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 |
|---|---|---|---|---|
| Immob elbow child sm HCPCS L3762 | $48.51 | $138.60 | $29.11 – $103.95 | 11 |
| Immune complex assay CPT 86332 | $81.59 | $233.10 | $19.45 – $174.83 | 25 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $101.15 | $289.00 | $32.00 – $216.75 | 9 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $101.85 | $291.00 | $16.61 – $218.25 | 25 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $90.04 | $257.25 | $16.61 – $192.94 | 25 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $49.77 | $142.20 | $9.56 – $106.65 | 25 |
| Immunodiffusion nes CPT 86329 | $63.00 | $180.00 | $11.21 – $135.00 | 25 |
| Immunofixation electrophoresis serum CPT 86334 | $93.79 | $267.95 | $17.83 – $186.30 | 25 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $120.65 | $344.70 | $203.38 – $344.70 | 11 |
| Immunoglobulin assay CPT 86023 | $49.77 | $142.20 | $9.95 – $106.65 | 25 |
| Immunology procedure CPT 86849 | $27.09 | $77.40 | $38.70 – $58.05 | 8 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $5,895.81 | $16,845.15 | $165.60 – $591.42 | 14 |
| Implant ureth bulk agent HCPCS L8606 | $565.95 | $1,617.00 | $339.57 – $1,212.75 | 14 |
| In-111 autol wbc diag per dose HCPCS A9570 | $3,927.05 | $11,220.14 | $100.00 – $8,415.11 | 9 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $1,541.61 | $4,404.60 | $100.00 – $3,303.45 | 9 |
| In-111 pentetreotide HCPCS A9572 | $5,771.75 | $16,490.70 | $100.00 – $12,368.03 | 9 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $927.36 | $2,649.60 | $1,589.76 – $1,987.20 | 8 |
| Incision of burn scab initi CPT 16035 | $97.34 | $278.10 | $166.86 – $208.58 | 8 |
| Incisn of toe tndn CPT 28010 | $749.39 | $2,141.10 | $1,284.66 – $1,605.83 | 8 |
| Incisn windpipe CPT 31600 | $2,687.30 | $7,678.00 | $4,606.80 – $5,758.50 | 8 |
| Infect ag drug suscept pheno predict CPT 87900 | $223.97 | $639.90 | $104.02 – $479.93 | 26 |
| Infect ag eia influenza a or b ea CPT 87400 | $128.10 | $366.00 | $11.28 – $252.00 | 26 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $167.90 | $479.70 | $205.45 – $479.70 | 26 |
| Infect ag ia optc obs influenza CPT 87804 | $40.95 | $117.00 | $13.21 – $87.75 | 26 |
| Infect ag if hep delta agent CPT 87380 | $83.79 | $239.40 | $14.65 – $179.55 | 25 |
| Infect ag if influenza b CPT 87275 | $33.71 | $96.30 | $9.78 – $72.23 | 26 |
| Infect ag if legionella pneumophila CPT 87278 | $44.42 | $126.90 | $12.44 – $95.18 | 25 |
| Infect ag if nos ea CPT 87299 | $90.41 | $258.30 | $12.84 – $193.73 | 25 |
| Infect ag if pneumocystis carinii CPT 87281 | $78.25 | $223.56 | $9.56 – $167.67 | 25 |
| Infect ag if varicella zoster CPT 87290 | $34.97 | $99.90 | $10.71 – $74.93 | 25 |
| Infect ag na hep b amp CPT 87516 | $73.08 | $208.80 | $28.01 – $156.60 | 25 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $104.90 | $299.70 | $76.45 – $224.78 | 25 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $268.38 | $766.80 | $332.60 – $771.83 | 25 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $125.69 | $359.10 | $33.02 – $269.33 | 26 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $51.45 | $147.00 | $9.56 – $110.25 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $33.71 | $96.30 | $10.71 – $72.23 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $30.62 | $87.48 | $11.03 – $51.30 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $34.34 | $98.10 | $11.48 – $73.58 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $101.80 | $290.85 | $8.25 – $218.14 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $48.65 | $139.00 | $9.56 – $103.50 | 26 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $61.43 | $175.50 | $9.56 – $131.63 | 25 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $45.36 | $129.60 | $9.56 – $97.20 | 25 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $117.94 | $336.95 | $28.01 – $219.38 | 25 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $146.27 | $417.90 | $28.01 – $229.50 | 25 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $64.84 | $185.23 | $29.74 – $138.93 | 25 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $133.00 | $380.00 | $28.01 – $285.00 | 25 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $75.60 | $216.00 | $28.01 – $162.00 | 25 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $61.74 | $176.40 | $33.26 – $132.30 | 25 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $148.11 | $423.15 | $28.01 – $317.37 | 25 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $82.85 | $236.70 | $40.95 – $177.53 | 25 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $203.81 | $582.30 | $34.19 – $410.40 | 25 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $313.74 | $896.40 | $34.19 – $596.03 | 25 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $163.49 | $467.10 | $67.91 – $350.33 | 25 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,476.30 | $4,218.00 | $100.00 – $3,163.50 | 9 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $54.18 | $154.80 | $10.30 – $116.10 | 9 |
| Inj dx for sinogram CPT 20501 | $238.77 | $682.20 | $45.37 – $511.65 | 10 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $65.52 | $187.20 | $12.45 – $140.40 | 10 |
| Injection during cath supravalvular aortography CPT 93567 | $961.07 | $2,745.90 | $100.00 – $2,059.43 | 8 |
| Injection epidural blood patch or clot CPT 62273 | $835.07 | $2,385.90 | $1,431.54 – $1,789.43 | 7 |
| Injection for arthrography wrist (both sides) CPT 25246 | $151.52 | $432.90 | $28.79 – $324.68 | 10 |
| Injection for bladder x-ray CPT 51600 | $263.97 | $754.20 | $100.00 – $565.65 | 8 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $288.12 | $823.20 | $54.75 – $617.40 | 10 |
| Injection for ureter x-ray CPT 50684 | $39.38 | $112.50 | $7.49 – $84.38 | 10 |
| Injection for ureter x-ray CPT 50690 | $54.50 | $155.70 | $93.42 – $116.78 | 8 |
| Injection of sinus tract CPT 20500 | $330.75 | $945.00 | $567.00 – $708.75 | 8 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $2,000.57 | $5,715.90 | $380.11 – $4,286.93 | 9 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $205.38 | $586.80 | $352.08 – $440.10 | 8 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $624.33 | $1,783.80 | $1,070.28 – $1,337.85 | 7 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,127.30 | $6,078.00 | $3,646.62 – $4,558.28 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $168.84 | $482.40 | $289.44 – $361.80 | 8 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $375.20 | $1,072.00 | $643.14 – $803.93 | 8 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $306.25 | $875.00 | $24.73 – $656.25 | 9 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $129.50 | $370.00 | $34.73 – $277.50 | 9 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $306.25 | $875.00 | $57.87 – $656.25 | 9 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $306.25 | $875.00 | $88.29 – $656.25 | 9 |
| Inject sacroiliac joint CPT 27096 | $1,619.73 | $4,627.80 | $2,776.68 – $3,470.85 | 8 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,234.17 | $3,526.20 | $2,115.72 – $2,644.65 | 7 |
| Inj for ext venography CPT 36005 | $374.54 | $1,070.10 | $71.17 – $802.58 | 10 |
| Inj for mammo ductogram CPT 19030 | $87.89 | $251.10 | $100.00 – $188.33 | 8 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $761.36 | $2,175.30 | $100.00 – $1,631.48 | 8 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $637.70 | $1,822.00 | $121.17 – $1,366.50 | 9 |
| Inj proc ankle arthr CPT 27648 | $88.52 | $252.90 | $16.82 – $189.68 | 10 |
| Inj proc elbow arthro CPT 24220 | $154.00 | $440.00 | $29.26 – $330.00 | 10 |
| Inj proc myelogram lumbar CPT 62284 | $924.53 | $2,641.50 | $100.00 – $1,981.13 | 8 |
| Inj retro urethrocysto CPT 51610 | $104.58 | $298.80 | $19.88 – $224.10 | 10 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | $569.63 | $1,627.50 | $12.67 – $1,220.63 | 14 |
| Inj w/fluor eval cv device CPT 36598 | $141.75 | $405.00 | $243.00 – $303.75 | 8 |
| Ins cath ren art 1st bi CPT 36252 | $4,331.25 | $12,375.00 | $822.94 – $9,281.25 | 10 |
| Ins cath ren art 1st uni CPT 36251 | $3,810.87 | $10,888.20 | $6,532.92 – $8,166.15 | 8 |
| Ins cath ren art 2nd+ bi CPT 36254 | $4,305.00 | $12,300.00 | $817.95 – $9,225.00 | 10 |
| Ins cath ren art 2nd+ uni CPT 36253 | $3,793.65 | $10,839.00 | $6,503.40 – $8,129.25 | 8 |
| Insert cath pleura with image CPT 32557 | $1,604.05 | $4,583.00 | $2,749.80 – $3,437.25 | 8 |
| Insert cath pleura without image CPT 32556 | $1,716.40 | $4,904.00 | $2,942.40 – $3,678.00 | 8 |
| Insertion catheter bladder non indwelling CPT 51701 | $65.21 | $186.30 | $12.39 – $139.50 | 12 |
| Insertion catheter bladder temporary simple CPT 51702 | $126.35 | $361.00 | $24.01 – $270.75 | 12 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $1,062.81 | $3,036.60 | $1,821.96 – $2,277.45 | 8 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $1,317.40 | $3,764.00 | $250.31 – $2,823.00 | 12 |
| Insertion intra-aortic circulation dev 33970 CPT 33970 | $826.88 | $2,362.50 | $157.11 – $1,771.88 | 10 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $4,283.41 | $12,238.30 | $813.85 – $9,178.73 | 10 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $829.15 | $2,369.00 | $1,421.40 – $1,776.75 | 7 |
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.