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 |
|---|---|---|---|---|
| Mayo muramidase CPT 85549 | $61.43 | $175.50 | $14.96 – $131.63 | 25 |
| Mayo myoglobin CPT 83874 | $55.13 | $157.50 | $10.31 – $106.65 | 25 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $46.55 | $133.00 | $16.93 – $99.75 | 25 |
| Mayo organic acids qualitative each specimen CPT 83919 | $98.28 | $280.80 | $13.13 – $210.60 | 25 |
| Mayo oxalate 24 hour urine CPT 83945 | $31.19 | $89.10 | $11.53 – $66.83 | 25 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $36.86 | $105.30 | $12.00 – $78.98 | 25 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $140.00 | $400.00 | $9.61 – $300.00 | 25 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $61.04 | $174.40 | $28.01 – $122.85 | 25 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $41.90 | $119.70 | $14.34 – $89.78 | 26 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $35.28 | $100.80 | $10.98 – $75.60 | 25 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $30.87 | $88.20 | $6.74 – $66.15 | 25 |
| Mayo pregnenolone CPT 84140 | $64.89 | $185.40 | $16.49 – $139.05 | 25 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $36.86 | $105.30 | $13.24 – $78.98 | 25 |
| Mayo proinsulin CPT 84206 | $134.82 | $385.20 | $21.30 – $288.90 | 25 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $117.25 | $335.00 | $14.69 – $251.25 | 25 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $87.26 | $249.30 | $10.66 – $186.98 | 25 |
| Mayo receptor assay transferrin soluble CPT 84238 | $55.76 | $159.30 | $29.18 – $119.48 | 25 |
| Mayo renin CPT 84244 | $51.03 | $145.80 | $17.55 – $102.60 | 25 |
| Mayo repu protein electrophoresis urine CPT 84166 | $92.25 | $263.55 | $14.23 – $180.23 | 25 |
| Mayo selenium CPT 84255 | $66.78 | $190.80 | $20.38 – $143.10 | 25 |
| Mayo serotonin CPT 84260 | $58.91 | $168.30 | $24.72 – $118.80 | 25 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $41.58 | $118.80 | $15.44 – $89.10 | 25 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $87.26 | $249.30 | $10.95 – $186.98 | 25 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $113.05 | $323.00 | $3.41 – $153.00 | 26 |
| Mayo tgrp testosterone free CPT 84402 | $89.85 | $256.71 | $20.32 – $192.54 | 25 |
| Mayo tgrp testosterone total CPT 84403 | $96.08 | $274.50 | $20.60 – $205.88 | 25 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $86.94 | $248.40 | $8.12 – $186.30 | 26 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $68.99 | $197.10 | $9.89 – $139.05 | 25 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $59.85 | $171.00 | $11.30 – $128.25 | 26 |
| Mayo vasoactive intestinal peptide CPT 84586 | $43.16 | $123.30 | $28.20 – $92.48 | 25 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $67.10 | $191.70 | $16.15 – $143.78 | 25 |
| Mayo vitamin b3 (niacin) CPT 84591 | $74.66 | $213.30 | $13.61 – $159.98 | 25 |
| Mayo vitamin k CPT 84597 | $141.75 | $405.00 | $10.94 – $303.75 | 25 |
| Measurement post void urine by ultrasound CPT 51798 | $75.60 | $216.00 | $127.44 – $162.00 | 9 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $4.05 | $11.55 | $1.98 – $11.55 | 11 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $89.25 | $255.00 | $0.56 – $191.25 | 9 |
| Metabolic Blood Panel (Basic) CPT 80048 | $359.45 | $1,027.00 | $6.75 – $408.75 | 25 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $469.70 | $1,342.00 | $8.43 – $614.25 | 25 |
| Metabolic panel ionized ca CPT 80047 | $63.32 | $180.90 | $10.95 – $135.68 | 25 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $98.00 | $280.00 | $9.38 – $210.00 | 9 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $9.93 | $28.35 | $0.26 – $21.27 | 14 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $12.13 | $34.65 | $14.89 – $34.65 | 11 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $2.21 | $6.30 | $0.36 – $6.30 | 11 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $71.30 | $203.70 | $5.67 – $9.45 | 8 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $4.05 | $11.55 | $1.47 – $11.55 | 11 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $303.56 | $867.30 | $0.40 – $650.48 | 14 |
| Microalbumin urine screen CPT 82044 | $31.94 | $91.23 | $4.97 – $68.43 | 26 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $8.46 | $24.15 | $0.09 – $22.05 | 11 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $15,750.00 | $45,000.00 | $1,855.95 – $6,628.39 | 14 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $18.38 | $52.50 | $0.08 – $6.54 | 11 |
| MRA chest w IV cont HCPCS C8909 | $1,532.48 | $4,378.50 | $538.41 – $3,283.88 | 12 |
| MRA chest wo IV cont HCPCS C8910 | $1,654.38 | $4,726.80 | $328.59 – $3,545.10 | 12 |
| MRA chest wwo IV cont HCPCS C8911 | $1,654.38 | $4,726.80 | $538.41 – $3,545.10 | 12 |
| MRA pelvis w IV cont HCPCS C8918 | $1,565.20 | $4,472.00 | $538.41 – $3,354.00 | 12 |
| MRA pelvis wo IV cont HCPCS C8919 | $1,565.24 | $4,472.10 | $328.59 – $3,354.08 | 12 |
| MRA w/cont, abd HCPCS C8900 | $812.07 | $2,320.20 | $538.41 – $1,740.15 | 12 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,516.73 | $4,333.50 | $538.41 – $3,250.13 | 12 |
| Mra, w/dye, spinal canal HCPCS C8931 | $890.82 | $2,545.20 | $538.41 – $1,908.90 | 12 |
| Mra, w/dye, upper extremity HCPCS C8934 | $1,055.57 | $3,015.90 | $538.41 – $2,261.93 | 12 |
| MRA without cont, abd HCPCS C8901 | $2,050.65 | $5,859.00 | $328.59 – $4,394.25 | 12 |
| MRA without cont, lwr ext HCPCS C8913 | $1,516.73 | $4,333.50 | $328.59 – $3,250.13 | 12 |
| Mra, without dye, spinal canal HCPCS C8932 | $890.82 | $2,545.20 | $328.59 – $1,908.90 | 12 |
| Mra, without dye, upper extr HCPCS C8935 | $1,055.57 | $3,015.90 | $328.59 – $2,261.93 | 12 |
| MRA without fol w/cont, abd HCPCS C8902 | $2,050.65 | $5,859.00 | $538.41 – $4,394.25 | 12 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,516.73 | $4,333.50 | $538.41 – $3,250.13 | 12 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,234.49 | $3,527.10 | $538.41 – $2,645.33 | 12 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $833.18 | $2,380.50 | $538.41 – $1,785.38 | 12 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $1,055.57 | $3,015.90 | $538.41 – $2,261.93 | 12 |
| MRI chest without contrast CPT 71550 | $1,717.07 | $4,905.90 | $221.80 – $3,679.43 | 16 |
| MRI chest without & w/contrast CPT 71552 | $1,904.49 | $5,441.40 | $348.10 – $4,081.05 | 16 |
| MRI chest w IV cont CPT 71551 | $1,337.81 | $3,822.30 | $365.99 – $2,866.73 | 16 |
| MRI loex nonjt w IV cont CPT 73719 | $5,163.55 | $14,753.00 | $257.74 – $6,355.50 | 16 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $4,105.50 | $11,730.00 | $218.70 – $5,385.40 | 16 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $3,795.05 | $10,843.00 | $330.13 – $8,132.25 | 16 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,463.49 | $4,181.38 | $221.57 – $3,135.75 | 16 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,321.99 | $6,634.25 | $331.70 – $4,975.50 | 16 |
| MRI orbit fac&nck w IV cont CPT 70542 | $908.15 | $2,594.70 | $262.83 – $1,946.03 | 16 |
| MRI tmj CPT 70336 | $714.11 | $2,040.30 | $221.80 – $1,535.00 | 16 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $4,105.50 | $11,730.00 | $221.80 – $3,738.75 | 16 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,355.50 | $6,730.00 | $348.10 – $5,047.50 | 16 |
| MRI upper extremity w/dye CPT 73219 | $5,163.55 | $14,753.00 | $324.72 – $4,075.50 | 16 |
| Mr safety determination physician/other qhp CPT 76016 | $92.40 | $264.00 | $100.00 – $1,535.00 | 10 |
| Mr safety implant elec prepj CPT 76018 | $96.25 | $275.00 | $100.00 – $1,535.00 | 10 |
| Mr safety implt pos&/immoblj CPT 76019 | $62.30 | $178.00 | $100.00 – $1,535.00 | 10 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $25.55 | $73.00 | $43.80 – $1,535.00 | 10 |
| Mr sfty med physics xm cstmz CPT 76017 | $218.75 | $625.00 | $100.00 – $1,535.00 | 10 |
| Mthfr gene analy common variants CPT 81291 | $1,554.21 | $4,440.60 | $52.15 – $3,330.45 | 26 |
| Mucin synovial fluid CPT 83872 | $21.42 | $61.20 | $4.67 – $45.90 | 25 |
| Mucopolysaccharides CPT 83864 | $100.80 | $288.00 | $22.74 – $216.00 | 25 |
| Multiple sleep latency test CPT 95805 | $1,544.90 | $4,414.00 | $100.00 – $3,310.50 | 12 |
| Mumps antibody igg CPT 86735 | $42.53 | $121.50 | $10.41 – $91.13 | 25 |
| Mycoplasma antibody igm CPT 86738 | $46.20 | $132.00 | $10.56 – $99.00 | 25 |
| Myelogphy 2/> spine regions CPT 72270 | $1,209.29 | $3,455.10 | $140.00 – $2,591.33 | 15 |
| Myelography l-s spine CPT 72265 | $1,036.67 | $2,961.90 | $103.80 – $2,221.43 | 15 |
| Myelography neck spine CPT 72240 | $985.32 | $2,815.20 | $106.65 – $2,111.40 | 15 |
| Myelography thoracic spine CPT 72255 | $518.18 | $1,480.50 | $102.53 – $1,110.38 | 15 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $2,262.05 | $6,463.00 | $429.79 – $4,847.18 | 9 |
| Myelography via inj w/s&i cervical CPT 62302 | $2,035.25 | $5,815.00 | $386.70 – $4,361.18 | 9 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,087.19 | $5,963.40 | $396.54 – $4,472.25 | 9 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,641.15 | $4,689.00 | $311.82 – $3,516.75 | 9 |
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.