Supplies, drugs & other prices at Chi St. Luke's Health Brazosport

Lake Jackson, TX · every code in this section with a posted price and a Medicare benchmark.

37 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $12.95 $37 0.4×
Admin hepatitis b vaccine (G0010) $35.35 $101 0.8×
Admin influenza virus vac (G0008) $38.15 $109 0.8×
Admin pneumococcal vaccine (G0009) $38.15 $109 0.8×
Covid-19 lab test non-cdc (U0002) $79.80 $228 1.6×
Direct refer hospital observ (G0379) $197.05 $563 0.3×
Drug test def 1-7 classes (G0480) $51.10 $146 0.4×
Drug test def 15-21 classes (G0482) $101.50 $290 0.5×
Drug test def 22+ classes (G0483) $28.70 $82 0.1×
Drug test def 8-14 classes (G0481) $58.10 $166 0.4×
Elec stim other than wound (G0283) $87.26 $249.30 6.9×
Elisa hiv-1/hiv-2 screen (G0433) $45.34 $129.54 2.5×
Fern test (Q0114) $9.80 $28 1.0×
Hbot, full body chamber, 30m (G0277) $478.45 $1,367 3.5×
Mra w/cont, abd (C8900) $760.20 $2,172 2.2×
Mra w/cont, chest (C8909) $1,421.28 $4,060.80 4.1×
Mra w/cont, lwr ext (C8912) $877.91 $2,508.30 2.5×
Mra w/cont, pelvis (C8918) $821.84 $2,348.10 2.3×
Mra w/o cont, abd (C8901) $684.18 $1,954.80 2.9×
Mra w/o cont, pelvis (C8919) $1,366.47 $3,904.20 5.7×
Mra w/o fol w/cont, abd (C8902) $1,636.14 $4,674.66 4.7×
Mra w/o fol w/cont, chest (C8911) $1,851.57 $5,290.20 5.3×
Mri w/cont, breast, bi (C8906) $1,492.40 $4,264 4.3×
Mri w/cont, breast, uni (C8903) $1,014.65 $2,899 5.8×
Oth resp proc, group (G0239) $13.23 $37.80 0.4×
Oth resp proc, indiv (G0238) $68.44 $195.55 2.4×
Pathogen test for platelets (P9100) $84.35 $241 1.4×
Perc d-e cor revasc t cabg s (C9604) $7,345.10 $20,986 0.6×
Perc drug-el cor stent sing (C9600)
unusually low: confirm this is the full procedure
$5,455.80 $15,588 0.5×
Psa screening (G0103) $89.67 $256.20 4.6×
Therapeutic procd strg endur (G0237) $11.97 $34.20 0.4×
Tomosynthesis, mammo (G0279) $39.55 $113 3.1×
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation;… (0236T) $6,599.88 $18,856.80 0.6×
Trauma respons w/hosp criti (G0390) $2,249.10 $6,426 1.7×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T)
unusually low: confirm this is the full procedure
$5,430.92 $15,516.90 0.5×
Trluml peripheral atherectomy iliac artery ea (0238T)
likely a partial charge, not the full procedure
$3,514.14 $10,040.40 0.2×
Unsched dialysis esrd pt hos (G0257) $1,465.59 $4,187.40 2.1×