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 |
|---|---|---|---|---|
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $43.75 | $124.99 | $4.41 – $23.89 | 7 |
| Biofeedback, pt CPT 90901 | $22.05 | $63.00 | $9.45 – $255.00 | 5 |
| Biopsy abdominal mass CPT 49180 | $595.98 | $1,702.80 | $255.42 – $851.40 | 2 |
| Biopsy bone trocar/needle superficial CPT 20220 | $673.16 | $1,923.30 | $288.50 – $961.65 | 2 |
| Biopsy conjunctiva CPT 68100 | not published | not published | $93.65 – $93.65 | 1 |
| Biopsy external ear 69100 CPT 69100 | not published | not published | $54.39 – $54.39 | 1 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,365.70 | $3,902.00 | $92.81 – $1,951.00 | 3 |
| Biopsy muscle percutaneous needle CPT 20206 | $634.10 | $1,811.70 | $271.76 – $905.85 | 2 |
| Biopsy needle liver percutaneous CPT 47000 | $781.20 | $2,232.00 | $334.80 – $1,116.00 | 2 |
| Biopsy needle lymph node superficial CPT 38505 | $1,075.55 | $3,073.00 | $460.95 – $1,536.50 | 2 |
| Biopsy of heart lining CPT 93505 | $1,746.99 | $4,991.40 | $299.49 – $2,495.70 | 5 |
| Biopsy of lip 40490 CPT 40490 | not published | not published | $64.48 – $64.48 | 1 |
| Biopsy of salivary gland 42400 CPT 42400 | not published | not published | $60.28 – $60.28 | 1 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $823.90 | $2,354.00 | $353.10 – $1,177.00 | 2 |
| Biopsy skin incisional single lesion CPT 11106 | $524.30 | $1,498.00 | $87.55 – $749.00 | 3 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $118.31 – $118.31 | 1 |
| Bivalirudin HCPCS J0583 | $1,038.91 | $2,968.29 | $0.20 – $1,929.39 | 7 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $167.27 | $477.90 | $39.53 – $238.95 | 3 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $149.54 – $149.54 | 1 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $58.57 | $167.34 | $25.11 – $108.78 | 7 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $1,722.11 | $4,920.30 | $41.58 – $138.60 | 2 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $237.41 | $678.30 | $66.78 – $222.60 | 2 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $4,390.89 | $12,545.40 | $1,463.65 – $4,878.83 | 2 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $112.90 | $322.56 | $33.71 – $182.59 | 8 |
| Block paracervical nrv CPT 64435 | not published | not published | $62.24 – $62.24 | 1 |
| Blood Clotting (PT/INR) Test CPT 85610 | $72.10 | $206.00 | $3.32 – $17.42 | 23 |
| Blood Clotting (PTT) Test CPT 85730 | $68.95 | $197.00 | $4.05 – $24.68 | 23 |
| Blood Count (CBC) Test CPT 85025 | $86.45 | $247.00 | $6.53 – $118.50 | 23 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $72.40 | $206.85 | $5.43 – $61.20 | 23 |
| Blood Culture Test CPT 87040 | $148.84 | $425.25 | $8.67 – $212.63 | 23 |
| Blood draw capillary 36416 CPT 36416 | not published | not published | $1.72 – $8.24 | 2 |
| Blood gases o2 saturation direct measurement CPT 82805 | $280.25 | $800.70 | $23.96 – $400.35 | 23 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $39.90 | $114.00 | $13.37 – $66.83 | 23 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $40.06 | $114.45 | $2.75 – $57.23 | 23 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $25.35 | $72.42 | $2.75 – $36.21 | 23 |
| Blood typing abo CPT 86900 | $163.10 | $466.00 | $2.51 – $279.60 | 11 |
| Blood typing ag donor ea ag CPT 86902 | $415.10 | $1,186.00 | $3.23 – $711.60 | 11 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $451.15 | $1,289.00 | $3.22 – $773.40 | 11 |
| Blood typing rh (d) CPT 86901 | $69.30 | $198.00 | $2.51 – $80.57 | 11 |
| Bone biopsy open superficial CPT 20240 | $1,400.70 | $4,002.00 | $600.30 – $2,001.00 | 2 |
| Bone Density Scan (DEXA) CPT 77080 | $399.70 | $1,142.00 | $38.09 – $685.20 | 11 |
| Bone/joint imaging ltd area CPT 78300 | $1,063.65 | $3,039.00 | $182.34 – $1,519.50 | 11 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $737.10 | $2,106.00 | $315.90 – $1,053.00 | 2 |
| Bone marrow imaging body CPT 78104 | $1,011.78 | $2,890.80 | $173.45 – $1,445.40 | 11 |
| Boot j walker l HCPCS L4386 | $71.51 | $204.29 | $24.52 – $132.79 | 7 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $42.13 | $120.36 | $14.31 – $71.20 | 23 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $1,441.96 | $4,119.87 | $2.26 – $2,677.92 | 7 |
| Bowel imaging CPT 78290 | $807.98 | $2,308.50 | $138.51 – $1,154.25 | 11 |
| Brace afo lg left 6607 HCPCS L1930 | $115.72 | $330.62 | $39.68 – $214.91 | 7 |
| Brace wrist classic lft sm HCPCS L3908 | $126.54 | $361.54 | $5.00 – $27.08 | 7 |
| Brach/thor cath 1st CPT 36215 | $417.06 | $1,191.60 | $71.50 – $1,191.60 | 5 |
| Brach/thor cath 2nd CPT 36216 | $404.46 | $1,155.60 | $69.34 – $1,155.60 | 5 |
| Brach/thor cath 3rd CPT 36217 | $440.37 | $1,258.20 | $75.50 – $1,258.20 | 5 |
| Brach/thor cath addl CPT 36218 | $559.13 | $1,597.50 | $95.85 – $1,597.50 | 5 |
| Braf gene CPT 81210 | $182.39 | $521.10 | $78.17 – $736.60 | 23 |
| Brain flow imaging only CPT 78610 | $381.78 | $1,090.80 | $65.45 – $654.48 | 11 |
| Brain image < 4 views CPT 78600 | $438.80 | $1,253.70 | $75.23 – $752.22 | 11 |
| Brain image 4+ views CPT 78605 | $469.98 | $1,342.80 | $80.57 – $805.68 | 11 |
| Brain image w/flow < 4 views CPT 78601 | $488.88 | $1,396.80 | $83.81 – $838.08 | 11 |
| Brain image w/flow 4 + views CPT 78606 | $572.67 | $1,636.20 | $98.18 – $981.72 | 11 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $922.04 | $2,634.39 | $158.07 – $1,317.20 | 11 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $1,102.82 | $3,150.90 | $189.06 – $1,575.45 | 11 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $1,930.95 | $5,517.00 | $224.54 – $2,678.01 | 11 |
| Brain MRI (with and without contrast) CPT 70553 | $4,338.95 | $12,397.00 | $332.80 – $6,198.50 | 11 |
| Brain MRI (with contrast) CPT 70552 | $1,640.45 | $4,687.00 | $265.38 – $2,343.50 | 11 |
| Brain MRI (without contrast) CPT 70551 | $2,646.00 | $7,560.00 | $204.15 – $3,780.00 | 11 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $1,029.70 | $2,942.00 | $441.30 – $1,471.00 | 2 |
| Breast punct aspir cyst, bil CPT 19000 | $405.72 | $1,159.20 | $68.49 – $579.60 | 3 |
| Breath hydrogen test 91065 CPT 91065 | $153.41 | $438.30 | $65.75 – $219.15 | 3 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | $8,343.06 | $23,837.30 | $278.67 – $15,494.25 | 7 |
| Bronchial challenge CPT 94070 | $601.65 | $1,719.00 | $63.95 – $859.50 | 4 |
| Br punct aspir ea add, l CPT 19001 | $278.78 | $796.50 | $47.79 – $398.25 | 4 |
| Bundled special stain group 1 microorganisms CPT 88312 | $129.61 | $370.30 | $10.24 – $370.30 | 7 |
| Bundled special stain group 2 CPT 88313 | $172.55 | $493.00 | $10.24 – $294.74 | 7 |
| Buprenorphine and metabolite - sendout CPT 80348 | $0.95 | $2.70 | $0.41 – $14.43 | 9 |
| Bur rotalink 2.15mm HCPCS C1724 | $793.07 | $2,265.90 | $339.89 – $1,132.95 | 2 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $5.88 | $16.80 | $2.04 – $10.92 | 7 |
| Bx bone trocar/ndl deep CPT 20225 | $1,428.00 | $4,080.00 | $612.00 – $2,040.00 | 2 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $185.50 | $530.00 | $31.80 – $265.00 | 4 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $66.85 | $191.00 | $28.65 – $95.50 | 2 |
| Bx skin punch ea sep/ addl les CPT 11105 | $66.85 | $191.00 | $28.65 – $95.50 | 2 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $167.58 | $478.80 | $28.65 – $95.50 | 4 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $674.10 | $1,926.00 | $42.34 – $963.00 | 3 |
| Bx vag mucos smpl (sep proc) CPT 57100 | not published | not published | $32.52 – $32.52 | 1 |
| Bypass temp external fem-fem CPT 37799 | $6,401.85 | $18,291.00 | $1,097.46 – $9,145.50 | 4 |
| C1 esterase inhibitor func - sendout CPT 86161 | $11.97 | $34.20 | $5.13 – $50.84 | 23 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | $11,027.84 | $31,508.10 | $311.70 – $20,480.27 | 7 |
| Cadd pump refill CPT 96521 | $222.08 | $634.50 | $95.18 – $317.25 | 4 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $2,917.73 | $8,336.37 | $1,250.46 – $5,418.65 | 7 |
| Calcium 24 hour urine CPT 82340 | $63.58 | $181.65 | $5.07 – $90.83 | 23 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $27.30 | $78.00 | $4.41 – $19.11 | 6 |
| Calcium ionized CPT 82330 | $72.77 | $207.90 | $11.49 – $58.10 | 23 |
| Calcium total CPT 82310 | $38.85 | $111.00 | $4.33 – $55.50 | 23 |
| Calculi urinary-sendout CPT 82360 | $79.10 | $226.00 | $10.81 – $113.00 | 23 |
| Calprotectin fecal CPT 83993 | $32.90 | $94.00 | $14.10 – $82.82 | 23 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $10,932.10 | $31,234.56 | $713.19 – $3,863.07 | 8 |
| Cap trach decann 15mm HCPCS C1750 | $458.64 | $1,310.40 | $114.35 – $619.39 | 8 |
| Carbamazepine total therapeutic drug level CPT 80156 | $117.46 | $335.58 | $12.24 – $167.79 | 23 |
| Carbon dioxide CPT 82374 | $17.64 | $50.40 | $4.10 – $25.20 | 23 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $435.70 | $1,244.84 | $4.90 – $164.27 | 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.