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 |
|---|---|---|---|---|
| Ntsty modul rad tx dlvr smpl CPT 77385 | $3,428.25 | $9,795.00 | $752.43 – $9,795.00 | 18 |
| Nuclear exam of tear flow CPT 78660 | $356.65 | $1,019.00 | $81.52 – $1,019.00 | 23 |
| Nuclear rx intra-arterial CPT 79445 | $468.65 | $1,339.00 | $107.12 – $1,339.00 | 23 |
| Nuclear rx IV admin CPT 79101 | $1,314.95 | $3,757.00 | $71.13 – $3,757.00 | 23 |
| Nuclear Stress Test (Heart) CPT 78452 | $4,876.90 | $13,934.00 | $438.05 – $13,934.00 | 23 |
| Nushield 1 square cm HCPCS Q4160 | $302.05 | $863.00 | $134.13 – $863.00 | 22 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | $358,185.45 | $1,023,387.00 | $1,136.33 – $1,023,387.00 | 23 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $20,900.15 | $59,714.69 | $70.90 – $59,714.69 | 23 |
| Observation direct referral from physician office for admission HCPCS G0379 | $545.65 | $1,559.00 | $90.00 – $1,559.00 | 26 |
| Observation per hour HCPCS G0378 | $21.70 | $62.00 | $4.96 – $90.90 | 26 |
| Obtaining screen pap smear HCPCS Q0091 | $21.70 | $62.00 | $16.74 – $62.00 | 16 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $204.18 | $583.37 | $0.68 – $55.54 | 23 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $16,529.25 | $47,226.41 | $227.40 – $17,495.65 | 23 |
| Ocular reconst transplant CPT 65780 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Ocular reconst transplant CPT 65781 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Ocular reconst transplant CPT 65782 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $1,690.32 | $4,829.48 | $771.75 – $3,675.00 | 23 |
| Oncoprotein dcp CPT 83951 | $87.50 | $250.00 | $46.38 – $250.00 | 39 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $29.44 | $84.09 | $0.01 – $0.25 | 23 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $41.23 | $117.78 | $0.13 – $54.21 | 23 |
| Open nasoethmoid fx with fixj CPT 21339 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Open nasoethmoid fx without fixj CPT 21338 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Open thrombectomy of av fistula without revision 36831 CPT 36831 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Open tx nose fx w/skele fixj CPT 21330 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Open tx nose & septal fx CPT 21335 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Opn ax/subcla art expos CPT 34715 | $103.60 | $296.00 | $23.68 – $296.00 | 19 |
| Opn fem art expos cndt crtj 34714 CPT 34714 | $97.30 | $278.00 | $22.24 – $278.00 | 19 |
| Opn ilac art expos cndt crtj CPT 34833 | $325.85 | $931.00 | $74.48 – $931.00 | 22 |
| Opn impltj nea neuromuscular CPT 64580 | not published | not published | $958.00 – $958.00 | 1 |
| Opn impltj nea perph nerve CPT 64575 | not published | not published | $958.00 – $958.00 | 1 |
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Opn tx dprsd zygomatic arch CPT 21356 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Optx lunate dislocation CPT 25695 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Optx medial ankle fx CPT 27766 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx sho dislc fx CPT 23670 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Oral everolimus HCPCS J7527 | $6.67 | $19.04 | $1.11 – $5.03 | 23 |
| Orchiectomy partial CPT 54522 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $12,058.80 | $34,453.69 | $7,579.82 – $34,453.69 | 22 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $1,385.00 | $3,957.12 | $26.35 – $3,903.49 | 23 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $24.70 | $70.55 | $11.75 – $68.26 | 23 |
| Oscillation chest wall mechanical per session CPT 94669 | $155.40 | $444.00 | $100.00 – $444.00 | 16 |
| Osmolality blood CPT 83930 | $83.30 | $238.00 | $4.76 – $238.00 | 39 |
| Osmolality urine CPT 83935 | $66.50 | $190.00 | $4.91 – $190.00 | 39 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Osteoplasty humerus CPT 24420 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Oth resp proc, indiv HCPCS G0238 | $105.35 | $301.00 | $14.73 – $301.00 | 16 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $129.15 | $369.00 | $75.25 – $369.00 | 16 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $126.00 | $360.00 | $71.03 – $360.00 | 16 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $112.70 | $322.00 | $41.57 – $322.00 | 16 |
| Otoplasty 69300 CPT 69300 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $98.00 | $280.00 | $59.45 – $280.00 | 18 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $141.40 | $404.00 | $34.21 – $404.00 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $148.75 | $425.00 | $35.26 – $425.00 | 16 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $122.50 | $350.00 | $45.77 – $350.00 | 16 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $112.70 | $322.00 | $52.09 – $322.00 | 16 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $81.20 | $232.00 | $51.04 – $232.00 | 18 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $48.86 | $139.59 | $1.53 – $55.12 | 23 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $346.65 | $990.41 | $0.11 – $427.68 | 23 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $36.72 | $104.89 | $0.59 – $32.74 | 23 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $88,200.00 | $252,000.00 | $15,435.00 – $73,500.00 | 23 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $322.77 | $922.19 | $0.16 – $389.46 | 23 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $4,072.50 | $11,635.71 | $14.87 – $10,063.17 | 23 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $7,874.22 | $22,497.75 | $1,027.97 – $12,080.20 | 23 |
| Palonosetron hcl HCPCS J2469 | $354.74 | $1,013.52 | $0.84 – $65.41 | 23 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $99.46 | $284.16 | $9.00 – $89.11 | 23 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $16,565.51 | $47,330.02 | $134.78 – $12,118.03 | 23 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $26.50 | $75.69 | $12.09 – $54.95 | 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.