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 |
|---|---|---|---|---|
| X-ray nasal bones complete > 3 views CPT 70160 | $291.55 | $833.00 | $37.76 – $833.00 | 24 |
| X-ray neck soft tissue CPT 70360 | $251.30 | $718.00 | $31.41 – $718.00 | 24 |
| X-ray nose to rectum for foreign body child CPT 76010 | $96.60 | $276.00 | $22.08 – $276.00 | 24 |
| X-ray of mammary ducts CPT 77054 | $707.35 | $2,021.00 | $69.16 – $2,021.00 | 24 |
| X-ray pelvis 1-2 views CPT 72170 | $457.45 | $1,307.00 | $28.06 – $1,307.00 | 24 |
| X-ray pelvis complete > 3 views CPT 72190 | $690.90 | $1,974.00 | $42.44 – $1,974.00 | 24 |
| Xray place dist ext thor ao CPT 75959 | $39.90 | $114.00 | $30.78 – $114.00 | 19 |
| Xray place prox ext thor ao CPT 75958 | $39.90 | $114.00 | $30.78 – $114.00 | 19 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,771.70 | $5,062.00 | $65.55 – $5,062.00 | 24 |
| X-ray ribs 2 views left CPT 71100 | $393.75 | $1,125.00 | $36.75 – $1,125.00 | 24 |
| X-ray ribs 3 views bilateral CPT 71110 | $470.75 | $1,345.00 | $44.10 – $1,345.00 | 24 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $452.55 | $1,293.00 | $42.44 – $1,293.00 | 24 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $561.40 | $1,604.00 | $52.79 – $1,604.00 | 24 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $494.55 | $1,413.00 | $39.43 – $1,413.00 | 24 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $411.95 | $1,177.00 | $32.75 – $1,177.00 | 24 |
| X-ray scapula complete (both sides) CPT 73010 | $374.50 | $1,070.00 | $23.73 – $1,070.00 | 24 |
| X-ray sella turcica CPT 70240 | $86.45 | $247.00 | $19.76 – $247.00 | 24 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $329.70 | $942.00 | $21.71 – $942.00 | 24 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $744.45 | $2,127.00 | $37.76 – $2,127.00 | 24 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $662.20 | $1,892.00 | $59.81 – $1,892.00 | 24 |
| X-ray skull < 4 views CPT 70250 | $407.05 | $1,163.00 | $36.09 – $1,163.00 | 24 |
| X-ray skull > 4 views complete CPT 70260 | $537.25 | $1,535.00 | $44.78 – $1,535.00 | 24 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $105.35 | $301.00 | $24.08 – $301.00 | 24 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $676.20 | $1,932.00 | $121.96 – $1,932.00 | 24 |
| X-ray small intestine follow-through study CPT 74248 | $453.25 | $1,295.00 | $67.58 – $1,295.00 | 24 |
| X-ray spine single view CPT 72020 | $298.90 | $854.00 | $24.39 – $854.00 | 24 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $414.40 | $1,184.00 | $41.44 – $1,184.00 | 24 |
| X-ray sternum > 2 views CPT 71120 | $336.70 | $962.00 | $33.75 – $962.00 | 24 |
| X-ray surgical specimen CPT 76098 | $642.95 | $1,837.00 | $42.10 – $1,837.00 | 24 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $1,078.70 | $3,082.00 | $124.96 – $3,082.00 | 24 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $493.15 | $1,409.00 | $53.13 – $1,409.00 | 24 |
| X-ray thoracic spine 2 views CPT 72070 | $405.65 | $1,159.00 | $33.08 – $1,159.00 | 24 |
| X-ray thoracic spine 3 views CPT 72072 | $709.45 | $2,027.00 | $39.43 – $2,027.00 | 24 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $361.55 | $1,033.00 | $34.75 – $1,033.00 | 24 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $503.65 | $1,439.00 | $42.78 – $1,439.00 | 24 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $1,065.40 | $3,044.00 | $70.50 – $3,044.00 | 24 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $484.75 | $1,385.00 | $31.74 – $1,385.00 | 24 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $258.65 | $739.00 | $29.40 – $739.00 | 24 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,152.55 | $3,293.00 | $139.34 – $3,293.00 | 24 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $801.15 | $2,289.00 | $122.96 – $2,289.00 | 24 |
| X-ray wrist 2 views (both sides) CPT 73100 | $300.65 | $859.00 | $34.09 – $859.00 | 24 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $271.95 | $777.00 | $62.16 – $777.00 | 24 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $25,438.35 | $72,681.00 | $18,897.06 – $72,681.00 | 17 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $60.86 | $173.86 | $1.55 – $162.83 | 24 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $62.56 | $178.73 | $10.27 – $85.45 | 24 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $4,156.78 | $11,876.51 | $2,612.84 – $11,876.51 | 22 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $93.30 | $266.56 | $7.36 – $78.42 | 24 |
| Zoster vaccine-live inj CPT 90736 | $73.01 | $208.58 | $45.89 – $208.58 | 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.