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 |
|---|---|---|---|---|
| Carcinoembryonic ag (cea) CPT 82378 | $133.70 | $382.00 | $15.93 – $191.00 | 23 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $3,809.05 | $10,883.00 | $315.75 – $5,441.50 | 11 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $209.30 | $598.00 | $28.43 – $299.00 | 4 |
| Cardiolipin antibody iga CPT 86147 | $73.50 | $210.00 | $21.38 – $107.51 | 23 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $544.42 | $1,555.47 | $233.33 – $777.74 | 2 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,178.10 | $3,366.00 | $191.46 – $1,683.00 | 10 |
| Car outp meas drg cath chd CPT 93598 | $200.97 | $574.20 | $34.46 – $574.20 | 5 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $456.29 | $1,303.68 | $82.42 – $446.41 | 8 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $1,278.08 | $3,651.65 | $6.62 – $2,373.58 | 8 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $3,317.43 | $9,478.35 | $334.53 – $1,115.10 | 2 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $5,206.32 | $14,875.20 | $892.52 – $7,437.60 | 5 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $182.00 | $520.00 | $48.83 – $162.75 | 2 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $855.91 | $2,445.45 | $366.82 – $1,222.73 | 2 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $743.40 | $2,124.00 | $134.03 – $725.96 | 8 |
| Cath hawkone s directional HCPCS C1714 | $873.55 | $2,495.85 | $374.38 – $1,247.93 | 2 |
| Cath left heart/lv gram CPT 93452 | $4,122.09 | $11,777.40 | $706.65 – $5,888.70 | 5 |
| Cath left heart transseptal punc CPT 93462 | $1,651.55 | $4,718.70 | $283.13 – $2,359.35 | 5 |
| Cath lt/rt pulm art CPT 36014 | $360.05 | $1,028.70 | $61.73 – $514.35 | 4 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $492.45 | $1,407.00 | $211.05 – $703.50 | 2 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $11,176.55 | $31,933.00 | $1,600.00 – $15,966.50 | 5 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $9,173.85 | $26,211.00 | $1,572.66 – $13,105.50 | 5 |
| Cath plc art/grft/angio right hrt CPT 93457 | $10,023.30 | $28,638.00 | $1,600.00 – $14,319.00 | 5 |
| Cath right heart w/o2 sat & card CPT 93451 | $1,352.93 | $3,865.50 | $231.93 – $1,932.75 | 5 |
| Cath right hrt mnpul art CPT 36013 | $232.16 | $663.30 | $39.80 – $663.30 | 5 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $144.90 | $414.00 | $62.10 – $207.00 | 2 |
| Cath segmntl pulm art CPT 36015 | $180.81 | $516.60 | $31.00 – $516.60 | 5 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $1,015.13 | $2,900.35 | $348.05 – $1,885.23 | 8 |
| Cauterization chemical granulation tissue CPT 17250 | $109.20 | $312.00 | $46.80 – $156.00 | 2 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $23.60 | $67.41 | $0.32 – $10.23 | 7 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $25.17 | $71.90 | $1.40 – $41.64 | 7 |
| Cefotaxime sodium injection HCPCS J0698 | $8.82 | $25.20 | $3.01 – $16.38 | 7 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $37.76 | $107.86 | $5.19 – $22.53 | 7 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $67.25 | $192.12 | $1.91 – $43.68 | 7 |
| Ceftazidime and avibactam HCPCS J0714 | $326.41 | $932.58 | $115.67 – $606.18 | 7 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $27.92 | $79.77 | $0.51 – $10.24 | 7 |
| Cell count body fluid CPT 89050 | $87.85 | $251.00 | $3.96 – $125.50 | 23 |
| Cell marker study CPT 88182 | $91.04 | $260.10 | $21.89 – $464.18 | 7 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | $8,308.46 | $23,738.43 | $40.67 – $11,869.22 | 4 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $1,275.28 | $3,643.64 | $108.69 – $1,123.72 | 7 |
| Change cystostomy tube simple CPT 51705 | not published | not published | $44.57 – $44.57 | 1 |
| Chemo adm cns w/lmbr punct CPT 96450 | $364.14 | $1,040.40 | $156.06 – $520.20 | 5 |
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $66.93 – $66.93 | 1 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | not published | not published | $48.30 – $48.30 | 1 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | not published | not published | $40.73 – $40.73 | 1 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $97.28 – $97.28 | 1 |
| Chemodenerv musc migraine 64615 CPT 64615 | not published | not published | $34.77 – $34.77 | 1 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | not published | not published | $31.11 – $31.11 | 1 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $54.39 – $54.39 | 1 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $43.40 – $43.40 | 1 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $49.74 – $49.74 | 1 |
| Chemo ia infuse each addl hr CPT 96423 | $77.18 | $220.50 | $33.08 – $169.13 | 5 |
| Chemo ia infusion up to 1 hr CPT 96422 | $355.32 | $1,015.20 | $152.28 – $507.60 | 5 |
| Chemo ia push tecnique CPT 96420 | $355.32 | $1,015.20 | $152.28 – $507.60 | 5 |
| Chemo intralesional over 7 CPT 96406 | $417.69 | $1,193.40 | $93.79 – $596.70 | 5 |
| Chemo intralesional up to 7 96405 CPT 96405 | $200.97 | $574.20 | $86.13 – $287.10 | 5 |
| Chemotherapy injection 96542 CPT 96542 | $55.44 | $158.40 | $23.76 – $85.28 | 4 |
| Chemotx admn pertl cav impl CPT 96446 | $263.66 | $753.30 | $58.27 – $376.65 | 5 |
| Chest 2 vws w oblique CPT 71048 | $402.85 | $1,151.00 | $41.40 – $690.60 | 11 |
| Chest CT scan (with and without contrast) CPT 71270 | $4,193.00 | $11,980.00 | $180.34 – $5,990.00 | 11 |
| Chest CT scan (with contrast) CPT 71260 | $3,569.65 | $10,199.00 | $173.08 – $5,099.50 | 11 |
| Chest CT scan (without contrast) CPT 71250 | $2,832.90 | $8,094.00 | $106.88 – $4,046.98 | 11 |
| Chest X-ray CPT 71046 | $634.55 | $1,813.00 | $30.18 – $916.80 | 11 |
| Chest X-ray (single view) CPT 71045 | $484.40 | $1,384.00 | $21.75 – $830.40 | 11 |
| Chlamydia culture CPT 87110 | $57.96 | $165.60 | $16.46 – $82.82 | 23 |
| Chlamydia trachomatis ag if CPT 87270 | $4.29 | $12.24 | $1.84 – $50.84 | 23 |
| Chlamydia type CPT 87140 | $85.05 | $243.00 | $4.68 – $121.50 | 23 |
| Chlnggrphy intraop addl s&i CPT 74301 | $155.05 | $443.00 | $20.65 – $265.80 | 5 |
| Chloride CPT 82435 | $22.05 | $63.00 | $3.86 – $31.50 | 23 |
| Chloride 24 hour urine CPT 82436 | $44.10 | $126.00 | $4.24 – $63.00 | 23 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $20.06 | $57.30 | $0.08 – $26.30 | 7 |
| Chmotx admn plrl cav thrcnts CPT 96440 | $263.66 | $753.30 | $113.00 – $376.65 | 5 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $815.46 | $2,329.87 | $35.79 – $1,164.94 | 5 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $2,310.00 | $6,600.00 | $990.00 – $3,300.00 | 2 |
| Cholesterol CPT 82465 | $12.29 | $35.10 | $3.65 – $18.89 | 23 |
| Cholesterol (Lipid) Test CPT 80061 | $102.54 | $292.95 | $7.66 – $146.48 | 23 |
| Chorion biopsy CPT 59015 | not published | not published | $48.22 – $48.22 | 1 |
| Chromatography CPT 83021 | $21.42 | $61.20 | $9.18 – $75.56 | 23 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $31.98 | $91.35 | $2.14 – $35.49 | 7 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $231.70 | $661.98 | $99.30 – $330.99 | 2 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $53.55 | $153.00 | $3.41 – $95.14 | 7 |
| Clearance of airways CPT 31720 | $73.15 | $209.00 | $31.35 – $104.50 | 2 |
| Clearance of tear duct CPT 68530 | not published | not published | $113.24 – $113.24 | 1 |
| Clip ligating vesolock lg HCPCS C1760 | $557.87 | $1,593.90 | $86.45 – $468.25 | 8 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | not published | not published | $72.33 – $72.33 | 1 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $74.70 – $74.70 | 1 |
| Clot factor xiii fibrin scrn CPT 85291 | $25.20 | $72.00 | $7.51 – $37.78 | 23 |
| Clot factor xiii fibrin stab CPT 85290 | $47.25 | $135.00 | $13.73 – $68.30 | 23 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | not published | not published | $84.28 – $84.28 | 1 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $84.28 – $84.28 | 1 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | $84.28 – $84.28 | 1 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | $113.73 – $113.73 | 1 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $113.73 – $113.73 | 1 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | not published | not published | $53.27 – $53.27 | 1 |
| Cmv pcr-sendout CPT 87496 | $232.79 | $665.10 | $29.48 – $332.55 | 23 |
| Coagulation time activated teg CPT 85347 | $66.15 | $189.00 | $3.59 – $78.75 | 23 |
| Cold agglutinin titer CPT 86157 | $44.73 | $127.80 | $6.77 – $63.90 | 23 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $100.80 | $288.00 | $17.28 – $262.76 | 5 |
| Collection of venous blood by venipuncture CPT 36415 | $21.35 | $61.00 | $1.80 – $29.50 | 19 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $208.00 | $594.26 | $14.01 – $356.56 | 7 |
| Compatibility test each unit immediate spin technique CPT 86920 | $203.92 | $582.61 | $8.96 – $349.57 | 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.