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 |
|---|---|---|---|---|
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $245.13 | $700.35 | $29.57 – $100.80 | 14 |
| Drug admin & hemodynmic meas CPT 93463 | $378.32 | $1,080.90 | $71.88 – $810.68 | 10 |
| Drug of abuse screen urine CPT 80305 | $154.67 | $441.90 | $10.05 – $331.43 | 25 |
| Drug test def 15-21 classes HCPCS G0482 | $59.50 | $170.00 | $100.30 – $298.11 | 26 |
| Drug test def 1-7 classes HCPCS G0480 | $236.60 | $676.00 | $55.76 – $171.65 | 26 |
| Drug test def 22+ classes HCPCS G0483 | $77.00 | $220.00 | $129.80 – $370.38 | 26 |
| Drug test def 8-14 classes HCPCS G0481 | $44.10 | $126.00 | $74.34 – $234.89 | 26 |
| Drug test prsmv instrmnt CPT 80306 | $154.67 | $441.90 | $13.68 – $62.78 | 25 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $156.10 | $446.00 | $49.59 – $164.25 | 25 |
| Drvvt confirm - quest CPT 85597 | $62.65 | $179.00 | $14.34 – $134.25 | 25 |
| Ductogram sgl duct CPT 77053 | $319.10 | $911.70 | $51.42 – $683.78 | 15 |
| Duplex scan unilateral study 93986 CPT 93986 | $582.44 | $1,664.10 | $185.98 – $1,248.08 | 9 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $210.42 | $601.20 | $101.54 – $450.90 | 13 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,389.50 | $3,970.00 | $186.33 – $2,977.50 | 13 |
| Dxa bone density axl vrt fx CPT 77085 | $182.35 | $521.00 | $50.79 – $390.75 | 15 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,410.26 | $4,029.30 | $2,417.58 – $3,021.98 | 7 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $1,655.64 | $4,730.40 | $2,838.24 – $3,547.80 | 7 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,466.80 | $7,048.00 | $4,228.74 – $5,285.93 | 7 |
| Ecg 12 lead tracing only CPT 93005 | $469.35 | $1,341.00 | $80.31 – $1,005.75 | 9 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $95.55 | $273.00 | $80.31 – $209.00 | 9 |
| Ecg external < 48 hours recording CPT 93225 | $260.19 | $743.40 | $100.00 – $557.55 | 9 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $908.78 | $2,596.50 | $100.00 – $1,947.38 | 9 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $3,033.80 | $8,668.00 | $100.00 – $6,501.00 | 9 |
| Echocardiography doppler color flow mapping CPT 93325 | $327.95 | $937.00 | $32.62 – $925.00 | 9 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $404.25 | $1,155.00 | $93.33 – $925.00 | 13 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $493.50 | $1,410.00 | $100.00 – $1,057.50 | 9 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $349.30 | $998.00 | $28.94 – $925.00 | 9 |
| Echo exam uterus 76831- CPT 76831 | $1,240.75 | $3,545.00 | $110.78 – $2,658.75 | 15 |
| Echo tee guidance CPT 93355 | $2,999.50 | $8,570.00 | $100.00 – $6,427.50 | 12 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,953.70 | $5,582.00 | $100.00 – $4,186.50 | 13 |
| Echo transesophageal intraop CPT 93318 | $1,608.71 | $4,596.30 | $100.00 – $3,447.23 | 13 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,346.41 | $3,846.88 | $100.00 – $2,885.16 | 13 |
| E coli 0157 ag ia CPT 87335 | $22.03 | $62.92 | $10.10 – $47.19 | 25 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $556.92 | $1,591.20 | $100.00 – $1,193.40 | 9 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $768.29 | $2,195.10 | $59.45 – $1,646.33 | 9 |
| Eeg during surgery CPT 95955 | $497.07 | $1,420.20 | $100.00 – $1,065.15 | 9 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $823.90 | $2,354.00 | $100.00 – $1,765.50 | 9 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $720.72 | $2,059.20 | $100.00 – $1,544.40 | 9 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $332.01 | $948.60 | $100.00 – $876.00 | 9 |
| Eeg recording awake and asleep CPT 95819 | $1,420.65 | $4,059.00 | $100.00 – $3,044.25 | 9 |
| E equine encephalitis igg CPT 86652 | $49.14 | $140.40 | $10.53 – $105.30 | 26 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $383.67 | $1,096.20 | $657.72 – $822.15 | 8 |
| Egd control bleeding any CPT 43255 | $980.70 | $2,802.00 | $1,681.20 – $2,101.50 | 7 |
| Egd dilate stricture CPT 43245 | $877.10 | $2,506.00 | $1,503.60 – $1,879.50 | 7 |
| Egd endoscopic stent place CPT 43266 | $2,249.73 | $6,427.80 | $3,856.68 – $4,820.85 | 8 |
| Egd guide wire insertion CPT 43248 | $727.97 | $2,079.90 | $1,247.94 – $1,559.93 | 7 |
| Egd injection varices CPT 43243 | $672.84 | $1,922.40 | $1,153.44 – $1,441.80 | 7 |
| Egd lesion ablation CPT 43270 | $521.49 | $1,489.95 | $893.97 – $1,117.47 | 8 |
| Egd remove foreign body CPT 43247 | $815.85 | $2,331.00 | $1,398.60 – $1,748.25 | 7 |
| Egd remove lesion snare CPT 43251 | $836.80 | $2,390.85 | $1,434.51 – $1,793.14 | 7 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $688.59 | $1,967.40 | $1,180.44 – $1,475.55 | 7 |
| Egd varices ligation CPT 43244 | $993.72 | $2,839.20 | $1,703.52 – $2,129.40 | 7 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | not published | not published | $53.14 – $69.16 | 2 |
| Elect analysis of infusion pump 62367 CPT 62367 | not published | not published | $37.89 – $49.31 | 2 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | not published | not published | $53.14 – $77.17 | 2 |
| Electrd sq emblem s-icd HCPCS C1896 | $8,732.54 | $24,950.10 | $100.00 – $14,888.48 | 14 |
| Electrical bone stim 20974 CPT 20974 | not published | not published | $86.68 – $130.02 | 13 |
| Electrical stimulation/unattended 97014 CPT 97014 | $95.90 | $274.00 | $22.10 – $293.00 | 9 |
| Electrocorticography durng sx CPT 95829 | $437.54 | $1,250.10 | $100.00 – $1,250.10 | 9 |
| Electrolyte panel CPT 80051 | $154.00 | $440.00 | $5.60 – $315.90 | 25 |
| Electrophysiology evaluation CPT 93641 | $617.72 | $1,764.90 | $100.00 – $1,323.68 | 11 |
| Embolization s&i CPT 75894 | $729.86 | $2,085.30 | $100.00 – $1,563.98 | 11 |
| Embo or occlude vascular arterial s&i CPT 37242 | $3,363.89 | $9,611.10 | $5,766.66 – $7,208.33 | 8 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $4,973.85 | $14,211.00 | $8,526.60 – $10,658.25 | 8 |
| Embo or occlude vascular venous s&i CPT 37241 | $3,578.72 | $10,224.90 | $6,134.94 – $7,668.68 | 8 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $240.35 | $686.70 | $100.00 – $515.03 | 9 |
| Encephalitis, california igg/igm CPT 86651 | $40.01 | $114.30 | $10.53 – $85.73 | 26 |
| Encephalitis, st louis igg/igm CPT 86653 | $26.78 | $76.50 | $10.53 – $57.38 | 26 |
| Encephalitis, western equine igg/igm CPT 86654 | $45.05 | $128.70 | $10.53 – $96.53 | 26 |
| Endo cath bile duct s&i CPT 74328 | $606.01 | $1,731.45 | $51.32 – $1,298.59 | 11 |
| Endo cholangiopancreatograph CPT 43261 | $2,098.25 | $5,995.00 | $3,597.00 – $4,496.25 | 7 |
| Endo cholangiopancreatograph CPT 43262 | $2,217.95 | $6,337.00 | $3,802.20 – $4,752.75 | 7 |
| Endoluminal bx biliary tree CPT 47543 | $2,115.23 | $6,043.50 | $100.00 – $4,532.63 | 9 |
| Endoluminl ivus oct c 1st CPT 92978 | $1,804.95 | $5,157.00 | $100.00 – $3,867.75 | 11 |
| Endoluminl ivus oct c ea CPT 92979 | $565.43 | $1,615.50 | $100.00 – $1,211.63 | 11 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $152.52 | $435.75 | $0.80 – $109.20 | 11 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | $36.86 | $105.30 | $9.56 – $78.98 | 25 |
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $572.36 | $1,635.30 | $981.18 – $1,226.48 | 7 |
| Epidrm a-grft f/n/hf/g addl CPT 15116 | $572.60 | $1,636.00 | $100.00 – $1,227.00 | 9 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $407.30 | $1,163.70 | $698.22 – $872.78 | 7 |
| Epidrm autogrft t/a/l add-on CPT 15111 | $407.30 | $1,163.70 | $77.39 – $872.78 | 9 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $762.93 | $2,179.80 | $100.00 – $1,634.85 | 9 |
| Epstein barr early antigen antibody CPT 86663 | $29.40 | $84.00 | $10.47 – $63.00 | 26 |
| Epstein barr nuclear antigen antibody CPT 86664 | $26.60 | $75.99 | $12.20 – $57.00 | 26 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $85.40 | $244.00 | $14.48 – $183.00 | 26 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $774.33 | $2,212.35 | $16.57 – $541.80 | 14 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $1,332.77 | $3,807.90 | $2,284.74 – $2,855.93 | 8 |
| Ercp remove duct calculi 43264 CPT 43264 | $983.12 | $2,808.90 | $1,685.34 – $2,106.68 | 7 |
| Ercp remove forgn body duct 43275 CPT 43275 | $900.27 | $2,572.20 | $1,543.32 – $1,929.15 | 8 |
| Ercp stent exchange w/dilate CPT 43276 | $1,337.49 | $3,821.40 | $2,292.84 – $2,866.05 | 8 |
| Ercp w/specimen collection CPT 43260 | $1,998.15 | $5,709.00 | $3,425.40 – $4,281.75 | 7 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $207.27 | $592.20 | $15.72 – $592.20 | 11 |
| ER Visit (level 1, minor) CPT 99281 | $236.60 | $676.00 | $48.79 – $507.00 | 13 |
| ER Visit (level 2) CPT 99282 | $508.20 | $1,452.00 | $48.79 – $1,089.00 | 13 |
| ER Visit (level 3) CPT 99283 | $891.80 | $2,548.00 | $48.79 – $1,911.00 | 13 |
| ER Visit (level 4) CPT 99284 | $1,351.35 | $3,861.00 | $256.76 – $2,895.75 | 13 |
| ER Visit (level 5, high severity) CPT 99285 | $1,753.15 | $5,009.00 | $333.10 – $3,756.75 | 13 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $823.73 | $2,353.50 | $1,412.10 – $1,765.13 | 7 |
| Esoph egd dilation <30 mm CPT 43249 | $813.33 | $2,323.80 | $1,394.28 – $1,742.85 | 7 |
| Establish access to artery CPT 36100 | $269.01 | $768.60 | $51.12 – $576.45 | 10 |
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.