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 |
|---|---|---|---|---|
| St cognitve performance testing healthcare professional each hour CPT 96125 | $157.19 | $449.10 | $100.00 – $380.00 | 9 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $11,632.60 | $33,236.00 | $19,941.60 – $24,927.00 | 8 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $13,340.25 | $38,115.00 | $48.51 – $199.98 | 14 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $318.26 | $909.30 | $64.83 – $231.53 | 14 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $6,999.04 | $19,997.25 | $100.00 – $742.56 | 14 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $9,475.83 | $27,073.80 | $16,244.28 – $20,305.35 | 8 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $4,756.50 | $13,590.00 | $100.00 – $10,192.50 | 10 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $8,765.40 | $25,044.00 | $15,026.40 – $18,783.00 | 8 |
| St evaluate speech sound production CPT 92522 | $147.74 | $422.10 | $100.00 – $380.00 | 9 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $297.50 | $850.00 | $100.00 – $637.50 | 9 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $448.00 | $1,280.00 | $100.00 – $960.00 | 9 |
| St evaluation swallow function CPT 92610 | $286.02 | $817.20 | $100.00 – $612.75 | 9 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $78.12 | $223.20 | $133.80 – $167.25 | 8 |
| Strapping of chest CPT 29200 | $78.12 | $223.20 | $133.80 – $167.25 | 8 |
| Strapping of elbow or wrist 29260 CPT 29260 | $85.68 | $244.80 | $16.28 – $183.60 | 12 |
| Strapping of hand or finger CPT 29280 | $85.68 | $244.80 | $16.28 – $183.60 | 12 |
| Strapping of hip CPT 29520 | $39.06 | $111.60 | $7.43 – $83.70 | 12 |
| Strapping of knee CPT 29530 | $113.40 | $324.00 | $21.55 – $243.00 | 12 |
| Strapping of toes 29550 CPT 29550 | $117.25 | $335.00 | $22.27 – $251.10 | 12 |
| Strep a ag ia CPT 87430 | $50.09 | $143.10 | $13.41 – $107.33 | 26 |
| Stress test pulmonary CPT 94618 | $96.08 | $274.50 | $100.00 – $978.00 | 9 |
| Stress tte complete CPT 93351 | $2,339.82 | $6,685.20 | $100.00 – $5,013.90 | 9 |
| St treatment speech individual CPT 92507 | $256.55 | $733.00 | $100.00 – $549.75 | 9 |
| St treatment swallow dysfunction/oral CPT 92526 | $146.30 | $418.00 | $100.00 – $380.00 | 9 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $36.02 | $102.90 | $1.45 – $77.18 | 14 |
| Sugars single quant CPT 84378 | $44.42 | $126.90 | $9.21 – $95.18 | 25 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $309.81 | $885.15 | $26.37 – $885.15 | 11 |
| Surgical pathology level 1 gross examination only CPT 88300 | $116.20 | $332.00 | $26.21 – $249.00 | 11 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $203.75 | $582.12 | $33.57 – $436.59 | 11 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $337.05 | $963.00 | $67.05 – $722.25 | 11 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $415.80 | $1,188.00 | $67.05 – $891.00 | 11 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $494.90 | $1,414.00 | $323.15 – $1,060.50 | 11 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,093.75 | $3,125.00 | $708.41 – $2,343.75 | 11 |
| Susceptibility agar dilution per agent CPT 87181 | $23.94 | $68.40 | $3.79 – $51.30 | 25 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $28.04 | $80.10 | $3.79 – $60.08 | 25 |
| Susceptibility mic per plate CPT 87186 | $185.15 | $529.00 | $6.91 – $396.12 | 25 |
| Svc venogram s&i CPT 75827 | $1,115.73 | $3,187.80 | $113.00 – $2,390.85 | 15 |
| System pacing micra av HCPCS C1786 | $30,074.00 | $85,925.70 | $832.39 – $2,972.82 | 14 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $107,728.59 | $307,795.95 | $3,039.16 – $10,854.12 | 14 |
| T3 (triiodothyronine) free CPT 84481 | $44.61 | $127.44 | $13.52 – $95.58 | 25 |
| T3 (triiodothyronine) total CPT 84480 | $114.10 | $326.00 | $11.31 – $244.50 | 25 |
| T4 (thyroxine) free CPT 84439 | $74.55 | $213.00 | $7.20 – $159.75 | 25 |
| T4 (thyroxine) total CPT 84436 | $78.75 | $225.00 | $5.48 – $168.75 | 25 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $9.56 | $27.30 | $0.26 – $27.30 | 11 |
| Tacrolimus therapeutic drug level CPT 80197 | $126.95 | $362.70 | $10.95 – $272.03 | 25 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $32.76 | $93.60 | $49.46 – $114.78 | 25 |
| Tc-99m apcitide diag HCPCS A9504 | $383.99 | $1,097.10 | $100.00 – $822.83 | 7 |
| Tc-99m exametazime diag HCPCS A9521 | $2,389.91 | $6,828.30 | $100.00 – $5,121.00 | 9 |
| Tc-99m maa HCPCS A9540 | $399.11 | $1,140.30 | $32.57 – $855.23 | 9 |
| Tc-99m mebrofenin HCPCS A9537 | $239.40 | $684.00 | $60.06 – $498.13 | 9 |
| Tc-99m medronate HCPCS A9503 | $384.78 | $1,099.35 | $14.12 – $824.52 | 9 |
| Tc-99m mertiatide HCPCS A9562 | $893.40 | $2,552.55 | $100.00 – $1,914.42 | 9 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $46.62 | $133.20 | $29.10 – $99.90 | 7 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $8.82 | $25.20 | $4.28 – $18.75 | 9 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $120.75 | $345.00 | $89.70 – $538.00 | 10 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $658.22 | $1,880.61 | $100.00 – $1,410.46 | 9 |
| Tc-99m sulfur colloid HCPCS A9541 | $356.48 | $1,018.50 | $58.05 – $763.88 | 9 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $165.20 | $472.00 | $100.00 – $354.00 | 9 |
| Tc-99m tilmanocept diag HCPCS A9520 | $932.09 | $2,663.10 | $100.00 – $1,997.33 | 9 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $229.32 | $655.20 | $37.49 – $491.40 | 25 |
| T cells absolute cd 4 count CPT 86361 | $193.41 | $552.60 | $21.38 – $389.48 | 25 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $1,167.13 | $3,334.65 | $2,000.79 – $2,500.99 | 8 |
| Test for porphobilinogen CPT 84106 | $48.20 | $137.70 | $4.65 – $103.28 | 25 |
| Testicular imaging w/vasc flow CPT 78761 | $916.65 | $2,619.00 | $190.14 – $1,964.25 | 15 |
| Test stress cardiovascular tracing only CPT 93017 | $1,814.75 | $5,185.00 | $100.00 – $3,888.75 | 10 |
| Test urine for porphyrins CPT 84119 | $63.63 | $181.80 | $10.66 – $136.35 | 25 |
| Theophylline therapeutic drug level CPT 80198 | $45.68 | $130.50 | $11.29 – $97.88 | 25 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $22.68 | $64.80 | $36.01 – $72.00 | 22 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $15.75 | $45.00 | $27.00 – $72.00 | 22 |
| Ther/proph/diag inj ia CPT 96373 | $306.25 | $875.00 | $27.89 – $656.25 | 9 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $17.64 | $50.40 | $2.51 – $7.35 | 11 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,240.75 | $3,545.00 | $2,127.00 – $2,658.75 | 8 |
| Thrombectmy crnry perq mechanical CPT 92973 | $1,882.76 | $5,379.30 | $357.73 – $4,034.48 | 8 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $4,948.65 | $14,139.00 | $8,483.40 – $10,604.25 | 7 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $6,623.19 | $18,923.40 | $11,354.04 – $14,192.55 | 7 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $9,916.52 | $28,332.90 | $16,999.74 – $21,249.68 | 7 |
| Thrombin time CPT 85670 | $42.53 | $121.50 | $4.61 – $91.13 | 25 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $54.18 | $154.80 | $5.16 – $116.10 | 25 |
| Thyroglobulin antibody CPT 86800 | $38.43 | $109.80 | $12.69 – $82.35 | 25 |
| Thyroid imaging CPT 78013 | $568.40 | $1,624.00 | $163.15 – $1,723.00 | 15 |
| Thyroid met imaging CPT 78015 | $841.37 | $2,403.90 | $205.38 – $1,802.93 | 15 |
| Thyroid (TSH) Test CPT 84443 | $180.95 | $517.00 | $13.40 – $237.00 | 25 |
| Thyroid Ultrasound CPT 76536 | $1,026.20 | $2,932.00 | $99.51 – $2,198.84 | 15 |
| Thyroid uptake measurement CPT 78012 | $308.07 | $880.20 | $77.14 – $1,723.00 | 15 |
| Thyroxine binding globulin (tbg) CPT 84442 | $56.70 | $162.00 | $11.80 – $109.35 | 25 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $9,313.15 | $26,609.00 | $15,965.40 – $19,956.75 | 8 |
| Tib/per revasc stnt & ather CPT 37235 | $4,656.75 | $13,305.00 | $100.00 – $9,978.75 | 10 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | $4,109.00 | $11,740.00 | $100.00 – $8,805.00 | 10 |
| Tigecycline injection HCPCS J3243 | $93.80 | $268.00 | $0.90 – $201.00 | 9 |
| Tilt table study CPT 93660 | $1,933.47 | $5,524.20 | $96.81 – $4,143.15 | 10 |
| Tissue culture skin/biopsy CPT 88233 | $231.53 | $661.50 | $112.30 – $496.13 | 26 |
| Tissue exam koh skin/hair/nails CPT 87220 | $14.18 | $40.50 | $3.41 – $30.38 | 26 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $36.02 | $102.90 | $10.81 – $38.59 | 14 |
| Tl-201 thallium diag per mci HCPCS A9505 | $27.09 | $77.40 | $20.13 – $538.00 | 10 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $11.20 | $32.00 | $0.49 – $23.83 | 9 |
| Tobramycin peak therapeutic drug level CPT 80200 | $88.52 | $252.90 | $12.87 – $189.68 | 25 |
| Toxoplasma antibody igg CPT 86777 | $71.75 | $205.00 | $11.49 – $153.75 | 25 |
| Toxoplasma antibody igm CPT 86778 | $77.70 | $222.00 | $11.49 – $166.50 | 25 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $34.65 | $99.00 | $54.05 – $95.01 | 22 |
| Transcath biopsy CPT 37200 | $1,521.45 | $4,347.00 | $2,608.20 – $3,260.25 | 8 |
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.