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 |
|---|---|---|---|---|
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $166.95 | $477.00 | $286.20 – $357.75 | 7 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $90.41 | $258.30 | $154.98 – $193.73 | 8 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $472.19 | $1,349.10 | $809.46 – $1,011.83 | 7 |
| Clsd tx fracture of radius 25500 CPT 25500 | $79.07 | $225.90 | $135.54 – $169.43 | 8 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $131.67 | $376.20 | $225.72 – $282.15 | 8 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $90.41 | $258.30 | $154.98 – $193.73 | 8 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $153.41 | $438.30 | $262.98 – $328.73 | 8 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $509.99 | $1,457.10 | $874.26 – $1,092.83 | 7 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $79.07 | $225.90 | $135.54 – $169.43 | 8 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $465.57 | $1,330.20 | $798.12 – $997.65 | 7 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $74.66 | $213.30 | $127.98 – $159.98 | 8 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $168.84 | $482.40 | $289.44 – $361.80 | 7 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $85.37 | $243.90 | $146.34 – $182.93 | 7 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $131.99 | $377.10 | $226.26 – $282.83 | 7 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $941.85 | $2,691.00 | $1,614.60 – $2,018.25 | 8 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $85.37 | $243.90 | $146.34 – $182.93 | 8 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $138.29 | $395.10 | $237.06 – $296.33 | 8 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $87.57 | $250.20 | $150.12 – $187.65 | 7 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $78.75 | $225.00 | $135.00 – $168.75 | 8 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $75.29 | $215.10 | $129.06 – $161.33 | 8 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $837.59 | $2,393.10 | $1,435.86 – $1,794.83 | 7 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $472.19 | $1,349.10 | $809.46 – $1,011.83 | 7 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $228.69 | $653.40 | $392.04 – $490.05 | 7 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $128.21 | $366.30 | $219.78 – $274.73 | 7 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $461.16 | $1,317.60 | $790.56 – $988.20 | 7 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $79.70 | $227.70 | $136.62 – $170.78 | 8 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $132.93 | $379.80 | $227.88 – $284.85 | 8 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $465.57 | $1,330.20 | $798.12 – $997.65 | 7 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $311.22 | $889.20 | $533.52 – $666.90 | 7 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $115.92 | $331.20 | $198.72 – $248.40 | 7 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $80.01 | $228.60 | $137.16 – $171.45 | 8 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $131.67 | $376.20 | $225.72 – $282.15 | 7 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $465.57 | $1,330.20 | $798.12 – $997.65 | 7 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $74.97 | $214.20 | $128.52 – $160.65 | 8 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $120.02 | $342.90 | $205.74 – $257.18 | 7 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $126.95 | $362.70 | $217.62 – $272.03 | 8 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $131.67 | $376.20 | $225.72 – $282.15 | 8 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $79.07 | $225.90 | $135.54 – $169.43 | 7 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $124.74 | $356.40 | $213.84 – $267.30 | 8 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $82.85 | $236.70 | $142.02 – $177.53 | 7 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $852.08 | $2,434.50 | $1,460.70 – $1,825.88 | 7 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $272.16 | $777.60 | $466.56 – $583.20 | 7 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $917.60 | $2,621.70 | $1,573.02 – $1,966.28 | 7 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $74.66 | $213.30 | $127.98 – $159.98 | 7 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $74.66 | $213.30 | $127.98 – $159.98 | 7 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $74.66 | $213.30 | $127.98 – $159.98 | 7 |
| C motor evoked lwr limbs CPT 95929 | $572.67 | $1,636.20 | $100.00 – $1,227.15 | 9 |
| C motor evoked uppr limbs CPT 95928 | $525.11 | $1,500.30 | $100.00 – $1,125.23 | 9 |
| #cmvcul-virus inoculation shell CPT 87254 | $18.27 | $52.20 | $15.61 – $39.15 | 25 |
| Coagulation time activated teg CPT 85347 | $108.05 | $308.70 | $3.42 – $165.38 | 25 |
| Cold agglutinin titer CPT 86157 | $52.92 | $151.20 | $6.43 – $113.40 | 25 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | not published | not published | $159.18 – $207.16 | 2 |
| Collection of venous blood by venipuncture CPT 36415 | $24.85 | $71.00 | $4.50 – $40.50 | 20 |
| Colonoscopy (diagnostic) CPT 45378 | $1,375.92 | $3,931.20 | $2,358.72 – $2,948.40 | 7 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $1,462.29 | $4,177.95 | $2,506.77 – $3,133.47 | 7 |
| Colonoscopy for bleeding 44391 CPT 44391 | $771.12 | $2,203.20 | $1,321.92 – $1,652.40 | 7 |
| Colonoscopy submucous njx CPT 45381 | $1,154.30 | $3,298.00 | $1,978.80 – $2,473.50 | 7 |
| Colonoscopy w/ablation CPT 45388 | $1,548.75 | $4,425.00 | $2,655.00 – $3,318.75 | 7 |
| Colonoscopy w/balloon dilat CPT 45386 | $1,212.75 | $3,465.00 | $2,079.00 – $2,598.75 | 7 |
| Colonoscopy w/control bleed CPT 45382 | $1,475.60 | $4,216.00 | $2,529.60 – $3,162.00 | 7 |
| Colonoscopy w/dilation CPT 44405 | $286.34 | $818.10 | $490.86 – $613.58 | 7 |
| Colonoscopy w/fb removal CPT 45379 | $1,358.70 | $3,882.00 | $2,329.20 – $2,911.50 | 7 |
| Colonoscopy (with biopsy) CPT 45380 | $1,521.45 | $4,347.00 | $2,608.20 – $3,260.25 | 7 |
| Colonoscopy (with polyp removal) CPT 45385 | $1,460.82 | $4,173.75 | $2,504.25 – $3,130.32 | 7 |
| Colpocentesis 57020 CPT 57020 | $547.47 | $1,564.20 | $938.52 – $1,173.15 | 7 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $1,058.09 | $3,023.10 | $1,813.86 – $2,267.33 | 7 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $249.62 | $713.20 | $90.04 – $534.90 | 10 |
| Compatibility test each unit electronic CPT 86923 | $51.03 | $145.80 | $67.74 – $193.77 | 10 |
| Compatibility test each unit immediate spin technique CPT 86920 | $249.62 | $713.20 | $84.26 – $534.90 | 10 |
| Compatibility test incubate CPT 86921 | $48.83 | $139.50 | $76.00 – $193.77 | 10 |
| Complement antigen each component c3 CPT 86160 | $133.00 | $380.00 | $9.58 – $285.00 | 25 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $179.24 | $512.10 | $307.26 – $384.08 | 7 |
| Concentration infection agents any type CPT 87015 | $31.82 | $90.90 | $5.33 – $64.13 | 25 |
| Condylomata destruction 56420 CPT 56420 | $74.34 | $212.40 | $127.44 – $159.30 | 8 |
| Connector tis 2x10mm HCPCS C9352 | $4,193.55 | $11,981.55 | $2,447.78 – $8,742.04 | 14 |
| Consultation pathology during surgery CPT 88329 | $58.16 | $166.15 | $47.70 – $124.62 | 11 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $1,092.76 | $3,122.15 | $78.37 – $2,341.62 | 11 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $163.27 | $466.48 | $32.09 – $349.86 | 11 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $292.25 | $835.00 | $99.04 – $626.25 | 11 |
| Contrast baths charges CPT 97034 | $40.01 | $114.30 | $22.63 – $317.00 | 9 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $3,162.03 | $9,034.37 | $120.31 – $6,775.78 | 15 |
| Contrast exam thoracic aorta CPT 75600 | $1,415.93 | $4,045.50 | $140.00 – $4,045.50 | 15 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $5,244.26 | $14,983.58 | $114.90 – $11,237.69 | 15 |
| Contrast x-ray of ankle CPT 73615 | $372.65 | $1,064.70 | $121.89 – $798.53 | 15 |
| Contrast x-ray of elbow CPT 73085 | $261.10 | $746.00 | $95.23 – $559.50 | 15 |
| Contrast x-ray of knee joint CPT 73580 | $643.86 | $1,839.60 | $105.39 – $1,379.70 | 15 |
| Contrast x-ray of wrist CPT 73115 | $275.31 | $786.60 | $128.56 – $589.95 | 15 |
| Controller infinity pt dbs HCPCS C1787 | $4,566.19 | $13,046.25 | $1,513.74 – $5,406.19 | 14 |
| Control nosebleed pack+caut 30905 CPT 30905 | $106.75 | $305.00 | $183.00 – $228.75 | 7 |
| Control of nosebleed ant comp 30903 CPT 30903 | $148.05 | $423.00 | $253.80 – $317.25 | 7 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $73.08 | $208.80 | $13.89 – $156.60 | 12 |
| Conversion ext bil drg cath CPT 47535 | $2,877.21 | $8,220.60 | $4,932.36 – $6,165.45 | 7 |
| Convert nephrostomy catheter CPT 50434 | $4,045.30 | $11,558.00 | $6,934.80 – $8,668.50 | 7 |
| Coombs direct CPT 86880 | $73.50 | $210.00 | $4.30 – $157.50 | 14 |
| Coombs indirect titer reference CPT 86886 | $76.23 | $217.80 | $4.13 – $217.80 | 14 |
| Core ndl bx lng/med perq CPT 32408 | $760.10 | $2,171.70 | $1,303.02 – $1,628.78 | 7 |
| Cor hlx vlgs double osteot CPT 28299 | $1,853.15 | $5,294.70 | $3,176.82 – $3,971.03 | 7 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | $1,795.50 | $5,130.00 | $3,078.00 – $3,847.50 | 7 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $8,176.35 | $23,361.00 | $1,553.51 – $17,520.75 | 9 |
| Coronary angio/lv gram/lt heart CPT 93458 | $7,570.50 | $21,630.00 | $1,438.40 – $16,222.50 | 9 |
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.