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 |
|---|---|---|---|---|
| Bilirubin direct CPT 82248 | $93.80 | $268.00 | $4.01 – $201.00 | 26 |
| Bilirubin total CPT 82247 | $55.76 | $159.30 | $4.01 – $119.48 | 26 |
| Biopsy abdominal mass CPT 49180 | $690.55 | $1,973.00 | $1,183.68 – $1,479.60 | 7 |
| Biopsy bone trocar/needle superficial CPT 20220 | $642.60 | $1,836.00 | $1,101.60 – $1,377.00 | 7 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,234.80 | $3,528.00 | $2,116.80 – $2,646.00 | 8 |
| Biopsy muscle percutaneous needle CPT 20206 | $486.05 | $1,388.70 | $833.22 – $1,041.53 | 7 |
| Biopsy needle liver percutaneous CPT 47000 | $1,234.80 | $3,528.00 | $2,116.80 – $2,646.00 | 7 |
| Biopsy needle lymph node superficial CPT 38505 | $622.92 | $1,779.75 | $1,067.85 – $1,334.82 | 7 |
| Biopsy of foot joint lining CPT 28052 | $977.45 | $2,792.70 | $1,675.62 – $2,094.53 | 7 |
| Biopsy of prostate CPT 55700 | $907.83 | $2,593.80 | $1,556.28 – $1,945.35 | 7 |
| Biopsy of salivary gland 42400 CPT 42400 | $350.91 | $1,002.60 | $601.56 – $751.95 | 8 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $956.90 | $2,734.00 | $1,640.40 – $2,050.50 | 7 |
| Biopsy skin incisional single lesion CPT 11106 | $305.24 | $872.10 | $523.26 – $654.08 | 7 |
| Biospy of bladder CPT 53899 | $1,094.00 | $3,125.70 | $207.86 – $2,344.28 | 9 |
| Bivalirudin HCPCS J0583 | $863.63 | $2,467.50 | $0.23 – $1,850.63 | 9 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $136.15 | $389.00 | $233.40 – $291.75 | 8 |
| Bld prd mix CPT 86965 | $63.95 | $182.70 | $78.49 – $193.77 | 10 |
| Bld push tfuj 2 yr/< CPT 36440 | $265.86 | $759.60 | $455.76 – $569.70 | 8 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $8,124.20 | $23,212.00 | $92.61 – $311.91 | 14 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $12,250.00 | $35,000.00 | $100.00 – $444.15 | 6 |
| Bln dil 900ml preperitnl HCPCS C1727 | $3,379.90 | $9,656.85 | $100.00 – $2,100.27 | 6 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $6,967.44 | $19,906.95 | $100.00 – $4,128.87 | 14 |
| Bln press regulation 71-80cm HCPCS C1815 | $9,745.74 | $27,844.95 | $1,047.82 – $3,742.20 | 14 |
| Blood Clotting (PT/INR) Test CPT 85610 | $177.80 | $508.00 | $3.42 – $232.50 | 26 |
| Blood Clotting (PTT) Test CPT 85730 | $177.80 | $508.00 | $4.80 – $282.00 | 26 |
| Blood Count (CBC) Test CPT 85025 | $95.20 | $272.00 | $6.20 – $163.50 | 26 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $168.70 | $482.00 | $5.16 – $361.50 | 26 |
| Blood Culture Test CPT 87040 | $293.30 | $838.00 | $8.24 – $628.50 | 25 |
| Blood draw capillary 36416 CPT 36416 | not published | not published | $4.32 – $4.69 | 2 |
| Blood gases o2 saturation direct measurement CPT 82805 | $254.80 | $728.00 | $62.86 – $546.00 | 26 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $41.27 | $117.90 | $12.70 – $88.43 | 25 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $16.54 | $47.25 | $3.50 – $35.44 | 26 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $10.08 | $28.80 | $4.25 – $20.25 | 26 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $46.55 | $133.00 | $3.03 – $99.75 | 26 |
| Blood typing abo CPT 86900 | $189.66 | $541.88 | $2.38 – $406.41 | 14 |
| Blood typing ag donor ea ag CPT 86902 | $79.70 | $227.70 | $5.06 – $227.70 | 14 |
| Blood typing patient serum CPT 86904 | $40.64 | $116.10 | $13.04 – $87.08 | 14 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $493.15 | $1,409.00 | $3.06 – $216.90 | 14 |
| Blood typing rh (d) CPT 86901 | $46.31 | $132.30 | $2.38 – $99.23 | 14 |
| Bone Density Scan (DEXA) CPT 77080 | $405.30 | $1,158.00 | $37.14 – $868.50 | 15 |
| Bone/joint imaging ltd area CPT 78300 | $1,523.90 | $4,354.00 | $201.57 – $3,265.50 | 15 |
| Bone marrow;aspiration only 38220 CPT 38220 | $560.70 | $1,602.00 | $961.20 – $1,201.50 | 8 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $666.54 | $1,904.40 | $1,142.64 – $1,428.30 | 8 |
| Bone marrow imaging body CPT 78104 | $761.36 | $2,175.30 | $222.83 – $1,723.00 | 15 |
| Bone tendon board add on HCPCS C9356 | $10,838.31 | $30,966.60 | $320.87 – $23,224.95 | 14 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $34.65 | $99.00 | $13.59 – $74.25 | 26 |
| (both sides) smear without diff wbc count CPT 85008 | $8.82 | $25.20 | $2.74 – $18.90 | 26 |
| Bowel imaging CPT 78290 | $586.85 | $1,676.70 | $292.35 – $1,723.00 | 15 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $165.75 | $473.55 | $99.45 – $355.17 | 11 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $112.09 | $320.25 | $67.26 – $240.19 | 11 |
| Brace wrist classic lft sm HCPCS L3908 | $27.57 | $78.75 | $16.54 – $59.07 | 11 |
| Brach/thor cath 1st CPT 36215 | $1,199.52 | $3,427.20 | $100.00 – $2,570.40 | 10 |
| Brach/thor cath 2nd CPT 36216 | $620.87 | $1,773.90 | $100.00 – $1,330.43 | 10 |
| Brach/thor cath 3rd CPT 36217 | $1,229.76 | $3,513.60 | $100.00 – $2,635.20 | 10 |
| Brach/thor cath addl CPT 36218 | $275.94 | $788.40 | $52.43 – $591.30 | 10 |
| Brain image 4+ views CPT 78605 | $952.88 | $2,722.50 | $179.65 – $2,041.88 | 15 |
| Brain image w/flow 4 + views CPT 78606 | $1,242.05 | $3,548.70 | $289.49 – $2,661.53 | 15 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $2,331.00 | $6,660.00 | $323.14 – $4,995.00 | 16 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $1,599.85 | $4,571.00 | $222.52 – $3,428.25 | 16 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $1,523.55 | $4,353.00 | $211.09 – $3,264.42 | 16 |
| Brain MRI (with and without contrast) CPT 70553 | $4,891.25 | $13,975.00 | $311.70 – $10,481.25 | 16 |
| Brain MRI (with contrast) CPT 70552 | $4,141.20 | $11,832.00 | $264.73 – $8,874.00 | 16 |
| Brain MRI (without contrast) CPT 70551 | $3,000.90 | $8,574.00 | $192.04 – $6,430.50 | 16 |
| Bra surgical elizabeth pink sm HCPCS L8000 | $55.13 | $157.50 | $33.08 – $118.13 | 11 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $2,045.61 | $5,844.60 | $3,506.76 – $4,383.45 | 8 |
| Breast punct aspir cyst, bil CPT 19000 | $515.03 | $1,471.50 | $882.90 – $1,103.63 | 8 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | $1,916.46 | $5,475.60 | $3,285.36 – $4,106.70 | 7 |
| Br punct aspir ea add, l CPT 19001 | $252.32 | $720.90 | $100.00 – $540.68 | 8 |
| Bundled special stain group 1 microorganisms CPT 88312 | $189.67 | $541.90 | $67.05 – $406.43 | 11 |
| Bundled special stain group 2 CPT 88313 | $173.95 | $497.00 | $47.70 – $327.38 | 11 |
| Bur rotalink 2.15mm HCPCS C1724 | $9,628.85 | $27,511.00 | $100.00 – $10,291.42 | 14 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $6.99 | $19.95 | $0.99 – $14.97 | 9 |
| Bx bone trocar/ndl deep CPT 20225 | $1,167.08 | $3,334.50 | $2,000.70 – $2,500.88 | 7 |
| Bx breast 1st lesion strtctc CPT 19081 | $2,745.23 | $7,843.50 | $4,706.10 – $5,882.63 | 8 |
| Bx breast add lesion strtctc CPT 19082 | $2,489.45 | $7,112.70 | $100.00 – $5,334.53 | 10 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $1,473.15 | $4,209.00 | $100.00 – $3,156.75 | 10 |
| Bx pancreas pq ndl CPT 48102 | $542.75 | $1,550.70 | $930.42 – $1,163.03 | 7 |
| Bx pleura pq ndl CPT 32400 | $716.94 | $2,048.40 | $1,229.04 – $1,536.30 | 7 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $178.92 | $511.20 | $34.00 – $383.40 | 9 |
| Bx skin punch ea sep/ addl les CPT 11105 | $178.92 | $511.20 | $34.00 – $383.40 | 9 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $178.92 | $511.20 | $34.00 – $383.40 | 9 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $1,151.33 | $3,289.50 | $1,973.70 – $2,467.13 | 8 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $158.03 | $451.50 | $270.90 – $1,631.36 | 10 |
| Calcium 24 hour urine CPT 82340 | $34.02 | $97.20 | $4.82 – $72.90 | 25 |
| Calcium ionized CPT 82330 | $88.20 | $252.00 | $10.92 – $177.53 | 25 |
| Calcium total CPT 82310 | $75.71 | $216.30 | $4.11 – $162.23 | 25 |
| Calprotectin fecal CPT 83993 | $106.58 | $304.50 | $15.67 – $228.38 | 25 |
| Campylobacter antibody CPT 86625 | $52.61 | $150.30 | $10.47 – $112.73 | 26 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $23,084.88 | $65,956.80 | $100.00 – $562.50 | 14 |
| Cap nerve 2x15mm HCPCS C1763 | $14,393.14 | $41,123.25 | $232.63 – $830.82 | 14 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | $875.70 | $2,502.00 | $1,501.20 – $1,876.50 | 7 |
| Cap trach decann 15mm HCPCS C1750 | $807.40 | $2,306.85 | $332.96 – $1,189.13 | 14 |
| Carbamazepine free CPT 80157 | $62.37 | $178.20 | $10.57 – $133.65 | 25 |
| Carbamazepine total therapeutic drug level CPT 80156 | $45.50 | $130.00 | $11.63 – $93.15 | 25 |
| Carbon dioxide CPT 82374 | $22.37 | $63.90 | $3.89 – $47.93 | 25 |
| Carboxyhemoglobin quantitative CPT 82375 | $33.08 | $94.50 | $9.83 – $70.88 | 25 |
| Carcinoembryonic ag (cea) CPT 82378 | $207.90 | $594.00 | $15.13 – $445.50 | 25 |
| Cardiac perf planar mult/ef/wm CPT 78454 | $5,327.35 | $15,221.00 | $386.31 – $11,415.75 | 15 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | $4,421.90 | $12,634.00 | $259.02 – $9,475.50 | 15 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $4,421.90 | $12,634.00 | $299.96 – $9,475.50 | 15 |
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.