St. Joseph Health Grimes Hospital
210 South Judson Street, Navasota, TX · CommonSpirit Health · · NPI 1154317774
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 |
|---|---|---|---|---|
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $4,318.13 | $24,675.00 | $7,157.73 – $21,911.40 | 17 |
| Kit hfx iq ipg bundle HCPCS C1822 | $3,572.63 | $20,415.00 | $7,402.48 – $22,660.65 | 17 |
| Kit lead specify 5-6-5 HCPCS C1778 | $12,358.15 | $70,618.00 | $56.20 – $311.91 | 19 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,332.80 | $7,616.00 | $1,523.20 – $8,453.76 | 19 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $2,446.33 | $13,979.00 | $30.28 – $15,516.69 | 19 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $5,788.48 | $33,077.00 | $3,815.60 – $19,449.42 | 19 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,554.88 | $8,885.00 | $1,545.20 – $8,575.86 | 19 |
| Kras gene addl variants CPT 81276 | $104.13 | $595.00 | $173.93 – $579.75 | 19 |
| Kras gene variants exon 2 CPT 81275 | $104.83 | $599.00 | $173.93 – $579.75 | 19 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $42.70 | $244.00 | $88.48 – $270.84 | 18 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $47.43 | $271.00 | $98.27 – $300.81 | 18 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $4.08 | $23.30 | $0.23 – $25.87 | 17 |
| Lactate dehydrogenase (ldh) CPT 83615 | $28.88 | $165.00 | $5.44 – $140.25 | 19 |
| Lactated ringers intravenous solution HCPCS J7120 | $0.35 | $1.98 | $0.58 – $2.41 | 18 |
| Lactic acid CPT 83605 | $37.10 | $212.00 | $10.41 – $180.20 | 19 |
| Lactoferrin fecal qualitative CPT 83630 | $26.43 | $151.00 | $17.73 – $128.35 | 19 |
| Lap insert tunnel ip cath CPT 49324 | $88.55 | $506.00 | $183.48 – $561.66 | 16 |
| Largsc w/removal lesion CPT 31578 | $932.05 | $5,326.00 | $1,931.21 – $5,911.86 | 16 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $146.30 | $836.00 | $303.14 – $927.96 | 16 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $869.40 | $4,968.00 | $1,801.40 – $5,514.48 | 16 |
| Laryngoscopy with biopsy CPT 31576 | $932.05 | $5,326.00 | $1,931.21 – $5,911.86 | 16 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $586.78 | $3,353.00 | $1,215.80 – $3,721.83 | 16 |
| Laser surgery of prostate CPT 52648 | $405.13 | $2,315.00 | $839.42 – $2,569.65 | 16 |
| Lateral canthopexy CPT 21282 | $85.23 | $487.00 | $176.59 – $540.57 | 16 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $10,666.78 | $60,953.00 | $1,346.80 – $7,474.74 | 19 |
| Lead capillary CPT 83655 | $30.45 | $174.00 | $10.90 – $147.90 | 19 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $13,636.18 | $77,921.00 | $147.60 – $819.18 | 19 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $24,930.50 | $142,460.00 | $2,697.40 – $14,970.57 | 19 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $385.53 | $2,203.00 | $263.00 – $2,445.33 | 19 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,041.25 | $5,950.00 | $171.20 – $950.16 | 19 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $175.18 | $1,001.00 | $200.20 – $1,111.11 | 19 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $1.94 | $11.03 | $1.20 – $4.16 | 18 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $237.14 | $1,355.07 | $60.01 – $391.83 | 18 |
| Levalbuterol non-comp unit HCPCS J7614 | $0.22 | $1.24 | $0.09 – $1.38 | 18 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $3.90 | $22.26 | $0.05 – $8.88 | 18 |
| Levetiracetam therapeutic drug level CPT 80177 | $44.10 | $252.00 | $11.93 – $214.20 | 19 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $0.96 | $5.44 | $0.58 – $1.89 | 18 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $52.78 | $301.58 | $51.27 – $334.76 | 18 |
| Liberta rc ipg HCPCS C1820 | $38,725.40 | $221,288.00 | $1,922.00 – $10,667.10 | 19 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.60 | $3.40 | $0.58 – $3.78 | 18 |
| Lidocaine therapeutic drug level CPT 80176 | $37.10 | $212.00 | $13.22 – $180.20 | 19 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $849.80 | $4,856.00 | $142.51 – $436.23 | 16 |
| Ligation of inf vena cava CPT 37619 | $851.20 | $4,864.00 | $1,763.69 – $5,399.04 | 17 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $1,502.38 | $8,585.00 | $3,112.93 – $9,529.35 | 16 |
| Lig/band angioaccess av fistula CPT 37607 | $928.20 | $5,304.00 | $375.66 – $1,149.96 | 16 |
| Lincomycin injection HCPCS J2010 | $2.63 | $15.00 | $5.44 – $16.65 | 18 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $2.41 | $13.73 | $0.02 – $0.08 | 18 |
| Lipase CPT 83690 | $54.25 | $310.00 | $6.20 – $263.50 | 19 |
| Lipoprotein direct measurement hdl CPT 83718 | $27.48 | $157.00 | $7.37 – $133.45 | 19 |
| Lipoprotein direct measurement ldl CPT 83721 | $26.78 | $153.00 | $9.45 – $130.05 | 19 |
| Lithium therapeutic drug level CPT 80178 | $34.13 | $195.00 | $5.95 – $165.75 | 19 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,612.40 | $14,928.00 | $5,412.90 – $16,570.08 | 16 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | $697.55 | $3,986.00 | $1,445.33 – $4,424.46 | 17 |
| Liver Function Test CPT 80076 | $111.13 | $635.00 | $7.35 – $539.75 | 19 |
| Liver/spleen imag static only CPT 78215 | $404.60 | $2,312.00 | $402.49 – $2,566.32 | 19 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $14.18 | $81.00 | $0.17 – $0.50 | 18 |
| Low cost skin substitute app HCPCS C5271 | $140.88 | $805.00 | $291.90 – $893.55 | 17 |
| Low cost skin substitute app HCPCS C5273 | $211.23 | $1,207.00 | $437.66 – $1,339.77 | 17 |
| Low cost skin substitute app HCPCS C5275 | $140.88 | $805.00 | $291.90 – $893.55 | 17 |
| Low cost skin substitute app HCPCS C5277 | $140.88 | $805.00 | $291.90 – $893.55 | 17 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $813.23 | $4,647.00 | $220.58 – $5,158.17 | 19 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $691.78 | $3,953.00 | $461.69 – $4,387.83 | 19 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $527.98 | $3,017.00 | $131.99 – $3,348.87 | 19 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,250.03 | $7,143.00 | $461.69 – $7,928.73 | 19 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,051.40 | $6,008.00 | $461.69 – $6,668.88 | 19 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $827.75 | $4,730.00 | $294.17 – $5,250.30 | 19 |
| L/s ratio fetal lung CPT 83661 | $81.03 | $463.00 | $19.79 – $393.55 | 19 |
| Lumbar diskogram s&i CPT 72295 | $525.88 | $3,005.00 | $207.75 – $3,335.55 | 18 |
| Lung function test (mbc/mvv) CPT 94200 | $5.78 | $33.00 | $11.97 – $77.00 | 17 |
| Lung Function Test (Spirometry) CPT 94010 | $149.63 | $855.00 | $77.00 – $949.05 | 18 |
| Lung perfusion imaging CPT 78580 | $312.73 | $1,787.00 | $476.95 – $1,983.57 | 19 |
| Lymphatics/lymph node imaging CPT 78195 | $606.73 | $3,467.00 | $635.67 – $3,848.37 | 19 |
| Lysis intranasal synechia 30560 CPT 30560 | $65.63 | $375.00 | $135.98 – $416.25 | 16 |
| Magnesium CPT 83735 | $39.73 | $227.00 | $6.03 – $192.95 | 19 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $2.77 | $15.82 | $0.01 – $0.04 | 18 |
| Makena, 10 mg HCPCS J1726 | $120.75 | $690.00 | $13.82 – $765.90 | 18 |
| Mammosite ced HCPCS C1728 | $12.08 | $69.00 | $25.02 – $76.59 | 17 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $119.00 | $680.00 | $200.00 – $754.80 | 18 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $75.78 | $433.00 | $157.01 – $670.00 | 18 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $0.74 | $4.19 | $1.52 – $4.66 | 18 |
| Map tachycard site(s) CPT 93609 | $847.35 | $4,842.00 | $580.92 – $5,374.62 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,433.25 | $8,190.00 | $21.20 – $117.66 | 19 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $1,063.30 | $6,076.00 | $1,215.20 – $6,744.36 | 18 |
| Mastoids complete CPT 70130 | $34.13 | $195.00 | $70.71 – $216.45 | 19 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $4,447.10 | $25,412.00 | $20.56 – $691.53 | 19 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $66.50 | $380.00 | $13.01 – $323.00 | 19 |
| Mayo aathr protein s free CPT 85306 | $47.43 | $271.00 | $13.79 – $230.35 | 19 |
| Mayo activated protein c resistance assay CPT 85307 | $107.28 | $613.00 | $13.79 – $521.05 | 19 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $60.20 | $344.00 | $15.36 – $381.84 | 19 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $10.68 | $61.00 | $22.12 – $67.71 | 19 |
| Mayo alpha 1 antitrypsin CPT 82103 | $44.45 | $254.00 | $12.10 – $215.90 | 19 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $29.05 | $166.00 | $13.57 – $141.10 | 19 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $3.68 | $21.00 | $7.62 – $23.31 | 19 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $135.10 | $772.00 | $82.49 – $656.20 | 19 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $51.98 | $297.00 | $13.14 – $252.45 | 19 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $28.70 | $164.00 | $13.55 – $139.40 | 19 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $26.25 | $150.00 | $9.16 – $127.50 | 19 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $26.60 | $152.00 | $11.61 – $129.20 | 19 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $3.68 | $21.00 | $7.62 – $23.31 | 19 |
| Mayo brcmg brucella antibody igm CPT 86622 | $23.63 | $135.00 | $8.04 – $114.75 | 19 |
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.