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 |
|---|---|---|---|---|
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $25.43 | $169.48 | $10.85 – $152.54 | 10 |
| Buprenorphine hydrochloride HCPCS J0592 | $42.14 | $280.91 | $4.55 – $292.15 | 9 |
| Bur rotalink 2.15mm HCPCS C1724 | $4,923.93 | $32,826.15 | $100.00 – $13,130.46 | 10 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $138.53 | $923.52 | $1.95 – $93.71 | 10 |
| Bx bone trocar/ndl deep CPT 20225 | $297.15 | $1,981.00 | $356.40 – $2,059.20 | 7 |
| Bx breast 1st lesion mr imag CPT 19085 | $1,011.00 | $6,740.00 | $1,213.20 – $7,009.60 | 7 |
| Bx breast 1st lesion strtctc CPT 19081 | $1,401.57 | $9,343.75 | $1,287.00 – $7,436.00 | 7 |
| Bx breast add lesion mr imag CPT 19086 | $981.45 | $6,543.00 | $100.00 – $10,540.78 | 10 |
| Bx breast add lesion strtctc CPT 19082 | $878.40 | $5,856.00 | $100.00 – $9,159.91 | 10 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $976.95 | $6,513.00 | $100.00 – $10,492.45 | 10 |
| Bx pancreas pq ndl CPT 48102 | $528.75 | $3,525.00 | $634.50 – $3,666.00 | 7 |
| Bx pleura pq ndl CPT 32400 | $528.75 | $3,525.00 | $634.50 – $3,666.00 | 7 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $114.30 | $762.00 | $100.00 – $1,227.59 | 10 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | $332.25 | $2,215.00 | $398.70 – $2,303.60 | 7 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $291.60 | $1,944.00 | $349.92 – $2,021.76 | 7 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $310.80 | $2,072.00 | $372.96 – $2,154.88 | 7 |
| C-1 esterase, berinert HCPCS J0597 | $10,255.04 | $68,366.88 | $77.25 – $61,530.20 | 9 |
| C1 esterase inhibitor func - sendout CPT 86161 | $134.55 | $897.00 | $10.08 – $807.30 | 21 |
| Cable cath 22-pin diag HCPCS C1730 | $1,530.12 | $10,200.75 | $55.92 – $335.48 | 10 |
| Cadd pump refill CPT 96521 | $117.94 | $786.24 | $100.00 – $817.69 | 9 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $36.02 | $240.11 | $1.72 – $56.52 | 10 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $5,434.82 | $36,232.14 | $1,325.56 – $23,773.90 | 9 |
| Calcium 24 hour urine CPT 82340 | $22.35 | $149.00 | $5.07 – $134.10 | 21 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $78.09 | $520.56 | $5.46 – $35.06 | 9 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $68.55 | $456.94 | $7.02 – $40.51 | 8 |
| Calcium ionized CPT 82330 | $41.31 | $275.40 | $11.49 – $247.86 | 21 |
| Calcium total CPT 82310 | $39.57 | $263.75 | $4.14 – $22.43 | 21 |
| Calculi urinary-sendout CPT 82360 | $13.50 | $90.00 | $10.81 – $81.00 | 21 |
| Calprotectin fecal CPT 83993 | $70.95 | $473.00 | $16.49 – $425.70 | 21 |
| Campylobacter antibody CPT 86625 | $101.85 | $679.00 | $11.02 – $611.10 | 21 |
| Candida dna CPT 87480 | $21.60 | $144.00 | $16.84 – $129.60 | 21 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $51,677.49 | $344,516.55 | $48.20 – $289.17 | 10 |
| Cap nerve 2x15mm HCPCS C1763 | $17,536.84 | $116,912.25 | $31.98 – $191.84 | 10 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | $894.15 | $5,961.00 | $1,072.98 – $6,199.44 | 7 |
| Cap trach decann 15mm HCPCS C1750 | $2,555.28 | $17,035.20 | $100.00 – $707.81 | 10 |
| Carbamazepine free CPT 80157 | $34.05 | $227.00 | $11.13 – $204.30 | 21 |
| Carbamazepine free -sendout CPT 80161 | $53.25 | $355.00 | $15.66 – $319.50 | 21 |
| Carbamazepine total therapeutic drug level CPT 80156 | $72.60 | $484.00 | $8.28 – $62.83 | 21 |
| Carbohydrate deficient transf - sendout CPT 82373 | $52.95 | $353.00 | $15.17 – $317.70 | 21 |
| Carbon dioxide CPT 82374 | $25.67 | $171.08 | $4.10 – $153.98 | 21 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $11.22 | $74.78 | $4.79 – $67.31 | 10 |
| Carcinoembryonic ag (cea) CPT 82378 | $98.85 | $659.00 | $8.28 – $82.28 | 21 |
| Cardiac MRI w/stress img CPT 75559 | $526.80 | $3,512.00 | $632.16 – $3,652.48 | 15 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $1,829.55 | $12,197.00 | $532.55 – $12,684.88 | 15 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $89.25 | $595.00 | $30.86 – $618.80 | 9 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $46.50 | $310.00 | $19.28 – $322.40 | 9 |
| Cardiac shunt imaging CPT 78428 | $316.20 | $2,108.00 | $285.93 – $2,192.32 | 15 |
| Cardiolipin antibody iga CPT 86147 | $86.55 | $577.00 | $14.58 – $110.67 | 21 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $388.35 | $2,589.00 | $100.00 – $2,692.56 | 14 |
| Cardioversion/elective/internal 92961 CPT 92961 | $273.45 | $1,823.00 | $100.00 – $2,761.26 | 10 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | $8,057.09 | $53,713.89 | $69.91 – $48,342.51 | 9 |
| Carotene CPT 82380 | $20.55 | $137.00 | $7.74 – $123.30 | 21 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $567.30 | $3,782.00 | $294.24 – $3,932.39 | 15 |
| Car seat/bed test additional 30 minutes CPT 94781 | $18.15 | $121.00 | $18.51 – $125.84 | 9 |
| Catecholamines,fractionated, urine CPT 82382 | $50.95 | $339.66 | $22.93 – $305.70 | 21 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $855.70 | $5,704.65 | $144.59 – $867.51 | 10 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $2,963.37 | $19,755.75 | $100.00 – $4,149.60 | 8 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $26.15 | $174.30 | $31.38 – $181.28 | 8 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $2,755.94 | $18,372.90 | $100.00 – $8,828.82 | 8 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $1,387.89 | $9,252.60 | $5.86 – $147.84 | 10 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $3,715.59 | $24,770.55 | $100.00 – $9,908.22 | 10 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $6,300.00 | $42,000.00 | $9.45 – $961.38 | 10 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $220.50 | $1,470.00 | $100.00 – $1,528.80 | 8 |
| Cath bi-dir df smarttouch HCPCS C1732 | $3,548.48 | $23,656.50 | $100.00 – $721.82 | 8 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $2,184.69 | $14,564.55 | $94.88 – $5,825.82 | 10 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $7,699.50 | $51,330.00 | $100.00 – $82,692.63 | 10 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $21,053.03 | $140,353.50 | $7.56 – $327.60 | 10 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $946.26 | $6,308.40 | $100.00 – $1,953.42 | 10 |
| Cath entrl fd nutri 5fr 40cm HCPCS B4082 | $30.04 | $200.23 | $36.05 – $208.24 | 8 |
| Catheter declot mechanical CPT 36596 | $281.25 | $1,875.00 | $337.50 – $1,950.00 | 7 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $44.40 | $296.00 | $2.34 – $26.49 | 18 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $40,636.74 | $270,911.55 | $0.95 – $5.67 | 10 |
| Cath hawkone s directional HCPCS C1714 | $4,580.73 | $30,538.20 | $100.00 – $11,556.64 | 8 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $2,666.79 | $17,778.60 | $100.00 – $2,708.16 | 8 |
| Cath infuse micro 150cm rapidtransit HCPCS A4351 | $3.30 | $22.00 | $0.42 – $2.41 | 9 |
| Cath left heart/lv gram CPT 93452 | $6,062.55 | $40,417.00 | $100.00 – $65,111.79 | 10 |
| Cath left heart transseptal punc CPT 93462 | $1,071.45 | $7,143.00 | $100.00 – $11,507.38 | 10 |
| Cath lt/rt pulm art CPT 36014 | $1,548.15 | $10,321.00 | $100.00 – $16,627.14 | 10 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $686.39 | $4,575.90 | $5.58 – $493.08 | 10 |
| Cath place 1st order venous 36011 CPT 36011 | $145.50 | $970.00 | $100.00 – $1,562.67 | 10 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $9,282.60 | $61,884.00 | $100.00 – $99,695.13 | 10 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $7,607.55 | $50,717.00 | $100.00 – $81,705.09 | 10 |
| Cath plc art/grft/angio right hrt CPT 93457 | $8,235.75 | $54,905.00 | $100.00 – $88,451.96 | 10 |
| Cath right heart w/o2 sat & card CPT 93451 | $5,820.15 | $38,801.00 | $100.00 – $29,927.55 | 10 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $172.65 | $1,151.00 | $100.00 – $1,631.95 | 10 |
| Cath segmntl pulm art CPT 36015 | $2,687.55 | $17,917.00 | $100.00 – $28,864.29 | 10 |
| Cath soaker 5in 400mlx4ml/hr on-q silvr dual 2ml site HCPCS A4306 | $293.27 | $1,955.10 | $75.79 – $437.90 | 8 |
| Cath steerable flex adv 12f HCPCS C1766 | $1,674.70 | $11,164.65 | $100.00 – $4,914.00 | 10 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $6,639.73 | $44,264.85 | $1,130.38 – $6,782.27 | 10 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $139.55 | $930.30 | $7.56 – $37.80 | 10 |
| Cauterization chemical granulation tissue CPT 17250 | $105.60 | $704.00 | $126.72 – $1,134.15 | 9 |
| #cbg+cort-cbg CPT 84449 | $20.10 | $134.00 | $15.12 – $120.60 | 21 |
| Cdna analysis for variants CPT 81403 | $611.85 | $4,079.00 | $155.57 – $3,671.10 | 21 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $542.25 | $3,615.00 | $0.81 – $35.06 | 10 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $587.95 | $3,919.63 | $1.38 – $80.35 | 10 |
| Cefotaxime sodium injection HCPCS J0698 | $190.88 | $1,272.48 | $4.43 – $35.06 | 10 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $70.56 | $470.40 | $5.10 – $35.06 | 10 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $850.95 | $5,672.95 | $4.45 – $35.06 | 9 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $795.30 | $5,302.00 | $1.88 – $35.06 | 10 |
| Ceftazidime and avibactam HCPCS J0714 | $1,137.20 | $7,581.29 | $113.66 – $6,823.17 | 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.