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 |
|---|---|---|---|---|
| Ghs abscess postoperative iandd complex CPT 10180 | $1,036.67 | $2,961.90 | $1,777.14 – $2,221.43 | 7 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $37.80 | $108.00 | $7.83 – $81.00 | 25 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $50.09 | $143.10 | $13.65 – $107.33 | 25 |
| Ghs antibodies (torch) igm CPT 86694 | $30.56 | $87.30 | $11.49 – $65.48 | 26 |
| Ghs bladder cath - complex-foley CPT 51703 | $154.04 | $440.10 | $264.06 – $330.08 | 8 |
| Ghs bleeding time (ivy) CPT 85002 | $27.41 | $78.30 | $3.85 – $58.73 | 25 |
| Ghs central line insert < age 5, failed CPT 36555 | $505.75 | $1,445.00 | $867.00 – $1,083.75 | 7 |
| Ghs change cysto/gastrost CPT 43762 | $144.59 | $413.10 | $247.80 – $309.75 | 7 |
| Ghs chemo IV push, ea addtl CPT 96411 | $94.50 | $270.00 | $86.81 – $202.50 | 12 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $166.95 | $477.00 | $286.20 – $357.75 | 8 |
| Ghs closed reduction ankle dislocation CPT 27840 | $215.46 | $615.60 | $369.36 – $461.70 | 7 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $461.16 | $1,317.60 | $790.56 – $988.20 | 7 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $126.95 | $362.70 | $217.62 – $272.03 | 7 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $472.19 | $1,349.10 | $809.46 – $1,011.83 | 7 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $950.99 | $2,717.10 | $1,630.26 – $2,037.83 | 7 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $126.95 | $362.70 | $217.62 – $272.03 | 7 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $472.19 | $1,349.10 | $809.46 – $1,011.83 | 7 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $126.95 | $362.70 | $217.62 – $272.03 | 7 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $87.57 | $250.20 | $150.12 – $187.65 | 8 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $112.77 | $322.20 | $21.43 – $241.65 | 12 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $54.50 | $155.70 | $10.36 – $116.78 | 12 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $159.08 | $454.50 | $30.23 – $340.88 | 12 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $164.43 | $469.80 | $31.25 – $352.35 | 12 |
| Ghs cricothyroidotomy CPT 31605 | $355.32 | $1,015.20 | $609.12 – $761.40 | 8 |
| Ghs cutdown placement age 1 and over CPT 36425 | $399.35 | $1,141.00 | $75.88 – $855.75 | 12 |
| Ghs cutdown placement under 1 yr CPT 36420 | $128.10 | $366.00 | $24.34 – $274.50 | 12 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $80.64 | $230.40 | $12.14 – $172.80 | 26 |
| Ghs dislocation elbow closed treatment CPT 24600 | $79.70 | $227.70 | $136.62 – $170.78 | 7 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $81.27 | $232.20 | $139.32 – $174.15 | 8 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $354.06 | $1,011.60 | $606.96 – $758.70 | 8 |
| Ghs fb removal foot - deep - left CPT 28192 | $774.59 | $2,213.10 | $1,327.86 – $1,659.83 | 7 |
| Ghs fb removal from muscle - complicated CPT 20525 | $523.85 | $1,496.70 | $898.02 – $1,122.53 | 7 |
| Ghs fb removal - incisional CPT 10121 | $756.95 | $2,162.70 | $1,297.62 – $1,622.03 | 7 |
| Ghs fb removal - non-incisional CPT 20520 | $488.25 | $1,395.00 | $837.00 – $1,046.25 | 8 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $55.13 | $157.50 | $5.57 – $118.13 | 25 |
| Ghs gastric intub aspiration lavage CPT 43753 | $90.72 | $259.20 | $17.24 – $194.40 | 12 |
| Ghs hcv amplificaiton CPT 87521 | $197.75 | $565.00 | $28.01 – $423.75 | 25 |
| Ghs histoplasma antigen CPT 87385 | $63.95 | $182.70 | $10.57 – $137.03 | 25 |
| Ghs HIV antibody CPT 86703 | $114.66 | $327.60 | $10.94 – $245.70 | 26 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | $217.98 | $622.80 | $84.70 – $467.10 | 25 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $1,283.63 | $3,667.50 | $2,200.50 – $2,750.63 | 7 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $204.75 | $585.00 | $351.00 – $438.75 | 8 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $100.49 | $287.10 | $172.26 – $215.33 | 8 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $110.25 | $315.00 | $189.00 – $236.25 | 7 |
| Ghs inf midline insertion CPT 36140 | $846.41 | $2,418.30 | $100.00 – $1,813.73 | 10 |
| Ghs inhibitor screen CPT 85335 | $158.76 | $453.60 | $10.27 – $340.20 | 25 |
| Ghs init tx 1st degree burn CPT 16000 | $73.40 | $209.70 | $13.95 – $157.28 | 12 |
| Ghs inj tendon origin/insertion CPT 20551 | $183.02 | $522.90 | $313.74 – $392.18 | 8 |
| Ghs insertion of needle - bone CPT 36680 | $112.77 | $322.20 | $21.43 – $241.65 | 12 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $332.85 | $951.00 | $570.60 – $713.25 | 7 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $8,678.25 | $24,795.00 | $10.66 – $10,413.90 | 16 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $262.40 | $749.70 | $449.82 – $562.28 | 7 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $394.45 | $1,127.00 | $37.00 – $845.25 | 7 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $394.45 | $1,127.00 | $37.00 – $845.25 | 7 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $104.27 | $297.90 | $19.82 – $223.43 | 11 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $332.85 | $951.00 | $570.60 – $713.25 | 8 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $332.85 | $951.00 | $570.60 – $713.25 | 7 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $60.48 | $172.80 | $6.86 – $129.60 | 25 |
| Ghs low level laser therapy CPT 97039 | $36.54 | $104.40 | $16.31 – $293.00 | 9 |
| Ghs mbp CPT 83873 | $68.36 | $195.30 | $13.73 – $146.48 | 25 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $214.55 | $613.00 | $15.78 – $459.75 | 8 |
| Ghs nailbed repair/nail removal CPT 11760 | $168.21 | $480.60 | $288.36 – $360.45 | 8 |
| Ghs nerve block interscaline CPT 64510 | $509.04 | $1,454.40 | $872.64 – $1,090.80 | 7 |
| Ghs ng placement w fluoro guidance CPT 43752 | $217.98 | $622.80 | $373.68 – $467.10 | 8 |
| Ghs o2 saturation CPT 82810 | $43.16 | $123.30 | $7.80 – $92.48 | 26 |
| Ghs ot dds rom CPT 95851 | $52.92 | $151.20 | $11.58 – $293.00 | 9 |
| Ghs ot prosthetic training/15 min CPT 97761 | $80.96 | $231.30 | $61.04 – $293.00 | 9 |
| Ghs ot work hardening-additional hours CPT 97546 | $74.66 | $213.30 | $68.93 – $293.00 | 11 |
| Ghs pacing - transcutaneous CPT 92953 | $175.46 | $501.30 | $33.34 – $375.98 | 11 |
| Ghs peritonsillar abscess i andd CPT 42700 | $158.45 | $452.70 | $271.62 – $339.53 | 7 |
| Ghs picc line insert < 5 CPT 36568 | $2,310.00 | $6,600.00 | $3,960.00 – $4,950.00 | 7 |
| Ghs plngl fx pm cl CPT 26725 | $87.57 | $250.20 | $150.12 – $187.65 | 8 |
| Ghs plt ct-manual CPT 85032 | $39.06 | $111.60 | $3.44 – $83.70 | 26 |
| Ghs ppd (tb intradermal) CPT 86580 | $13.23 | $37.80 | $22.31 – $37.80 | 11 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $13.55 | $38.70 | $7.70 – $29.03 | 25 |
| Ghs protoporphyrins fract CPT 84202 | $75.29 | $215.10 | $11.45 – $161.33 | 25 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $83.16 | $237.60 | $100.00 – $293.00 | 11 |
| Ghs quinidine CPT 80194 | $49.14 | $140.40 | $11.65 – $105.30 | 25 |
| Ghs removal intranasal foreign body CPT 30300 | $78.44 | $224.10 | $14.91 – $168.08 | 12 |
| Ghs removal pharyngeal foreign body CPT 42809 | $114.03 | $325.80 | $21.67 – $244.35 | 12 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $793.49 | $2,267.10 | $1,360.26 – $1,700.33 | 7 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $1,621.31 | $4,632.30 | $2,779.38 – $3,474.23 | 7 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $136.71 | $390.60 | $11.10 – $236.93 | 25 |
| Ghs sedimentation rate CPT 85651 | $71.67 | $204.75 | $3.41 – $153.57 | 26 |
| Ghs semen analysis fert CPT 89320 | $44.42 | $126.90 | $12.31 – $95.18 | 24 |
| Ghs sensitivity (per antimicro) CPT 87184 | $41.58 | $118.80 | $5.97 – $89.10 | 25 |
| Ghs somatosensory testing lower extremit CPT 95926 | $484.16 | $1,383.30 | $100.00 – $1,037.48 | 9 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $771.75 | $2,205.00 | $100.00 – $1,653.75 | 9 |
| Ghs strapping shoulder - 29240 CPT 29240 | $78.12 | $223.20 | $14.85 – $167.25 | 12 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $153.30 | $438.00 | $23.16 – $328.50 | 9 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $306.25 | $875.00 | $100.00 – $656.25 | 9 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $228.06 | $651.60 | $390.96 – $488.70 | 7 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,272.95 | $3,637.00 | $2,182.20 – $2,727.75 | 7 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $86.94 | $248.40 | $149.04 – $186.30 | 8 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $217.35 | $621.00 | $372.60 – $465.75 | 8 |
| Ghs urine, hydroxproline total CPT 83505 | $93.24 | $266.40 | $19.39 – $199.80 | 25 |
| Ghs urine, porphyrins quant CPT 84120 | $42.53 | $121.50 | $11.74 – $91.13 | 25 |
| Ghs vaginal delivery only CPT 59409 | $1,283.63 | $3,667.50 | $243.89 – $2,750.63 | 12 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,408.18 | $6,880.50 | $100.00 – $5,160.38 | 9 |
| Ghs windowing of cast CPT 29730 | $66.15 | $189.00 | $113.40 – $141.75 | 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.