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 |
|---|---|---|---|---|
| Protein s total CPT 85305 | $106.75 | $305.00 | $9.26 – $228.75 | 25 |
| Protein total 24 hour urine CPT 84156 | $77.35 | $221.00 | $2.93 – $165.75 | 25 |
| Protein total body fluid CPT 84157 | $66.89 | $191.10 | $3.19 – $96.08 | 25 |
| Protein total serum plasma whole blood CPT 84155 | $74.20 | $212.00 | $2.93 – $159.00 | 25 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $27.72 | $79.20 | $3.14 – $59.40 | 25 |
| Prq cardiac angio addl art CPT 92921 | $1,548.05 | $4,423.00 | $294.13 – $3,317.25 | 9 |
| Prq card revasc chronic addl CPT 92944 | $4,643.45 | $13,267.00 | $882.26 – $9,950.25 | 9 |
| Prq card revasc mi 1 vsl CPT 92941 | $9,146.20 | $26,132.00 | $1,737.78 – $19,599.00 | 9 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $10,131.10 | $28,946.00 | $1,924.91 – $21,709.50 | 9 |
| Prq card stent w/angio addl CPT 92929 | $1,548.05 | $4,423.00 | $294.13 – $3,317.25 | 9 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $4,221.35 | $12,061.00 | $802.06 – $9,045.75 | 9 |
| Prq revasc byp graft addl CPT 92938 | $1,548.05 | $4,423.00 | $294.13 – $3,317.25 | 9 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $5,628.35 | $16,081.00 | $1,069.39 – $12,060.75 | 9 |
| Prq trlml c athrc st angiop1 CPT 92933 | $6,472.55 | $18,493.00 | $1,229.79 – $13,869.75 | 9 |
| Prq trluml c angiop 1art&/br CPT 92920 | $4,362.05 | $12,463.00 | $828.79 – $9,347.25 | 9 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $4,221.35 | $12,061.00 | $802.06 – $9,045.75 | 9 |
| Prq trluml revsc ch occ ant CPT 92943 | $4,502.75 | $12,865.00 | $855.53 – $9,648.75 | 9 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $94.50 | $270.00 | $17.96 – $202.50 | 12 |
| Pr removal intrauterine device CPT 58301 | $130.73 | $373.50 | $224.10 – $280.13 | 8 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $332.85 | $951.00 | $219.00 – $273.75 | 8 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $86.94 | $248.40 | $16.52 – $186.30 | 12 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $101.43 | $289.80 | $19.28 – $217.35 | 12 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $96.60 | $276.00 | $18.36 – $207.00 | 12 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $1,481.13 | $4,231.80 | $2,539.08 – $3,173.85 | 7 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,604.05 | $4,583.00 | $304.77 – $3,437.25 | 12 |
| PSA (Prostate) Test CPT 84153 | $108.11 | $308.88 | $14.68 – $231.66 | 25 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $88.90 | $254.00 | $22.10 – $293.00 | 9 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $59.85 | $171.00 | $9.48 – $293.00 | 9 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $45.99 | $131.40 | $31.04 – $293.00 | 9 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $67.20 | $192.00 | $20.53 – $293.00 | 9 |
| Pt application of modality traction mechanical CPT 97012 | $82.41 | $235.44 | $22.10 – $293.00 | 9 |
| Pt evaluation high complexity patient/family CPT 97163 | $339.50 | $970.00 | $100.00 – $727.50 | 9 |
| Pt evaluation low complexity patient/family CPT 97161 | $203.70 | $582.00 | $100.00 – $436.50 | 9 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $271.60 | $776.00 | $100.00 – $582.00 | 9 |
| Pt re-evaluation patient/family CPT 97164 | $203.70 | $582.00 | $85.76 – $436.50 | 9 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $95.64 | $273.24 | $21.05 – $293.00 | 9 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $70.56 | $201.60 | $45.25 – $293.00 | 9 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $35.28 | $100.80 | $42.62 – $293.00 | 9 |
| Pulmonary vent imaging CPT 78579 | $569.45 | $1,627.00 | $167.61 – $1,723.00 | 15 |
| Pulse ox continuous overnight monitoring CPT 94762 | $877.45 | $2,507.00 | $100.00 – $1,880.25 | 9 |
| Pulse ox single CPT 94760 | $90.65 | $259.00 | $3.68 – $597.00 | 9 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $302.09 | $863.10 | $181.26 – $647.33 | 14 |
| Punc of shunt for asp or inj CPT 61070 | $95.45 | $272.70 | $163.62 – $204.53 | 7 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $85.05 | $243.00 | $16.16 – $182.25 | 12 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $151.90 | $434.00 | $260.40 – $325.50 | 8 |
| Puncture spinal lumbar diagnostic CPT 62270 | $583.10 | $1,666.00 | $999.60 – $1,249.50 | 7 |
| Pyruvate CPT 84210 | $77.81 | $222.30 | $11.55 – $166.73 | 25 |
| Pyruvate kinase CPT 84220 | $68.67 | $196.20 | $7.53 – $147.15 | 25 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $779.63 | $2,227.50 | $267.91 – $1,723.00 | 15 |
| Quant diff pulm perf w/imaging CPT 78597 | $721.98 | $2,062.80 | $178.70 – $1,723.00 | 15 |
| Quest t3 uptake CPT 84479 | $25.20 | $72.00 | $5.16 – $54.00 | 25 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,279.53 | $3,655.80 | $274.26 – $2,741.85 | 15 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,622.57 | $4,635.90 | $572.32 – $3,476.93 | 15 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,748.25 | $4,995.00 | $337.43 – $3,636.75 | 15 |
| Radphm lcl tumor plr sgl day CPT 78800 | $465.26 | $1,329.30 | $223.78 – $1,723.00 | 15 |
| Rbc count only automated CPT 85041 | $7.88 | $22.50 | $2.41 – $16.88 | 25 |
| Rbc deglycerolized each unit HCPCS P9039 | $533.75 | $1,525.00 | $88.00 – $1,143.75 | 7 |
| Red blood cells each unit HCPCS P9021 | $232.75 | $665.00 | $88.00 – $498.75 | 7 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $310.45 | $887.00 | $88.00 – $665.25 | 7 |
| Red cell sequestration CPT 78140 | $288.54 | $824.40 | $103.48 – $1,723.00 | 15 |
| Relocation skin pocket aicd CPT 33223 | $669.06 | $1,911.60 | $1,146.96 – $1,433.70 | 7 |
| Relocation skin pocket pm CPT 33222 | $587.48 | $1,678.50 | $1,007.10 – $1,258.88 | 7 |
| Rem/biv cast full arm/leg CPT 29705 | $83.79 | $239.40 | $143.64 – $179.55 | 8 |
| Rem/biv cast shldr/hip spica CPT 29710 | $96.08 | $274.50 | $164.70 – $205.88 | 8 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $873.95 | $2,497.00 | $100.00 – $1,872.75 | 6 |
| Rem endovas vena cava filter CPT 37193 | $4,173.40 | $11,924.00 | $713.66 – $8,048.70 | 10 |
| Removal biliary drg cath CPT 47537 | $782.46 | $2,235.60 | $1,341.36 – $1,676.70 | 7 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,958.60 | $5,596.00 | $3,357.60 – $4,197.00 | 7 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,722.65 | $7,779.00 | $4,667.40 – $5,834.25 | 7 |
| Removal cerumen impacted (both sides) CPT 69210 | $68.99 | $197.10 | $13.11 – $147.83 | 12 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $132.30 | $378.00 | $25.14 – $295.29 | 11 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $253.89 | $725.40 | $48.24 – $544.05 | 12 |
| Removal foreign body foot cmplx CPT 28193 | $507.15 | $1,449.00 | $869.40 – $1,086.75 | 7 |
| Removal foreign body foot subcutaneous right CPT 28190 | $466.52 | $1,332.90 | $799.74 – $999.68 | 8 |
| Removal foreign body mouth CPT 40805 | $1,362.38 | $3,892.50 | $2,335.50 – $2,919.38 | 8 |
| Removal of foot lesion CPT 28080 | $1,298.43 | $3,709.80 | $2,225.88 – $2,782.35 | 7 |
| Removal of foreign body CPT 27372 | $1,476.09 | $4,217.40 | $2,530.44 – $3,163.05 | 7 |
| Removal of hip foreign body 27087 CPT 27087 | $1,136.84 | $3,248.10 | $1,948.86 – $2,436.08 | 7 |
| Removal of scrotum lesion CPT 55120 | $1,203.30 | $3,438.00 | $2,062.80 – $2,578.50 | 7 |
| Removal of skin tags each add'l 10 CPT 11201 | $96.39 | $275.40 | $18.32 – $206.55 | 12 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $3,934.67 | $11,241.90 | $6,745.14 – $8,431.43 | 8 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $74.03 | $211.50 | $14.07 – $158.63 | 12 |
| Removal tunnled intprtnl cath CPT 49422 | $1,223.46 | $3,495.60 | $2,097.36 – $2,621.70 | 7 |
| Remove hip foreign body 27086 CPT 27086 | $444.47 | $1,269.90 | $761.94 – $952.43 | 7 |
| Remove renal tube w/fluoro CPT 50389 | $1,162.00 | $3,320.00 | $1,327.80 – $1,659.75 | 8 |
| Remove shoulder foreign body subq 23330 CPT 23330 | $444.47 | $1,269.90 | $761.94 – $952.43 | 7 |
| Renal cyst study s&i CPT 74470 | $563.24 | $1,609.25 | $77.28 – $1,206.94 | 17 |
| Renal venogram bil s&i CPT 75833 | $1,411.83 | $4,033.80 | $140.00 – $4,033.80 | 15 |
| Repair extns tendon finger without grft ea CPT 26418 | $1,599.89 | $4,571.10 | $2,742.66 – $3,428.33 | 7 |
| Repair finger/hand tendon CPT 26350 | $1,669.19 | $4,769.10 | $2,861.46 – $3,576.83 | 7 |
| Repair finger/hand tendon CPT 26356 | $1,546.02 | $4,417.20 | $2,650.32 – $3,312.90 | 7 |
| Repair lac palate<2 cm CPT 42180 | $180.81 | $516.60 | $309.96 – $387.45 | 7 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $403.52 | $1,152.90 | $691.74 – $864.68 | 7 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $399.74 | $1,142.10 | $685.26 – $856.58 | 7 |
| Repair of ankle ligament CPT 27695 | $1,859.45 | $5,312.70 | $3,187.62 – $3,984.53 | 7 |
| Repair of body cast CPT 29720 | $69.62 | $198.90 | $119.34 – $149.18 | 8 |
| Repair of foot tendon CPT 28200 | $934.92 | $2,671.20 | $1,602.72 – $2,003.40 | 7 |
| Repair pm/icd lead dual CPT 33220 | $3,277.40 | $9,364.00 | $5,618.40 – $7,023.00 | 8 |
| Repair pm/icd lead sgl CPT 33218 | $3,277.40 | $9,364.00 | $5,618.40 – $7,023.00 | 8 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $311.85 | $891.00 | $534.60 – $668.25 | 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.