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 |
|---|---|---|---|---|
| Disability dlco CPT 94727 | $90.30 | $602.00 | $100.00 – $626.08 | 9 |
| Disaccharidases CPT 82657 | $103.20 | $688.00 | $18.62 – $560.70 | 21 |
| Dna antibody native/double stranded CPT 86225 | $64.26 | $428.40 | $5.22 – $59.81 | 21 |
| Dna gardnerella CPT 87510 | $21.60 | $144.00 | $16.84 – $129.60 | 21 |
| Dna probe gc CPT 87590 | $64.80 | $432.00 | $22.58 – $388.80 | 21 |
| Dna trichomonas CPT 87660 | $21.60 | $144.00 | $16.84 – $129.60 | 21 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $138.63 | $924.20 | $5.46 – $35.06 | 10 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $2,809.44 | $18,729.56 | $1.07 – $715.77 | 10 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $53.07 | $353.79 | $0.54 – $35.06 | 10 |
| Doppler echo complete CPT 93320 | $146.10 | $974.00 | $76.36 – $1,012.96 | 9 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $561.00 | $3,740.00 | $100.00 – $6,025.14 | 10 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $332.70 | $2,218.00 | $183.24 – $2,306.72 | 15 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $210.60 | $1,404.00 | $233.32 – $1,459.90 | 9 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $775.55 | $5,170.32 | $4.65 – $67.31 | 10 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $374.08 | $2,493.83 | $187.64 – $2,244.45 | 9 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $241.25 | $1,608.30 | $289.50 – $1,672.64 | 8 |
| Drainage external ear simple 69000 CPT 69000 | $388.93 | $2,592.84 | $466.72 – $2,696.56 | 8 |
| Drainage lymph node lesion 38300 CPT 38300 | $1,089.60 | $7,264.00 | $1,307.52 – $7,554.56 | 8 |
| Drainage mouth roof lesion CPT 42000 | $97.20 | $648.00 | $116.64 – $673.92 | 8 |
| Drainage of arm bursa 23931 CPT 23931 | $574.35 | $3,829.00 | $689.22 – $3,982.16 | 8 |
| Drainage of kidney lesion CPT 50390 | $498.90 | $3,326.00 | $598.68 – $3,459.04 | 7 |
| Drainage of pelvis bursa CPT 26991 | $853.35 | $5,689.00 | $1,024.02 – $5,916.56 | 8 |
| Drain blood from under nail 11740 CPT 11740 | $68.55 | $456.96 | $82.26 – $475.24 | 13 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $1,119.75 | $7,465.00 | $1,343.70 – $7,763.60 | 7 |
| Drain cath image guided visceral pq CPT 49405 | $738.30 | $4,922.00 | $832.86 – $7,454.10 | 9 |
| Drain finger abscess;simple 26010 CPT 26010 | $177.75 | $1,185.00 | $213.30 – $1,232.40 | 8 |
| Drain lower leg lesion 27603 CPT 27603 | $481.35 | $3,209.00 | $577.62 – $3,337.36 | 7 |
| Drain shoulder lesion CPT 23030 | $481.35 | $3,209.00 | $577.62 – $3,337.36 | 7 |
| Drain thigh/knee lesion 27301 CPT 27301 | $510.30 | $3,402.00 | $612.36 – $3,538.08 | 7 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $350.25 | $2,335.00 | $420.30 – $2,428.40 | 8 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $177.00 | $1,180.00 | $212.25 – $1,226.29 | 8 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $412.20 | $2,748.00 | $494.64 – $2,857.92 | 8 |
| Drng of eyelid abscess 67700 CPT 67700 | $163.41 | $1,089.36 | $196.09 – $1,132.94 | 8 |
| Drng of finger abscess comp 26011 CPT 26011 | $860.94 | $5,739.54 | $1,033.12 – $5,969.13 | 8 |
| Drng of hydrocele 55000 CPT 55000 | $232.65 | $1,551.00 | $279.18 – $1,613.04 | 8 |
| Drng of scrotum abscess 55100 CPT 55100 | $879.30 | $5,861.94 | $1,055.15 – $6,096.42 | 8 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1.97 | $13.11 | $0.83 – $5.31 | 10 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $16.58 | $110.50 | $3.57 – $42.00 | 10 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,358.91 | $9,059.40 | $519.91 – $3,119.45 | 10 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $3.21 | $21.35 | $2.99 – $21.35 | 10 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $318.13 | $2,120.82 | $10.35 – $1,908.74 | 9 |
| Drug admin & hemodynmic meas CPT 93463 | $98.85 | $659.00 | $100.00 – $966.60 | 11 |
| Drug assay rufinamide CPT 80210 | $53.25 | $355.00 | $22.77 – $319.50 | 21 |
| Drug asy hydroxychloroquine CPT 80220 | $45.30 | $302.00 | $54.36 – $314.08 | 8 |
| Drug test def 1-7 classes HCPCS G0480 | $159.60 | $1,064.00 | $0.81 – $495.05 | 21 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $373.95 | $2,493.00 | $6.30 – $269.22 | 21 |
| Drvvt confirm - quest CPT 85597 | $28.65 | $191.00 | $15.10 – $171.90 | 21 |
| Ductogram sgl duct CPT 77053 | $170.25 | $1,135.00 | $161.32 – $1,180.40 | 15 |
| Duplex scan bilateral study 93985 CPT 93985 | $605.40 | $4,036.00 | $435.65 – $4,197.44 | 9 |
| Duplex scan unilateral study 93986 CPT 93986 | $288.77 | $1,925.10 | $247.97 – $2,002.11 | 9 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $185.76 | $1,238.40 | $134.67 – $1,287.94 | 15 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $408.60 | $2,724.00 | $306.19 – $2,832.96 | 15 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $352.20 | $2,348.00 | $294.24 – $2,441.92 | 15 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $1,349.96 | $8,999.68 | $115.37 – $3,544.64 | 9 |
| Ear irrigation 69209 CPT 69209 | $40.95 | $273.00 | $49.14 – $283.92 | 13 |
| Ecallantide injection HCPCS J1290 | $47,843.14 | $318,954.25 | $639.39 – $287,058.83 | 9 |
| Ecg 12 lead tracing only CPT 93005 | $176.85 | $1,179.00 | $100.00 – $797.68 | 9 |
| Ecg external < 48 hours recording CPT 93225 | $701.55 | $4,677.00 | $100.00 – $3,046.16 | 9 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $393.60 | $2,624.00 | $100.00 – $1,964.56 | 9 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $935.70 | $6,238.00 | $100.00 – $6,487.52 | 9 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $1,356.90 | $9,046.00 | $100.00 – $9,407.84 | 9 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $535.80 | $3,572.00 | $100.00 – $3,714.10 | 15 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $535.80 | $3,572.00 | $100.00 – $3,714.88 | 9 |
| Echo exam of fetal heart CPT 76828 | $89.40 | $596.00 | $103.03 – $619.84 | 15 |
| Echo exam uterus 76831- CPT 76831 | $241.05 | $1,607.00 | $289.26 – $1,671.28 | 15 |
| Echo guide for amniocentesis CPT 76946 | $189.90 | $1,266.00 | $25.06 – $1,316.64 | 9 |
| Echo guide for artery repair CPT 76936 | $289.50 | $1,930.00 | $327.25 – $1,893.84 | 15 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $755.70 | $5,038.00 | $100.00 – $5,238.80 | 15 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $610.80 | $4,072.00 | $100.00 – $4,234.88 | 15 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $112.35 | $749.00 | $100.00 – $778.96 | 9 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $131.25 | $875.00 | $87.14 – $910.00 | 9 |
| Eeg during surgery CPT 95955 | $107.85 | $719.00 | $100.00 – $747.76 | 9 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $345.00 | $2,300.00 | $100.00 – $2,392.00 | 9 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $249.60 | $1,664.00 | $100.00 – $1,730.56 | 9 |
| Eeg recording awake and asleep CPT 95819 | $396.75 | $2,645.00 | $100.00 – $2,750.80 | 9 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $65.45 | $436.30 | $78.54 – $453.76 | 9 |
| Eeg without vid ea 12-26hr intmt CPT 95709 | $303.05 | $2,020.30 | $100.00 – $2,101.12 | 9 |
| Eeg wo vid 2-12hr intmt mntr CPT 95706 | $177.47 | $1,183.12 | $100.00 – $1,230.45 | 9 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | $217.35 | $1,449.00 | $100.00 – $1,506.96 | 9 |
| E equine encephalitis igg CPT 86652 | $33.45 | $223.00 | $11.08 – $184.50 | 21 |
| Egd remove foreign body CPT 43247 | $334.34 | $2,228.88 | $401.20 – $2,318.04 | 8 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | not published | not published | $69.16 – $69.16 | 1 |
| Elect analysis of infusion pump 62367 CPT 62367 | not published | not published | $49.31 – $49.31 | 1 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | not published | not published | $77.90 – $77.90 | 1 |
| Electrd sq emblem s-icd HCPCS C1896 | $8,818.74 | $58,791.60 | $6,552.32 – $39,313.89 | 10 |
| Electrical bone stim 20974 CPT 20974 | not published | not published | $80.66 – $241.98 | 10 |
| Electrolyte panel CPT 80051 | $113.85 | $759.00 | $7.01 – $683.10 | 21 |
| Electron microscopy diagnostic CPT 88348 | $112.65 | $751.00 | $135.18 – $1,666.10 | 9 |
| Electrophysiologic study CPT 93624 | $2,524.79 | $16,831.90 | $100.00 – $11,665.26 | 11 |
| Electrophysiology evaluation CPT 93619 | $2,555.40 | $17,036.00 | $100.00 – $27,445.00 | 11 |
| Electrophysiology evaluation CPT 93620 | $3,549.00 | $23,660.00 | $100.00 – $38,116.26 | 10 |
| Electrophysiology evaluation CPT 93621 | $2,377.95 | $15,853.00 | $100.00 – $25,539.19 | 11 |
| Electrophysiology evaluation CPT 93622 | $2,448.90 | $16,326.00 | $100.00 – $26,301.19 | 11 |
| Electrophysiology evaluation CPT 93641 | $1,262.85 | $8,419.00 | $100.00 – $8,755.76 | 9 |
| Electrophysiology evaluation CPT 93642 | $378.15 | $2,521.00 | $100.00 – $4,061.34 | 11 |
| Electrophysiology evaluation CPT 93644 | $770.85 | $5,139.00 | $100.00 – $8,278.93 | 11 |
| Electrophys map 3d add-on CPT 93613 | $198.15 | $1,321.00 | $100.00 – $2,128.14 | 11 |
| Embolization s&i CPT 75894 | $149.85 | $999.00 | $100.00 – $1,038.96 | 9 |
| Embo or occlude vascular arterial s&i CPT 37242 | $2,136.15 | $14,241.00 | $2,563.38 – $14,810.64 | 7 |
| Embo or occlude vascular venous s&i CPT 37241 | $2,136.15 | $14,241.00 | $2,563.38 – $14,810.64 | 7 |
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.