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 |
|---|---|---|---|---|
| Anca screen with reflex to titer -quest CPT 86021 | $34.97 | $233.12 | $12.64 – $103.50 | 21 |
| An cholangiogram percutaneous compl CPT 47531 | $1,523.10 | $10,154.00 | $1,827.72 – $16,358.10 | 9 |
| Androstanediol CPT 82154 | $42.90 | $286.00 | $24.22 – $257.40 | 21 |
| An fluoro guide for cvp CPT 77001 | $143.85 | $959.00 | $100.00 – $997.36 | 9 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $7,146.75 | $47,645.00 | $8,576.10 – $49,550.80 | 7 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $4,676.10 | $31,174.00 | $5,611.32 – $32,420.96 | 7 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $2,844.60 | $18,964.00 | $100.00 – $30,551.01 | 10 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $95.09 | $633.91 | $6.69 – $38.62 | 8 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $7,650.90 | $51,006.00 | $9,181.08 – $53,046.24 | 7 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $1,414.05 | $9,427.00 | $100.00 – $15,186.90 | 10 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $2,544.15 | $16,961.00 | $3,052.98 – $17,639.44 | 7 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $527.85 | $3,519.00 | $100.00 – $5,669.11 | 10 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $1,649.70 | $10,998.00 | $1,979.64 – $11,437.92 | 7 |
| Ankle X-ray CPT 73610 | $264.30 | $1,762.00 | $109.09 – $1,796.08 | 15 |
| Anodyne therapy charges pt CPT 97026 | $7.95 | $53.00 | $9.00 – $52.00 | 9 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $44.64 | $297.57 | $10.82 – $235.80 | 21 |
| Antibody elution rbc reference CPT 86860 | $84.17 | $561.09 | $101.00 – $583.54 | 9 |
| Antibody htlv/hiv confirm test CPT 86689 | $26.32 | $175.44 | $16.25 – $148.50 | 21 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $61.50 | $410.00 | $15.43 – $369.00 | 21 |
| Antibody id rbc panel CPT 86870 | $199.50 | $1,330.00 | $31.50 – $188.45 | 9 |
| Antibody influenza virus CPT 86710 | $14.25 | $95.00 | $11.38 – $85.50 | 21 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $17.85 | $119.00 | $10.81 – $107.10 | 21 |
| Antibody screen rbc CPT 86850 | $65.10 | $434.00 | $25.40 – $279.90 | 9 |
| Antibody tetanus CPT 86774 | $54.15 | $361.00 | $12.43 – $324.90 | 21 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $49.32 | $328.75 | $59.18 – $341.90 | 8 |
| Antinuclear antibodies CPT 86038 | $74.70 | $498.00 | $10.16 – $448.20 | 21 |
| Antinuclear antibodies titer CPT 86039 | $60.00 | $400.00 | $8.28 – $47.88 | 21 |
| Antiphosphatidylserine antibody CPT 86148 | $19.05 | $127.00 | $13.50 – $114.30 | 21 |
| Antistreptolysin o screen CPT 86063 | $44.77 | $298.45 | $3.60 – $25.41 | 21 |
| Antithrombin iii activity CPT 85300 | $91.83 | $612.16 | $9.95 – $550.95 | 21 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $3,135.75 | $20,905.00 | $3,762.90 – $21,741.20 | 7 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $354.30 | $2,362.00 | $100.00 – $3,805.19 | 10 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $236.25 | $1,575.00 | $100.00 – $2,537.33 | 10 |
| Application long leg splint 29505 CPT 29505 | $116.70 | $778.00 | $140.04 – $809.12 | 8 |
| Application lower leg splint 29515 CPT 29515 | $122.56 | $817.02 | $147.07 – $849.71 | 8 |
| Application multi layer compression below knee (both sides) CPT 29581 | $116.10 | $774.00 | $139.28 – $804.70 | 7 |
| Application of paste boot 29580 CPT 29580 | $219.90 | $1,466.00 | $263.88 – $1,524.64 | 7 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $1,312.05 | $8,747.00 | $1,574.46 – $9,096.88 | 7 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $1,167.75 | $7,785.00 | $1,401.30 – $8,096.40 | 7 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $27.30 | $182.00 | $15.43 – $189.28 | 9 |
| Apply intrcav radiat compl CPT 77763 | $850.65 | $5,671.00 | $877.92 – $5,897.84 | 9 |
| Apply intrcav radiat interm CPT 77762 | $618.90 | $4,126.00 | $667.84 – $4,291.04 | 9 |
| Apply intrcav radiat simple CPT 77761 | $458.55 | $3,057.00 | $550.26 – $3,179.28 | 9 |
| Apply rigid leg cast 29445 CPT 29445 | $132.15 | $881.00 | $158.58 – $916.24 | 7 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $36.90 | $246.00 | $39.96 – $230.88 | 9 |
| Argatroban nonesrd (auromed) HCPCS J0898 | $13.54 | $90.24 | $12.64 – $81.22 | 9 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $2,051.27 | $13,675.12 | $2.95 – $35.06 | 9 |
| Arterial blood draw/perc 36620 CPT 36620 | $25.80 | $172.00 | $30.96 – $178.88 | 14 |
| Artery-vein nonautograft CPT 36830 | $1,449.45 | $9,663.00 | $1,739.34 – $10,049.52 | 7 |
| Artery xray each vessel 7577426 CPT 75774 | $138.30 | $922.00 | $100.00 – $958.88 | 9 |
| Artery xray of abdomen 75726-26 CPT 75726 | $1,187.25 | $7,915.00 | $346.63 – $8,231.60 | 15 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $1,219.50 | $8,130.00 | $310.88 – $8,455.20 | 15 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $1,325.40 | $8,836.00 | $321.17 – $9,189.44 | 15 |
| Artery x-rays chest CPT 75756 | $1,306.80 | $8,712.00 | $463.26 – $8,516.56 | 15 |
| Artery x-rays spine CPT 75705 | $1,258.50 | $8,390.00 | $578.42 – $8,725.60 | 15 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $108.15 | $721.00 | $129.78 – $749.84 | 8 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $152.10 | $1,014.00 | $182.52 – $1,054.56 | 7 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $172.20 | $1,148.00 | $206.64 – $1,193.92 | 8 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $105.45 | $703.00 | $126.54 – $731.12 | 7 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $133.50 | $890.00 | $160.20 – $925.60 | 8 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $133.50 | $890.00 | $160.20 – $925.60 | 7 |
| Ascenda two piece catheter HCPCS C1772 | $982.96 | $6,553.05 | $982.96 – $5,897.75 | 10 |
| Aspirate pleura without imaging 32554 CPT 32554 | $611.70 | $4,078.00 | $734.04 – $4,241.12 | 7 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $526.20 | $3,508.00 | $631.44 – $3,648.32 | 7 |
| Aspiration peritonsillar abscess CPT 42999 | $80.70 | $538.00 | $96.84 – $559.52 | 13 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $942.60 | $6,284.00 | $1,131.12 – $6,535.36 | 7 |
| Assay free hydroxyproline CPT 83500 | $34.35 | $229.00 | $19.03 – $206.10 | 21 |
| Assay of breath ethanol CPT 82075 | $21.72 | $144.76 | $25.20 – $130.29 | 21 |
| Assay of corticosterone CPT 82528 | $47.10 | $314.00 | $18.92 – $282.60 | 21 |
| Assay of endocrine hormone CPT 84235 | $60.15 | $401.00 | $59.83 – $360.90 | 21 |
| Assay of feces porphyrins CPT 84126 | $52.65 | $351.00 | $32.85 – $315.90 | 21 |
| Assay of glutathione CPT 82978 | $17.10 | $114.00 | $12.98 – $102.60 | 21 |
| Assay of leflunomide CPT 80193 | $53.25 | $355.00 | $32.40 – $319.50 | 21 |
| Assay of lrh hormone CPT 83727 | $76.50 | $510.00 | $14.44 – $459.00 | 21 |
| Assay of osteocalcin CPT 83937 | $28.65 | $191.00 | $25.07 – $171.90 | 21 |
| Assay of procainamide w/metab CPT 80192 | $44.10 | $294.00 | $14.07 – $264.60 | 21 |
| Assay of salicylate CPT 80179 | $36.72 | $244.80 | $15.66 – $220.32 | 21 |
| Assay of sialic acid CPT 84275 | $24.90 | $166.00 | $11.29 – $149.40 | 21 |
| Assay of somatostatin CPT 84307 | $99.45 | $663.00 | $15.36 – $596.70 | 21 |
| Assay of tyrosine CPT 84510 | $55.35 | $369.00 | $8.93 – $332.10 | 21 |
| Assay of urine sulfate CPT 84392 | $56.77 | $378.42 | $4.61 – $340.58 | 21 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $94.50 | $630.00 | $100.00 – $609.44 | 8 |
| Assess cyst contrast inject CPT 49424 | $27.90 | $186.00 | $33.48 – $299.65 | 10 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $22.65 | $151.00 | $3.59 – $20.70 | 21 |
| Ast/sgot CPT 84450 | $60.30 | $402.00 | $3.06 – $22.43 | 21 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | $1,751.66 | $11,677.74 | $121.60 – $10,509.97 | 9 |
| Athrectomy fem/pop/unilateral 37225 CPT 37225 | $9,657.60 | $64,384.00 | $11,589.12 – $66,959.36 | 7 |
| Athrectomy tib/pero/unilat/ini ves 37229 CPT 37229 | $9,808.80 | $65,392.00 | $11,770.56 – $68,007.68 | 7 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $65.39 | $435.93 | $0.11 – $35.06 | 10 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $2,176.20 | $14,508.00 | $2,611.44 – $23,372.39 | 9 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $2,508.45 | $16,723.00 | $3,010.14 – $17,391.92 | 7 |
| Autologous blood process CPT 86890 | $67.95 | $453.00 | $81.54 – $471.12 | 9 |
| Autolog prp diab wound ulcer HCPCS G0465 | $829.80 | $5,532.00 | $100.00 – $8,912.06 | 10 |
| Avul nail plate addl CPT 11732 | $55.95 | $373.00 | $67.14 – $600.91 | 10 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $109.89 | $732.56 | $72.54 – $692.27 | 13 |
| Azacitidine injection HCPCS J9025 | $2,031.03 | $13,540.16 | $0.45 – $12,186.15 | 10 |
| Azathioprine 50 mg tablet HCPCS J7500 | $21.92 | $146.08 | $1.31 – $35.06 | 10 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $99.46 | $663.04 | $2.33 – $72.89 | 10 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $254.41 | $1,696.07 | $100.00 – $657.13 | 8 |
| Bacterial meningitis antigen CPT 86403 | $52.80 | $352.00 | $9.69 – $316.80 | 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.