Providence St Luke's Rehabilitation Medical Center
711 S Cowley St, Spokane, WA · Providence · · NPI 1497752091
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 |
|---|---|---|---|---|
| Adj gastric band via subq port CPT 43999 | not published | not published | $1,010.69 – $1,111.76 | 5 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $8,085.92 – $8,894.51 | 5 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $2,299.21 – $2,529.13 | 5 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $679.27 | $970.39 | $2.73 – $2.73 | 1 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | not published | not published | $80.23 – $88.26 | 5 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | not published | not published | $80.23 – $88.26 | 5 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | not published | not published | $368.07 – $404.88 | 5 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $368.07 – $404.88 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | not published | not published | $80.23 – $88.26 | 5 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | not published | not published | $80.23 – $88.26 | 5 |
| Administration immunization 1 vaccine CPT 90471 | $103.60 | $148.00 | $80.23 – $88.26 | 5 |
| Administration immunization each additional component CPT 90461 | not published | not published | $41.54 – $41.54 | 1 |
| Administration immunization each additional vaccine CPT 90472 | not published | not published | $41.54 – $41.54 | 1 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $83.66 – $83.66 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $80.23 – $88.26 | 5 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $41.54 – $41.54 | 1 |
| Administration vaccine hepatitis b HCPCS G0010 | not published | not published | $52.18 – $57.40 | 5 |
| Administration vaccine influenza virus HCPCS G0008 | not published | not published | $52.18 – $57.40 | 5 |
| Administration vaccine pneumococcal HCPCS G0009 | not published | not published | $52.18 – $57.40 | 5 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $42.20 – $46.42 | 5 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $120.30 – $1,586.95 | 5 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $3,938.03 – $3,938.03 | 1 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $231.36 – $231.36 | 1 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $20.05 – $22.06 | 5 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $8.04 | 5 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $115.36 – $126.90 | 5 |
| Aflibercept injection HCPCS J0178 | not published | not published | $731.88 – $805.07 | 5 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $682.08 – $750.29 | 5 |
| After cataract laser surgery CPT 66821 | not published | not published | $612.89 – $674.18 | 5 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $227.58 – $250.34 | 5 |
| Air conduction bilat CPT 92552 | not published | not published | $148.26 – $163.09 | 5 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $305.00 – $305.00 | 1 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $41.38 – $157.72 | 5 |
| Albumin body fluid quantitative each specimen CPT 82042 | $44.10 | $63.00 | $7.78 – $8.56 | 5 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $383.99 | $548.55 | $53.08 – $58.38 | 5 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $23.35 | 5 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $350.60 | $500.85 | $53.08 – $58.38 | 5 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $11.68 | 5 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $37.33 | 5 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $181.44 | $259.20 | $5.78 – $6.36 | 5 |
| Albumin serum plasma or whole blood CPT 82040 | $70.56 | $100.80 | $4.95 – $5.44 | 5 |
| Albuterol ipratrop non-comp HCPCS J7620 | $8.11 | $11.58 | $0.43 – $0.43 | 1 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.46 – $0.46 | 1 |
| Albuterol non-comp unit HCPCS J7613 | $7.26 | $10.37 | $0.15 – $0.15 | 1 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $279.72 | $399.60 | $17.27 – $19.00 | 5 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $32.23 – $35.45 | 5 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $197.79 – $217.57 | 5 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $3,338.87 – $3,672.76 | 5 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,440.42 – $2,684.46 | 5 |
| Alkaline phosphatase CPT 84075 | $34.65 | $49.50 | $5.18 – $5.70 | 5 |
| Allergen alpha lactalbumin ige CPT 86008 | not published | not published | $17.93 – $19.72 | 5 |
| Allergen egg white ige CPT 86003 | not published | not published | $5.22 – $5.74 | 5 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $7.97 – $8.77 | 5 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $52.18 – $57.40 | 5 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $52.18 – $57.40 | 5 |
| Allergy Skin Testing CPT 95004 | not published | not published | $848.82 – $1,052.63 | 5 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $848.82 – $1,052.63 | 5 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $14,306.71 – $15,737.38 | 5 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $138.67 – $152.54 | 5 |
| Alloskin HCPCS Q4115 | not published | not published | $30.00 – $152.54 | 5 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $41.62 – $45.78 | 5 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $32.23 – $35.45 | 5 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.14 – $5.66 | 5 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $70.85 | 5 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $17.00 – $18.70 | 5 |
| Alpha-fetoprotein tumor marker CPT 82105 | $223.65 | $319.50 | $16.77 – $18.45 | 5 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $1,536.68 | $2,195.25 | $95.09 – $104.60 | 5 |
| Alt/sgpt CPT 84460 | $34.65 | $49.50 | $5.30 – $5.83 | 5 |
| Aluminum - quest CPT 82108 | not published | not published | $25.48 – $28.03 | 5 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $3,694.56 – $4,064.02 | 5 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $105.94 – $116.54 | 5 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $148.26 – $163.09 | 5 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | not published | not published | $5.26 – $5.26 | 1 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $15.26 | 5 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $15.60 | 5 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $19.61 – $21.57 | 5 |
| Aminolevulinic acid delta CPT 82135 | not published | not published | $16.45 – $18.10 | 5 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $390.02 – $429.02 | 5 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | not published | not published | $29.67 – $29.67 | 1 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $70.66 | $100.94 | not published | 0 |
| Ammonia CPT 82140 | $88.20 | $126.00 | $14.57 – $16.03 | 5 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $1,026.37 – $1,129.00 | 5 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $339.57 – $373.53 | 5 |
| Amniotic fluid scan CPT 82143 | not published | not published | $9.35 – $10.28 | 5 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $3,646.14 – $4,010.75 | 5 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | not published | not published | $105.56 – $105.56 | 1 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $44.62 – $44.62 | 1 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $22.81 – $25.09 | 5 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $314.20 | $448.85 | $3.57 – $3.57 | 1 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $536.57 | $766.53 | $9.57 – $9.57 | 1 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $289.29 | 5 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $3,646.14 – $4,010.75 | 5 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $2,335.69 – $4,010.75 | 5 |
| Amputate hand at wrist CPT 25922 | not published | not published | $1,791.86 – $1,971.04 | 5 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $3,646.14 – $4,010.75 | 5 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $2,582.99 – $4,010.75 | 5 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $3,646.14 – $4,010.75 | 5 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $3,646.14 – $4,010.75 | 5 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $7,851.46 – $8,894.51 | 5 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $2,299.21 – $2,529.13 | 5 |
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.