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 |
|---|---|---|---|---|
| Comp cystometrogram/void presssure 51728 CPT 51728 | not published | not published | $165.69 – $165.69 | 1 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | not published | not published | $168.21 – $168.21 | 1 |
| Complement antigen each component c3 CPT 86160 | $53.66 | $153.30 | $10.08 – $72.98 | 23 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $168.35 | $481.00 | $72.15 – $240.50 | 2 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $168.35 | $481.00 | $72.15 – $240.50 | 2 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $290.85 | $831.00 | $124.65 – $415.50 | 2 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $247.45 | $707.00 | $106.05 – $353.50 | 2 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $86.10 | $246.00 | $14.76 – $123.00 | 7 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $163.10 | $466.00 | $69.90 – $233.00 | 2 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $186.90 | $534.00 | $80.10 – $267.00 | 2 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $67.90 | $194.00 | $11.64 – $97.00 | 7 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $66.85 | $191.00 | $11.46 – $95.50 | 7 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $147.35 | $421.00 | $63.15 – $210.50 | 2 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $170.80 | $488.00 | $29.28 – $244.00 | 7 |
| Concentration infection agents any type CPT 87015 | $32.20 | $92.00 | $5.61 – $27.62 | 23 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $291.38 | $832.51 | $124.88 – $570.56 | 7 |
| Consultation pathology during surgery CPT 88329 | $48.46 | $138.44 | $10.24 – $94.53 | 6 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $910.53 | $2,601.50 | $10.24 – $1,560.90 | 6 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $94.85 | $271.00 | $10.24 – $162.60 | 7 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $235.55 | $673.00 | $21.89 – $403.80 | 7 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $45.50 | $130.00 | $19.50 – $119.22 | 6 |
| Contrast baths charges CPT 97034 | $30.24 | $86.40 | $12.96 – $255.00 | 5 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $1,190.00 | $3,400.00 | $126.30 – $3,400.00 | 11 |
| Contrast exam thoracic aorta CPT 75600 | $991.31 | $2,832.30 | $169.94 – $2,832.30 | 11 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $1,037.93 | $2,965.50 | $120.63 – $2,965.50 | 11 |
| Contrast x-ray gallbladder CPT 74290 | $232.16 | $663.30 | $39.80 – $397.98 | 11 |
| Contrast x-ray of ankle CPT 73615 | $575.82 | $1,645.20 | $98.72 – $987.12 | 11 |
| Contrast x-ray of brain CPT 70010 | $1,150.70 | $3,287.70 | $58.14 – $1,643.85 | 11 |
| Contrast x-ray of brain CPT 70015 | $1,185.03 | $3,385.80 | $143.49 – $1,692.90 | 11 |
| Contrast x-ray of elbow CPT 73085 | $575.82 | $1,645.20 | $95.08 – $987.12 | 11 |
| Contrast x-ray of hip CPT 73525 | $525.11 | $1,500.30 | $90.02 – $900.18 | 11 |
| Contrast x-ray of knee joint CPT 73580 | $613.31 | $1,752.30 | $105.14 – $1,000.00 | 11 |
| Contrast x-ray of wrist CPT 73115 | $475.65 | $1,359.00 | $81.54 – $815.40 | 11 |
| Controller infinity pt dbs HCPCS C1787 | $2,181.12 | $6,231.75 | $934.77 – $3,115.88 | 2 |
| Control nose/throat bleeding w/pst nsl packs 42970 CPT 42970 | not published | not published | $74.70 – $74.70 | 1 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $440.36 | $1,258.17 | $75.50 – $629.09 | 7 |
| Convert nephrostomy catheter CPT 50434 | not published | not published | $229.11 – $229.11 | 1 |
| Coombs direct CPT 86880 | $56.00 | $160.00 | $4.53 – $96.00 | 11 |
| Coombs indirect titer reference CPT 86886 | $49.14 | $140.40 | $4.35 – $140.40 | 11 |
| Core ndl bx lng/med perq CPT 32408 | $1,164.87 | $3,328.20 | $499.23 – $1,664.10 | 2 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $9,173.85 | $26,211.00 | $1,572.66 – $13,105.50 | 5 |
| Coronary angio/lv gram/lt heart CPT 93458 | $8,494.15 | $24,269.00 | $1,456.14 – $12,134.50 | 5 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $10,193.05 | $29,123.00 | $1,600.00 – $14,561.50 | 5 |
| Coronary art/grft angio s&i CPT 93455 | $5,640.25 | $16,115.00 | $966.90 – $8,057.50 | 5 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $4,027.52 | $11,507.20 | $690.44 – $5,753.60 | 5 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $282.80 | $808.00 | $121.20 – $404.00 | 2 |
| Correct skin color 6.0 cm/< CPT 11920 | not published | not published | $90.83 – $90.83 | 1 |
| Cortisol total am CPT 82533 | $117.25 | $335.00 | $13.69 – $85.00 | 23 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $100.70 | $287.70 | $28.85 – $187.01 | 7 |
| Co-treatment - group 15 mins, st CPT 92508 | $17.85 | $51.00 | $7.65 – $255.00 | 5 |
| Counseling smoke cess interm >10mins CPT 99407 | $27.30 | $78.00 | $11.70 – $51.88 | 3 |
| Covid-19 lab test non-cdc HCPCS U0002 | $79.80 | $228.00 | $30.79 – $133.41 | 23 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $94.50 | $270.00 | $10.95 – $135.00 | 23 |
| C-peptide CPT 84681 | $63.70 | $182.00 | $17.48 – $91.00 | 23 |
| C-reactive protein CPT 86140 | $77.81 | $222.30 | $4.35 – $45.68 | 23 |
| C-reactive protein high sensitivity CPT 86141 | $69.83 | $199.50 | $10.88 – $99.75 | 23 |
| Creatine kinase CPT 82550 | $66.85 | $191.00 | $5.47 – $95.50 | 23 |
| Creatine kinase isoenzymes CPT 82552 | $30.56 | $87.30 | $11.25 – $56.67 | 23 |
| Creatine kinase mb CPT 82553 | $79.38 | $226.80 | $9.70 – $113.40 | 23 |
| Creatinine CPT 82565 | $36.40 | $104.00 | $4.30 – $32.00 | 23 |
| Creatinine 24 hour urine CPT 82570 | $50.35 | $143.85 | $4.35 – $46.20 | 23 |
| Creatinine clearance urine CPT 82575 | $92.75 | $265.00 | $7.95 – $132.50 | 23 |
| #creutz-prot.,western blot CPT 84182 | $31.85 | $91.00 | $13.65 – $122.03 | 23 |
| Critical care 30-74 minutes CPT 99291 | $2,534.35 | $7,241.00 | $434.46 – $3,620.50 | 8 |
| Critical care each additional 30 minutes CPT 99292 | $481.60 | $1,376.00 | $82.56 – $688.00 | 8 |
| Crotalidae poly immune fab HCPCS J0840 | $4,534.22 | $12,954.90 | $1,943.24 – $8,420.69 | 7 |
| Cryoprecipitate each unit HCPCS P9012 | $47.25 | $135.00 | $20.25 – $67.50 | 3 |
| Crystal identification light microscopy CPT 89060 | $69.62 | $198.90 | $6.04 – $99.45 | 23 |
| Csf shunt reprogram 62252 CPT 62252 | not published | not published | $30.28 – $30.28 | 1 |
| CT 3d report other modality w/workstation CPT 76377 | $823.90 | $2,354.00 | $60.57 – $1,177.00 | 5 |
| Cta abdomen without & /or w/contrast CPT 74175 | $3,254.30 | $9,298.00 | $180.34 – $4,649.00 | 11 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $4,274.66 | $12,213.30 | $180.34 – $6,106.65 | 11 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,450.47 | $9,858.47 | $180.34 – $4,929.24 | 11 |
| Cta neck without &/or w/contrast CPT 70498 | $3,920.00 | $11,200.00 | $180.34 – $5,600.00 | 11 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $4,230.80 | $12,088.00 | $265.38 – $6,044.00 | 11 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,489.68 | $9,970.50 | $180.34 – $4,985.25 | 11 |
| CT Angiogram of the Head CPT 70496 | $3,920.00 | $11,200.00 | $180.34 – $5,600.00 | 11 |
| CT angio pelvis CPT 72191 | $1,865.33 | $5,329.50 | $180.34 – $2,664.75 | 11 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,546.82 | $10,133.75 | $180.34 – $5,066.88 | 11 |
| CT guidance for needle placement CPT 77012 | $1,602.39 | $4,578.23 | $149.36 – $2,289.12 | 5 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $899.96 | $2,571.30 | $121.84 – $1,285.65 | 5 |
| CT guid parench tis ablat CPT 77013 | $355.32 | $1,015.20 | $152.28 – $609.12 | 5 |
| CT limited or localized follow-up study CPT 76380 | $291.69 | $833.40 | $50.01 – $500.04 | 11 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,325.75 | $6,645.00 | $173.08 – $3,322.50 | 11 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,802.85 | $5,151.00 | $106.88 – $2,575.50 | 11 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,722.65 | $7,779.00 | $180.34 – $3,889.50 | 11 |
| CT neck soft tissue w/contrast CPT 70491 | $2,744.70 | $7,842.00 | $180.34 – $3,921.00 | 11 |
| CT neck soft tissue without contrast CPT 70490 | $2,223.20 | $6,352.00 | $106.88 – $3,176.00 | 11 |
| CT neck soft tissue without & w/contrast CPT 70492 | $3,293.85 | $9,411.00 | $180.34 – $4,705.50 | 11 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $2,007.25 | $5,735.00 | $180.34 – $2,867.50 | 11 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,720.60 | $4,916.00 | $180.34 – $2,458.00 | 11 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,509.20 | $4,312.00 | $106.88 – $2,156.00 | 11 |
| CT scan for therapy guide CPT 77014 | $455.18 | $1,300.50 | $70.34 – $365.00 | 5 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $7,633.85 | $21,811.00 | $265.38 – $10,905.50 | 11 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $7,068.25 | $20,195.00 | $265.38 – $10,097.50 | 11 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $5,937.40 | $16,964.00 | $189.79 – $8,482.00 | 11 |
| CT thoracic spine w/contrast CPT 72129 | $4,420.85 | $12,631.00 | $176.43 – $6,315.50 | 11 |
| CT thoracic spine without contrast CPT 72128 | $3,374.46 | $9,641.30 | $106.88 – $4,820.65 | 11 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $112.14 | $320.38 | $19.23 – $365.00 | 11 |
| CT t-spine w /wo contrast CPT 72130 | $5,196.80 | $14,848.00 | $180.34 – $7,424.00 | 11 |
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.