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 |
|---|---|---|---|---|
| Chemo ia push tecnique CPT 96420 | $614.95 | $1,757.00 | $155.23 – $1,757.00 | 19 |
| Chemotherapy injection 96542 CPT 96542 | $183.40 | $524.00 | $62.62 – $524.00 | 19 |
| Chemotx admn pertl cav impl CPT 96446 | $268.80 | $768.00 | $41.57 – $768.00 | 19 |
| Chest 2 vws w oblique CPT 71048 | $777.70 | $2,222.00 | $45.78 – $2,222.00 | 24 |
| Chest apical lordotic proj CPT 71047 | $721.00 | $2,060.00 | $42.44 – $2,060.00 | 24 |
| Chest CT scan (with and without contrast) CPT 71270 | $4,177.60 | $11,936.00 | $175.06 – $11,936.00 | 25 |
| Chest CT scan (with contrast) CPT 71260 | $3,540.25 | $10,115.00 | $171.74 – $10,115.00 | 25 |
| Chest CT scan (without contrast) CPT 71250 | $2,796.85 | $7,991.00 | $104.75 – $7,991.00 | 25 |
| Chest X-ray CPT 71046 | $572.25 | $1,635.00 | $33.75 – $1,635.00 | 24 |
| Chest X-ray (single view) CPT 71045 | $436.80 | $1,248.00 | $25.73 – $1,248.00 | 24 |
| Chg pr pul rehab for copd patients CPT 94626 | $92.05 | $263.00 | $71.01 – $263.00 | 15 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $818.30 | $2,338.00 | $109.93 – $2,338.00 | 24 |
| Chlamydia culture CPT 87110 | $99.40 | $284.00 | $14.11 – $284.00 | 40 |
| Chloride CPT 82435 | $37.80 | $108.00 | $3.31 – $108.00 | 40 |
| Chloride 24 hour urine CPT 82436 | $47.60 | $136.00 | $4.14 – $136.00 | 40 |
| Chloroprocaine hcl injection HCPCS J2401 | $46.27 | $132.18 | $17.62 – $80.09 | 22 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $721.69 | $2,061.95 | $12.40 – $56.36 | 24 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $55.28 | $157.92 | $12.37 – $56.19 | 24 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $1.23 | $3.51 | $0.06 – $0.25 | 24 |
| Cholangiogram percutaneous compl CPT 47532 | $3,427.55 | $9,793.00 | $2,644.11 – $9,793.00 | 16 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $160.30 | $458.00 | $26.42 – $458.00 | 19 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $2,552.20 | $7,292.00 | $1,968.84 – $7,292.00 | 20 |
| Cholesterol CPT 82465 | $71.05 | $203.00 | $3.13 – $203.00 | 40 |
| Cholesterol (Lipid) Test CPT 80061 | $155.05 | $443.00 | $7.66 – $443.00 | 40 |
| Cholinesterase CPT 82480 | $53.55 | $153.00 | $5.67 – $153.00 | 40 |
| Chromosome analysis 15-20 cell count CPT 88262 | $314.30 | $898.00 | $85.05 – $407.84 | 41 |
| Chromosome karyotype study CPT 88280 | $94.15 | $269.00 | $24.10 – $269.00 | 41 |
| Cidofovir injection HCPCS J0740 | $654.57 | $1,870.19 | $392.87 – $1,785.74 | 24 |
| Cilastatin sodium injection HCPCS J0743 | $63.15 | $180.41 | $3.76 – $77.48 | 24 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $25.90 | $74.00 | $1.19 – $54.72 | 24 |
| Circumcision (newborn) CPT 54150 | $754.25 | $2,155.00 | $581.85 – $2,155.00 | 16 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $294.63 | $841.78 | $2.67 – $427.61 | 24 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $518.35 | $1,481.00 | $237.25 – $1,481.00 | 40 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $227.09 | $648.82 | $16.09 – $370.50 | 24 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $18,007.87 | $51,451.05 | $100.00 – $1,290.00 | 15 |
| Clearance of airways CPT 31720 | $109.90 | $314.00 | $84.78 – $314.00 | 16 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $48.08 | $137.36 | $11.98 – $54.43 | 22 |
| Clip ligating vesolock lg HCPCS C1760 | $4,404.05 | $12,583.00 | $34.62 – $164.85 | 24 |
| Clip phn wireless f/baha4 proc HCPCS L9900 | $0.35 | $1.00 | $0.27 – $40,285.00 | 19 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $2,484.98 | $7,099.92 | $12.08 – $4,613.85 | 24 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $29.36 | $83.88 | $13.81 – $62.73 | 24 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $86.45 | $247.00 | $66.69 – $247.00 | 19 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $603.40 | $1,724.00 | $465.48 – $1,724.00 | 16 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $128.10 | $366.00 | $98.82 – $366.00 | 19 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $80.15 | $229.00 | $61.83 – $229.00 | 19 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $217.35 | $621.00 | $167.67 – $621.00 | 19 |
| Clos txnose fx without stablz 21315 CPT 21315 | $614.60 | $1,756.00 | $474.12 – $1,756.00 | 16 |
| Closure paravalvlr leak pq CPT 33999 | $15,888.25 | $45,395.00 | $150.56 – $1,882.00 | 20 |
| Clot factor viii reltd antgn CPT 85244 | $166.60 | $476.00 | $14.70 – $476.00 | 40 |
| Clot factor xii hageman CPT 85280 | $123.20 | $352.00 | $13.93 – $352.00 | 40 |
| Clot factor xiii fibrin scrn CPT 85291 | $22.75 | $65.00 | $6.56 – $65.00 | 40 |
| Clotting assay whole blood CPT 85396 | $224.00 | $640.00 | $29.74 – $640.00 | 18 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $294.35 | $841.00 | $227.07 – $841.00 | 16 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $128.10 | $366.00 | $98.82 – $366.00 | 16 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $93.10 | $266.00 | $71.82 – $266.00 | 19 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $80.15 | $229.00 | $61.83 – $229.00 | 16 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $80.15 | $229.00 | $61.83 – $229.00 | 19 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $87.50 | $250.00 | $67.50 – $250.00 | 19 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $203.35 | $581.00 | $156.87 – $581.00 | 16 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $124.60 | $356.00 | $96.12 – $356.00 | 19 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Clsd tx fracture of radius 25500 CPT 25500 | $80.15 | $229.00 | $61.83 – $229.00 | 19 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $252.35 | $721.00 | $194.67 – $721.00 | 19 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $87.15 | $249.00 | $67.23 – $249.00 | 19 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $162.05 | $463.00 | $125.01 – $463.00 | 19 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $806.75 | $2,305.00 | $622.35 – $2,305.00 | 16 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $80.15 | $229.00 | $61.83 – $229.00 | 19 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $158.90 | $454.00 | $122.58 – $454.00 | 16 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $86.45 | $247.00 | $66.69 – $247.00 | 16 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $133.35 | $381.00 | $102.87 – $381.00 | 16 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $86.45 | $247.00 | $66.69 – $247.00 | 19 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $130.20 | $372.00 | $100.44 – $372.00 | 19 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $93.45 | $267.00 | $72.09 – $267.00 | 16 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $279.30 | $798.00 | $215.46 – $798.00 | 19 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $252.35 | $721.00 | $194.67 – $721.00 | 19 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $2,168.60 | $6,196.00 | $1,672.92 – $6,196.00 | 16 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $294.70 | $842.00 | $227.34 – $842.00 | 16 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $128.10 | $366.00 | $98.82 – $366.00 | 16 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 16 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $75.60 | $216.00 | $58.32 – $216.00 | 19 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $133.00 | $380.00 | $102.60 – $380.00 | 19 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $561.05 | $1,603.00 | $432.81 – $1,603.00 | 16 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,223.60 | $3,496.00 | $943.92 – $3,496.00 | 16 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,259.65 | $3,599.00 | $971.73 – $3,599.00 | 16 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $134.40 | $384.00 | $103.68 – $384.00 | 16 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $194.60 | $556.00 | $150.12 – $556.00 | 19 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $133.00 | $380.00 | $102.60 – $380.00 | 16 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $740.95 | $2,117.00 | $571.59 – $2,117.00 | 16 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $128.10 | $366.00 | $98.82 – $366.00 | 19 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $133.00 | $380.00 | $102.60 – $380.00 | 19 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $80.15 | $229.00 | $61.83 – $229.00 | 16 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $153.30 | $438.00 | $118.26 – $438.00 | 19 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $83.65 | $239.00 | $64.53 – $239.00 | 16 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $859.95 | $2,457.00 | $663.39 – $2,457.00 | 16 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $926.45 | $2,647.00 | $714.69 – $2,647.00 | 16 |
| Cltx post ankle fx w/mnpj CPT 27768 | $1,325.10 | $3,786.00 | $1,022.22 – $3,786.00 | 19 |
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.