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 |
|---|---|---|---|---|
| Papaverin hcl injection HCPCS J2440 | $76.40 | $218.26 | $26.01 – $118.20 | 23 |
| Parathormone (pth) intact CPT 83970 | $165.20 | $472.00 | $29.72 – $472.00 | 39 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,641.50 | $4,690.00 | $458.35 – $4,690.00 | 18 |
| Parathyroid planar imaging CPT 78070 | $430.85 | $1,231.00 | $98.48 – $1,231.00 | 23 |
| Parathyroid planar img w/tomo spect CPT 78071 | $859.25 | $2,455.00 | $196.40 – $2,455.00 | 23 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Paricalcitol HCPCS J2501 | $24.47 | $69.89 | $1.29 – $62.26 | 23 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $145.95 | $417.00 | $112.59 – $417.00 | 19 |
| Parotid duct diversion CPT 42507 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Parotid duct diversion CPT 42509 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Parotid duct diversion CPT 42510 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $958.00 – $958.00 | 1 |
| Partial exc bone humerus CPT 24140 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial excision of lip CPT 40500 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal finger bone CPT 26235 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal finger bone CPT 26236 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal foot fascia CPT 28060 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Partial removal of eye fluid CPT 67005 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Partial removal of eye fluid CPT 67010 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Partial removal of fibula CPT 27641 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of foot bone CPT 28288 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal of hand bone CPT 26230 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Partial removal of lip CPT 40530 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of nose CPT 30150 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal of penis CPT 54120 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Partial removal of radius CPT 25151 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of radius CPT 25230 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Partial removal of rib CPT 21600 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of tibia CPT 27640 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of toe CPT 28160 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal of tongue CPT 41120 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Partial removal of ulna CPT 25119 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Partial removal of ulna CPT 25150 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Partial removal of ulna CPT 25240 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Partial removal tear gland CPT 68505 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Part removal of metatarsal CPT 28110 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Part removal of metatarsal CPT 28113 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Passy muir valve metal trach HCPCS L8501 | $274.40 | $784.00 | $164.64 – $784.00 | 20 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Pegaspargase injection HCPCS J9266 | $47,943.02 | $136,980.03 | $19,098.10 – $88,910.23 | 23 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $11,457.16 | $32,734.73 | $7,201.65 – $32,734.73 | 22 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $8,134.93 | $23,242.64 | $193.57 – $13,147.76 | 23 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $5,713.45 | $16,324.13 | $3,591.31 – $16,324.13 | 22 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $4,012.46 | $11,464.16 | $178.93 – $11,375.07 | 23 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $1,194.98 | $3,414.21 | $751.13 – $3,414.21 | 22 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,005.80 | $8,588.00 | $175.06 – $8,588.00 | 24 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,722.65 | $7,779.00 | $175.06 – $7,779.00 | 24 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,573.60 | $4,496.00 | $104.75 – $4,496.00 | 24 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,936.05 | $14,103.00 | $347.16 – $14,103.00 | 24 |
| Pelvic MRI (with contrast) CPT 72196 | $3,949.05 | $11,283.00 | $276.66 – $11,283.00 | 24 |
| Pelvic MRI (without contrast) CPT 72195 | $3,356.85 | $9,591.00 | $233.47 – $9,591.00 | 24 |
| Pelvic Ultrasound (complete) CPT 76856 | $989.80 | $2,828.00 | $96.28 – $2,828.00 | 23 |
| Pelvic Ultrasound (limited) CPT 76857 | $435.40 | $1,244.00 | $50.79 – $1,244.00 | 23 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $14,703.02 | $42,008.62 | $52.32 – $42,008.62 | 23 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $10,212.37 | $29,178.18 | $7.53 – $455.73 | 23 |
| Peng benzathine/procaine inj HCPCS J0558 | $168.10 | $480.27 | $5.01 – $480.27 | 23 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $785.09 | $2,243.11 | $13.73 – $620.23 | 23 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $25.24 | $72.11 | $1.07 – $70.07 | 23 |
| Penicillin g procaine inj HCPCS J2510 | $5.67 | $16.19 | $3.57 – $16.19 | 23 |
| Penile injection CPT 54235 | $233.10 | $666.00 | $179.82 – $666.00 | 19 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $36,719.87 | $104,913.90 | $10.50 – $50.00 | 23 |
| Penile vascular study CPT 93980 | $242.20 | $692.00 | $55.36 – $692.00 | 21 |
| Penile venous occlusion CPT 37790 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Penis plastic surgery CPT 54360 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Pentobarbital sodium inj HCPCS J2515 | $4,370.93 | $12,488.37 | $39.80 – $4,207.81 | 23 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $6,112.62 | $17,464.62 | $2,477.03 – $17,464.62 | 23 |
| Perc cryo ablate renal tum CPT 50593 | $7,967.40 | $22,764.00 | $6,146.28 – $22,764.00 | 19 |
| Perc d-e cor revasc chro add HCPCS C9608 | $1,745.10 | $4,986.00 | $398.88 – $4,986.00 | 19 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $8,930.95 | $25,517.00 | $2,041.36 – $25,517.00 | 19 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $1,745.10 | $4,986.00 | $398.88 – $4,986.00 | 19 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $10,060.05 | $28,743.00 | $2,299.44 – $28,743.00 | 19 |
| Perc d-e cor stent ather br HCPCS C9603 | $3,182.20 | $9,092.00 | $727.36 – $9,092.00 | 19 |
| Perc d-e cor stent ather s HCPCS C9602 | $11,394.60 | $32,556.00 | $2,604.48 – $32,556.00 | 19 |
| Perc drug-el cor stent bran HCPCS C9601 | $3,079.65 | $8,799.00 | $703.92 – $8,799.00 | 19 |
| Perc drug-el cor stent sing HCPCS C9600 | $10,265.15 | $29,329.00 | $2,346.32 – $29,329.00 | 19 |
| Perc rf ablate renal tumor CPT 50592 | $2,549.75 | $7,285.00 | $1,966.95 – $7,285.00 | 19 |
| Percut ablate liver rf CPT 47382 | $7,889.35 | $22,541.00 | $6,086.07 – $22,541.00 | 19 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $135.10 | $386.00 | $59.42 – $351.43 | 23 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $1,091.30 | $3,118.00 | $249.44 – $3,118.00 | 19 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,212.40 | $3,464.00 | $935.28 – $3,464.00 | 16 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Peripheral vascular rehab CPT 93668 | $59.85 | $171.00 | $26.31 – $171.00 | 16 |
| Peri-proc device eval icd CPT 93287 | $440.65 | $1,259.00 | $29.46 – $1,259.00 | 16 |
| Peri-proc device eval pm CPT 93286 | $440.65 | $1,259.00 | $29.46 – $1,259.00 | 16 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $958.00 – $958.00 | 1 |
| Peritoneogram rs&i CPT 74190 | $679.70 | $1,942.00 | $81.04 – $1,942.00 | 23 |
| Perphenazine 4mg oral HCPCS Q0175 | $0.56 | $1.58 | $0.07 – $0.28 | 23 |
| Perq art m-thrombect &/nfs CPT 61645 | $5,539.10 | $15,826.00 | $4,273.02 – $15,826.00 | 16 |
| Perq clsr tcat l atr apndge CPT 33340 | $5,035.45 | $14,387.00 | $1,150.96 – $14,387.00 | 19 |
| Perq dev breast 1st mr guide CPT 19287 | $1,768.20 | $5,052.00 | $1,364.04 – $5,052.00 | 18 |
| Perq dev breast 1st strtctc CPT 19283 | $1,879.50 | $5,370.00 | $1,449.90 – $5,370.00 | 18 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $13,233.15 | $37,809.00 | $100.00 – $37,809.00 | 18 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $7,751.10 | $22,146.00 | $100.00 – $22,146.00 | 18 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $11,743.55 | $33,553.00 | $100.00 – $33,553.00 | 18 |
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.