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 |
|---|---|---|---|---|
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $140.00 | $400.00 | $9.21 – $135.68 | 25 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | $62.37 | $178.20 | $11.86 – $133.65 | 11 |
| Natriuretic peptide CPT 83880 | $152.60 | $436.00 | $31.33 – $199.50 | 25 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $11.97 | $34.20 | $20.52 – $28.63 | 9 |
| Ndl insj without njx 3+ musc CPT 20561 | $27.59 | $78.82 | $37.36 – $59.12 | 9 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $4,864.65 | $13,899.00 | $166.31 – $10,424.25 | 16 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $4,160.45 | $11,887.00 | $164.74 – $8,915.25 | 16 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $3,200.40 | $9,144.00 | $99.51 – $6,858.00 | 16 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $5,597.90 | $15,994.00 | $313.30 – $11,995.50 | 16 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $4,857.65 | $13,879.00 | $269.81 – $10,409.25 | 16 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,492.65 | $9,979.00 | $186.66 – $7,484.25 | 16 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $5,254.20 | $15,012.00 | $338.38 – $11,259.00 | 16 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $3,743.60 | $10,696.00 | $240.92 – $8,022.00 | 16 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $3,283.70 | $9,382.00 | $211.41 – $7,036.47 | 16 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $22.05 | $63.00 | $0.98 – $47.25 | 9 |
| N-invas est c ffr sw aly cta CPT 75580 | $1,381.44 | $3,946.95 | $100.00 – $2,960.22 | 7 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,042.65 | $2,979.00 | $198.11 – $2,234.25 | 9 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $2,335.55 | $6,673.00 | $306.64 – $5,004.75 | 15 |
| Nm imaging bone/joint whole body CPT 78306 | $1,978.99 | $5,654.25 | $261.88 – $4,240.69 | 15 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $523.53 | $1,495.80 | $202.20 – $1,723.00 | 15 |
| Nm imaging gastric emptying study CPT 78264 | $1,699.25 | $4,855.00 | $292.68 – $3,641.25 | 15 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $768.25 | $2,195.00 | $308.54 – $1,723.00 | 15 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,864.45 | $5,327.00 | $386.94 – $3,995.25 | 15 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,286.62 | $3,676.05 | $165.06 – $2,757.04 | 15 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,009.05 | $2,883.00 | $293.93 – $2,162.25 | 15 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,159.61 | $3,313.15 | $207.28 – $2,484.87 | 15 |
| Non-card vasc flow imaging CPT 78445 | $630.00 | $1,800.00 | $186.96 – $1,723.00 | 15 |
| Nuclear rx IV admin CPT 79101 | $1,040.13 | $2,971.80 | $71.13 – $2,228.85 | 15 |
| Nuclear Stress Test (Heart) CPT 78452 | $5,327.35 | $15,221.00 | $416.15 – $11,415.75 | 15 |
| Nushield 1 square cm HCPCS Q4160 | $508.26 | $1,452.15 | $134.13 – $918.23 | 14 |
| Observation direct referral from physician office for admission HCPCS G0379 | $189.35 | $541.00 | $35.98 – $405.75 | 16 |
| Observation per hour HCPCS G0378 | $155.40 | $444.00 | $4.39 – $90.00 | 16 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $41.16 | $117.60 | $0.68 – $60.90 | 11 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $35.28 | $100.80 | $22.18 – $100.80 | 14 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $36.75 | $105.00 | $0.13 – $101.85 | 11 |
| Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 | $1,782.20 | $5,092.00 | $3,055.20 – $3,819.00 | 8 |
| Ophthalmic mitomycin HCPCS J7315 | $417.85 | $1,193.85 | $262.65 – $895.39 | 14 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $24.99 | $71.40 | $11.75 – $53.55 | 14 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $129.73 | $370.65 | $77.84 – $277.99 | 11 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $224.18 | $640.50 | $134.51 – $480.38 | 11 |
| Ortho ewhf rigd without jnt cstm w HCPCS L3765 | $574.04 | $1,640.10 | $344.43 – $1,230.08 | 11 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $360.52 | $1,030.05 | $100.00 – $669.54 | 11 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $157.66 | $450.45 | $94.60 – $337.84 | 11 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $165.75 | $473.55 | $86.44 – $308.70 | 11 |
| Ortho hnd metcrpl fx prefb w/fit&adj HCPCS L3917 | $47.41 | $135.45 | $28.45 – $101.59 | 11 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $139.29 | $397.95 | $72.77 – $259.88 | 11 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $158.40 | $452.55 | $94.82 – $338.63 | 11 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $469.30 | $1,340.85 | $266.37 – $951.30 | 11 |
| Oscillation chest wall mechanical per session CPT 94669 | $108.36 | $309.60 | $100.00 – $978.00 | 9 |
| Osmolality blood CPT 83930 | $139.65 | $399.00 | $5.27 – $299.25 | 25 |
| Osmolality urine CPT 83935 | $71.75 | $205.00 | $5.44 – $93.75 | 25 |
| Ot evaluation high complexity patient/family CPT 97167 | $415.10 | $1,186.00 | $100.00 – $889.50 | 9 |
| Ot evaluation low complexity patient/family CPT 97165 | $248.50 | $710.00 | $100.00 – $532.50 | 9 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $330.75 | $945.00 | $100.00 – $708.75 | 9 |
| Oth resp proc, group HCPCS G0239 | $166.95 | $477.00 | $18.41 – $978.00 | 9 |
| Oth resp proc, indiv HCPCS G0238 | $132.30 | $378.00 | $14.73 – $978.00 | 9 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $46.62 | $133.20 | $75.25 – $293.00 | 9 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $76.55 | $218.70 | $71.03 – $293.00 | 9 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $109.90 | $314.00 | $41.57 – $293.00 | 9 |
| Ot re-evaluation patient/family CPT 97168 | $248.50 | $710.00 | $93.13 – $532.50 | 9 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $100.80 | $288.00 | $59.45 – $293.00 | 11 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $62.06 | $177.30 | $35.26 – $380.00 | 9 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $107.45 | $307.00 | $45.77 – $293.00 | 9 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $116.90 | $334.00 | $52.09 – $293.00 | 9 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $57.40 | $164.00 | $51.04 – $293.00 | 11 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $4.41 | $12.60 | $0.59 – $12.60 | 11 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $165.90 | $474.00 | $9.00 – $344.93 | 9 |
| Parathormone (pth) intact CPT 83970 | $160.30 | $458.00 | $32.95 – $209.25 | 25 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,261.58 | $3,604.50 | $458.35 – $2,703.38 | 11 |
| Parathyroid planar imaging CPT 78070 | $547.00 | $1,562.85 | $259.97 – $1,723.00 | 15 |
| Parathyroid planar img w/tomo spect CPT 78071 | $889.93 | $2,542.65 | $310.44 – $1,906.99 | 15 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $63.32 | $180.90 | $12.03 – $135.68 | 10 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $4,257.86 | $12,165.30 | $3.47 – $11.82 | 14 |
| Passy muir valve metal trach HCPCS L8501 | $224.18 | $640.50 | $134.51 – $480.38 | 14 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $5,436.55 | $15,533.00 | $166.31 – $11,649.75 | 16 |
| Pelvic CT scan (with contrast) CPT 72193 | $4,924.15 | $14,069.00 | $166.31 – $10,551.75 | 16 |
| Pelvic CT scan (without contrast) CPT 72192 | $3,818.85 | $10,911.00 | $99.51 – $6,099.00 | 16 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,936.05 | $14,103.00 | $329.80 – $10,576.88 | 16 |
| Pelvic MRI (with contrast) CPT 72196 | $3,948.70 | $11,282.00 | $262.83 – $8,461.50 | 16 |
| Pelvic MRI (without contrast) CPT 72195 | $3,356.50 | $9,590.00 | $221.80 – $7,192.50 | 16 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,041.43 | $2,975.50 | $91.47 – $2,231.63 | 15 |
| Pelvic Ultrasound (limited) CPT 76857 | $489.65 | $1,399.00 | $48.25 – $1,049.25 | 15 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $22,415.30 | $64,043.70 | $4,382.00 – $15,649.99 | 14 |
| Perc cryo ablate renal tum CPT 50593 | $3,839.75 | $10,970.71 | $6,582.43 – $8,228.04 | 8 |
| Perc d-e cor revasc chro add HCPCS C9608 | $2,251.55 | $6,433.00 | $427.80 – $4,824.75 | 9 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $8,161.30 | $23,318.00 | $1,550.65 – $17,488.50 | 9 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $2,110.85 | $6,031.00 | $401.07 – $4,523.25 | 9 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $6,894.65 | $19,699.00 | $1,309.99 – $14,774.25 | 9 |
| Perc d-e cor stent ather br HCPCS C9603 | $3,939.95 | $11,257.00 | $748.60 – $8,442.75 | 9 |
| Perc d-e cor stent ather s HCPCS C9602 | $13,507.90 | $38,594.00 | $2,566.51 – $28,945.50 | 9 |
| Perc drug-el cor stent bran HCPCS C9601 | $2,251.55 | $6,433.00 | $427.80 – $4,824.75 | 9 |
| Perc drug-el cor stent sing HCPCS C9600 | $14,070.70 | $40,202.00 | $2,673.44 – $30,151.50 | 9 |
| Perc rf ablate renal tumor CPT 50592 | $2,707.74 | $7,736.40 | $4,641.84 – $5,802.30 | 8 |
| Percut ablate liver rf CPT 47382 | $4,232.97 | $12,094.20 | $7,256.52 – $9,070.65 | 8 |
| Pericardiocentesis wwo imaging CPT 33016 | $387.14 | $1,106.10 | $663.66 – $829.58 | 7 |
| Perit-vens shunt pat tst CPT 78291 | $641.66 | $1,833.30 | $233.63 – $1,723.00 | 15 |
| Perq dev breast 1st strtctc CPT 19283 | $1,671.08 | $4,774.50 | $2,864.70 – $3,580.88 | 8 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | $2,976.12 | $8,503.20 | $5,101.92 – $6,377.40 | 8 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $2,610.72 | $7,459.20 | $4,475.52 – $5,594.40 | 8 |
| Perq plmt bile duct stent CPT 47538 | $5,663.07 | $16,180.20 | $9,708.12 – $12,135.15 | 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.