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 |
|---|---|---|---|---|
| Kidney imag w/bld flow multi CPT 78709 | $2,572.15 | $7,349.00 | $345.49 – $7,349.00 | 24 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,631.00 | $4,660.00 | $218.53 – $4,660.00 | 24 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,124.20 | $3,212.00 | $104.75 – $3,212.00 | 24 |
| Kit case 4.2mm spinejack HCPCS C1062 | $13,775.74 | $39,359.25 | $2,982.56 – $13,557.08 | 24 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $17,272.50 | $49,350.00 | $100.00 – $24,373.00 | 15 |
| Kit hfx iq ipg bundle HCPCS C1822 | $95,550.00 | $273,000.00 | $721.35 – $3,435.00 | 24 |
| Kit ipg optimizer smart HCPCS C1824 | $95,550.00 | $273,000.00 | $48,276.27 – $229,887.00 | 24 |
| Kit lead specify 5-6-5 HCPCS C1778 | $36,731.63 | $104,947.50 | $0.27 – $1,021.80 | 24 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $2,701.13 | $7,717.50 | $432.39 – $2,059.00 | 24 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $4,454.10 | $12,726.00 | $164.64 – $784.00 | 24 |
| Knee MRI (with and without contrast) CPT 73723 | $5,206.60 | $14,876.00 | $366.42 – $14,876.00 | 25 |
| Knee MRI (with contrast) CPT 73722 | $4,225.20 | $12,072.00 | $323.44 – $12,072.00 | 25 |
| Knee MRI (without contrast) CPT 73721 | $2,725.80 | $7,788.00 | $208.84 – $7,788.00 | 25 |
| Knee X-ray CPT 73564 | $579.60 | $1,656.00 | $46.78 – $1,656.00 | 24 |
| Kras gene addl variants CPT 81276 | $303.10 | $866.00 | $139.14 – $866.00 | 40 |
| Kras gene variants exon 2 CPT 81275 | $200.55 | $573.00 | $139.14 – $628.06 | 41 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $25.00 | $71.42 | $11.86 – $53.88 | 22 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $166.62 | $476.05 | $0.59 – $56.69 | 22 |
| Lactate dehydrogenase (ldh) CPT 83615 | $62.30 | $178.00 | $4.35 – $178.00 | 40 |
| Lactated ringers intravenous solution HCPCS J7120 | $24.28 | $69.37 | $0.59 – $2.64 | 24 |
| Lactic acid CPT 83605 | $102.90 | $294.00 | $8.33 – $294.00 | 40 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $24,143.75 | $68,982.14 | $64.23 – $57,735.14 | 24 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $232.05 | $663.00 | $179.01 – $663.00 | 16 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $1,452.85 | $4,151.00 | $1,120.77 – $4,151.00 | 16 |
| Laryngoscopy w/fb & op scope CPT 31531 | $3,087.70 | $8,822.00 | $2,381.94 – $8,822.00 | 16 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $9,555.00 | $27,300.00 | $0.21 – $1.00 | 24 |
| Lead capillary CPT 83655 | $46.55 | $133.00 | $8.72 – $133.00 | 40 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $2,887.50 | $8,250.00 | $0.21 – $1.00 | 24 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $22,417.50 | $64,050.00 | $0.21 – $1.00 | 24 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,336.65 | $3,819.00 | $188.79 – $3,819.00 | 22 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $3,675.00 | $10,500.00 | $100.00 – $750.00 | 22 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,819.13 | $5,197.50 | $100.00 – $525.00 | 22 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $735.00 | $2,100.00 | $100.00 – $646.00 | 22 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $113.50 | $324.28 | $2.80 – $56.62 | 24 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $831.70 | $2,376.28 | $230.09 – $1,045.86 | 24 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $12,963.00 | $37,037.13 | $828.52 – $12,599.33 | 24 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $40.05 | $114.42 | $0.07 – $55.25 | 24 |
| Levetiracetam therapeutic drug level CPT 80177 | $57.40 | $164.00 | $9.54 – $164.00 | 40 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $371.48 | $1,061.36 | $1.57 – $59.43 | 24 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $187.29 | $535.11 | $26.25 – $119.28 | 22 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $10,973.90 | $31,354.00 | $100.00 – $31,354.00 | 18 |
| Liberta rc ipg HCPCS C1820 | $97,020.00 | $277,200.00 | $0.27 – $1,706.25 | 24 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $27.97 | $79.90 | $17.58 – $79.90 | 22 |
| Lidocaine therapeutic drug level CPT 80176 | $70.70 | $202.00 | $10.58 – $202.00 | 40 |
| Ligation/major artery/extremity 37618 CPT 37618 | $2,636.90 | $7,534.00 | $602.72 – $7,534.00 | 22 |
| Liletta, 52 mg HCPCS J7297 | $2,360.29 | $6,743.68 | $816.85 – $6,743.68 | 24 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $125.66 | $359.01 | $4.26 – $83.18 | 24 |
| Lipase CPT 83690 | $160.65 | $459.00 | $4.96 – $459.00 | 40 |
| Lipoprotein direct measurement hdl CPT 83718 | $60.90 | $174.00 | $5.90 – $174.00 | 40 |
| Lithium therapeutic drug level CPT 80178 | $60.55 | $173.00 | $4.76 – $173.00 | 40 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,824.75 | $13,785.00 | $100.00 – $13,785.00 | 18 |
| Liver Function Test CPT 80076 | $326.55 | $933.00 | $5.88 – $933.00 | 40 |
| Liver/spleen imag static only CPT 78215 | $444.50 | $1,270.00 | $101.60 – $1,270.00 | 24 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $954.80 | $2,728.00 | $128.64 – $2,728.00 | 24 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.75 | $5.00 | $0.73 – $5.00 | 24 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $67,730.25 | $193,515.00 | $42,573.30 – $193,515.00 | 22 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $52.60 | $150.28 | $0.40 – $53.52 | 24 |
| Low cost skin substitute app HCPCS C5271 | $518.00 | $1,480.00 | $90.00 – $1,480.00 | 18 |
| Low cost skin substitute app HCPCS C5275 | $518.00 | $1,480.00 | $90.00 – $1,480.00 | 18 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $5,346.60 | $15,276.00 | $175.06 – $15,276.00 | 25 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $4,547.90 | $12,994.00 | $173.75 – $12,994.00 | 25 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $3,471.65 | $9,919.00 | $104.75 – $9,919.00 | 25 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $5,892.95 | $16,837.00 | $329.13 – $16,837.00 | 25 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $5,010.95 | $14,317.00 | $279.00 – $14,317.00 | 25 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,528.70 | $10,082.00 | $197.14 – $10,082.00 | 25 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $713.65 | $2,039.00 | $40.10 – $2,039.00 | 24 |
| Lumbar diskogram s&i CPT 72295 | $1,321.60 | $3,776.00 | $111.26 – $3,776.00 | 24 |
| Lumizyme injection HCPCS J0221 | $2,274.33 | $6,498.08 | $172.69 – $6,498.08 | 24 |
| Lung Function Test (Spirometry) CPT 94010 | $339.50 | $970.00 | $100.00 – $970.00 | 17 |
| Lung perfusion imaging CPT 78580 | $724.15 | $2,069.00 | $165.52 – $2,069.00 | 24 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $20,566.53 | $58,761.51 | $186.17 – $58,761.51 | 24 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $29,435.46 | $84,101.30 | $37.35 – $28,268.79 | 24 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $277.90 | $794.00 | $206.44 – $794.00 | 18 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $480.20 | $1,372.00 | $100.00 – $1,372.00 | 15 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,696.10 | $4,846.00 | $791.28 – $3,768.00 | 21 |
| Lymphatics/lymph node imaging CPT 78195 | $1,491.70 | $4,262.00 | $329.79 – $4,262.00 | 24 |
| Lymphocyte transformation mitogen CPT 86353 | $44.45 | $127.00 | $34.29 – $159.35 | 40 |
| Lymphocytotoxicity assay CPT 86805 | $241.15 | $689.00 | $136.45 – $689.00 | 40 |
| Lymph vessel x-ray trunk CPT 75805 | $3,310.30 | $9,458.00 | $140.00 – $9,458.00 | 24 |
| Lymph vessel x-ray trunk CPT 75807 | $4,792.55 | $13,693.00 | $140.00 – $13,693.00 | 24 |
| Magnesium CPT 83735 | $168.70 | $482.00 | $4.82 – $482.00 | 40 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $58.44 | $166.96 | $0.06 – $0.25 | 24 |
| Magnetic image bone marrow CPT 77084 | $1,301.65 | $3,719.00 | $233.47 – $3,719.00 | 25 |
| Makena, 10 mg HCPCS J1726 | $119.03 | $340.07 | $19.73 – $340.07 | 22 |
| Mammosite ced HCPCS C1728 | $5,212.99 | $14,894.25 | $100.00 – $14,894.25 | 15 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $135.80 | $388.00 | $100.00 – $388.00 | 17 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $128.80 | $368.00 | $99.36 – $368.00 | 17 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $23.22 | $66.32 | $3.35 – $28.84 | 24 |
| Manual diff wbc count b-coat CPT 85009 | $33.95 | $97.00 | $3.65 – $97.00 | 41 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $106.75 | $305.00 | $82.35 – $305.00 | 17 |
| Map tachycard site(s) CPT 93609 | $1,641.85 | $4,691.00 | $100.00 – $4,691.00 | 18 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,583.13 | $10,237.50 | $7.56 – $36.00 | 24 |
| Mastoids complete CPT 70130 | $106.40 | $304.00 | $24.32 – $304.00 | 24 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $126.00 | $360.00 | $10.41 – $360.00 | 40 |
| Mayo aathr protein s free CPT 85306 | $204.75 | $585.00 | $11.03 – $585.00 | 40 |
| Mayo activated protein c resistance assay CPT 85307 | $173.25 | $495.00 | $11.03 – $495.00 | 40 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $59.50 | $170.00 | $11.31 – $170.00 | 21 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $127.05 | $363.00 | $10.64 – $363.00 | 40 |
| Mayo alpha 1 antitrypsin CPT 82103 | $131.25 | $375.00 | $9.68 – $375.00 | 40 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $46.55 | $133.00 | $10.86 – $133.00 | 40 |
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.