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 |
|---|---|---|---|---|
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $38.85 | $259.00 | $8.15 – $233.10 | 21 |
| Warde gastrin CPT 82941 | $43.61 | $290.70 | $14.81 – $261.63 | 21 |
| Warde growth hormone (hgh) CPT 83003 | $70.69 | $471.24 | $14.00 – $424.12 | 21 |
| Warde haloperidol therapeutic drug level CPT 80173 | $12.15 | $81.00 | $13.26 – $72.90 | 21 |
| Warde helminth antibody strongyloides igg CPT 86682 | $59.25 | $395.00 | $10.93 – $144.00 | 21 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $48.00 | $320.00 | $10.81 – $288.00 | 21 |
| Warde hepatitis a antibody CPT 86708 | $38.40 | $256.00 | $5.22 – $53.84 | 21 |
| Warde hepatitis be antibody CPT 86707 | $32.47 | $216.41 | $9.72 – $194.77 | 21 |
| Warde hepatitis delta agent antibody CPT 86692 | $35.85 | $239.00 | $14.41 – $215.10 | 21 |
| Warde immunofixation electrophoresis urine CPT 86335 | $56.40 | $376.00 | $24.65 – $338.40 | 21 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $34.80 | $231.95 | $9.69 – $208.76 | 21 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $166.69 | $1,111.25 | $106.77 – $1,112.75 | 21 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $74.22 | $494.74 | $19.80 – $204.30 | 21 |
| Warde lipoprotein-associated phospholipase a2 CPT 83698 | $12.90 | $86.00 | $15.48 – $200.42 | 21 |
| Warde mitochondrial antibody each CPT 86381 | $58.91 | $392.70 | $70.69 – $408.41 | 8 |
| Warde protein c antigen CPT 85302 | $36.19 | $241.25 | $10.09 – $217.13 | 21 |
| Warde sex hormone binding globulin CPT 84270 | $21.87 | $145.80 | $9.00 – $94.21 | 21 |
| Warde somatomedin CPT 84305 | $49.88 | $332.50 | $17.86 – $270.00 | 21 |
| Warde sugars single qualitative each specimen stool CPT 84376 | $18.60 | $124.00 | $4.62 – $111.60 | 21 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $38.36 | $255.68 | $9.00 – $68.80 | 21 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $99.15 | $660.96 | $13.50 – $219.87 | 21 |
| Warde topiramate therapeutic drug level CPT 80201 | $42.75 | $285.00 | $10.01 – $256.50 | 21 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $22.95 | $153.00 | $21.90 – $137.70 | 21 |
| Warde viscosity CPT 85810 | $12.30 | $82.00 | $9.80 – $73.80 | 21 |
| Warde vitamin a CPT 84590 | $76.69 | $511.25 | $9.75 – $460.13 | 21 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $40.95 | $273.00 | $17.83 – $245.70 | 21 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $50.10 | $334.00 | $23.60 – $300.60 | 21 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $20.55 | $137.00 | $8.31 – $61.38 | 21 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $84.00 | $559.98 | $15.48 – $166.03 | 21 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $40.35 | $269.00 | $11.91 – $242.10 | 21 |
| Warde zinc CPT 84630 | $28.80 | $192.00 | $9.57 – $172.80 | 21 |
| Western blot test CPT 84181 | $32.13 | $214.20 | $14.31 – $192.78 | 21 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $281.85 | $1,879.00 | $50.14 – $1,954.16 | 15 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $281.85 | $1,879.00 | $56.30 – $1,954.16 | 15 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $97.20 | $648.00 | $100.00 – $673.92 | 15 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $193.50 | $1,290.00 | $100.00 – $1,341.60 | 15 |
| Wrist X-ray CPT 73110 | $238.35 | $1,589.00 | $109.09 – $1,652.56 | 15 |
| Xe133 xenon 10mci HCPCS A9558 | $102.67 | $684.42 | $100.00 – $697.84 | 9 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | $127.80 | $852.00 | $153.36 – $1,372.58 | 9 |
| X-ray abdomen 1 view CPT 74018 | $160.95 | $1,073.00 | $95.55 – $1,115.53 | 15 |
| X-ray abdomen 2 views CPT 74019 | $194.70 | $1,298.00 | $114.95 – $1,349.92 | 15 |
| X-ray abdomen >=3 views CPT 74021 | $194.70 | $1,298.00 | $131.99 – $1,349.92 | 15 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $194.70 | $1,298.00 | $131.99 – $1,349.92 | 15 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $81.60 | $544.00 | $86.56 – $565.76 | 15 |
| X-ray ankle 2 views (both sides) CPT 73600 | $137.55 | $917.00 | $108.99 – $953.68 | 15 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $341.10 | $2,274.00 | $409.28 – $2,364.70 | 15 |
| X-ray bone age studies CPT 77072 | $60.29 | $401.88 | $72.34 – $417.96 | 15 |
| X-ray bone length studies CPT 77073 | $40.80 | $272.00 | $48.96 – $282.88 | 15 |
| X-ray bone survey complete CPT 77075 | $1,118.55 | $7,457.00 | $131.99 – $7,755.28 | 15 |
| X-ray cervical spine 2-3 views CPT 72040 | $374.10 | $2,494.00 | $109.09 – $2,593.76 | 15 |
| X-ray cervical spine 4-5 views CPT 72050 | $505.50 | $3,370.00 | $131.99 – $3,504.80 | 15 |
| X-ray cervical spine >= 6 views CPT 72052 | $591.45 | $3,943.00 | $131.99 – $4,100.72 | 15 |
| X-ray clavicle complete (both sides) CPT 73000 | $239.40 | $1,596.00 | $107.48 – $1,626.56 | 15 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $317.25 | $2,115.00 | $220.58 – $2,199.60 | 15 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $422.85 | $2,819.00 | $220.58 – $2,931.76 | 15 |
| X-ray elbow 2 views (both sides) CPT 73070 | $223.80 | $1,492.00 | $94.04 – $1,551.68 | 15 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $254.40 | $1,696.00 | $107.48 – $1,763.84 | 15 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $121.50 | $810.00 | $111.11 – $842.40 | 15 |
| X-ray exam entire spi 6/> vw CPT 72084 | $151.50 | $1,010.00 | $130.10 – $1,050.40 | 15 |
| X-ray exam of arm infant CPT 73092 | $62.73 | $418.20 | $75.28 – $434.93 | 15 |
| X-ray exam of eye sockets CPT 70200 | $137.86 | $919.02 | $131.99 – $955.79 | 15 |
| X-ray exam of femur 1 CPT 73551 | $49.95 | $333.00 | $59.94 – $346.32 | 15 |
| X-ray exam of jaw joint CPT 70332 | $198.15 | $1,321.00 | $237.78 – $1,373.84 | 15 |
| X-ray exam of middle ear CPT 70134 | $117.30 | $782.00 | $140.76 – $813.28 | 15 |
| X-ray exam of sinuses CPT 70210 | $151.05 | $1,007.00 | $107.48 – $1,047.28 | 15 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $71.10 | $474.00 | $85.32 – $492.96 | 15 |
| X-ray facial bones complete > 3 views CPT 70150 | $225.57 | $1,503.75 | $131.99 – $1,563.90 | 15 |
| X-ray femur >=2 views (both sides) CPT 73552 | $237.45 | $1,583.00 | $109.09 – $1,614.08 | 15 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $205.95 | $1,373.00 | $109.09 – $1,398.80 | 15 |
| X-ray foot 2 views (both sides) CPT 73620 | $175.50 | $1,170.00 | $92.53 – $1,216.80 | 15 |
| X-ray forearm 2 views (both sides) CPT 73090 | $162.60 | $1,084.00 | $95.55 – $1,105.52 | 15 |
| X-ray hand 2 views (both sides) CPT 73120 | $217.80 | $1,452.00 | $103.03 – $1,510.08 | 15 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $134.67 | $897.75 | $94.04 – $933.66 | 15 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $166.05 | $1,107.00 | $131.99 – $1,151.28 | 15 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $113.40 | $756.00 | $131.99 – $786.24 | 15 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $148.95 | $993.00 | $131.99 – $1,032.72 | 15 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $171.30 | $1,142.00 | $80.63 – $1,187.68 | 15 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $90.90 | $606.00 | $104.50 – $630.24 | 15 |
| X-ray humerus >= 2 views left CPT 73060 | $245.17 | $1,634.41 | $107.48 – $1,666.47 | 15 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $161.40 | $1,076.00 | $109.09 – $1,119.04 | 15 |
| X-ray knee 3 views (both sides) CPT 73562 | $194.40 | $1,296.00 | $109.09 – $1,347.09 | 15 |
| X-ray knee ap standing bilateral CPT 73565 | $190.50 | $1,270.00 | $109.09 – $1,320.80 | 15 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $66.30 | $442.00 | $79.56 – $459.68 | 15 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $401.70 | $2,678.00 | $131.99 – $2,785.12 | 15 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $514.95 | $3,433.00 | $131.99 – $3,570.32 | 15 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $607.65 | $4,051.00 | $131.99 – $4,213.04 | 15 |
| X-ray mandible complete > 4 views CPT 70110 | $146.43 | $976.14 | $131.99 – $1,015.19 | 15 |
| X-ray nasal bones complete > 3 views CPT 70160 | $168.60 | $1,124.00 | $109.09 – $1,168.96 | 15 |
| X-ray neck soft tissue CPT 70360 | $166.03 | $1,106.85 | $101.51 – $1,151.13 | 15 |
| X-ray nose to rectum for foreign body child CPT 76010 | $63.81 | $425.34 | $75.06 – $433.68 | 15 |
| X-ray of mammary ducts CPT 77054 | $242.70 | $1,618.00 | $212.18 – $1,682.72 | 15 |
| X-ray optic foramina CPT 70190 | $70.95 | $473.00 | $85.14 – $491.92 | 15 |
| X-ray pelvis 1-2 views CPT 72170 | $170.40 | $1,136.00 | $86.56 – $1,181.10 | 15 |
| X-ray pelvis complete > 3 views CPT 72190 | $257.25 | $1,715.00 | $131.99 – $1,783.60 | 15 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $501.15 | $3,341.00 | $87.40 – $3,474.64 | 15 |
| X-ray ribs 2 views left CPT 71100 | $374.55 | $2,497.00 | $109.09 – $2,596.88 | 15 |
| X-ray ribs 3 views bilateral CPT 71110 | $447.75 | $2,985.00 | $131.99 – $3,104.40 | 15 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $430.50 | $2,870.00 | $131.42 – $2,984.80 | 15 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $538.05 | $3,587.00 | $131.99 – $3,730.48 | 15 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $266.40 | $1,776.00 | $126.92 – $1,847.04 | 15 |
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.