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 |
|---|---|---|---|---|
| Ghs init tx 1st degree burn CPT 16000 | $150.89 | $431.10 | $25.87 – $215.55 | 7 |
| Ghs insertion of needle - bone CPT 36680 | $126.95 | $362.70 | $21.77 – $181.35 | 7 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $167.30 | $478.00 | $71.70 – $239.00 | 2 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $218.75 | $625.00 | $93.75 – $312.50 | 2 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $158.20 | $452.00 | $67.80 – $226.00 | 2 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $51.35 | $146.70 | $22.01 – $73.35 | 2 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $75.29 | $215.10 | $32.27 – $107.55 | 4 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $433.13 | $1,237.50 | $135.00 – $900.00 | 4 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $207.20 | $592.00 | $88.80 – $296.00 | 2 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $141.40 | $404.00 | $60.60 – $202.00 | 2 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $133.00 | $380.00 | $57.00 – $190.00 | 2 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $217.35 | $621.00 | $93.15 – $310.50 | 2 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $196.00 | $560.00 | $84.00 – $280.00 | 2 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $316.05 | $903.00 | $135.45 – $451.50 | 2 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $167.30 | $478.00 | $71.70 – $239.00 | 2 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $162.05 | $463.00 | $69.45 – $231.50 | 2 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $320.60 | $916.00 | $137.40 – $458.00 | 2 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $158.20 | $452.00 | $67.80 – $226.00 | 2 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $272.65 | $779.00 | $116.85 – $389.50 | 2 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | $315.70 | $902.00 | $135.30 – $451.00 | 2 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $544.25 | $1,555.00 | $233.25 – $777.50 | 2 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | $87.15 | $249.00 | $37.35 – $124.50 | 2 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $150.15 | $429.00 | $64.35 – $214.50 | 2 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $25.83 | $73.80 | $7.22 – $36.90 | 23 |
| Ghs mbp CPT 83873 | $78.08 | $223.07 | $14.45 – $111.54 | 23 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $133.70 | $382.00 | $49.74 – $191.00 | 3 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $145.60 | $416.00 | $62.10 – $207.00 | 3 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $142.45 | $407.00 | $61.05 – $203.50 | 3 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $77.00 | $220.00 | $7.65 – $25.50 | 3 |
| Ghs nailbed repair/nail removal CPT 11760 | not published | not published | $191.10 – $191.10 | 1 |
| Ghs nerve block sciatic nerve CPT 64445 | not published | not published | $61.96 – $61.96 | 1 |
| Ghs nerve block suprascapular CPT 64418 | not published | not published | $74.57 – $74.57 | 1 |
| Ghs ng placement w fluoro guidance CPT 43752 | not published | not published | $111.18 – $111.18 | 1 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $95.20 | $272.00 | $40.80 – $136.00 | 4 |
| Ghs ot dds rom CPT 95851 | $10.40 | $29.70 | $4.46 – $255.00 | 5 |
| Ghs ot prosthetic training/15 min CPT 97761 | $31.50 | $90.00 | $13.50 – $255.00 | 5 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $41.98 | $119.93 | $17.99 – $255.00 | 5 |
| Ghs ot work hardening-additional hours CPT 97546 | $21.11 | $60.30 | $9.05 – $255.00 | 5 |
| Ghs pacing - transcutaneous CPT 92953 | $393.75 | $1,125.00 | $67.50 – $562.50 | 7 |
| Ghs phenylketonurid CPT 84030 | $88.20 | $252.00 | $4.62 – $126.00 | 23 |
| Ghs ppd (tb intradermal) CPT 86580 | $25.20 | $72.00 | $3.34 – $53.46 | 7 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $21.11 | $60.30 | $8.11 – $40.68 | 23 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $21.11 | $60.30 | $9.05 – $255.00 | 5 |
| Ghs quinidine CPT 80194 | $21.42 | $61.20 | $9.18 – $61.04 | 23 |
| Ghs reticulocyte count CPT 85044 | $54.27 | $155.04 | $3.62 – $77.52 | 23 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $101.15 | $289.00 | $10.13 – $144.50 | 23 |
| Ghs sedimentation rate CPT 85651 | $34.34 | $98.10 | $3.00 – $49.05 | 23 |
| Ghs semen analysis fert CPT 89320 | $45.68 | $130.50 | $10.18 – $65.25 | 20 |
| Ghs sensitivity (per antimicro) CPT 87184 | $37.10 | $106.00 | $5.83 – $53.00 | 23 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $543.55 | $1,553.00 | $232.95 – $776.50 | 2 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $582.05 | $1,663.00 | $249.45 – $831.50 | 2 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $665.00 | $1,900.00 | $285.00 – $950.00 | 2 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $701.40 | $2,004.00 | $300.60 – $1,002.00 | 2 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $340.55 | $973.00 | $58.38 – $486.50 | 7 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $424.55 | $1,213.00 | $72.78 – $606.50 | 7 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $429.45 | $1,227.00 | $64.59 – $613.50 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $828.10 | $2,366.00 | $354.90 – $1,183.00 | 2 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $787.85 | $2,251.00 | $337.65 – $1,125.50 | 2 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $18.27 | $52.20 | $7.83 – $255.00 | 5 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $41.51 – $41.51 | 1 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $73.08 | $208.80 | $31.32 – $255.00 | 5 |
| Ghs strapping shoulder - 29240 CPT 29240 | $46.94 | $134.10 | $20.12 – $67.05 | 2 |
| Ghs st - re-eval for alt comm CPT 92597 | $112.46 | $321.30 | $48.20 – $255.00 | 5 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $95.20 | $272.00 | $31.26 – $136.00 | 4 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $393.75 | $1,125.00 | $168.75 – $562.50 | 4 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $271.95 | $777.00 | $116.55 – $388.50 | 2 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $84.28 – $84.28 | 1 |
| Ghs urine, porphyrins quant CPT 84120 | $56.88 | $162.49 | $12.36 – $81.25 | 23 |
| Ghs windowing of cast CPT 29730 | not published | not published | $27.20 – $27.20 | 1 |
| Gi inhouse confirmation CPT 87045 | $113.75 | $325.00 | $7.93 – $162.50 | 23 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $154.54 | $441.54 | $66.24 – $287.01 | 7 |
| Glucagon plasma - sendout CPT 82943 | $48.51 | $138.60 | $12.00 – $69.30 | 23 |
| Glucose 1 hr post dose CPT 82950 | $51.35 | $146.70 | $3.99 – $73.35 | 23 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $24.26 | $69.30 | $1.97 – $18.00 | 20 |
| Glucose blood quantitative CPT 82947 | $28.67 | $81.90 | $3.30 – $37.28 | 23 |
| Glucose body fluid CPT 82945 | $68.25 | $195.00 | $3.30 – $97.50 | 23 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $59.87 | $171.05 | $10.81 – $85.53 | 23 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $31.19 | $89.10 | $3.29 – $31.95 | 23 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $51.45 | $147.00 | $15.61 – $78.46 | 23 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $64.75 | $185.00 | $15.56 – $92.50 | 23 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $627.55 | $1,793.00 | $268.95 – $1,174.30 | 7 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $1,317.31 | $3,763.73 | $13.32 – $68.11 | 7 |
| Graft axiofill 1000mg HCPCS J3590 | $46.40 | $132.57 | $19.89 – $86.18 | 6 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $5,659.50 | $16,170.00 | $93.68 – $1,863.23 | 8 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $4,824.43 | $13,784.06 | $577.06 – $3,125.74 | 8 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $9,341.21 | $26,689.15 | $735.93 – $3,986.24 | 8 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $9,795.72 | $27,987.75 | $157.50 – $4,648.77 | 8 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $1,250.85 | $3,573.85 | $56.20 – $1,822.04 | 7 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $2,425.86 | $6,931.01 | $22.26 – $120.56 | 8 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $3,656.63 | $10,447.50 | $51.45 – $278.69 | 8 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $68.90 – $68.90 | 1 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $609.32 | $1,740.90 | $8.27 – $27.55 | 2 |
| Guid loc target vol rad tx CPT 77387 | $407.05 | $1,163.00 | $174.45 – $697.80 | 6 |
| Gw stiffened micro access kit HCPCS C1894 | $881.64 | $2,518.95 | $29.93 – $99.75 | 2 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $11.40 | $32.55 | $1.18 – $21.16 | 7 |
| Hand X-ray CPT 73130 | $559.30 | $1,598.00 | $31.58 – $958.80 | 11 |
| Haptoglobin quantitative CPT 83010 | $97.65 | $279.00 | $10.57 – $85.00 | 23 |
| Hbot, full body chamber, 30m HCPCS G0277 | $478.45 | $1,367.00 | $205.05 – $683.50 | 3 |
| Hcg qualitative CPT 84703 | $93.45 | $267.00 | $6.32 – $133.50 | 23 |
| Hcg quantitative CPT 84702 | $141.40 | $404.00 | $12.64 – $81.00 | 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.