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 |
|---|---|---|---|---|
| Plmt ureteral stent prq CPT 50694 | $4,021.15 | $11,489.00 | $3,102.03 – $11,489.00 | 16 |
| Pm device progr eval dual CPT 93280 | $269.50 | $770.00 | $52.93 – $770.00 | 16 |
| Pm device progr eval multi CPT 93281 | $304.85 | $871.00 | $52.93 – $871.00 | 16 |
| Pm phone r-strip device eval CPT 93293 | $440.65 | $1,259.00 | $52.93 – $1,259.00 | 16 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $296.10 | $846.00 | $18.77 – $846.00 | 40 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $45,222.84 | $129,208.10 | $137.58 – $129,208.10 | 23 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $3,928.40 | $11,224.00 | $100.00 – $11,224.00 | 18 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,214.40 | $9,184.00 | $100.00 – $9,184.00 | 18 |
| Positional change of finger CPT 26555 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Potassium 24 hour urine CPT 84133 | $50.40 | $144.00 | $3.41 – $144.00 | 39 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $334.03 | $954.35 | $0.08 – $9.95 | 23 |
| Potassium serum/plasma/whole blood CPT 84132 | $129.50 | $370.00 | $3.43 – $370.00 | 39 |
| Pq biliary strict dil s&i CPT 74363 | $679.35 | $1,941.00 | $62.00 – $1,941.00 | 18 |
| Pq dr cath chg w cont s&i CPT 75984 | $712.60 | $2,036.00 | $96.54 – $2,036.00 | 18 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $6,087.55 | $17,393.00 | $4,696.11 – $17,393.00 | 16 |
| Pq thr inj ext pse CPT 36002 | $455.70 | $1,302.00 | $351.54 – $1,302.00 | 19 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $963.55 | $2,753.00 | $743.31 – $2,753.00 | 16 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $1,347.85 | $3,851.00 | $1,039.77 – $3,851.00 | 16 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $1,162.70 | $3,322.00 | $896.94 – $3,322.00 | 16 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Pr application of long arm splint CPT 29105 | $294.35 | $841.00 | $227.07 – $841.00 | 19 |
| Pr application splint static short arm CPT 29125 | $287.70 | $822.00 | $65.76 – $822.00 | 24 |
| Pr biopsy skin punch single lesion CPT 11104 | $354.55 | $1,013.00 | $90.00 – $1,013.00 | 18 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Pr correction hammertoe CPT 28285 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Prcrd drg 6+yr without anomly CPT 33017 | $1,273.30 | $3,638.00 | $291.04 – $3,638.00 | 19 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $413.00 | $1,180.00 | $35.78 – $1,180.00 | 19 |
| Prealbumin CPT 84134 | $173.95 | $497.00 | $10.50 – $497.00 | 39 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $25.67 | $73.34 | $0.06 – $0.25 | 23 |
| Prednisone 1 mg tablet HCPCS J7512 | $17.74 | $50.66 | $0.01 – $0.25 | 23 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,088.50 | $3,110.00 | $104.75 – $3,110.00 | 23 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $938.35 | $2,681.00 | $103.66 – $2,681.00 | 23 |
| Pre-plan 3d model w/ccta HCPCS C9793 | $871.50 | $2,490.00 | $100.00 – $2,490.00 | 18 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $958.00 – $958.00 | 1 |
| Pressure max expiratory/inspiratory CPT 94799 | $289.80 | $828.00 | $38.07 – $141.00 | 16 |
| Pressure velocity wire add ves CPT 93572 | $568.05 | $1,623.00 | $100.00 – $1,623.00 | 18 |
| Pretreat rbc absorption reference CPT 86978 | $108.15 | $309.00 | $47.70 – $309.00 | 17 |
| Pretreat rbc density gradient separation reference CPT 86972 | $237.30 | $678.00 | $98.32 – $678.00 | 17 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $53.55 | $153.00 | $41.31 – $153.00 | 17 |
| Pretreat rbc w enzyme reference CPT 86971 | $350.70 | $1,002.00 | $56.17 – $1,002.00 | 17 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $1,358.35 | $3,881.00 | $1,047.87 – $3,881.00 | 19 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $958.00 – $958.00 | 1 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $378.70 | $1,082.00 | $292.14 – $1,082.00 | 19 |
| Prgrmg dev eval impltbl sys CPT 93260 | $131.95 | $377.00 | $30.16 – $377.00 | 19 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $234.50 | $670.00 | $52.93 – $670.00 | 16 |
| Prgrmg dev eval scrms ip CPT 93285 | $440.65 | $1,259.00 | $52.93 – $1,259.00 | 16 |
| Prgrmg eval implantable dfb CPT 93282 | $158.55 | $453.00 | $52.93 – $453.00 | 16 |
| Prgrmg eval implantable dfb CPT 93283 | $375.20 | $1,072.00 | $52.93 – $1,072.00 | 16 |
| Prgrmg eval implantable dfb CPT 93284 | $586.25 | $1,675.00 | $52.93 – $1,675.00 | 16 |
| Prgr stim/pace a/iv drug CPT 93623 | $3,152.45 | $9,007.00 | $100.00 – $9,007.00 | 17 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $10,479.70 | $29,942.00 | $8,084.34 – $29,942.00 | 19 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $3,039.40 | $8,684.00 | $100.00 – $8,684.00 | 22 |
| Prin care mgmt staff 1st 30 CPT 99426 | $73.50 | $210.00 | $56.70 – $210.00 | 15 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $369.95 | $1,057.00 | $285.39 – $1,057.00 | 19 |
| Pr incision & drainage abscess simple/single CPT 10060 | $118.65 | $339.00 | $91.53 – $339.00 | 19 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $182.00 | $520.00 | $140.40 – $520.00 | 19 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $300.30 | $858.00 | $231.66 – $858.00 | 19 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | $105.35 | $301.00 | $74.00 – $301.00 | 16 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $788.55 | $2,253.00 | $18.41 – $2,253.00 | 16 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $10,425.98 | $29,788.50 | $9.93 – $36.75 | 15 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $958.00 – $958.00 | 1 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $787.61 | $2,250.30 | $17.06 – $77.52 | 23 |
| Procalcitonin CPT 84145 | $134.75 | $385.00 | $19.60 – $385.00 | 39 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $46.39 | $132.52 | $4.21 – $58.92 | 23 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $0.33 | $0.94 | $0.06 – $0.25 | 23 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $631.05 | $1,803.00 | $486.81 – $1,803.00 | 19 |
| Proctosigmoidoscopy removal CPT 45308 | $2,327.85 | $6,651.00 | $958.00 – $6,651.00 | 16 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $958.00 – $958.00 | 1 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $958.00 – $958.00 | 1 |
| Progesterone CPT 84144 | $89.95 | $257.00 | $15.02 – $257.00 | 39 |
| Prolactin CPT 84146 | $158.20 | $452.00 | $13.95 – $452.00 | 39 |
| Promethazine 25 mg tablet HCPCS Q0169 | $13.79 | $39.39 | $0.06 – $0.25 | 23 |
| Promethazine hcl injection HCPCS J2550 | $23.45 | $66.98 | $0.33 – $54.28 | 23 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Prophylactic tx radius CPT 25490 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $61.12 | $174.62 | $0.11 – $53.68 | 23 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $26.63 | $76.07 | $7.59 – $56.23 | 23 |
| Prostate biopsy, any mthd HCPCS G0416 | $408.10 | $1,166.00 | $314.82 – $1,166.00 | 18 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $4,759.13 | $13,597.50 | $911.86 – $4,342.17 | 20 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $63.26 | $180.72 | $1.31 – $59.48 | 23 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $6,700.41 | $19,144.02 | $3,233.94 – $19,144.02 | 22 |
| Protein c activity CPT 85303 | $184.80 | $528.00 | $9.96 – $528.00 | 39 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $91.70 | $262.00 | $7.73 – $262.00 | 39 |
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.