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 |
|---|---|---|---|---|
| Ultrasound retroperitoneal limited CPT 76775 | $969.85 | $2,771.00 | $57.90 – $1,385.50 | 11 |
| Ultrasound scrotum and contents CPT 76870 | $954.45 | $2,727.00 | $67.71 – $1,363.50 | 11 |
| Ultrasound spinal canal and contents CPT 76800 | $408.70 | $1,167.70 | $70.07 – $700.62 | 11 |
| Ultrasound transvaginal non obstetric CPT 76830 | $741.30 | $2,118.00 | $106.88 – $1,059.00 | 11 |
| Unlisted chemotherapy px CPT 96549 | $233.42 | $666.90 | $73.32 – $333.45 | 4 |
| Unlisted mr procedure CPT 76498 | $2,516.85 | $7,191.00 | $65.23 – $3,595.50 | 11 |
| Unlisted px med radj physics CPT 77399 | $1,032.50 | $2,950.00 | $423.68 – $1,475.00 | 6 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,465.59 | $4,187.40 | $628.11 – $2,093.70 | 3 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $5,615.75 | $16,045.00 | $335.14 – $8,022.50 | 11 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $4,785.20 | $13,672.00 | $285.35 – $6,836.00 | 11 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,322.90 | $9,494.00 | $198.48 – $4,747.00 | 11 |
| Urea nitrogen CPT 84520 | $31.85 | $91.00 | $3.32 – $45.50 | 23 |
| Urea nitrogen 24 hour urine CPT 84540 | $43.47 | $124.20 | $4.01 – $62.10 | 23 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $567.88 | $1,622.50 | $78.81 – $973.50 | 11 |
| Urethrocystography void s&i CPT 74455 | $568.05 | $1,623.00 | $81.74 – $973.80 | 11 |
| Uric acid blood CPT 84550 | $29.40 | $84.00 | $3.80 – $42.00 | 23 |
| Uric acid urine CPT 84560 | $63.58 | $181.65 | $3.15 – $21.79 | 23 |
| Urinalysis microscopic only CPT 81015 | $12.25 | $35.00 | $2.56 – $17.50 | 23 |
| Urinalysis (with microscopy) CPT 81001 | $48.65 | $139.00 | $2.66 – $69.50 | 23 |
| Urinalysis (without microscopy) CPT 81003 | $31.15 | $89.00 | $1.89 – $44.50 | 23 |
| Urine Culture Test CPT 87086 | $94.85 | $271.00 | $6.78 – $135.50 | 23 |
| Urine pregnancy test CPT 81025 | $85.05 | $243.00 | $5.34 – $121.50 | 23 |
| Urography, antegrade CPT 74425 | $415.80 | $1,188.00 | $71.28 – $712.80 | 11 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $36.18 | $103.36 | $11.00 – $65.00 | 20 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $5.18 | $14.80 | $1.63 – $14.80 | 21 |
| Vaccine mmr live subcutaneous CPT 90707 | $76.68 | $219.08 | $32.87 – $142.41 | 7 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $93.20 | $266.27 | $29.29 – $200.77 | 21 |
| Vaccine rabies im CPT 90675 | $216.67 | $619.05 | $92.86 – $504.42 | 7 |
| Vaccine tdap >=7 years im CPT 90715 | $95.57 | $273.03 | $26.46 – $114.66 | 7 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $62.92 | $179.76 | $26.97 – $116.85 | 7 |
| Valproic acid total therapeutic drug level CPT 80164 | $136.71 | $390.60 | $11.37 – $146.50 | 23 |
| Vancomycin hcl injection HCPCS J3370 | $54.39 | $155.40 | $2.48 – $75.08 | 7 |
| Vancomycin peak therapeutic drug level CPT 80202 | $51.09 | $145.95 | $11.37 – $56.67 | 23 |
| Varicella zoster antibody igg CPT 86787 | $65.45 | $187.00 | $10.82 – $93.50 | 23 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | not published | not published | $24.77 – $24.77 | 1 |
| Venogram ext bil s&i CPT 75822 | $752.22 | $2,149.20 | $128.96 – $1,074.60 | 11 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $420.53 | $1,201.50 | $72.09 – $1,201.50 | 11 |
| Venous mech thrombectomy CPT 37187 | $2,524.73 | $7,213.50 | $1,082.03 – $3,606.75 | 3 |
| Venous m-thrombectomy add-on CPT 37188 | $2,524.73 | $7,213.50 | $1,082.03 – $3,606.75 | 3 |
| Venous thrombosis imaging CPT 78457 | $425.57 | $1,215.90 | $72.96 – $729.54 | 11 |
| Ven thrombosis images bilat CPT 78458 | $520.70 | $1,487.70 | $89.27 – $892.62 | 11 |
| Ventilator each subsequent day CPT 94003 | $1,389.15 | $3,969.00 | $595.35 – $1,984.50 | 4 |
| Ventilator initial day CPT 94002 | $1,471.56 | $4,204.44 | $630.67 – $2,102.22 | 4 |
| Very long chain fatty acids CPT 82726 | $71.75 | $205.00 | $15.25 – $102.50 | 23 |
| Vinblastine 1 mg/ml intravenous solution HCPCS J9360 | $58.91 | $168.30 | $5.90 – $109.40 | 7 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $21.67 | $61.90 | $7.80 – $40.24 | 7 |
| Vitamin b-12 CPT 82607 | $51.09 | $145.95 | $12.67 – $72.98 | 23 |
| Vitamin D Test CPT 82306 | $77.18 | $220.50 | $24.86 – $124.93 | 23 |
| Volume measurement urine timed CPT 81050 | $10.15 | $29.00 | $2.53 – $15.99 | 23 |
| Warde 1003990 aldosterone CPT 82088 | $77.91 | $222.60 | $33.39 – $171.44 | 23 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $40.30 | $115.13 | $17.27 – $116.24 | 23 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $37.80 | $108.00 | $10.84 – $54.00 | 23 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $83.19 | $237.66 | $21.21 – $118.83 | 23 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $32.85 | $93.84 | $13.02 – $65.36 | 23 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $31.17 | $89.05 | $6.74 – $44.53 | 23 |
| Warde 3008005 oligoclonal bands CPT 83916 | $135.10 | $386.00 | $16.98 – $193.00 | 23 |
| Warde 3016000 west nile virus antibody CPT 86788 | $22.68 | $64.80 | $9.72 – $71.20 | 23 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $59.85 | $171.00 | $12.09 – $85.50 | 23 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $47.25 | $135.00 | $10.29 – $67.50 | 23 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $74.20 | $212.00 | $7.48 – $106.00 | 23 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $51.45 | $147.00 | $15.10 – $75.56 | 23 |
| Warde 3400852 arsenic CPT 82175 | $54.30 | $155.14 | $15.93 – $79.93 | 23 |
| Warde 3708165 mercury urine CPT 83825 | $57.84 | $165.24 | $13.66 – $82.62 | 23 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $16.39 | $46.81 | $7.03 – $23.41 | 2 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $46.31 | $132.30 | $5.90 – $66.15 | 23 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $126.35 | $361.00 | $32.44 – $180.50 | 23 |
| Warde aldolase CPT 82085 | $22.50 | $64.26 | $8.16 – $40.68 | 23 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $539.91 | $1,542.60 | $14.17 – $771.30 | 23 |
| Warde analysis gene hfe common variants CPT 81256 | $525.87 | $1,502.46 | $53.50 – $751.23 | 23 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $253.75 | $725.00 | $108.75 – $688.66 | 23 |
| Warde apolipoprotein b CPT 82172 | $3.50 | $10.00 | $1.50 – $88.62 | 23 |
| Warde calcitonin CPT 82308 | $42.74 | $122.09 | $18.32 – $111.87 | 23 |
| Warde collagen cross links c-telopeptide CPT 82523 | $74.97 | $214.20 | $15.69 – $107.10 | 23 |
| Warde complement total hemolytic CPT 86162 | $57.65 | $164.70 | $17.07 – $85.72 | 23 |
| Warde copper CPT 82525 | $32.85 | $93.84 | $10.42 – $52.31 | 23 |
| Warde cryoglobulin CPT 82595 | $41.65 | $119.00 | $5.43 – $59.50 | 23 |
| Warde erythropoietin CPT 82668 | $54.25 | $155.00 | $15.78 – $78.46 | 23 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $9.14 | $26.10 | $3.92 – $13.05 | 2 |
| Warde folic acid rbc CPT 82747 | $72.80 | $208.00 | $14.63 – $104.00 | 23 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $25.55 | $73.00 | $8.15 – $40.68 | 23 |
| Warde gastrin CPT 82941 | $32.90 | $94.00 | $14.10 – $74.09 | 23 |
| Warde growth hormone (hgh) CPT 83003 | $33.25 | $95.00 | $14.00 – $69.73 | 23 |
| Warde helminth antibody strongyloides igg CPT 86682 | $59.85 | $171.00 | $10.93 – $85.50 | 23 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $33.45 | $95.55 | $10.81 – $53.77 | 23 |
| Warde hepatitis a antibody CPT 86708 | $20.65 | $59.00 | $8.85 – $52.31 | 23 |
| Warde hepatitis be antibody CPT 86707 | $56.55 | $161.57 | $9.72 – $80.79 | 23 |
| Warde immunofixation electrophoresis urine CPT 86335 | $75.71 | $216.30 | $24.65 – $123.50 | 23 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $52.84 | $150.96 | $9.69 – $75.48 | 23 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $40.89 | $116.82 | $16.71 – $98.78 | 23 |
| Warde lipoprotein (a) CPT 83695 | $44.45 | $127.00 | $10.93 – $63.50 | 23 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $18.90 | $54.00 | $8.10 – $55.20 | 23 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $36.05 | $103.00 | $15.45 – $51.50 | 2 |
| Warde protein c antigen CPT 85302 | $33.95 | $97.00 | $10.09 – $50.84 | 23 |
| Warde sex hormone binding globulin CPT 84270 | $31.50 | $89.98 | $13.50 – $91.51 | 23 |
| Warde somatomedin CPT 84305 | $46.90 | $134.00 | $17.86 – $88.62 | 23 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $24.99 | $71.40 | $10.71 – $66.83 | 23 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $154.70 | $442.00 | $42.72 – $221.00 | 23 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $46.62 | $133.20 | $19.98 – $108.98 | 23 |
| Warde viscosity CPT 85810 | $23.63 | $67.50 | $9.80 – $49.41 | 23 |
| Warde vitamin a CPT 84590 | $52.50 | $150.00 | $9.75 – $75.00 | 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.