St. Luke's Health Memorial Livingston
1717 Highway 59 Bypass, Livingston, TX · CommonSpirit Health · · NPI 1689650616
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 |
|---|---|---|---|---|
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $154.83 | $1,032.15 | $154.83 – $928.94 | 10 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $154.83 | $1,032.15 | $154.83 – $928.94 | 10 |
| Orthopantogram CPT 70355 | $44.55 | $297.00 | $35.70 – $267.30 | 15 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $204.91 | $1,366.05 | $204.91 – $1,229.45 | 10 |
| Oscillation chest wall mechanical per session CPT 94669 | $103.28 | $688.50 | $100.00 – $619.65 | 8 |
| Osmolality blood CPT 83930 | $49.69 | $331.25 | $5.55 – $28.43 | 22 |
| Osmolality urine CPT 83935 | $53.63 | $357.50 | $5.73 – $29.90 | 22 |
| Ot evaluation high complexity patient/family CPT 97167 | $164.25 | $1,095.00 | $100.00 – $985.50 | 8 |
| Ot evaluation low complexity patient/family CPT 97165 | $98.55 | $657.00 | $100.00 – $591.30 | 8 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $131.40 | $876.00 | $100.00 – $788.40 | 8 |
| Other immunoelectrophoresis CPT 86325 | $42.75 | $285.00 | $19.43 – $256.50 | 22 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $24.60 | $164.00 | $36.08 – $147.60 | 8 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $41.25 | $275.00 | $60.50 – $247.50 | 8 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $54.15 | $361.00 | $60.93 – $324.90 | 8 |
| Ot re-evaluation patient/family CPT 97168 | $98.55 | $657.00 | $100.00 – $591.30 | 8 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $56.25 | $375.00 | $82.50 – $337.50 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $25.95 | $173.00 | $38.06 – $155.70 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $27.30 | $182.00 | $39.88 – $163.13 | 8 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $42.90 | $286.00 | $62.92 – $257.40 | 8 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $36.15 | $241.00 | $52.97 – $216.69 | 8 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $41.85 | $279.00 | $61.38 – $251.10 | 8 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $780.84 | $5,205.60 | $0.98 – $35.06 | 10 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $460.76 | $3,071.73 | $0.08 – $67.31 | 10 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $62.73 | $418.19 | $1.16 – $35.06 | 10 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $37,800.00 | $252,000.00 | $37,800.00 – $226,800.00 | 10 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $105.64 | $704.23 | $0.14 – $35.06 | 10 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $4,782.25 | $31,881.61 | $18.81 – $28,693.45 | 10 |
| Palonosetron hcl HCPCS J2469 | $138.82 | $925.44 | $0.83 – $35.06 | 8 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $9.38 | $62.47 | $5.46 – $35.06 | 10 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $435.42 | $2,902.80 | $5.46 – $35.06 | 9 |
| Papaverin hcl injection HCPCS J2440 | $718.55 | $4,790.31 | $14.85 – $60.74 | 8 |
| Parathormone (pth) intact CPT 83970 | $99.15 | $660.96 | $12.76 – $178.00 | 22 |
| Parathyroid planar imaging CPT 78070 | $528.19 | $3,521.25 | $489.74 – $2,535.30 | 15 |
| Parathyroid planar img w/tomo spect CPT 78071 | $422.55 | $2,817.00 | $489.74 – $2,535.30 | 15 |
| Paricalcitol HCPCS J2501 | $867.60 | $5,784.00 | $0.86 – $35.06 | 10 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $113.70 | $758.00 | $113.70 – $682.20 | 8 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $1,804.54 | $12,030.25 | $2.89 – $720.96 | 10 |
| Passy muir valve metal trach HCPCS L8501 | $451.71 | $3,011.40 | $451.71 – $2,710.26 | 10 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $12.13 | $80.85 | $12.13 – $72.77 | 10 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $36,040.45 | $240,269.61 | $33,637.75 – $216,242.65 | 9 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $22,702.20 | $151,348.00 | $136.14 – $136,213.20 | 10 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $24,148.20 | $160,988.00 | $202.17 – $144,889.20 | 10 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $24,872.65 | $165,817.64 | $23,214.47 – $149,235.88 | 9 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $24,148.20 | $160,988.00 | $191.10 – $144,889.20 | 8 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $14,460.00 | $96,400.00 | $13,496.00 – $86,760.00 | 9 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,636.50 | $10,910.00 | $209.55 – $9,819.00 | 15 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,482.30 | $9,882.00 | $209.55 – $8,893.80 | 15 |
| Pelvic CT scan (without contrast) CPT 72192 | $856.80 | $5,712.00 | $128.89 – $5,140.80 | 15 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,584.45 | $10,563.00 | $439.13 – $9,506.16 | 15 |
| Pelvic MRI (with contrast) CPT 72196 | $1,267.50 | $8,450.00 | $439.13 – $7,605.00 | 15 |
| Pelvic MRI (without contrast) CPT 72195 | $1,077.45 | $7,183.00 | $268.00 – $6,464.70 | 15 |
| Pelvic Ultrasound (complete) CPT 76856 | $605.55 | $4,037.00 | $137.30 – $3,633.30 | 15 |
| Pelvic Ultrasound (limited) CPT 76857 | $282.45 | $1,883.00 | $108.99 – $1,694.70 | 15 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $20,467.46 | $136,449.67 | $82.09 – $23,846.43 | 10 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $11,973.75 | $79,824.99 | $5.89 – $14,733.94 | 10 |
| Peng benzathine/procaine inj HCPCS J0558 | $363.50 | $2,423.31 | $5.46 – $35.06 | 10 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $437.38 | $2,915.82 | $26.96 – $1,891.37 | 10 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $121.99 | $813.24 | $1.14 – $35.06 | 10 |
| Penicillin g procaine inj HCPCS J2510 | $160.16 | $1,067.73 | $5.46 – $38.95 | 10 |
| Penile injection CPT 54235 | $79.88 | $532.53 | $95.86 – $479.28 | 7 |
| Perc d-e cor revasc chro add HCPCS C9608 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc d-e cor stent ather br HCPCS C9603 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc d-e cor stent ather s HCPCS C9602 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc drug-el cor stent bran HCPCS C9601 | $7,561.20 | $50,408.00 | $100.00 – $45,367.20 | 9 |
| Perc drug-el cor stent sing HCPCS C9600 | $7,561.13 | $50,407.50 | $100.00 – $45,366.75 | 9 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $412.98 | $2,753.19 | $26.20 – $187.11 | 10 |
| Pericardiocentesis wwo imaging CPT 33016 | $220.50 | $1,470.00 | $323.40 – $1,323.00 | 6 |
| Peripheral vascular rehab CPT 93668 | $28.16 | $187.68 | $38.56 – $168.92 | 8 |
| Peri-proc device eval icd CPT 93287 | $344.10 | $2,294.00 | $43.19 – $2,064.60 | 10 |
| Perit-vens shunt pat tst CPT 78291 | $199.95 | $1,333.00 | $293.26 – $1,199.70 | 15 |
| Perphenazine 4mg oral HCPCS Q0175 | $0.73 | $4.85 | $0.16 – $2.07 | 19 |
| Perq clsr tcat l atr apndge CPT 33340 | $7,454.44 | $49,696.25 | $7,454.44 – $44,726.63 | 8 |
| Perq dev breast 1st mr guide CPT 19287 | $393.90 | $2,626.00 | $393.90 – $2,363.40 | 8 |
| Perq dev breast 1st strtctc CPT 19283 | $725.55 | $4,837.00 | $725.52 – $4,353.11 | 8 |
| Perq plmt bile duct stent CPT 47538 | $2,324.10 | $15,494.00 | $3,408.68 – $13,944.60 | 6 |
| Perq plmt bile duct stent CPT 47539 | $2,324.10 | $15,494.00 | $3,408.68 – $13,944.60 | 6 |
| Perq plmt bile duct stent CPT 47540 | $2,324.10 | $15,494.00 | $3,408.68 – $13,944.60 | 6 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | $531.60 | $3,544.00 | $100.00 – $3,189.60 | 9 |
| Pertussis ag if CPT 87265 | $61.80 | $412.00 | $10.06 – $370.80 | 22 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $1,370.85 | $9,138.97 | $22.73 – $8,225.08 | 10 |
| Pet CT skull-mid thgh initial CPT 78815 | $1,764.15 | $11,761.00 | $1,581.95 – $10,584.90 | 15 |
| Pet CT whole body initial CPT 78816 | $1,817.10 | $12,114.00 | $1,581.95 – $10,902.60 | 15 |
| Pet fdg brain metoblic eval sb CPT 78608 | $1,109.70 | $7,398.00 | $1,581.95 – $6,658.20 | 15 |
| Pet image w/ct lmtd CPT 78814 | $1,023.30 | $6,822.00 | $1,500.84 – $6,139.80 | 15 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $23,112.97 | $154,086.45 | $39.45 – $236.70 | 10 |
| Ph body fluid CPT 83986 | $26.07 | $173.75 | $3.01 – $125.10 | 22 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $75.73 | $504.83 | $5.46 – $38.95 | 10 |
| Phenobarbital therapeutic drug level CPT 80184 | $63.90 | $426.00 | $12.76 – $65.81 | 22 |
| Phentolaine mesylate inj HCPCS J2760 | $1,474.92 | $9,832.80 | $414.85 – $8,849.52 | 10 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $520.56 | $3,470.40 | $5.46 – $35.06 | 9 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $58.13 | $387.53 | $0.50 – $35.06 | 10 |
| Phenytoin total therapeutic drug level CPT 80185 | $62.58 | $417.18 | $10.12 – $56.83 | 22 |
| Phlebotomy therapeutic CPT 99195 | $60.00 | $400.00 | $36.96 – $151.20 | 7 |
| Phosphorus CPT 84100 | $33.51 | $223.38 | $3.74 – $20.96 | 22 |
| Phosphorus 24 hour urine CPT 84105 | $26.93 | $179.52 | $4.86 – $140.44 | 22 |
| Phys blood bank serv authrj CPT 86079 | $23.40 | $156.00 | $34.32 – $140.40 | 8 |
| Phys blood bank serv reactj CPT 86078 | $22.80 | $152.00 | $33.44 – $152.00 | 8 |
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.