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 |
|---|---|---|---|---|
| Revision of radius CPT 25355 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision of sciatic nerve CPT 64712 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Revision of scrotum CPT 55175 | not published | not published | $958.00 – $958.00 | 1 |
| Revision of scrotum CPT 55180 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Revision of spinal shunt CPT 63744 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision of testis CPT 54660 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Revision of thigh muscles CPT 27430 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Revision of toe CPT 28312 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision of ulna CPT 25360 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Revision of urethra CPT 53450 | not published | not published | $958.00 – $958.00 | 1 |
| Revision of urethra CPT 53460 | not published | not published | $958.00 – $958.00 | 1 |
| Revision of urethra CPT 57220 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision open av fistula without thromb CPT 36832 | $5,427.10 | $15,506.00 | $1,929.00 – $15,506.00 | 16 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Revision tips CPT 37183 | $3,603.25 | $10,295.00 | $2,779.65 – $10,295.00 | 19 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $958.00 – $958.00 | 1 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $958.00 – $958.00 | 1 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $958.00 – $958.00 | 1 |
| Revsc opn/prq tib/pero stent CPT 37234 | $2,873.50 | $8,210.00 | $100.00 – $8,210.00 | 22 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $5,186.57 | $14,818.75 | $3,260.13 – $14,818.75 | 22 |
| Rheumatoid factor qualitative CPT 86430 | $44.45 | $127.00 | $4.42 – $127.00 | 39 |
| Rheumatoid factor quantitative CPT 86431 | $73.50 | $210.00 | $4.08 – $210.00 | 39 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $122.27 | $349.33 | $6.98 – $349.33 | 23 |
| Rho d immune globulin inj HCPCS J2790 | $248.15 | $709.00 | $80.56 – $366.17 | 23 |
| R hrt cath chd abnl nt cnj CPT 93594 | $4,608.10 | $13,166.00 | $100.00 – $13,166.00 | 18 |
| R hrt cath chd nml nt cnj CPT 93593 | $2,897.65 | $8,279.00 | $100.00 – $8,279.00 | 18 |
| Rib cartilage graft CPT 21230 | not published | not published | $3,115.00 – $3,115.00 | 1 |
| Right ventric recording CPT 93603 | $1,143.80 | $3,268.00 | $882.36 – $3,268.00 | 16 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $2,642.59 | $7,550.24 | $81.06 – $386.00 | 23 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | $38.22 | $109.20 | $6.45 – $36.75 | 16 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $831.15 | $2,374.71 | $10.21 – $2,374.71 | 23 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $6,940.86 | $19,831.02 | $101.69 – $4,009.91 | 23 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $3,339.13 | $9,540.36 | $45.45 – $1,951.74 | 23 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $3,475.50 | $9,929.99 | $446.54 – $2,029.71 | 22 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $4,304.98 | $12,299.94 | $33.69 – $2,503.70 | 23 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | $4,648.35 | $13,281.00 | $100.00 – $13,281.00 | 18 |
| R&l hrt cath chd nml nt cnj CPT 93596 | $4,740.75 | $13,545.00 | $100.00 – $13,545.00 | 18 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $958.00 – $958.00 | 1 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $926.80 | $2,648.00 | $714.96 – $2,648.00 | 16 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $1,336.65 | $3,819.00 | $1,031.13 – $3,819.00 | 19 |
| Rmvl icd by tv extr CPT 33244 | $1,468.25 | $4,195.00 | $335.60 – $4,195.00 | 22 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $12,778.85 | $36,511.00 | $9,857.97 – $36,511.00 | 19 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $19,072.55 | $54,493.00 | $14,713.11 – $54,493.00 | 19 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $12,778.85 | $36,511.00 | $9,857.97 – $36,511.00 | 19 |
| Rmvl icd pulse gen only CPT 33241 | $1,713.60 | $4,896.00 | $1,321.92 – $4,896.00 | 19 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $2,109.80 | $6,028.00 | $1,627.56 – $6,028.00 | 19 |
| Rmvl perm pm pulse gen CPT 33233 | $6,608.00 | $18,880.00 | $1,285.00 – $18,880.00 | 16 |
| Rmvl perq right heart vad CPT 33997 | $2,355.85 | $6,731.00 | $538.48 – $6,731.00 | 19 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $9,900.80 | $28,288.00 | $7,637.76 – $28,288.00 | 19 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $6,574.75 | $18,785.00 | $5,071.95 – $18,785.00 | 19 |
| Rmvl pq iabp CPT 33968 | $294.00 | $840.00 | $67.20 – $840.00 | 22 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $2,722.30 | $7,778.00 | $622.24 – $7,778.00 | 22 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Rmvl sq defib electrode CPT 33272 | $3,237.85 | $9,251.00 | $740.08 – $9,251.00 | 19 |
| Rmvl subq card rhythm mntr CPT 33286 | $1,096.55 | $3,133.00 | $845.91 – $3,133.00 | 16 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $958.00 – $958.00 | 1 |
| Rmvl tv pm lead dual CPT 33235 | $3,237.85 | $9,251.00 | $2,497.77 – $9,251.00 | 19 |
| Rmvl tv pm lead sgl CPT 33234 | $3,237.85 | $9,251.00 | $2,497.77 – $9,251.00 | 19 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $7,510.72 | $21,459.20 | $4,721.03 – $21,459.20 | 22 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $404.80 | $1,156.57 | $0.03 – $55.29 | 23 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | $23,286.44 | $66,532.66 | $14,637.19 – $66,532.66 | 22 |
| Rplcmt oi implt skl prq esp CPT 69717 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $830.55 | $2,373.00 | $640.71 – $2,373.00 | 16 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,531.95 | $4,377.00 | $255.61 – $4,377.00 | 23 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $2,659.65 | $7,599.00 | $436.04 – $7,599.00 | 23 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $5,042.80 | $14,408.00 | $823.96 – $14,408.00 | 23 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $2,171.75 | $6,205.00 | $958.00 – $6,205.00 | 16 |
| Rpl tun-cvad w subq port CPT 36582 | $9,171.40 | $26,204.00 | $1,609.00 – $26,204.00 | 16 |
| Rpl tun-cvad w subq pump CPT 36583 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Rpl tun cvc wo subq port CPT 36581 | $5,841.50 | $16,690.00 | $1,285.00 – $16,690.00 | 16 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $3,246.95 | $9,277.00 | $742.16 – $9,277.00 | 22 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Rpr umbil hern block < 5 yr CPT 49582 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Rp therapy unlisted px CPT 79999 | $89.95 | $257.00 | $69.39 – $257.00 | 18 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Rsv assay w/optic CPT 87807 | $50.75 | $145.00 | $9.43 – $145.00 | 39 |
| Rubella antibody igg CPT 86762 | $104.30 | $298.00 | $10.36 – $298.00 | 39 |
| Rubeola antibody igg CPT 86765 | $42.70 | $122.00 | $9.27 – $122.00 | 39 |
| Russell viper venom diluted CPT 85613 | $77.35 | $221.00 | $6.90 – $221.00 | 39 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $6,466.16 | $18,474.72 | $35.81 – $18,474.72 | 23 |
| Sargramostim injection HCPCS J2820 | $426.68 | $1,219.07 | $55.08 – $1,219.07 | 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.