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 |
|---|---|---|---|---|
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $467.95 | $1,337.00 | $223.30 – $1,015.00 | 22 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $128.18 | $366.21 | $1.98 – $54.40 | 24 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $9,422.50 | $26,921.41 | $30.92 – $26,921.41 | 24 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $41.70 | $119.13 | $0.56 – $55.11 | 24 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | $51,414.28 | $146,897.94 | $54.25 – $11,500.55 | 24 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $289.13 | $826.07 | $2.26 – $385.65 | 24 |
| Metabolic Blood Panel (Basic) CPT 80048 | $380.10 | $1,086.00 | $6.09 – $1,086.00 | 40 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $472.85 | $1,351.00 | $7.60 – $1,351.00 | 40 |
| Methadone injection HCPCS J1230 | $25.78 | $73.63 | $13.19 – $64.82 | 24 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $29.43 | $84.08 | $9.38 – $61.73 | 24 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $0.91 | $2.60 | $0.12 – $0.51 | 24 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $259.16 | $740.44 | $1.30 – $403.33 | 24 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $30,664.20 | $87,612.00 | $1.26 – $72.75 | 24 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $48.37 | $138.19 | $14.89 – $79.92 | 24 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $163.20 | $466.28 | $1.05 – $97.93 | 24 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $0.59 | $1.67 | $0.06 – $0.26 | 24 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $34.47 | $98.46 | $12.83 – $58.30 | 22 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $96.23 | $274.94 | $13.38 – $60.80 | 22 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $21.72 | $62.03 | $1.47 – $54.68 | 24 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $23.55 | $67.27 | $12.49 – $56.75 | 22 |
| Mgmt promoter methylation analysis CPT 81287 | $159.60 | $456.00 | $89.74 – $456.00 | 41 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $294.67 | $841.89 | $0.40 – $90.65 | 24 |
| Microdissection manual CPT 88381 | $210.00 | $600.00 | $147.96 – $600.00 | 19 |
| Microvolt t-wave assess CPT 93025 | $392.35 | $1,121.00 | $100.00 – $1,121.00 | 17 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $369.81 | $1,056.59 | $0.09 – $1.29 | 24 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $19.33 | $55.21 | $12.15 – $55.21 | 22 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $108.42 | $309.76 | $1.87 – $71.10 | 24 |
| Minocycline hydrochloride HCPCS J2265 | $323.57 | $924.47 | $1.77 – $293.75 | 24 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $3,158.38 | $9,023.92 | $66.19 – $651.14 | 24 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $433.14 | $1,237.52 | $40.78 – $1,237.52 | 24 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $18,032.35 | $51,521.00 | $1,266.80 – $6,032.36 | 24 |
| Mopath procedure level 3 CPT 81402 | $235.90 | $674.00 | $108.24 – $674.00 | 41 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $86.76 | $247.87 | $0.08 – $49.86 | 24 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $22.12 | $63.19 | $12.03 – $54.64 | 22 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $491.17 | $1,403.32 | $5.08 – $53.32 | 24 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $362.25 | $1,035.00 | $193.77 – $1,035.00 | 19 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $249.55 | $713.00 | $192.51 – $713.00 | 19 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | $1,682.99 | $4,808.53 | $1,057.88 – $4,808.53 | 22 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $303.80 | $868.00 | $193.77 – $868.00 | 19 |
| MRA chest w IV cont HCPCS C8909 | $1,613.15 | $4,609.00 | $538.41 – $4,609.00 | 20 |
| MRA chest wo IV cont HCPCS C8910 | $1,205.05 | $3,443.00 | $328.59 – $3,443.00 | 20 |
| MRA chest wwo IV cont HCPCS C8911 | $1,943.20 | $5,552.00 | $538.41 – $5,552.00 | 20 |
| MRA pelvis w IV cont HCPCS C8918 | $1,211.35 | $3,461.00 | $538.41 – $3,461.00 | 20 |
| MRA pelvis wo IV cont HCPCS C8919 | $904.75 | $2,585.00 | $328.59 – $2,585.00 | 20 |
| MRA w/cont, abd HCPCS C8900 | $1,509.90 | $4,314.00 | $538.41 – $4,314.00 | 20 |
| MRA w/cont, lwr ext HCPCS C8912 | $1,607.90 | $4,594.00 | $538.41 – $4,594.00 | 20 |
| Mra, w/dye, spinal canal HCPCS C8931 | $316.40 | $904.00 | $244.08 – $1,398.60 | 20 |
| MRA without cont, abd HCPCS C8901 | $1,128.05 | $3,223.00 | $328.59 – $3,223.00 | 20 |
| MRA without cont, lwr ext HCPCS C8913 | $972.65 | $2,779.00 | $328.59 – $2,779.00 | 20 |
| Mra, without dye, spinal canal HCPCS C8932 | $192.85 | $551.00 | $148.77 – $1,398.60 | 20 |
| MRA without fol w/cont, abd HCPCS C8902 | $1,818.95 | $5,197.00 | $538.41 – $5,197.00 | 20 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $1,830.15 | $5,229.00 | $538.41 – $5,229.00 | 20 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $1,459.15 | $4,169.00 | $538.41 – $4,169.00 | 20 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $316.40 | $904.00 | $244.08 – $1,398.60 | 20 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | $712.60 | $2,036.00 | $538.41 – $2,036.00 | 20 |
| Mr elastography CPT 76391 | $1,811.95 | $5,177.00 | $207.16 – $5,177.00 | 25 |
| MRI breast c- unilateral CPT 77046 | $1,206.80 | $3,448.00 | $340.24 – $3,448.00 | 20 |
| MRI breast c-+ w/cad uni CPT 77048 | $372.40 | $1,064.00 | $287.28 – $1,398.60 | 20 |
| MRI breast without cont bi CPT 77047 | $1,163.05 | $3,323.00 | $340.24 – $3,323.00 | 20 |
| MRI breast w IV cont bi CPT 77049 | $988.75 | $2,825.00 | $427.78 – $2,825.00 | 20 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $1,264.55 | $3,613.00 | $233.47 – $3,613.00 | 25 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $1,453.20 | $4,152.00 | $332.16 – $4,152.00 | 25 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $1,453.20 | $4,152.00 | $332.16 – $4,152.00 | 25 |
| MRI chest without contrast CPT 71550 | $1,548.40 | $4,424.00 | $233.47 – $4,424.00 | 25 |
| MRI chest without & w/contrast CPT 71552 | $2,150.40 | $6,144.00 | $366.42 – $6,144.00 | 25 |
| MRI chest w IV cont CPT 71551 | $1,414.00 | $4,040.00 | $323.20 – $4,040.00 | 25 |
| MRI fetal ea addl gestation CPT 74713 | $576.10 | $1,646.00 | $131.68 – $1,646.00 | 25 |
| MRI fetal sngl/1st gestation CPT 74712 | $1,187.55 | $3,393.00 | $233.47 – $3,393.00 | 25 |
| MRI guid ndl plc s&i CPT 77021 | $1,161.65 | $3,319.00 | $100.00 – $3,319.00 | 20 |
| MRI loex nonjt w IV cont CPT 73719 | $3,427.20 | $9,792.00 | $271.31 – $9,792.00 | 25 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,904.30 | $8,298.00 | $230.21 – $8,298.00 | 25 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $4,385.50 | $12,530.00 | $347.50 – $12,530.00 | 25 |
| MRI orbit/face/neck without contrast CPT 70540 | $1,555.75 | $4,445.00 | $233.23 – $4,445.00 | 25 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,321.90 | $6,634.00 | $349.16 – $6,634.00 | 25 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,069.60 | $3,056.00 | $244.48 – $3,056.00 | 25 |
| MRI tmj CPT 70336 | $673.75 | $1,925.00 | $154.00 – $1,925.00 | 25 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,951.95 | $5,577.00 | $233.47 – $5,577.00 | 25 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,637.60 | $7,536.00 | $366.42 – $7,536.00 | 25 |
| MRI upper extremity w/dye CPT 73219 | $2,136.75 | $6,105.00 | $341.81 – $6,105.00 | 25 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 20 |
| MRI w/cont, breast, uni HCPCS C8903 | $905.10 | $2,586.00 | $256.93 – $2,586.00 | 20 |
| MRI without fol w/cont, breast HCPCS C8908 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 20 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $1,885.45 | $5,387.00 | $538.41 – $5,387.00 | 20 |
| Mr safety determination physician/other qhp CPT 76016 | $77.00 | $220.00 | $59.40 – $220.00 | 15 |
| Mr safety implant elec prepj CPT 76018 | $80.50 | $230.00 | $62.10 – $230.00 | 15 |
| Mr safety implt pos&/immoblj CPT 76019 | $52.15 | $149.00 | $40.23 – $149.00 | 15 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $21.35 | $61.00 | $16.47 – $61.00 | 15 |
| Mr sfty med physics xm cstmz CPT 76017 | $211.40 | $604.00 | $100.00 – $604.00 | 15 |
| Mr spectroscopy CPT 76390 | $273.70 | $782.00 | $211.14 – $1,398.60 | 20 |
| Mthfr gene analy common variants CPT 81291 | $1,830.50 | $5,230.00 | $47.04 – $5,230.00 | 41 |
| Multiple sleep latency test CPT 95805 | $1,544.90 | $4,414.00 | $100.00 – $4,414.00 | 19 |
| Mumps antibody igg CPT 86735 | $61.60 | $176.00 | $9.40 – $176.00 | 40 |
| Muscle test cran nerv unilat CPT 95867 | $547.75 | $1,565.00 | $94.18 – $1,565.00 | 17 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3.10 | $8.85 | $0.06 – $0.25 | 24 |
| Mycophenolic acid HCPCS J7518 | $2.22 | $6.34 | $0.07 – $0.29 | 24 |
| Mycoplasma antibody igm CPT 86738 | $50.40 | $144.00 | $9.53 – $144.00 | 40 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $276.85 | $791.00 | $126.29 – $791.00 | 38 |
| Myelogphy 2/> spine regions CPT 72270 | $1,224.30 | $3,498.00 | $140.00 – $3,498.00 | 24 |
| Myelography l-s spine CPT 72265 | $971.60 | $2,776.00 | $109.26 – $2,776.00 | 24 |
| Myelography neck spine CPT 72240 | $982.45 | $2,807.00 | $112.26 – $2,807.00 | 24 |
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.