St. Luke's Health - Lakeside Hospital
17400 St Lukes Way, The Woodlands, TX · CommonSpirit Health · · NPI 1184868879
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 |
|---|---|---|---|---|
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $237.65 | $679.00 | $183.33 – $679.00 | 16 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $470.29 | $1,343.66 | $0.17 – $127.26 | 24 |
| Foscarnet sodium injection HCPCS J1455 | $452.69 | $1,293.40 | $54.66 – $1,293.40 | 24 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $76.77 | $219.33 | $3.58 – $56.52 | 24 |
| Fracture assessment via dxa CPT 77086 | $108.85 | $311.00 | $24.88 – $311.00 | 24 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $162.75 | $465.00 | $88.00 – $465.00 | 15 |
| Frozen plasma, pooled, sd HCPCS P9023 | $122.15 | $349.00 | $88.00 – $349.00 | 17 |
| Fructosamine glycated protein CPT 82985 | $19.60 | $56.00 | $12.07 – $56.00 | 40 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $54.30 | $155.13 | $0.56 – $55.00 | 24 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $77.00 | $220.00 | $31.42 – $220.00 | 17 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $140.35 | $401.00 | $70.37 – $401.00 | 17 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $48.79 | $139.38 | $0.40 – $2.00 | 24 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $107.12 | $306.05 | $1.93 – $11.00 | 24 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $86.54 | $247.24 | $0.17 – $7.00 | 24 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $210.50 | $601.42 | $17.93 – $90.00 | 24 |
| Gallium locametz 1 millicuri HCPCS A9800 | $2,517.90 | $7,194.00 | $100.00 – $7,194.00 | 15 |
| Gamma globulin > 10 cc inj HCPCS J1560 | $1,233.73 | $3,524.94 | $228.09 – $1,036.74 | 24 |
| Gammaglobulin iga CPT 82784 | $158.90 | $454.00 | $6.70 – $454.00 | 40 |
| Gammaglobulin ige CPT 82785 | $150.50 | $430.00 | $11.85 – $430.00 | 40 |
| Gamma glutamyltransferase CPT 82977 | $73.15 | $209.00 | $5.18 – $209.00 | 40 |
| Gamunex-c/gammaked HCPCS J1561 | $7,978.45 | $22,795.57 | $49.43 – $3,157.82 | 24 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $86.54 | $247.24 | $41.04 – $212.68 | 24 |
| Gastric emptying imag study CPT 78265 | $1,270.50 | $3,630.00 | $290.40 – $3,630.00 | 24 |
| Gastroesophageal reflux study CPT 78262 | $1,093.40 | $3,124.00 | $230.55 – $3,124.00 | 24 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $1,678.16 | $4,794.72 | $4.10 – $404.48 | 24 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $25,193.74 | $71,982.11 | $210.51 – $71,982.11 | 24 |
| Generator barostim neo2 2014 HCPCS C1767 | $143,857.88 | $411,022.50 | $0.27 – $29,337.10 | 24 |
| Generator emblem MRI sicd subq HCPCS C1722 | $73,500.00 | $210,000.00 | $0.21 – $1.00 | 24 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $102,900.00 | $294,000.00 | $50,715.00 – $241,500.00 | 24 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $32.48 | $92.78 | $1.80 – $54.71 | 24 |
| Gentamicin peak therapeutic drug level CPT 80170 | $79.10 | $226.00 | $11.79 – $226.00 | 40 |
| Ghs abscess perianal iandd CPT 46050 | $590.10 | $1,686.00 | $455.22 – $1,686.00 | 16 |
| Ghs antibodies (torch) igm CPT 86694 | $36.05 | $103.00 | $10.36 – $103.00 | 41 |
| Ghs aspiration bladder - needle CPT 51100 | $820.40 | $2,344.00 | $632.88 – $2,344.00 | 19 |
| Ghs bladder cath - complex-foley CPT 51703 | $385.00 | $1,100.00 | $297.00 – $1,100.00 | 19 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $570.15 | $1,629.00 | $439.83 – $1,629.00 | 19 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,334.55 | $3,813.00 | $1,029.51 – $3,813.00 | 16 |
| Ghs change cysto/gastrost CPT 43762 | $221.90 | $634.00 | $171.18 – $634.00 | 16 |
| Ghs chemo >8 hrs CPT 96416 | $534.45 | $1,527.00 | $209.42 – $1,527.00 | 19 |
| Ghs chemo infusion >8 hrs CPT 96425 | $1,015.00 | $2,900.00 | $270.45 – $2,900.00 | 19 |
| Ghs chemo IV push, ea addtl CPT 96411 | $299.60 | $856.00 | $86.81 – $856.00 | 19 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $86.80 | $248.00 | $25.26 – $248.00 | 40 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $280.35 | $801.00 | $216.27 – $801.00 | 19 |
| Ghs closed reduction ankle dislocation CPT 27840 | $230.30 | $658.00 | $177.66 – $658.00 | 16 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $609.00 | $1,740.00 | $469.80 – $1,740.00 | 16 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $128.10 | $366.00 | $98.82 – $366.00 | 16 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $128.10 | $366.00 | $98.82 – $366.00 | 16 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $793.45 | $2,267.00 | $612.09 – $2,267.00 | 16 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $128.10 | $366.00 | $98.82 – $366.00 | 16 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $97.30 | $278.00 | $75.06 – $278.00 | 19 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $319.90 | $914.00 | $73.12 – $914.00 | 24 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $63.00 | $180.00 | $14.40 – $180.00 | 24 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $419.65 | $1,199.00 | $95.92 – $1,199.00 | 24 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $512.40 | $1,464.00 | $117.12 – $1,464.00 | 24 |
| Ghs dislocation elbow closed treatment CPT 24600 | $95.90 | $274.00 | $73.98 – $274.00 | 16 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $221.55 | $633.00 | $170.91 – $633.00 | 19 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $354.20 | $1,012.00 | $100.00 – $1,012.00 | 17 |
| Ghs excision ingrown nail CPT 11765 | $295.40 | $844.00 | $67.52 – $844.00 | 24 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $354.20 | $1,012.00 | $273.24 – $1,012.00 | 19 |
| Ghs fb removal foot - deep - left CPT 28192 | $816.55 | $2,333.00 | $629.91 – $2,333.00 | 16 |
| Ghs fb removal - non-incisional CPT 20520 | $547.75 | $1,565.00 | $422.55 – $1,565.00 | 19 |
| Ghs fish cytogen CPT 88271 | $304.15 | $869.00 | $15.42 – $869.00 | 41 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $26.60 | $76.00 | $20.52 – $166.37 | 41 |
| Ghs gastric intub aspiration lavage CPT 43753 | $258.65 | $739.00 | $59.12 – $739.00 | 24 |
| Ghs hcv amplificaiton CPT 87521 | $178.15 | $509.00 | $25.26 – $509.00 | 40 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $113.75 | $325.00 | $11.15 – $325.00 | 40 |
| Ghs histoplasma antigen CPT 87385 | $103.25 | $295.00 | $9.54 – $295.00 | 40 |
| Ghs HIV antibody CPT 86703 | $131.25 | $375.00 | $9.87 – $375.00 | 41 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | $262.85 | $751.00 | $76.42 – $751.00 | 40 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $1,547.35 | $4,421.00 | $1,193.67 – $4,421.00 | 16 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $830.20 | $2,372.00 | $640.44 – $2,372.00 | 16 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $882.00 | $2,520.00 | $680.40 – $2,520.00 | 19 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $264.25 | $755.00 | $203.85 – $755.00 | 19 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $96.60 | $276.00 | $74.52 – $276.00 | 19 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $111.30 | $318.00 | $85.86 – $318.00 | 16 |
| Ghs inf midline insertion CPT 36140 | $1,161.65 | $3,319.00 | $100.00 – $3,319.00 | 22 |
| Ghs inhibitor screen CPT 85335 | $229.60 | $656.00 | $9.27 – $656.00 | 40 |
| Ghs init tx 1st degree burn CPT 16000 | $83.30 | $238.00 | $19.04 – $238.00 | 24 |
| Ghs inj tendon origin/insertion CPT 20551 | $184.80 | $528.00 | $142.56 – $528.00 | 19 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $896.35 | $2,561.00 | $100.00 – $2,561.00 | 16 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $514.15 | $1,469.00 | $396.63 – $1,469.00 | 16 |
| Ghs insertion of needle - bone CPT 36680 | $339.15 | $969.00 | $77.52 – $969.00 | 24 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $2,340.10 | $6,686.00 | $1,805.22 – $6,686.00 | 16 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $2,730.00 | $7,800.00 | $2,106.00 – $7,800.00 | 16 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $3,175.90 | $9,074.00 | $2,449.98 – $9,074.00 | 16 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $218.05 | $623.00 | $100.00 – $623.00 | 18 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $316.40 | $904.00 | $244.08 – $904.00 | 16 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $100.80 | $288.00 | $55.64 – $288.00 | 18 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $159.25 | $455.00 | $36.40 – $455.00 | 24 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $328.65 | $939.00 | $75.12 – $939.00 | 21 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $1,485.75 | $4,245.00 | $1,146.15 – $4,245.00 | 19 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $134.40 | $384.00 | $103.68 – $384.00 | 19 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $998.90 | $2,854.00 | $770.58 – $2,854.00 | 19 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $1,174.95 | $3,357.00 | $906.39 – $3,357.00 | 19 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $186.20 | $532.00 | $143.64 – $532.00 | 19 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $1,269.10 | $3,626.00 | $979.02 – $3,626.00 | 19 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $2,005.85 | $5,731.00 | $1,547.37 – $5,731.00 | 16 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $491.75 | $1,405.00 | $379.35 – $1,405.00 | 16 |
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.