St. Luke's Health Memorial San Augustine
511 E. Hospital Street, San Augustine, TX · CommonSpirit Health · · NPI 1578547345
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 |
|---|---|---|---|---|
| Phys blood bank serv xmatch CPT 86077 | $11.71 | $78.02 | $14.05 – $136.04 | 9 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $169.94 | $1,132.91 | $2.84 – $35.06 | 10 |
| Pin caspar distraction 12mm HCPCS C1821 | $17,298.54 | $115,323.60 | $1,106.91 – $6,641.46 | 10 |
| Pinworm exam CPT 87172 | $21.75 | $145.00 | $3.59 – $130.50 | 21 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $662.27 | $4,415.12 | $1.24 – $35.06 | 10 |
| Place cath intracranial art CPT 36228 | $2,103.45 | $14,023.00 | $2,524.14 – $22,591.06 | 9 |
| Place cath xtrnl carotid CPT 36227 | $636.15 | $4,241.00 | $763.38 – $6,832.26 | 9 |
| Place duod/jej tube perc CPT 49441 | $755.55 | $5,037.00 | $906.66 – $5,238.48 | 7 |
| Place gastrostomy tube perc CPT 49440 | $633.00 | $4,220.00 | $759.60 – $4,388.80 | 7 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $708.60 | $4,724.00 | $850.32 – $7,610.37 | 9 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $354.30 | $2,362.00 | $100.00 – $3,805.19 | 10 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $777.60 | $5,184.00 | $933.12 – $8,351.43 | 9 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $2,073.75 | $13,825.00 | $2,488.50 – $14,378.00 | 7 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $132.60 | $884.00 | $100.00 – $1,311.36 | 10 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $3,944.40 | $26,296.00 | $4,733.28 – $27,347.84 | 7 |
| Place non-slctv cath thoracic arta CPT 36221 | $1,040.85 | $6,939.00 | $1,249.02 – $11,178.73 | 9 |
| Place right device/marker pros CPT 55876 | $642.75 | $4,285.00 | $771.30 – $4,456.40 | 7 |
| Place slctv cath carotd art uni CPT 36224 | $1,946.70 | $12,978.00 | $2,336.04 – $20,907.56 | 9 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $1,503.45 | $10,023.00 | $1,804.14 – $16,147.06 | 9 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $1,734.75 | $11,565.00 | $2,081.70 – $18,631.22 | 9 |
| Place slctv cath subclavian art CPT 36225 | $1,715.40 | $11,436.00 | $2,058.48 – $18,423.40 | 9 |
| Place slctv cath vertebral art uni CPT 36226 | $1,927.41 | $12,849.40 | $2,312.90 – $20,700.39 | 9 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $67.35 | $449.00 | $80.82 – $466.96 | 8 |
| Platelet aggregation each agent teg CPT 85576 | $13.08 | $87.16 | $15.69 – $107.69 | 21 |
| Platelet automated CPT 85049 | $23.85 | $159.00 | $3.76 – $143.10 | 21 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $508.05 | $3,387.00 | $100.00 – $1,259.44 | 8 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $463.80 | $3,092.00 | $100.00 – $1,709.76 | 8 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $658.50 | $4,390.00 | $100.00 – $1,811.68 | 8 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $894.60 | $5,964.00 | $1,073.52 – $6,202.56 | 7 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $1,266.30 | $8,442.00 | $1,519.56 – $8,779.68 | 7 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $1,949.40 | $12,996.00 | $2,339.28 – $13,515.84 | 7 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $303.15 | $2,021.00 | $100.00 – $3,255.84 | 10 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $325.20 | $2,168.00 | $100.00 – $3,492.17 | 10 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $325.95 | $2,173.00 | $100.00 – $3,500.71 | 10 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $112.80 | $751.99 | $100.00 – $782.07 | 9 |
| Plmt biliary drainage cath CPT 47534 | $2,089.05 | $13,927.00 | $2,506.86 – $14,484.08 | 7 |
| Plmt nephroureteral catheter CPT 50433 | $2,073.75 | $13,825.00 | $2,409.30 – $13,920.40 | 7 |
| Plmt ureteral stent prq CPT 50694 | $2,073.75 | $13,825.00 | $2,488.50 – $14,378.00 | 7 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $1,830.15 | $12,201.00 | $100.00 – $12,689.04 | 9 |
| Potassium 24 hour urine CPT 84133 | $35.70 | $238.00 | $3.97 – $214.20 | 21 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $71.74 | $478.21 | $0.12 – $35.06 | 10 |
| Potassium serum/plasma/whole blood CPT 84132 | $32.59 | $217.26 | $3.06 – $20.96 | 21 |
| Pq dr cath chg w cont s&i CPT 75984 | $534.60 | $3,564.00 | $100.00 – $3,706.56 | 9 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $2,508.45 | $16,723.00 | $3,010.14 – $17,391.92 | 7 |
| Pq thr inj ext pse CPT 36002 | $387.30 | $2,582.00 | $464.76 – $2,685.28 | 7 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $786.75 | $5,245.00 | $944.10 – $8,449.70 | 9 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $867.45 | $5,783.00 | $1,040.94 – $6,014.32 | 7 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $815.40 | $5,436.00 | $978.48 – $5,653.44 | 7 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $300.89 | $2,005.90 | $62.69 – $362.16 | 9 |
| Pr application of long arm splint CPT 29105 | $93.33 | $622.20 | $112.00 – $647.09 | 8 |
| Pr application splint static short arm CPT 29125 | $124.50 | $830.00 | $149.40 – $863.20 | 13 |
| Pr biopsy skin punch single lesion CPT 11104 | $105.90 | $706.00 | $127.08 – $734.24 | 7 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $16.95 | $113.00 | $20.34 – $117.52 | 15 |
| Prcrd drg 6+yr without anomly CPT 33017 | $447.90 | $2,986.00 | $537.48 – $4,810.45 | 9 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $94.95 | $633.00 | $52.45 – $657.80 | 15 |
| Prealbumin CPT 84134 | $29.25 | $195.00 | $5.22 – $62.83 | 21 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $5.85 | $38.95 | $0.41 – $116.85 | 19 |
| Prednisone 1 mg tablet HCPCS J7512 | $39.05 | $260.28 | $0.01 – $116.85 | 19 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $546.44 | $3,642.88 | $655.72 – $3,788.60 | 8 |
| Pregnancy associated plasma protein-a CPT 84163 | $95.85 | $639.00 | $12.64 – $575.10 | 21 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $561.75 | $3,745.00 | $131.99 – $3,894.80 | 15 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $484.35 | $3,229.00 | $131.99 – $3,357.15 | 15 |
| Prep skin to 100cm2 other CPT 15004 | $272.40 | $1,816.00 | $326.88 – $1,888.64 | 7 |
| Pressure velocity wire add ves CPT 93572 | $213.30 | $1,422.00 | $100.00 – $2,290.85 | 10 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $54.00 | $360.00 | $61.97 – $358.02 | 9 |
| Pretreat rbc absorption reference CPT 86978 | $20.74 | $138.24 | $21.66 – $152.54 | 9 |
| Pretreat rbc density gradient separation reference CPT 86972 | $24.15 | $161.00 | $28.98 – $178.00 | 9 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $43.29 | $288.58 | $11.88 – $127.13 | 9 |
| Pretreat rbc w enzyme reference CPT 86971 | $101.55 | $677.00 | $101.68 – $704.08 | 9 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $210.84 | $1,405.60 | $253.01 – $1,461.83 | 8 |
| Prgrmg eval implantable dfb CPT 93283 | $149.25 | $995.00 | $77.58 – $1,034.80 | 9 |
| Prgr stim/pace a/iv drug CPT 93623 | $2,217.45 | $14,783.00 | $100.00 – $23,815.42 | 11 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $1,036.50 | $6,910.00 | $1,243.80 – $7,186.40 | 7 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $1,141.35 | $7,609.00 | $100.00 – $12,258.10 | 10 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $304.35 | $2,029.00 | $365.22 – $2,110.16 | 8 |
| Pr incision & drainage abscess simple/single CPT 10060 | $177.00 | $1,180.00 | $212.25 – $1,226.29 | 8 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $182.53 | $1,216.86 | $219.04 – $1,265.54 | 8 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $281.10 | $1,874.00 | $337.28 – $1,948.69 | 8 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $333.00 | $2,220.00 | $26.99 – $2,308.80 | 9 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $3,701.41 | $24,676.05 | $3,677.47 – $22,064.81 | 10 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $587.42 | $3,916.10 | $26.30 – $151.93 | 9 |
| Procalcitonin CPT 84145 | $68.25 | $455.00 | $22.86 – $409.50 | 21 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $312.34 | $2,082.24 | $4.14 – $38.33 | 10 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | $0.12 | $0.75 | $0.11 – $1.79 | 19 |
| Progesterone CPT 84144 | $51.90 | $346.00 | $7.20 – $89.75 | 21 |
| Prolactin CPT 84146 | $74.85 | $499.00 | $7.20 – $83.75 | 21 |
| Promethazine 25 mg tablet HCPCS Q0169 | $1.59 | $10.58 | $0.10 – $1.52 | 19 |
| Promethazine hcl injection HCPCS J2550 | $74.47 | $496.46 | $0.64 – $35.06 | 10 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $157.26 | $1,048.35 | $0.10 – $35.06 | 10 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $294.99 | $1,966.56 | $5.46 – $35.06 | 10 |
| Prostate biopsy, any mthd HCPCS G0416 | $176.87 | $1,179.12 | $212.25 – $1,226.29 | 9 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $44.89 | $299.25 | $44.89 – $269.33 | 10 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $40.61 | $270.70 | $1.22 – $35.06 | 10 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $2,565.84 | $17,105.55 | $1,238.76 – $15,395.00 | 10 |
| Protein c activity CPT 85303 | $89.54 | $596.90 | $11.63 – $537.21 | 21 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $37.35 | $249.00 | $5.22 – $46.37 | 21 |
| Protein s total CPT 85305 | $44.85 | $299.00 | $9.75 – $269.10 | 21 |
| Protein total 24 hour urine CPT 84156 | $37.20 | $248.00 | $3.08 – $20.70 | 21 |
| Protein total body fluid CPT 84157 | $40.50 | $270.00 | $3.36 – $243.00 | 21 |
| Protein total serum plasma whole blood CPT 84155 | $31.95 | $213.00 | $3.08 – $191.70 | 21 |
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.