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 |
|---|---|---|---|---|
| X-ray thoracic spine 3 views CPT 72072 | $782.95 | $2,237.00 | $34.39 – $1,118.50 | 11 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $368.79 | $1,053.66 | $33.33 – $632.20 | 11 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $252.35 | $721.00 | $43.26 – $432.60 | 11 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $601.65 | $1,719.00 | $28.41 – $1,000.00 | 11 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $121.59 | $347.40 | $20.85 – $208.44 | 11 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $545.74 | $1,559.25 | $93.56 – $935.55 | 11 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $679.70 | $1,942.00 | $111.92 – $1,000.00 | 11 |
| X-ray wrist 2 views (both sides) CPT 73100 | $641.90 | $1,834.00 | $31.23 – $1,000.00 | 11 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $226.80 | $648.00 | $38.88 – $388.80 | 11 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $53.66 | $153.30 | $8.54 – $99.65 | 7 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $1,099.86 | $3,142.43 | $9.32 – $102.54 | 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.