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 |
|---|---|---|---|---|
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $6.99 | $19.95 | $1.86 – $10.92 | 7 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $103.03 | $294.36 | $0.40 – $57.84 | 7 |
| Metabolic Blood Panel (Basic) CPT 80048 | $242.90 | $694.00 | $7.15 – $347.00 | 23 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $305.90 | $874.00 | $8.92 – $437.00 | 23 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $76.44 | $218.40 | $8.34 – $141.96 | 7 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $12.59 | $35.95 | $0.25 – $23.37 | 7 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $6.10 | $17.42 | $2.42 – $11.33 | 7 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $16.54 | $47.25 | $7.09 – $30.72 | 7 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $3.15 | $8.99 | $0.28 – $5.85 | 7 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $10.29 | $29.40 | $4.41 – $19.11 | 6 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $56.23 | $160.65 | $3.00 – $12.97 | 6 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $5.52 | $15.75 | $1.14 – $10.24 | 7 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $168.62 | $481.76 | $0.33 – $313.15 | 7 |
| Microdissection manual CPT 88381 | $67.73 | $193.50 | $29.03 – $796.91 | 6 |
| Microsatellite instability CPT 81301 | $292.95 | $837.00 | $125.55 – $1,463.05 | 23 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $45.22 | $129.20 | $0.15 – $11.61 | 7 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $2,358.99 | $6,739.95 | $29.67 – $190.27 | 7 |
| Mitomycin instillation HCPCS J9281 | $15,382.21 | $43,949.17 | $442.57 – $28,566.97 | 7 |
| Mnl appl strs jt radiography CPT 77071 | $114.35 | $326.70 | $19.61 – $334.48 | 11 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $57.33 | $163.80 | $0.14 – $10.92 | 7 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $267.75 | $765.00 | $110.17 – $1,211.52 | 7 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $45.68 | $130.50 | $19.58 – $329.62 | 7 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $237.51 | $678.60 | $21.89 – $407.16 | 7 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $155.40 | $444.00 | $66.60 – $1,461.25 | 7 |
| MRA abdomen post contrast CPT 74185 | $1,190.70 | $3,402.00 | $510.30 – $1,701.00 | 6 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $1,263.78 | $3,610.80 | $529.33 – $1,805.40 | 6 |
| MRA chest w IV cont HCPCS C8909 | $1,421.28 | $4,060.80 | $300.00 – $2,030.40 | 6 |
| MRA chest wwo IV cont HCPCS C8911 | $1,851.57 | $5,290.20 | $300.00 – $2,645.10 | 6 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $1,426.32 | $4,075.20 | $533.06 – $2,037.60 | 6 |
| MRA pelvis w IV cont HCPCS C8918 | $821.84 | $2,348.10 | $300.00 – $1,174.05 | 6 |
| MRA pelvis wo IV cont HCPCS C8919 | $1,366.47 | $3,904.20 | $300.00 – $1,952.10 | 6 |
| MRA spinal canal CPT 72159 | $877.91 | $2,508.30 | $376.25 – $1,254.15 | 6 |
| MRA upper extremity post contrast-bil CPT 73225 | $877.91 | $2,508.30 | $376.25 – $1,254.15 | 6 |
| MRA w/cont, abd HCPCS C8900 | $760.20 | $2,172.00 | $300.00 – $1,086.00 | 6 |
| MRA w/cont, lwr ext HCPCS C8912 | $877.91 | $2,508.30 | $300.00 – $1,254.15 | 6 |
| MRA without cont, abd HCPCS C8901 | $684.18 | $1,954.80 | $293.22 – $977.40 | 6 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,636.14 | $4,674.66 | $300.00 – $2,337.33 | 6 |
| MRI breast c- unilateral CPT 77046 | $896.00 | $2,560.00 | $358.83 – $1,196.10 | 6 |
| MRI breast without cont bi CPT 77047 | $1,304.10 | $3,726.00 | $403.16 – $1,863.00 | 6 |
| MRI breast w IV cont bi CPT 77049 | $2,055.55 | $5,873.00 | $506.89 – $2,936.50 | 6 |
| MRI chest without contrast CPT 71550 | $1,778.35 | $5,081.00 | $204.81 – $1,706.67 | 11 |
| MRI chest without & w/contrast CPT 71552 | $1,772.51 | $5,064.30 | $303.86 – $2,532.15 | 11 |
| MRI chest w IV cont CPT 71551 | $1,421.28 | $4,060.80 | $243.65 – $2,030.40 | 11 |
| MRI loex nonjt w IV cont CPT 73719 | $3,025.05 | $8,643.00 | $265.38 – $4,321.50 | 11 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $3,871.00 | $11,060.00 | $233.52 – $3,662.07 | 11 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $3,871.00 | $11,060.00 | $353.51 – $5,530.00 | 11 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,778.35 | $5,081.00 | $233.52 – $2,540.50 | 11 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,654.05 | $7,583.00 | $354.85 – $3,791.50 | 11 |
| MRI orbit fac&nck w IV cont CPT 70542 | $2,096.50 | $5,990.00 | $281.00 – $2,995.00 | 11 |
| MRI tmj CPT 70336 | $1,185.03 | $3,385.80 | $203.15 – $1,692.90 | 11 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,601.90 | $7,434.00 | $233.52 – $2,753.00 | 11 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,601.90 | $7,434.00 | $368.43 – $3,717.00 | 11 |
| MRI upper extremity w/dye CPT 73219 | $2,100.70 | $6,002.00 | $348.50 – $3,001.00 | 11 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,492.40 | $4,264.00 | $300.00 – $2,132.00 | 6 |
| MRI w/cont, breast, uni HCPCS C8903 | $1,014.65 | $2,899.00 | $300.00 – $1,449.50 | 6 |
| Multiple sleep latency test CPT 95805 | $618.98 | $1,768.50 | $265.28 – $884.25 | 4 |
| Mumps antibody igg CPT 86735 | $47.25 | $135.00 | $10.96 – $67.50 | 23 |
| Mycoplasma antibody igm CPT 86738 | $33.95 | $97.00 | $11.12 – $55.20 | 23 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $263.03 | $751.50 | $105.24 – $736.60 | 20 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $1,474.20 | $4,212.00 | $631.80 – $2,106.00 | 2 |
| Myelography via inj w/s&i cervical CPT 62302 | $1,125.55 | $3,215.84 | $482.38 – $1,607.92 | 2 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $1,131.83 | $3,233.79 | $485.07 – $1,616.90 | 2 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,138.10 | $3,251.70 | $487.76 – $1,625.85 | 2 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $77.35 | $221.00 | $9.69 – $58.00 | 23 |
| Natriuretic peptide CPT 83880 | $91.70 | $262.00 | $24.75 – $164.18 | 23 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | not published | not published | $39.98 – $39.98 | 1 |
| Ndl insj without njx 3+ musc CPT 20561 | not published | not published | $60.39 – $60.39 | 1 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $4,723.95 | $13,497.00 | $180.34 – $6,748.50 | 11 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $4,040.40 | $11,544.00 | $175.09 – $5,772.00 | 11 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $3,108.00 | $8,880.00 | $106.88 – $4,440.00 | 11 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $5,102.30 | $14,578.00 | $334.46 – $7,289.00 | 11 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $4,277.70 | $12,222.00 | $287.69 – $6,111.00 | 11 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,453.45 | $9,867.00 | $198.48 – $4,933.50 | 11 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,252.27 | $6,435.05 | $360.53 – $3,217.53 | 11 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $1,599.15 | $4,569.00 | $256.61 – $2,284.50 | 11 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $1,396.50 | $3,990.00 | $224.88 – $1,995.00 | 11 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $80.85 | $231.00 | $0.36 – $98.97 | 7 |
| New Patient Office Visit (level 2) CPT 99202 | $143.52 | $410.04 | $45.00 – $180.90 | 4 |
| New Patient Office Visit (level 3) CPT 99203 | $198.14 | $566.10 | $45.00 – $226.80 | 4 |
| New Patient Office Visit (level 4) CPT 99204 | $240.62 | $687.48 | $45.00 – $275.40 | 4 |
| New Patient Office Visit (level 5) CPT 99205 | $272.04 | $777.24 | $45.00 – $339.67 | 4 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $6,133.77 | $17,525.04 | $45.72 – $4,649.66 | 7 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | $5,212.48 | $14,892.79 | $2,233.92 – $9,680.32 | 6 |
| Njx interlaminar crv/thrc CPT 62324 | not published | not published | $269.47 – $269.47 | 1 |
| Njx interlaminar crv/thrc CPT 62325 | not published | not published | $269.47 – $269.47 | 1 |
| Njx interlaminar lmbr/sac CPT 62326 | not published | not published | $269.47 – $269.47 | 1 |
| Njx interlaminar lmbr/sac CPT 62327 | not published | not published | $269.47 – $269.47 | 1 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,087.80 | $3,108.00 | $466.20 – $1,554.00 | 2 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,629.60 | $4,656.00 | $279.36 – $2,328.00 | 11 |
| Nm imaging bone/joint whole body CPT 78306 | $1,381.10 | $3,946.00 | $236.76 – $1,973.00 | 11 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $276.57 | $790.20 | $47.42 – $474.12 | 11 |
| Nm imaging gastric emptying study CPT 78264 | $860.65 | $2,459.00 | $147.54 – $1,229.50 | 11 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $626.12 | $1,788.89 | $107.34 – $1,000.00 | 11 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $895.60 | $2,558.85 | $153.54 – $1,279.43 | 11 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,614.20 | $4,612.00 | $173.75 – $2,306.00 | 11 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,103.61 | $3,153.15 | $189.19 – $1,576.58 | 11 |
| Non-card vasc flow imaging CPT 78445 | $513.45 | $1,467.00 | $88.02 – $880.20 | 11 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $3,238.55 | $9,253.00 | $1,000.00 – $4,644.25 | 6 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $3,116.05 | $8,903.00 | $1,000.00 – $4,451.50 | 6 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | $3,115.90 | $8,902.56 | $1,000.00 – $4,451.28 | 6 |
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.