St. Luke's Health - Patients Medical Center
4600 E. Sam Houston Parkway South, Pasadena, TX · CommonSpirit Health · · NPI 1407990088
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $74.97 | $214.20 | $23.37 – $160.65 | 25 |
| 17-hydroxypregnenolone CPT 84143 | $39.06 | $111.60 | $18.20 – $83.70 | 25 |
| 17-ketosteroids CPT 83586 | $14.49 | $41.40 | $10.21 – $31.05 | 25 |
| 2019-ncov diagnostic p HCPCS U0001 | $85.40 | $244.00 | $28.66 – $183.00 | 24 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $2,735.25 | $7,815.00 | $100.00 – $5,861.25 | 10 |
| 2nd order venous cath CPT 36012 | $2,674.00 | $7,640.00 | $100.00 – $3,819.75 | 10 |
| 3d recon without postprocess indpndt CPT 76376 | $501.17 | $1,431.90 | $18.80 – $1,315.00 | 12 |
| 5' nucleotidase - sendout CPT 83915 | $51.03 | $145.80 | $8.90 – $109.35 | 25 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $82.85 | $236.70 | $24.30 – $177.53 | 11 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $54.18 | $154.80 | $9.59 – $116.10 | 26 |
| Abd aorta w/runoff s&i CPT 75630 | $3,921.05 | $11,203.00 | $149.19 – $8,402.25 | 14 |
| Abd/low ext cath 1st CPT 36245 | $1,154.79 | $3,299.40 | $100.00 – $2,474.25 | 10 |
| Abd/low ext cath 2nd CPT 36246 | $1,755.25 | $5,015.00 | $100.00 – $3,761.25 | 10 |
| Abd/low ext cath 3rd CPT 36247 | $2,089.40 | $5,969.70 | $100.00 – $4,477.28 | 10 |
| Abd/low ext cath addl CPT 36248 | $1,233.05 | $3,523.00 | $100.00 – $2,642.25 | 10 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $4,556.65 | $13,019.00 | $166.31 – $9,764.25 | 16 |
| Abdominal CT scan (with contrast) CPT 74160 | $4,032.44 | $11,521.24 | $166.31 – $8,640.75 | 16 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,339.05 | $6,683.00 | $99.51 – $5,012.25 | 16 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,936.05 | $14,103.00 | $331.07 – $10,576.88 | 16 |
| Abdominal MRI (with contrast) CPT 74182 | $4,442.55 | $12,693.00 | $296.16 – $9,519.75 | 16 |
| Abdominal MRI (without contrast) CPT 74181 | $2,863.00 | $8,180.00 | $191.72 – $6,135.00 | 16 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,239.30 | $6,398.00 | $3,838.80 – $4,798.50 | 8 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,569.78 | $4,485.07 | $99.51 – $3,363.75 | 15 |
| Abdominal Ultrasound (limited) CPT 76705 | $926.45 | $2,647.00 | $82.85 – $1,985.25 | 15 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $604.80 | $1,728.00 | $1,036.80 – $1,296.00 | 8 |
| Ablate bone tumor(s) perq CPT 20982 | $6,333.60 | $18,096.00 | $10,857.60 – $13,572.00 | 8 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $5,296.10 | $15,131.70 | $100.00 – $11,348.78 | 10 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,583.05 | $4,523.00 | $2,713.50 – $3,391.88 | 8 |
| Acetone qualitative CPT 82009 | $18.90 | $54.00 | $3.61 – $40.50 | 25 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $17.96 | $51.30 | $16.77 – $72.00 | 22 |
| Acute hepatitis panel CPT 80074 | $368.55 | $1,053.00 | $38.01 – $789.75 | 25 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $8.82 | $25.20 | $0.07 – $18.90 | 9 |
| Adapter b 8 channel 10cm HCPCS C1883 | $7,248.94 | $20,711.25 | $714.87 – $2,553.08 | 14 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $413.70 | $1,182.00 | $0.46 – $885.75 | 9 |
| Adenovirus antibody,serum - quest CPT 86603 | $19.85 | $56.70 | $10.27 – $42.53 | 26 |
| Adh-sendout CPT 84588 | $56.39 | $161.10 | $27.08 – $120.83 | 25 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $432.55 | $1,235.85 | $0.15 – $420.00 | 11 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $94.50 | $270.00 | $45.25 – $202.50 | 12 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $282.80 | $808.00 | $90.00 – $606.00 | 12 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $282.80 | $808.00 | $90.00 – $606.00 | 12 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $121.28 | $346.50 | $88.29 – $259.88 | 12 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $151.83 | $433.80 | $88.29 – $325.35 | 12 |
| Administration immunization 1 vaccine CPT 90471 | $75.25 | $215.00 | $37.00 – $161.25 | 9 |
| Administration vaccine hepatitis b HCPCS G0010 | $75.25 | $215.00 | $37.00 – $96.75 | 9 |
| Administration vaccine influenza virus HCPCS G0008 | $75.25 | $215.00 | $34.73 – $161.25 | 9 |
| Administration vaccine pneumococcal HCPCS G0009 | $45.15 | $129.00 | $37.00 – $96.75 | 9 |
| _afb id by dna probe rflx ast CPT 87149 | $43.47 | $124.20 | $16.00 – $93.15 | 25 |
| #afb mycobacteria suscep. #1 CPT 87190 | $26.78 | $76.50 | $5.83 – $57.38 | 25 |
| Albumin body fluid quantitative each specimen CPT 82042 | $58.59 | $167.40 | $6.21 – $125.55 | 25 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $275.26 | $786.45 | $67.81 – $288.23 | 14 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $32.13 | $91.80 | $4.62 – $68.85 | 25 |
| Albumin serum plasma or whole blood CPT 82040 | $77.00 | $220.00 | $3.95 – $165.00 | 25 |
| Alkaline phosphatase CPT 84075 | $24.26 | $69.30 | $4.13 – $51.98 | 25 |
| Allergen egg white ige CPT 86003 | $59.85 | $171.00 | $4.16 – $122.85 | 25 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $10,136.39 | $28,961.10 | $123.81 – $598.50 | 14 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $6,748.04 | $19,280.10 | $179.05 – $639.45 | 14 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $7,899.05 | $22,568.70 | $4,739.43 – $16,926.53 | 14 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $3,937.50 | $11,250.00 | $22.72 – $81.12 | 14 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $3,202.40 | $9,149.70 | $219.92 – $749.70 | 14 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $5,419.16 | $15,483.30 | $91.02 – $310.28 | 14 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $11,572.58 | $33,064.50 | $163.40 – $583.54 | 14 |
| Alpha-fetoprotein tumor marker CPT 82105 | $127.05 | $363.00 | $13.39 – $272.25 | 25 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $205.10 | $586.00 | $41.04 – $426.04 | 14 |
| Alt/sgpt CPT 84460 | $26.46 | $75.60 | $4.23 – $56.70 | 25 |
| Aluminum - quest CPT 82108 | $24.89 | $71.10 | $20.33 – $53.33 | 25 |
| Amino acid screen, urine CPT 82128 | $141.44 | $404.10 | $11.07 – $303.08 | 25 |
| Aminolevulinic acid delta CPT 82135 | $30.24 | $86.40 | $13.13 – $64.80 | 25 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $2.21 | $6.30 | $0.22 – $4.50 | 9 |
| Amitriptyline (elavil) -sendout CPT 80335 | $51.35 | $146.70 | $3.99 – $110.03 | 12 |
| Ammonia CPT 82140 | $122.50 | $350.00 | $11.63 – $262.50 | 25 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $24.85 | $71.00 | $2.34 – $53.25 | 9 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $778.37 | $2,223.90 | $1,334.34 – $1,667.93 | 7 |
| Amylase CPT 82150 | $195.30 | $558.00 | $5.17 – $268.50 | 25 |
| Anal/urinary muscle study CPT 51785 | $164.75 | $470.70 | $282.42 – $353.03 | 7 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | $319.41 | $912.60 | $79.98 – $684.45 | 9 |
| Analysis gene f2 20210g>a variant CPT 81240 | $301.77 | $862.20 | $52.42 – $646.65 | 26 |
| Analysis gene f5 leiden variant CPT 81241 | $275.63 | $787.50 | $58.55 – $590.63 | 26 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $199.08 | $568.80 | $59.98 – $579.00 | 9 |
| Anca screen with reflex to titer -quest CPT 86021 | $109.20 | $312.00 | $12.01 – $233.70 | 25 |
| An cholangiogram percutaneous compl CPT 47531 | $2,785.65 | $7,959.00 | $529.26 – $5,969.03 | 9 |
| An fluoro guide for cvp CPT 77001 | $2,285.33 | $6,529.49 | $100.00 – $4,896.75 | 11 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $7,225.16 | $20,643.30 | $12,385.98 – $15,482.48 | 8 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $6,568.07 | $18,765.90 | $11,259.54 – $14,074.43 | 8 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $2,534.00 | $7,240.00 | $100.00 – $5,430.00 | 10 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $6,847.79 | $19,565.10 | $11,739.06 – $14,673.83 | 8 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $3,318.84 | $9,482.40 | $5,689.44 – $7,111.80 | 7 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $2,700.18 | $7,714.80 | $100.00 – $5,786.10 | 9 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $3,195.68 | $9,130.50 | $5,478.30 – $6,847.88 | 7 |
| Ankle arthroscopy/surgery CPT 29891 | $1,484.28 | $4,240.80 | $2,544.48 – $3,180.60 | 7 |
| Ankle X-ray CPT 73610 | $614.95 | $1,757.00 | $34.91 – $1,317.75 | 15 |
| Anodyne therapy charges pt CPT 97026 | $29.93 | $85.50 | $9.48 – $317.00 | 9 |
| Anora (draw only) CPT 99001 | $21.17 | $60.48 | $8.95 – $37.80 | 9 |
| Anoscopy remove fb 46608 CPT 46608 | $647.01 | $1,848.60 | $1,109.16 – $1,386.45 | 7 |
| Antibody CPT 86744 | $27.41 | $78.30 | $12.76 – $58.73 | 25 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $34.65 | $99.00 | $10.28 – $74.25 | 26 |
| Antibody elution rbc reference CPT 86860 | $77.81 | $222.30 | $76.00 – $222.30 | 10 |
| Antibody htlv/hiv confirm test CPT 86689 | $55.76 | $159.30 | $15.44 – $119.48 | 26 |
| Antibody htlv-i CPT 86687 | $52.92 | $151.20 | $7.26 – $113.40 | 26 |
| Antibody htlv-ii CPT 86688 | $29.30 | $83.70 | $11.17 – $62.78 | 26 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $225.75 | $645.00 | $14.66 – $311.18 | 25 |
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.