healthcosts.net

St. Luke's Health Memorial San Augustine

511 E. Hospital Street, San Augustine, TX · CommonSpirit Health · · NPI 1578547345

Source: hospital's published price file ↗ · Published Feb 28, 2026 · Ingested Sep 10, 2026

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
Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 $154.83 $1,032.15 $154.83 – $928.94 10
Ortho hnd without jnt w/fit&adj HCPCS L3919 $154.83 $1,032.15 $154.83 – $928.94 10
Orthopantogram CPT 70355 $44.55 $297.00 $35.70 – $308.88 15
Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 $204.91 $1,366.05 $204.91 – $1,229.45 10
Oscillation chest wall mechanical per session CPT 94669 $103.28 $688.50 $100.00 – $716.04 9
Osmolality blood CPT 83930 $49.69 $331.25 $5.04 – $28.43 21
Osmolality urine CPT 83935 $53.63 $357.50 $5.04 – $29.90 21
Ot evaluation high complexity patient/family CPT 97167 $164.25 $1,095.00 $100.00 – $1,138.80 9
Ot evaluation low complexity patient/family CPT 97165 $98.55 $657.00 $100.00 – $683.28 9
Ot evaluation moderate complexity patient/family CPT 97166 $131.40 $876.00 $100.00 – $911.04 9
Other immunoelectrophoresis CPT 86325 $42.75 $285.00 $19.43 – $256.50 21
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 $24.60 $164.00 $29.52 – $170.56 9
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 $41.25 $275.00 $49.50 – $286.00 9
Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 $54.15 $361.00 $60.93 – $375.44 9
Ot re-evaluation patient/family CPT 97168 $98.55 $657.00 $100.00 – $683.28 9
Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 $56.25 $375.00 $67.50 – $390.00 9
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 $25.95 $173.00 $31.14 – $179.92 9
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 $27.30 $182.00 $32.63 – $188.50 9
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 $42.90 $286.00 $51.48 – $297.44 9
Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 $36.15 $241.00 $43.34 – $250.40 9
Ot training self care/home management direct contact each 15 minutes CPT 97535 $41.85 $279.00 $50.22 – $290.16 9
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 $780.84 $5,205.60 $0.98 – $35.06 10
Oxaliplatin 5 mg/ml desensitization HCPCS J9263 $460.76 $3,071.73 $0.08 – $67.31 10
Oxytocin 10 unit/ml injection solution HCPCS J2590 $62.73 $418.19 $1.16 – $35.06 10
Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 $37,800.00 $252,000.00 $37,800.00 – $226,800.00 10
Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 $105.64 $704.23 $0.14 – $35.06 10
Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 $4,782.25 $31,881.61 $18.81 – $28,693.45 9
Palonosetron hcl HCPCS J2469 $138.82 $925.44 $0.83 – $40.51 9
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 $9.38 $62.47 $5.46 – $35.06 10
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 $435.42 $2,902.80 $5.46 – $35.06 9
Papaverin hcl injection HCPCS J2440 $718.55 $4,790.31 $12.15 – $70.18 9
Parathormone (pth) intact CPT 83970 $99.15 $660.96 $10.44 – $178.00 21
Parathyroid planar imaging CPT 78070 $528.19 $3,521.25 $489.74 – $2,929.68 15
Parathyroid planar img w/tomo spect CPT 78071 $422.55 $2,817.00 $489.74 – $2,929.68 15
Paricalcitol HCPCS J2501 $867.60 $5,784.00 $0.86 – $35.06 10
Paring/cutting benign hyperkeratotic lesion single CPT 11055 $113.70 $758.00 $136.44 – $1,221.14 9
Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 $1,804.54 $12,030.25 $2.89 – $720.96 10
Passy muir valve metal trach HCPCS L8501 $451.71 $3,011.40 $451.71 – $2,710.26 10
Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 $12.13 $80.85 $12.13 – $72.77 10
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 $36,040.45 $240,269.61 $33,637.75 – $216,242.65 9
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 $22,702.20 $151,348.00 $136.14 – $136,213.20 9
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 $24,148.20 $160,988.00 $202.17 – $144,889.20 9
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 $24,872.65 $165,817.64 $23,214.47 – $149,235.88 9
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 $24,148.20 $160,988.00 $191.10 – $167,427.52 9
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 $14,460.00 $96,400.00 $13,496.00 – $86,760.00 9
Pelvic CT scan (with and without contrast) CPT 72194 $1,636.50 $10,910.00 $209.55 – $11,346.40 15
Pelvic CT scan (with contrast) CPT 72193 $1,482.30 $9,882.00 $209.55 – $10,277.28 15
Pelvic CT scan (without contrast) CPT 72192 $856.80 $5,712.00 $128.89 – $5,940.48 15
Pelvic MRI (with and without contrast) CPT 72197 $1,584.45 $10,563.00 $439.13 – $10,984.89 15
Pelvic MRI (with contrast) CPT 72196 $1,267.50 $8,450.00 $439.13 – $8,788.00 15
Pelvic MRI (without contrast) CPT 72195 $1,077.45 $7,183.00 $268.00 – $7,470.32 15
Pelvic Ultrasound (complete) CPT 76856 $605.55 $4,037.00 $137.30 – $4,198.48 15
Pelvic Ultrasound (limited) CPT 76857 $282.45 $1,883.00 $108.99 – $1,958.32 15
Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 $20,467.46 $136,449.67 $82.09 – $23,846.43 9
Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 $11,973.75 $79,824.99 $5.89 – $14,733.94 9
Peng benzathine/procaine inj HCPCS J0558 $363.50 $2,423.31 $5.46 – $35.06 9
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 $437.38 $2,915.82 $26.96 – $1,891.37 9
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 $121.99 $813.24 $1.14 – $35.06 10
Penicillin g procaine inj HCPCS J2510 $160.16 $1,067.73 $5.46 – $38.95 9
Penile injection CPT 54235 $79.88 $532.53 $95.86 – $553.84 8
Perc d-e cor revasc chro add HCPCS C9608 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc d-e cor revasc chro sin HCPCS C9607 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc d-e cor revasc t cabg b HCPCS C9605 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc d-e cor revasc t cabg s HCPCS C9604 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc d-e cor stent ather br HCPCS C9603 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc d-e cor stent ather s HCPCS C9602 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc drug-el cor stent bran HCPCS C9601 $7,561.20 $50,408.00 $100.00 – $81,207.29 10
Perc drug-el cor stent sing HCPCS C9600 $7,561.13 $50,407.50 $100.00 – $81,206.49 10
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 $412.98 $2,753.19 $26.20 – $187.11 10
Pericardiocentesis wwo imaging CPT 33016 $220.50 $1,470.00 $264.60 – $1,528.80 7
Peripheral vascular rehab CPT 93668 $28.16 $187.68 $33.79 – $195.19 9
Peri-proc device eval icd CPT 93287 $344.10 $2,294.00 $43.19 – $3,695.64 11
Perit-vens shunt pat tst CPT 78291 $199.95 $1,333.00 $239.94 – $1,386.32 15
Perphenazine 4mg oral HCPCS Q0175 $0.73 $4.85 $0.13 – $2.07 19
Perq clsr tcat l atr apndge CPT 33340 $7,454.44 $49,696.25 $8,945.33 – $80,060.66 9
Perq dev breast 1st mr guide CPT 19287 $393.90 $2,626.00 $472.68 – $4,230.49 9
Perq dev breast 1st strtctc CPT 19283 $725.55 $4,837.00 $870.63 – $7,792.06 9
Perq plmt bile duct stent CPT 47538 $2,324.10 $15,494.00 $2,788.92 – $16,113.76 7
Perq plmt bile duct stent CPT 47539 $2,324.10 $15,494.00 $2,788.92 – $16,113.76 7
Perq plmt bile duct stent CPT 47540 $2,324.10 $15,494.00 $2,788.92 – $16,113.76 7
Perqt bx lung/mediastinum 32405 CPT 32405 $531.60 $3,544.00 $100.00 – $5,709.39 10
Pertussis ag if CPT 87265 $61.80 $412.00 $10.06 – $370.80 21
Pertuzumab 30 mg/ml desensitization HCPCS J9306 $1,370.85 $9,138.97 $22.73 – $8,225.08 9
Pet CT skull-mid thgh initial CPT 78815 $1,764.15 $11,761.00 $1,581.95 – $12,231.44 15
Pet CT whole body initial CPT 78816 $1,817.10 $12,114.00 $1,581.95 – $12,598.56 15
Pet fdg brain metoblic eval sb CPT 78608 $1,109.70 $7,398.00 $1,331.64 – $7,693.92 15
Pet image w/ct lmtd CPT 78814 $1,023.30 $6,822.00 $1,227.96 – $7,094.88 15
Pfc sigma fem post aug sz3 8mm HCPCS C1776 $23,112.97 $154,086.45 $39.45 – $236.70 10
Ph body fluid CPT 83986 $26.07 $173.75 $3.01 – $125.10 21
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 $75.73 $504.83 $5.46 – $38.95 10
Phenobarbital therapeutic drug level CPT 80184 $63.90 $426.00 $10.44 – $65.81 21
Phentolaine mesylate inj HCPCS J2760 $1,474.92 $9,832.80 $414.85 – $8,849.52 9
Phenylephrine 10 mg/ml injection solution HCPCS J2371 $520.56 $3,470.40 $5.46 – $35.06 9
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 $58.13 $387.53 $0.50 – $35.06 10
Phenytoin total therapeutic drug level CPT 80185 $62.58 $417.18 $8.28 – $56.83 21
Phlebotomy therapeutic CPT 99195 $60.00 $400.00 $30.24 – $174.72 8
Phosphorus CPT 84100 $33.51 $223.38 $3.06 – $20.96 21
Phosphorus 24 hour urine CPT 84105 $26.93 $179.52 $4.86 – $140.44 21
Phys blood bank serv authrj CPT 86079 $23.40 $156.00 $28.08 – $162.24 9
Phys blood bank serv reactj CPT 86078 $22.80 $152.00 $27.36 – $158.08 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.