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 |
|---|---|---|---|---|
| Place slctv cath subclavian art CPT 36225 | $3,032.75 | $8,665.00 | $519.90 – $4,332.50 | 5 |
| Place slctv cath vertebral art uni CPT 36226 | $4,586.40 | $13,104.00 | $1,965.60 – $6,552.00 | 2 |
| Platelet aggregation each agent teg CPT 85576 | $68.25 | $195.00 | $18.14 – $104.61 | 23 |
| Platelet automated CPT 85049 | $55.65 | $159.00 | $3.76 – $79.50 | 23 |
| Platelets each unit HCPCS P9019 | $71.82 | $205.20 | $30.78 – $102.60 | 3 |
| Platelets irradiated ea unit HCPCS P9032 | $80.64 | $230.40 | $34.56 – $115.20 | 5 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $154.04 | $440.10 | $66.02 – $220.05 | 5 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $232.79 | $665.10 | $99.77 – $332.55 | 5 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $900.55 | $2,573.00 | $385.95 – $1,286.50 | 5 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,151.50 | $3,290.00 | $483.98 – $1,645.00 | 5 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $869.67 | $2,484.76 | $372.72 – $1,474.94 | 4 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $74.97 | $214.20 | $32.13 – $107.10 | 2 |
| Pm device progr eval dual CPT 93280 | $143.96 | $411.30 | $61.70 – $205.65 | 4 |
| Pm phone r-strip device eval CPT 93293 | $103.01 | $294.30 | $44.15 – $147.15 | 4 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $203.70 | $582.00 | $16.33 – $291.00 | 23 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $14,731.26 | $42,089.30 | $186.88 – $5,894.95 | 7 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $1,679.90 | $4,799.70 | $719.96 – $2,399.85 | 4 |
| Potassium 24 hour urine CPT 84133 | $48.29 | $137.97 | $3.63 – $68.99 | 23 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $28.71 | $82.02 | $0.08 – $7.99 | 7 |
| Potassium serum/plasma/whole blood CPT 84132 | $30.51 | $87.15 | $3.88 – $43.58 | 23 |
| Pq dr cath chg w cont s&i CPT 75984 | $334.85 | $956.70 | $130.78 – $574.02 | 5 |
| Pq thr inj ext pse CPT 36002 | $128.21 | $366.30 | $54.95 – $183.15 | 2 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $2,050.34 | $5,858.10 | $878.72 – $2,929.05 | 2 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $2,118.06 | $6,051.60 | $907.74 – $3,025.80 | 2 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $2,217.60 | $6,336.00 | $950.40 – $3,168.00 | 2 |
| Pr application of long arm splint CPT 29105 | $68.04 | $194.40 | $29.16 – $97.20 | 3 |
| Pr application splint static short arm CPT 29125 | $106.75 | $305.00 | $45.75 – $152.50 | 2 |
| Pr biopsy skin punch single lesion CPT 11104 | $332.85 | $951.00 | $70.97 – $475.50 | 3 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $30.24 | $86.40 | $12.96 – $43.20 | 3 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $160.30 | $458.00 | $48.31 – $255.00 | 4 |
| Prealbumin CPT 84134 | $42.35 | $121.00 | $12.26 – $61.04 | 23 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $5.12 | $14.61 | $0.20 – $9.50 | 7 |
| Prednisone 1 mg tablet HCPCS J7512 | $2.33 | $6.63 | $0.01 – $3.66 | 7 |
| Pregabalin - sendout CPT 80366 | $0.63 | $1.80 | $0.27 – $12.94 | 9 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,221.15 | $3,489.00 | $106.88 – $1,744.50 | 11 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,052.80 | $3,008.00 | $106.88 – $1,504.00 | 11 |
| Prep skin to 100cm2 other CPT 15004 | $150.26 | $429.30 | $64.40 – $214.65 | 2 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $563.54 | $1,610.10 | $241.52 – $805.05 | 2 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $660.87 | $1,888.20 | $113.30 – $944.10 | 4 |
| Pressure max expiratory/inspiratory CPT 94799 | $191.80 | $548.00 | $31.19 – $207.90 | 4 |
| Pressure velocity wire add ves CPT 93572 | $31.19 | $89.10 | $5.35 – $89.10 | 5 |
| Pretreat rbc absorption reference CPT 86978 | $96.39 | $275.40 | $15.05 – $165.24 | 6 |
| Pretreat rbc density gradient separation reference CPT 86972 | $61.43 | $175.50 | $8.96 – $175.50 | 6 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $45.36 | $129.60 | $8.96 – $123.50 | 6 |
| Pretreat rbc w enzyme reference CPT 86971 | $226.80 | $648.00 | $8.96 – $648.00 | 6 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $393.40 | $1,124.00 | $168.60 – $562.00 | 2 |
| Prgrmg dev eval scrms ip CPT 93285 | $33.08 | $94.50 | $14.18 – $74.73 | 4 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $2,524.73 | $7,213.50 | $1,082.03 – $3,606.75 | 3 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $1,029.11 | $2,940.30 | $176.42 – $1,600.00 | 5 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $186.55 | $533.00 | $79.95 – $266.50 | 2 |
| Pr incision & drainage abscess simple/single CPT 10060 | $266.35 | $761.00 | $55.51 – $339.00 | 3 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $307.65 | $879.00 | $25.58 – $314.00 | 3 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $3,415.18 | $9,757.65 | $1,463.65 – $4,878.83 | 2 |
| Procalcitonin CPT 84145 | $69.83 | $199.50 | $22.61 – $114.77 | 23 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $2.30 | $6.55 | $0.26 – $4.26 | 7 |
| Progesterone CPT 84144 | $41.97 | $119.90 | $17.52 – $87.19 | 23 |
| Prolactin CPT 84146 | $73.14 | $208.95 | $16.28 – $104.48 | 23 |
| Promethazine 25 mg tablet HCPCS Q0169 | $2.36 | $6.74 | $0.10 – $4.39 | 7 |
| Promethazine hcl injection HCPCS J2550 | $5.90 | $16.85 | $0.67 – $10.24 | 7 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $51.13 | $146.06 | $0.10 – $10.82 | 7 |
| _propoxygc/msur CPT 80367 | $0.95 | $2.70 | $0.41 – $14.66 | 9 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $22.42 | $64.05 | $1.24 – $41.64 | 7 |
| Protein c activity CPT 85303 | $131.20 | $374.85 | $11.63 – $187.43 | 23 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $46.68 | $133.35 | $9.02 – $66.68 | 23 |
| Protein s total CPT 85305 | $23.21 | $66.30 | $9.75 – $49.41 | 23 |
| Protein total 24 hour urine CPT 84156 | $34.55 | $98.70 | $3.08 – $49.35 | 23 |
| Protein total body fluid CPT 84157 | $67.55 | $193.00 | $3.10 – $96.50 | 23 |
| Protein total serum plasma whole blood CPT 84155 | $23.52 | $67.20 | $3.08 – $33.60 | 23 |
| Prothrombin complex kcentra HCPCS J7168 | $1,001.16 | $2,860.43 | $429.07 – $1,859.28 | 6 |
| Prq cardiac angio addl art CPT 92921 | $3,110.10 | $8,886.00 | $533.16 – $4,443.00 | 5 |
| Prq card revasc mi 1 vsl CPT 92941 | $4,995.59 | $14,273.10 | $856.39 – $7,136.55 | 5 |
| Prq card stent w/angio addl CPT 92929 | $4,474.05 | $12,783.00 | $766.98 – $6,391.50 | 5 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $7,345.10 | $20,986.00 | $1,259.16 – $10,493.00 | 5 |
| Prq revasc byp graft addl CPT 92938 | $4,868.01 | $13,908.60 | $834.52 – $6,954.30 | 5 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $4,474.05 | $12,783.00 | $766.98 – $6,391.50 | 5 |
| Prq trluml c angiop 1art&/br CPT 92920 | $3,110.10 | $8,886.00 | $533.16 – $4,443.00 | 5 |
| Pr removal drug delivery implant CPT 11982 | $54.50 | $155.70 | $23.36 – $77.85 | 2 |
| Pr removal intrauterine device CPT 58301 | not published | not published | $35.61 – $35.61 | 1 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $198.10 | $566.00 | $84.90 – $283.00 | 2 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $254.10 | $726.00 | $43.56 – $363.00 | 7 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $264.25 | $755.00 | $45.30 – $377.50 | 7 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $259.00 | $740.00 | $44.40 – $370.00 | 7 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $339.15 | $969.00 | $58.14 – $484.50 | 7 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $230.58 | $658.80 | $39.53 – $329.40 | 4 |
| PSA (Prostate) Test CPT 84153 | $126.42 | $361.20 | $15.45 – $180.60 | 23 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $43.16 | $123.30 | $18.50 – $255.00 | 5 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $32.45 | $92.70 | $12.79 – $255.00 | 5 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $23.94 | $68.40 | $10.26 – $255.00 | 5 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $65.80 | $188.00 | $27.01 – $255.00 | 5 |
| Pt application of modality traction mechanical CPT 97012 | $29.05 | $83.00 | $12.45 – $255.00 | 5 |
| Pt evaluation high complexity patient/family CPT 97163 | $241.50 | $690.00 | $67.50 – $255.00 | 5 |
| Pt evaluation low complexity patient/family CPT 97161 | $144.43 | $412.65 | $58.95 – $255.00 | 5 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $150.31 | $429.45 | $64.42 – $255.00 | 5 |
| Pt re-evaluation patient/family CPT 97164 | $100.45 | $287.00 | $43.05 – $255.00 | 5 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $87.26 | $249.30 | $29.84 – $255.00 | 5 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $50.35 | $143.85 | $21.58 – $255.00 | 5 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $36.75 | $105.00 | $15.75 – $255.00 | 5 |
| Pt wheelchair management each 15 minutes CPT 97542 | $57.75 | $165.00 | $24.75 – $255.00 | 5 |
| Pulmonary vent imaging CPT 78579 | $596.05 | $1,703.00 | $102.18 – $1,000.00 | 11 |
| Pulse ox continuous overnight monitoring CPT 94762 | $183.40 | $524.00 | $57.07 – $269.91 | 4 |
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.