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 |
|---|---|---|---|---|
| Antibody screen rbc CPT 86850 | $78.75 | $225.00 | $8.68 – $135.00 | 7 |
| Antibody tetanus CPT 86774 | $12.53 | $35.80 | $5.37 – $62.46 | 23 |
| Antidepressant not specified CPT 80338 | $0.63 | $1.80 | $0.27 – $11.25 | 9 |
| Anti mog serum - sendout CPT 86362 | $275.36 | $786.73 | $118.01 – $393.37 | 2 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $17.98 | $51.37 | $7.71 – $25.69 | 2 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $6.65 | $19.00 | $2.85 – $9.50 | 2 |
| Antinuclear antibodies CPT 86038 | $36.02 | $102.90 | $10.16 – $51.45 | 23 |
| Antinuclear antibodies titer CPT 86039 | $15.86 | $45.31 | $6.80 – $46.51 | 23 |
| Antiphosphatidylserine antibody CPT 86148 | $23.29 | $66.54 | $9.99 – $66.83 | 23 |
| Antistreptolysin o titer CPT 86060 | $21.35 | $61.00 | $6.13 – $30.52 | 23 |
| Antithrombin iii activity CPT 85300 | $38.50 | $110.00 | $9.95 – $55.00 | 23 |
| Apc gene dup/delet variants CPT 81203 | $229.95 | $657.00 | $98.55 – $839.75 | 23 |
| Apc gene full sequence CPT 81201 | $229.95 | $657.00 | $98.55 – $3,274.77 | 23 |
| Apheresis plasma CPT 36514 | $3,293.01 | $9,408.60 | $1,411.29 – $4,704.30 | 2 |
| Apheresis platelets CPT 36513 | $1,203.62 | $3,438.90 | $515.84 – $1,719.45 | 2 |
| Apheresis rbc CPT 36512 | $1,364.58 | $3,898.80 | $584.82 – $1,949.40 | 2 |
| Apheresis wbc CPT 36511 | $1,024.45 | $2,927.00 | $439.05 – $1,463.50 | 2 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $485.10 | $1,386.00 | $207.90 – $693.00 | 2 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $390.60 | $1,116.00 | $167.40 – $558.00 | 2 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $357.00 | $1,020.00 | $153.00 – $510.00 | 2 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $498.40 | $1,424.00 | $213.60 – $712.00 | 2 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $390.60 | $1,116.00 | $167.40 – $558.00 | 2 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $357.00 | $1,020.00 | $153.00 – $510.00 | 2 |
| Appl halo type body cast CPT 29000 | $181.13 | $517.50 | $77.63 – $258.75 | 2 |
| Application finger splntstatic 29130 CPT 29130 | $106.75 | $305.00 | $45.75 – $152.50 | 2 |
| Application long leg splint 29505 CPT 29505 | not published | not published | $45.13 – $45.13 | 1 |
| Application lower leg splint 29515 CPT 29515 | $193.90 | $554.00 | $34.77 – $277.00 | 3 |
| Application multi layer compression below knee (both sides) CPT 29581 | $322.35 | $921.00 | $41.22 – $460.50 | 3 |
| Application of paste boot 29580 CPT 29580 | $132.65 | $379.00 | $24.39 – $189.50 | 3 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $673.40 | $1,924.00 | $288.60 – $962.00 | 2 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $505.05 | $1,443.00 | $216.45 – $721.50 | 2 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $39.69 | $113.40 | $17.01 – $255.00 | 5 |
| Appl multlay comprs arm/hand CPT 29584 | $138.60 | $396.00 | $45.98 – $198.00 | 3 |
| Apply forearm splintdynamic 29126 CPT 29126 | $106.75 | $305.00 | $45.75 – $152.50 | 2 |
| Apply of finger splint 29131 CPT 29131 | $51.10 | $146.00 | $21.90 – $73.00 | 2 |
| Apply rigid leg cast 29445 CPT 29445 | $214.90 | $614.00 | $92.10 – $307.00 | 2 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $369.64 | $1,056.09 | $2.55 – $686.46 | 7 |
| #aptt mix-1:1 incubated CPT 87532 | $90.65 | $259.00 | $29.48 – $146.76 | 23 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $444.11 | $1,268.88 | $190.34 – $634.44 | 2 |
| Aquaporin-4 antibody cba each CPT 86052 | $241.62 | $690.34 | $103.56 – $345.17 | 2 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $35.91 | $102.60 | $15.39 – $255.00 | 5 |
| Aquatic exercise - group charge CPT 97150 | $35.60 | $101.70 | $15.26 – $255.00 | 5 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $1,327.93 | $3,794.06 | $3.09 – $2,466.14 | 7 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | $515.08 | $1,471.65 | $10.37 – $956.58 | 7 |
| Artery xray each vessel 7577426 CPT 75774 | $653.31 | $1,866.60 | $126.65 – $1,000.00 | 5 |
| Artery xray of abdomen 75726-26 CPT 75726 | $1,037.93 | $2,965.50 | $148.05 – $2,965.50 | 11 |
| Artery x-rays adrenal gland CPT 75731 | $1,037.93 | $2,965.50 | $153.36 – $1,482.75 | 11 |
| Artery x-rays adrenals CPT 75733 | $1,037.93 | $2,965.50 | $169.08 – $2,965.50 | 11 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $1,254.40 | $3,584.00 | $150.36 – $3,584.00 | 11 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $2,727.20 | $7,792.00 | $162.39 – $5,293.14 | 11 |
| Artery x-rays chest CPT 75756 | $739.62 | $2,113.20 | $126.80 – $2,113.20 | 11 |
| Artery x-rays lung CPT 75741 | $1,037.93 | $2,965.50 | $130.98 – $2,965.50 | 11 |
| Artery x-rays lung CPT 75746 | $717.89 | $2,051.10 | $123.07 – $1,025.55 | 11 |
| Artery x-rays lungs CPT 75743 | $1,007.37 | $2,878.20 | $148.35 – $2,878.20 | 11 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $1,037.93 | $2,965.50 | $143.01 – $2,965.50 | 11 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $430.15 | $1,229.00 | $18.78 – $614.50 | 3 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | not published | not published | $26.01 – $26.01 | 1 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | not published | not published | $26.01 – $26.01 | 1 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $423.50 | $1,210.00 | $17.66 – $605.00 | 3 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $436.10 | $1,246.00 | $22.71 – $623.00 | 3 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | not published | not published | $26.01 – $26.01 | 1 |
| Asp & inj bone cyst CPT 20615 | not published | not published | $118.60 – $118.60 | 1 |
| Aspirate pleura without imaging 32554 CPT 32554 | $524.30 | $1,498.00 | $180.77 – $749.00 | 3 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $680.40 | $1,944.00 | $55.73 – $972.00 | 3 |
| Assay of interleukin-6 (il-6) CPT 83529 | $57.65 | $164.70 | $24.71 – $82.35 | 2 |
| Assay of procainamide w/metab CPT 80192 | $30.56 | $87.30 | $13.10 – $69.73 | 23 |
| Assay of salicylate CPT 80179 | $44.80 | $128.00 | $11.18 – $78.46 | 23 |
| Assay of urine sulfate CPT 84392 | $7.81 | $22.29 | $3.35 – $23.26 | 23 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $152.95 | $437.00 | $65.55 – $255.00 | 4 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $63.70 | $182.00 | $3.59 – $91.00 | 23 |
| Assistive tech assessment, ot CPT 97755 | $37.80 | $108.00 | $16.20 – $255.00 | 5 |
| Ast/sgot CPT 84450 | $25.90 | $74.00 | $4.35 – $37.00 | 23 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | $8,701.80 | $24,862.28 | $124.19 – $16,160.49 | 7 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $14,634.20 | $41,812.00 | $1,600.00 – $20,906.00 | 3 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $14,634.20 | $41,812.00 | $1,600.00 – $20,906.00 | 3 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $7.35 | $21.00 | $0.02 – $10.24 | 7 |
| Autologous blood process CPT 86890 | $112.14 | $320.40 | $29.17 – $421.34 | 6 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $1,554.83 | $4,442.35 | $137.06 – $2,887.53 | 7 |
| Avul nail plate addl CPT 11732 | $39.69 | $113.40 | $17.01 – $56.70 | 2 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $54.18 | $154.80 | $9.29 – $77.40 | 7 |
| Azacitidine injection HCPCS J9025 | $223.72 | $639.18 | $0.46 – $415.47 | 7 |
| Azathioprine 50 mg tablet HCPCS J7500 | $2.76 | $7.86 | $1.18 – $5.11 | 7 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $43.26 | $123.59 | $2.37 – $45.05 | 7 |
| Baclofen eval charges CPT 97750 | $37.80 | $108.00 | $16.20 – $255.00 | 5 |
| Bacterial meningitis antigen CPT 86403 | $84.32 | $240.90 | $8.60 – $47.94 | 23 |
| Bacterial vaginosis pcr CPT 87801 | $107.96 | $308.45 | $46.27 – $294.94 | 23 |
| Bausch health Ultrasound surg HCPCS V2788 | $421.12 | $1,203.20 | $180.48 – $721.92 | 5 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $130.80 | $373.71 | $7.82 – $242.92 | 7 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $2,132.71 | $6,093.43 | $18.65 – $3,960.73 | 7 |
| Benign lesion paring 2-4 CPT 11056 | $220.50 | $630.00 | $94.50 – $315.00 | 2 |
| Benign lesion paring 4+ CPT 11057 | $133.70 | $382.00 | $32.52 – $191.00 | 3 |
| #_benzodiazconfur CPT 80346 | $0.63 | $1.80 | $0.27 – $16.16 | 9 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $67.99 | $194.25 | $19.04 – $126.27 | 7 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $52.15 | $149.00 | $21.38 – $107.51 | 23 |
| Beta-2 microglobulin CPT 82232 | $50.05 | $143.00 | $13.59 – $71.50 | 23 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $2,207.18 | $6,306.21 | $29.37 – $141.52 | 7 |
| Bilateral n block inj occipital 64405 CPT 64405 | not published | not published | $48.50 – $48.50 | 1 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | not published | not published | $64.21 – $64.21 | 1 |
| Bilirubin direct CPT 82248 | $35.70 | $102.00 | $4.22 – $51.00 | 23 |
| Bilirubin total CPT 82247 | $34.30 | $98.00 | $4.22 – $49.00 | 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.