St. Luke's Health - Brazosport Hospital
100 Medical Drive, Lake Jackson, TX · CommonSpirit Health · · NPI 1972581940
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 |
|---|---|---|---|---|
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,215.86 | $3,473.86 | $37.05 – $2,258.01 | 7 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $956.72 | $2,733.48 | $15.66 – $1,776.77 | 7 |
| Initiation & management bipap/cpap initial day CPT 94660 | $890.72 | $2,544.90 | $369.03 – $1,272.45 | 4 |
| Inj alymsys 10 mg HCPCS Q5126 | $111.73 | $319.22 | $34.03 – $147.46 | 6 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $151.83 | $433.80 | $26.03 – $216.90 | 4 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $1,143.61 | $3,267.45 | $490.12 – $2,405.94 | 7 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | $741.63 | $2,118.92 | $132.04 – $572.16 | 6 |
| Inj disk cerv-thor ea lev CPT 62291 | $239.09 | $683.10 | $40.99 – $341.55 | 4 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $34.20 – $34.20 | 1 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $142.70 | $407.70 | $24.47 – $203.85 | 4 |
| Injection, daratumumab 10 mg HCPCS J9145 | $983.43 | $2,809.79 | $93.77 – $456.60 | 7 |
| Injection during cath supravalvular aortography CPT 93567 | $1,117.28 | $3,192.21 | $191.54 – $1,600.00 | 5 |
| Injection epidural blood patch or clot CPT 62273 | $784.35 | $2,241.00 | $336.15 – $1,120.50 | 2 |
| Injection for bladder x-ray CPT 51600 | $333.90 | $954.00 | $143.10 – $477.00 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $170.80 | $488.00 | $29.28 – $244.00 | 4 |
| Injection for tear sac x-ray CPT 68850 | $201.29 | $575.10 | $34.51 – $287.55 | 4 |
| Injection, fulvestrant HCPCS J9395 | $899.70 | $2,570.57 | $10.81 – $1,670.88 | 7 |
| Injection into brain canal CPT 61055 | $201.29 | $575.10 | $86.27 – $287.55 | 2 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $104.01 – $104.01 | 1 |
| Injection of sinus tract CPT 20500 | not published | not published | $42.89 – $42.89 | 1 |
| Injection,onabotulinumtoxina HCPCS J0585 | $655.90 | $1,874.00 | $7.08 – $1,218.10 | 7 |
| Injection px peyronie ds CPT 54200 | not published | not published | $51.30 – $51.30 | 1 |
| Injection, renflexis HCPCS Q5104 | $677.92 | $1,936.91 | $31.26 – $1,259.00 | 7 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $49.34 – $49.34 | 1 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $606.20 | $1,732.00 | $40.66 – $866.00 | 3 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $213.92 – $213.92 | 1 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $213.92 – $213.92 | 1 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $133.88 | $382.50 | $57.38 – $191.25 | 2 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $282.10 | $806.00 | $36.23 – $136.00 | 4 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $66.15 | $189.00 | $28.35 – $94.50 | 4 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $393.75 | $1,125.00 | $93.08 – $403.00 | 4 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $282.10 | $806.00 | $60.60 – $202.00 | 4 |
| Injection treatment of nose CPT 30200 | not published | not published | $64.48 – $64.48 | 1 |
| Inject/treat eye socket CPT 67500 | not published | not published | $113.24 – $113.24 | 1 |
| Inject/treat eye socket CPT 67505 | not published | not published | $32.25 – $32.25 | 1 |
| Inject/treat eye socket CPT 67515 | not published | not published | $35.05 – $35.05 | 1 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $213.92 – $213.92 | 1 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $213.92 – $213.92 | 1 |
| Inj for ext venography CPT 36005 | $321.30 | $918.00 | $55.08 – $918.00 | 5 |
| Inj ivig privigen 500 mg HCPCS J1459 | $2,819.83 | $8,056.65 | $55.87 – $2,622.17 | 7 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $534.12 | $1,526.03 | $91.57 – $396.78 | 6 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $148.64 | $424.68 | $2.53 – $276.05 | 7 |
| Inj multihance HCPCS A9577 | $2.76 | $7.86 | $1.18 – $4.57 | 3 |
| Inj ogivri 10 mg HCPCS Q5114 | $3,325.90 | $9,502.56 | $77.99 – $2,213.40 | 7 |
| Inj peritoneal venous shunt CPT 49427 | $86.11 | $246.02 | $14.77 – $123.01 | 4 |
| Inj proc ankle arthr CPT 27648 | $144.90 | $414.00 | $24.84 – $207.00 | 4 |
| Inj proc elbow arthro CPT 24220 | $147.74 | $422.10 | $63.32 – $211.05 | 2 |
| Inj proc lumbr disk ea lvl CPT 62290 | $239.09 | $683.10 | $102.47 – $341.55 | 2 |
| Inj proc myelogram lumbar CPT 62284 | $186.17 | $531.90 | $79.79 – $265.95 | 2 |
| Inj proc sialogram CPT 42550 | $201.29 | $575.10 | $86.27 – $287.55 | 2 |
| Inj, releuko 1 mcg HCPCS Q5125 | $106.85 | $305.28 | $28.62 – $124.02 | 6 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $51.09 | $145.95 | $0.87 – $72.98 | 4 |
| Inj retro urethrocysto CPT 51610 | $105.70 | $302.00 | $18.12 – $151.00 | 4 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $84.66 – $84.66 | 1 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $81.03 – $81.03 | 1 |
| Ins cath ren art 1st bi CPT 36252 | $2,672.46 | $7,635.60 | $1,145.34 – $3,817.80 | 2 |
| Ins cath ren art 1st uni CPT 36251 | $2,238.39 | $6,395.40 | $959.31 – $3,197.70 | 2 |
| Insert cath pleura with image CPT 32557 | $461.48 | $1,318.50 | $180.77 – $659.25 | 3 |
| Insert cath pleura without image CPT 32556 | not published | not published | $180.77 – $180.77 | 1 |
| Insert drug delivery implant CPT 11981 | $54.50 | $155.70 | $23.36 – $77.85 | 2 |
| Insertion catheter bladder non indwelling CPT 51701 | $80.01 | $228.60 | $34.29 – $114.30 | 2 |
| Insertion catheter bladder temporary simple CPT 51702 | $287.35 | $821.00 | $49.26 – $410.50 | 7 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $813.65 | $2,324.70 | $348.71 – $1,162.35 | 2 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $4,563.41 | $13,038.30 | $782.30 – $6,519.15 | 5 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $4,586.05 | $13,103.00 | $786.18 – $6,551.50 | 5 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $693.63 | $1,981.80 | $296.10 – $987.00 | 2 |
| Insertion of cannula CPT 36810 | $2,089.08 | $5,968.80 | $895.32 – $2,984.40 | 2 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $4,933.53 | $14,095.80 | $1,600.00 – $7,047.90 | 3 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $4,407.80 | $12,593.70 | $1,600.00 – $6,296.85 | 3 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $1,336.65 | $3,819.00 | $572.85 – $1,909.50 | 2 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $1,302.84 | $3,722.40 | $558.36 – $1,861.20 | 3 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $6,420.02 | $18,342.90 | $1,600.00 – $9,171.45 | 3 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $2,929.82 | $8,370.90 | $1,255.64 – $4,185.45 | 2 |
| Insert pessary/other device CPT 57160 | not published | not published | $33.09 – $33.09 | 1 |
| Insert swan-ganz cath CPT 93503 | $1,692.81 | $4,836.60 | $725.49 – $2,418.30 | 2 |
| Insert vad art access left hrt arterial access CPT 33990 | $2,665.53 | $7,615.80 | $456.95 – $3,807.90 | 4 |
| Insitu hybridization auto CPT 88367 | $57.33 | $163.80 | $21.89 – $341.25 | 7 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $123.80 | $353.70 | $33.85 – $583.68 | 7 |
| Insj perq vad r hrt venous CPT 33995 | $2,363.90 | $6,754.00 | $405.24 – $3,377.00 | 4 |
| Ins mark abd/pel for right perq CPT 49411 | $1,156.40 | $3,304.00 | $275.31 – $1,652.00 | 3 |
| Ins mark thor for right perq CPT 32553 | $382.10 | $1,091.70 | $163.76 – $545.85 | 2 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | not published | not published | $249.38 – $249.38 | 1 |
| Ins/rpl pm gen exist dual lead CPT 33213 | $8,911.70 | $25,462.00 | $1,600.00 – $5,936.85 | 3 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $227.15 | $649.00 | $43.46 – $324.50 | 3 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,660.35 | $7,601.00 | $1,140.15 – $3,800.50 | 2 |
| Insulin total CPT 83525 | $36.40 | $104.00 | $9.60 – $52.00 | 23 |
| Ins vag brachytx device CPT 57156 | not published | not published | $116.30 – $116.30 | 1 |
| Interdiscal perq aspir dx CPT 62267 | $392.70 | $1,122.00 | $158.25 – $527.50 | 2 |
| Interrog evl pm/ldls pm ip CPT 93288 | $140.49 | $401.40 | $60.21 – $200.70 | 4 |
| Intranasal biopsy 30100 CPT 30100 | not published | not published | $81.59 – $81.59 | 1 |
| Intrinsic factor antibody CPT 86340 | $28.98 | $82.80 | $12.42 – $63.93 | 23 |
| Intro cath dialysis circuit CPT 36901 | not published | not published | $288.55 – $288.55 | 1 |
| Intro cath dialysis circuit w/pta CPT 36902 | $6,638.00 | $18,965.70 | $1,600.00 – $9,482.85 | 3 |
| Intro catheter aorta CPT 36200 | $502.42 | $1,435.46 | $86.13 – $1,435.46 | 5 |
| Intro long gi tube CPT 44500 | $151.83 | $433.80 | $65.07 – $216.90 | 2 |
| Intro long gi tube w/mult fluo CPT 74340 | $239.09 | $683.10 | $53.00 – $409.86 | 5 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $1,582.88 | $4,522.50 | $271.35 – $2,261.25 | 5 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $1,731.56 | $4,947.30 | $296.84 – $2,473.65 | 5 |
| Intubation endotracheal emergency procedure CPT 31500 | $638.05 | $1,823.00 | $74.70 – $337.50 | 3 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $2.76 | $7.86 | $0.63 – $3.90 | 7 |
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.