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 |
|---|---|---|---|---|
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $131.99 | $377.10 | $226.26 – $282.83 | 7 |
| Pertussis ag if CPT 87265 | $63.95 | $182.70 | $9.56 – $137.03 | 25 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $28,064.14 | $80,183.25 | $38.81 – $138.60 | 14 |
| Ph body fluid CPT 83986 | $38.12 | $108.90 | $2.86 – $76.95 | 25 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $38.59 | $110.25 | $30.44 – $82.69 | 10 |
| Phenobarbital therapeutic drug level CPT 80184 | $34.97 | $99.90 | $12.21 – $74.93 | 25 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $6.99 | $19.95 | $11.97 – $14.97 | 6 |
| Phenytoin total therapeutic drug level CPT 80185 | $152.25 | $435.00 | $10.57 – $326.25 | 25 |
| Phlebotomy therapeutic CPT 99195 | $205.80 | $588.00 | $100.00 – $441.00 | 8 |
| Phosphorus CPT 84100 | $162.05 | $463.00 | $3.78 – $347.25 | 25 |
| Phosphorus 24 hour urine CPT 84105 | $23.63 | $67.50 | $4.62 – $50.63 | 25 |
| Phys blood bank serv reactj CPT 86078 | $75.29 | $215.10 | $75.14 – $215.10 | 10 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $40.80 | $116.55 | $1.63 – $30.72 | 9 |
| Place cath intracranial art CPT 36228 | $3,038.00 | $8,680.00 | $384.78 – $4,339.58 | 10 |
| Place cath xtrnl carotid CPT 36227 | $5,935.30 | $16,958.00 | $751.78 – $8,478.68 | 10 |
| Place duod/jej tube perc CPT 49441 | $1,905.75 | $5,445.00 | $3,267.00 – $4,083.75 | 8 |
| Place gastrostomy tube perc CPT 49440 | $1,905.75 | $5,445.00 | $3,267.00 – $4,083.75 | 8 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,494.36 | $4,269.60 | $2,561.76 – $3,202.20 | 8 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $1,046.75 | $2,990.70 | $100.00 – $2,243.03 | 8 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $891.14 | $2,546.10 | $1,527.60 – $1,909.50 | 8 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $5,354.65 | $15,299.00 | $6,119.40 – $7,649.25 | 7 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $68.36 | $195.30 | $12.99 – $146.48 | 9 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $3,684.24 | $10,526.40 | $6,315.84 – $7,894.80 | 8 |
| Place non-slctv cath thoracic arta CPT 36221 | $1,143.14 | $3,266.10 | $217.20 – $2,449.58 | 10 |
| Place slctv cath carotd art uni CPT 36224 | $14,991.20 | $42,832.00 | $1,898.87 – $21,415.73 | 10 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $7,006.30 | $20,018.00 | $887.46 – $10,008.90 | 10 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $7,640.15 | $21,829.00 | $967.72 – $10,914.08 | 10 |
| Place slctv cath subclavian art CPT 36225 | $5,181.75 | $14,805.00 | $656.32 – $7,402.05 | 10 |
| Place slctv cath vertebral art uni CPT 36226 | $10,284.05 | $29,383.00 | $1,302.67 – $14,691.75 | 10 |
| Platelet aggregation each agent teg CPT 85576 | $33.08 | $94.50 | $19.87 – $70.88 | 25 |
| Platelet automated CPT 85049 | $146.65 | $419.00 | $3.57 – $314.25 | 26 |
| Platelet pheresis each unit HCPCS P9034 | $552.30 | $1,578.00 | $88.00 – $1,183.50 | 7 |
| Platelets each unit HCPCS P9019 | $112.00 | $320.00 | $88.00 – $240.00 | 7 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $223.65 | $639.00 | $88.00 – $479.25 | 7 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $2,877.21 | $8,220.60 | $4,932.36 – $6,165.45 | 8 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $2,838.47 | $8,109.90 | $4,865.94 – $6,082.43 | 7 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $1,760.54 | $5,030.10 | $3,018.06 – $3,772.58 | 7 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,175.90 | $3,359.70 | $2,015.82 – $2,519.78 | 7 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $826.25 | $2,360.70 | $100.00 – $1,770.53 | 7 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $1,257.17 | $3,591.90 | $100.00 – $2,693.93 | 8 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $480.38 | $1,372.50 | $100.00 – $1,029.38 | 8 |
| Plmt biliary drainage cath CPT 47534 | $2,618.28 | $7,480.80 | $4,488.48 – $5,610.60 | 8 |
| Plmt nephroureteral catheter CPT 50433 | $1,922.55 | $5,493.00 | $3,295.62 – $4,119.53 | 7 |
| Plmt ureteral stent prq CPT 50694 | $1,688.72 | $4,824.90 | $2,894.94 – $3,618.68 | 7 |
| #pnh-flow cytometry interp CPT 88187 | $66.47 | $189.90 | $54.26 – $142.43 | 11 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,497.20 | $9,992.00 | $100.00 – $7,494.00 | 12 |
| Potassium 24 hour urine CPT 84133 | $42.00 | $120.00 | $3.77 – $86.40 | 25 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $10.66 | $30.45 | $0.08 – $15.75 | 9 |
| Potassium serum/plasma/whole blood CPT 84132 | $118.34 | $338.10 | $3.80 – $155.25 | 25 |
| Pq dr cath chg w cont s&i CPT 75984 | $512.19 | $1,463.40 | $90.00 – $1,097.55 | 13 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $5,456.85 | $15,591.00 | $9,354.42 – $11,693.03 | 7 |
| Pq thr inj ext pse CPT 36002 | $245.07 | $700.20 | $420.12 – $525.15 | 8 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $1,058.09 | $3,023.10 | $1,813.86 – $2,267.33 | 7 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $1,352.30 | $3,863.70 | $2,318.22 – $2,897.78 | 7 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $1,165.82 | $3,330.90 | $1,998.54 – $2,498.18 | 7 |
| Pr application of long arm splint CPT 29105 | $167.58 | $478.80 | $287.28 – $359.10 | 8 |
| Pr application splint static short arm CPT 29125 | $197.35 | $563.85 | $37.50 – $422.89 | 12 |
| Pr biopsy skin punch single lesion CPT 11104 | $318.85 | $911.00 | $546.60 – $683.25 | 7 |
| Pr correction hammertoe CPT 28285 | $1,028.92 | $2,939.76 | $1,763.86 – $2,204.82 | 7 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $14.70 | $42.00 | $18.41 – $175.00 | 9 |
| Prcrd drg 6+yr without anomly CPT 33017 | $387.14 | $1,106.10 | $73.56 – $829.58 | 9 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $244.76 | $699.30 | $35.78 – $524.48 | 11 |
| Prealbumin CPT 84134 | $144.90 | $414.00 | $11.65 – $310.50 | 25 |
| Prednisone 1 mg tablet HCPCS J7512 | $2.21 | $6.30 | $0.01 – $4.20 | 11 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $1,068.55 | $3,053.00 | $1,831.80 – $2,289.75 | 7 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,088.50 | $3,110.00 | $99.51 – $2,332.50 | 15 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $938.35 | $2,681.00 | $99.51 – $2,010.46 | 15 |
| Prep skin to 100cm2 other CPT 15004 | $524.30 | $1,498.00 | $898.80 – $1,123.50 | 7 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $1,522.15 | $4,349.00 | $2,609.40 – $3,261.75 | 7 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $660.87 | $1,888.20 | $100.00 – $1,416.15 | 9 |
| Pressure max expiratory/inspiratory CPT 94799 | $206.50 | $590.00 | $100.00 – $597.00 | 9 |
| Pressure velocity wire add ves CPT 93572 | $370.44 | $1,058.40 | $70.39 – $793.80 | 8 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $41.90 | $119.70 | $71.82 – $193.77 | 10 |
| Pretreat rbc absorption reference CPT 86978 | $89.46 | $255.60 | $47.70 – $191.70 | 10 |
| Pretreat rbc density gradient separation reference CPT 86972 | $61.43 | $175.50 | $98.32 – $193.77 | 10 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $45.36 | $129.60 | $47.70 – $97.20 | 10 |
| Pretreat rbc w enzyme reference CPT 86971 | $79.70 | $227.70 | $56.17 – $323.15 | 10 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $794.75 | $2,270.70 | $1,362.42 – $1,703.03 | 7 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $372.96 | $1,065.60 | $639.36 – $799.20 | 8 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $2,808.54 | $8,024.40 | $4,814.64 – $6,018.30 | 8 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $2,507.40 | $7,164.00 | $100.00 – $5,373.00 | 10 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $522.20 | $1,492.00 | $895.20 – $1,119.00 | 8 |
| Pr incision & drainage abscess simple/single CPT 10060 | $167.30 | $478.00 | $286.80 – $358.50 | 8 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $150.26 | $429.30 | $257.58 – $321.98 | 8 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $178.92 | $511.20 | $306.72 – $383.40 | 8 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $857.15 | $2,449.00 | $18.41 – $1,836.75 | 8 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $6,634.11 | $18,954.60 | $100.00 – $7,108.77 | 6 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $111.30 | $318.00 | $105.76 – $261.37 | 9 |
| Procalcitonin CPT 84145 | $133.35 | $381.00 | $21.72 – $285.75 | 25 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $1,331.51 | $3,804.30 | $2,282.58 – $2,853.23 | 7 |
| Progesterone CPT 84144 | $75.60 | $216.00 | $16.64 – $162.00 | 25 |
| Prolactin CPT 84146 | $153.65 | $439.00 | $15.47 – $329.25 | 25 |
| Prolonged IV inf, req pump HCPCS C8957 | $138.29 | $395.10 | $90.00 – $296.33 | 8 |
| Promethazine 25 mg tablet HCPCS Q0169 | $27.57 | $78.75 | $0.07 – $78.75 | 11 |
| Promethazine hcl injection HCPCS J2550 | $1.47 | $4.20 | $0.33 – $5.10 | 11 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $7.88 | $22.50 | $7.59 – $16.88 | 9 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $19.85 | $56.70 | $1.31 – $56.70 | 11 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $6,967.44 | $19,906.95 | $2,197.51 – $7,848.23 | 14 |
| Protein c activity CPT 85303 | $147.42 | $421.20 | $11.05 – $225.45 | 25 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $109.55 | $313.00 | $8.57 – $234.75 | 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.