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 |
|---|---|---|---|---|
| Sarscov coronavirus ag ia CPT 87426 | $73.85 | $211.00 | $25.44 – $211.00 | 40 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $86.10 | $246.00 | $28.46 – $246.00 | 40 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,012.55 | $2,893.00 | $231.44 – $2,893.00 | 21 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $597.45 | $1,707.00 | $106.88 – $1,707.00 | 21 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $921.55 | $2,633.00 | $180.76 – $2,633.00 | 21 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $324.10 | $926.00 | $74.08 – $926.00 | 21 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $331.10 | $946.00 | $75.68 – $946.00 | 21 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $908.95 | $2,597.00 | $106.88 – $2,597.00 | 21 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,085.35 | $3,101.00 | $233.52 – $3,101.00 | 21 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $759.85 | $2,171.00 | $106.88 – $2,171.00 | 21 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $595.35 | $1,701.00 | $106.88 – $1,701.00 | 21 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,336.65 | $3,819.00 | $1,031.13 – $3,819.00 | 16 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $3,317.43 | $9,478.35 | $100.00 – $1,092.00 | 15 |
| Screening Mammogram CPT 77067 | $297.50 | $850.00 | $140.25 – $850.00 | 18 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $78,428.18 | $224,080.50 | $4.15 – $19.74 | 23 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $945.00 | $2,700.00 | $100.00 – $2,700.00 | 22 |
| Sedimentation rate erythrocyte automated CPT 85652 | $48.30 | $138.00 | $1.94 – $138.00 | 40 |
| Self-adher band w>=3" <5"/yd HCPCS A6454 | $38.22 | $109.20 | $0.99 – $109.20 | 16 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Serial casting application 97139app CPT 97139 | $57.75 | $165.00 | $22.10 – $165.00 | 16 |
| Serpina1 gene CPT 81332 | $700.70 | $2,002.00 | $31.43 – $2,002.00 | 40 |
| Set radiation therapy field CPT 77280 | $2,797.20 | $7,992.00 | $356.75 – $7,992.00 | 19 |
| Set radiation therapy field CPT 77285 | $4,615.45 | $13,187.00 | $597.72 – $13,187.00 | 18 |
| Set radiation therapy field CPT 77290 | $4,662.00 | $13,320.00 | $636.66 – $13,320.00 | 19 |
| Sever cranial nerve CPT 64771 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $143.85 | $411.00 | $110.97 – $411.00 | 19 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $5,212.99 | $14,894.25 | $88.46 – $327.60 | 15 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Shortening of hand tendon CPT 26479 | not published | not published | $958.00 – $958.00 | 1 |
| Shorten radius or ulna CPT 25390 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Shorten radius & ulna CPT 25392 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $2,177.00 – $2,177.00 | 1 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,419.50 | $9,770.00 | $366.42 – $9,770.00 | 24 |
| Shoulder MRI (with contrast) CPT 73222 | $2,775.15 | $7,929.00 | $323.10 – $7,929.00 | 24 |
| Shoulder MRI (without contrast) CPT 73221 | $1,790.25 | $5,115.00 | $209.16 – $5,115.00 | 24 |
| Shoulder X-ray CPT 73030 | $558.60 | $1,596.00 | $34.75 – $1,596.00 | 23 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $9,378.60 | $26,796.00 | $275.63 – $1,312.50 | 23 |
| Sialography s&i CPT 70390 | $348.25 | $995.00 | $79.60 – $995.00 | 23 |
| Sickling rbc CPT 85660 | $48.65 | $139.00 | $3.97 – $139.00 | 40 |
| Sigmoidoscopy and biopsy CPT 45331 | $723.80 | $2,068.00 | $558.36 – $2,068.00 | 16 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $723.80 | $2,068.00 | $558.36 – $2,068.00 | 16 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $958.00 – $958.00 | 1 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $958.00 – $958.00 | 1 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $279.30 | $798.00 | $28.74 – $798.00 | 21 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $958.00 – $958.00 | 1 |
| Sim ang w/prs cath rad emb HCPCS C8004 | $9,938.95 | $28,397.00 | $100.00 – $28,397.00 | 15 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $195.02 | $557.19 | $83.46 – $321.00 | 16 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,822.80 | $5,208.00 | $175.06 – $5,208.00 | 24 |
| Sinus CT scan (with contrast) CPT 70487 | $2,300.90 | $6,574.00 | $156.38 – $6,574.00 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $2,256.80 | $6,448.00 | $104.75 – $6,448.00 | 24 |
| Sinus/juglr venogram s&i CPT 75860 | $2,881.55 | $8,233.00 | $125.64 – $8,233.00 | 23 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Sirolimus, oral HCPCS J7520 | $2,566.06 | $7,331.60 | $1.08 – $4.88 | 23 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,929.00 – $1,929.00 | 1 |
| Skin Biopsy CPT 11102 | $285.95 | $817.00 | $90.00 – $817.00 | 18 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $1,609.00 – $1,609.00 | 1 |
| Sleep Study (Polysomnography) CPT 95810 | $2,948.75 | $8,425.00 | $100.00 – $8,425.00 | 18 |
| Sleep study unattended CPT 95806 | $301.70 | $862.00 | $100.00 – $862.00 | 18 |
| Sling suprapubic suburetheral HCPCS C1771 | $26,511.45 | $75,747.00 | $777.84 – $3,704.00 | 23 |
| Slitting of prepuce CPT 54000 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Slitting of prepuce CPT 54001 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Sm-153 lexidron ther HCPCS A9604 | $11,563.30 | $33,038.00 | $6,161.69 – $33,038.00 | 16 |
| Small bowel endoscopy CPT 44360 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44364 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44366 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44369 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44376 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44378 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy CPT 44382 | not published | not published | $958.00 – $958.00 | 1 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $1,285.00 – $1,285.00 | 1 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $958.00 – $958.00 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $5,460.00 – $5,460.00 | 1 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $105.00 | $300.00 | $3.88 – $300.00 | 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.