr safety determination physician/other qhp CPT 76016 | $77.00 | $220.00 | $59.40 – $220.00 | 15 |
| Mr safety implant elec prepj CPT 76018 | $80.50 | $230.00 | $62.10 – $230.00 | 15 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $42.70 | $122.00 | $32.94 – $122.00 | 15 |
| Mr safety implt pos&/immoblj CPT 76019 | $52.15 | $149.00 | $40.23 – $149.00 | 15 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $21.35 | $61.00 | $16.47 – $61.00 | 15 |
| Mr sfty med physics xm cstmz CPT 76017 | $211.40 | $604.00 | $100.00 – $604.00 | 15 |
| Mr spectroscopy CPT 76390 | $273.70 | $782.00 | $211.14 – $1,398.60 | 19 |
| Mthfr gene analy common variants CPT 81291 | $1,830.50 | $5,230.00 | $47.04 – $5,230.00 | 40 |
| Multiple sleep latency test CPT 95805 | $1,544.90 | $4,414.00 | $100.00 – $4,414.00 | 18 |
| Mumps antibody igg CPT 86735 | $61.60 | $176.00 | $9.40 – $176.00 | 39 |
| Muscle-skin graft arm CPT 15736 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Muscle-skin graft trunk CPT 15734 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Muscle test cran nerv unilat CPT 95867 | $547.75 | $1,565.00 | $94.18 – $1,565.00 | 16 |
| Muscle transfers CPT 23397 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Muscle transfer shoulder/arm CPT 23395 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3.10 | $8.85 | $0.06 – $0.25 | 23 |
| Mycophenolic acid HCPCS J7518 | $2.22 | $6.34 | $0.07 – $0.29 | 23 |
| Mycoplasma antibody igm CPT 86738 | $50.40 | $144.00 | $9.53 – $144.00 | 39 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $276.85 | $791.00 | $126.29 – $791.00 | 37 |
| Myelogphy 2/> spine regions CPT 72270 | $1,224.30 | $3,498.00 | $140.00 – $3,498.00 | 23 |
| Myelography l-s spine CPT 72265 | $971.60 | $2,776.00 | $109.26 – $2,776.00 | 23 |
| Myelography neck spine CPT 72240 | $982.45 | $2,807.00 | $112.26 – $2,807.00 | 23 |
| Myelography thoracic spine CPT 72255 | $516.60 | $1,476.00 | $107.93 – $1,476.00 | 23 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $2,459.80 | $7,028.00 | $1,897.56 – $7,028.00 | 16 |
| Myelography via inj w/s&i cervical CPT 62302 | $1,896.30 | $5,418.00 | $1,462.86 – $5,418.00 | 16 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,608.90 | $7,454.00 | $2,012.58 – $7,454.00 | 16 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,576.75 | $4,505.00 | $1,216.35 – $4,505.00 | 16 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $117.60 | $336.00 | $8.30 – $336.00 | 39 |
| Myocrd img pet 1std rst/strs CPT 78491 | $1,526.70 | $4,362.00 | $1,177.74 – $4,362.00 | 18 |
| Myocrd img pet 1 std w/ct CPT 78429 | $3,314.15 | $9,469.00 | $120.43 – $9,469.00 | 18 |
| Myocrd img pet 2rtracer CPT 78432 | $3,940.30 | $11,258.00 | $141.78 – $11,258.00 | 18 |
| Myocrd img pet 2rtracer CT CPT 78433 | $4,308.50 | $12,310.00 | $154.99 – $12,310.00 | 18 |
| Myocrd img pet mlt rst&strs CPT 78492 | $3,055.50 | $8,730.00 | $1,939.61 – $8,730.00 | 18 |
| Myocrd img pet rst&strs CT CPT 78431 | $3,682.35 | $10,521.00 | $133.13 – $10,521.00 | 18 |
| Myocrd img pet rst/strs w/ct CPT 78430 | $3,167.15 | $9,049.00 | $114.34 – $9,049.00 | 18 |
| Myomectomy vag method CPT 58145 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Myringoplasty CPT 69620 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $89.49 | $255.66 | $1.96 – $64.56 | 23 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $38.60 | $110.27 | $12.63 – $57.37 | 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.