Supplies, drugs & other prices at St. Luke's Patients Medical Center
Pasadena, TX · every code in this section with a posted price and a Medicare benchmark.
59 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2019-ncov diagnostic p (U0001) | $85.40 | $244 | 2.4× |
| 2d tee w or w/o fol w/con,in (C8925) | $2,735.25 | $7,815 | 3.5× |
| 2d tte w or w/o fol w/con,fu (C8924) | $493.50 | $1,410 | 1.4× |
| Admin hepatitis b vaccine (G0010) | $60.20 | $172 | 1.3× |
| Admin influenza virus vac (G0008) | $75.25 | $215 | 1.6× |
| Admin pneumococcal vaccine (G0009) | $45.15 | $129 | 1.0× |
| Ca screen;flexi sigmoidscope (G0104) | $1,011 | $2,888.55 | 1.1× |
| Catheterize for urine spec (P9612) | $25.20 | $72 | 2.7× |
| Colon ca scrn not hi rsk ind (G0121) | $1,376.20 | $3,932 | 1.5× |
| Colorectal scrn; hi risk ind (G0105) | $1,376.20 | $3,932 | 1.5× |
| Covid-19 lab test non-cdc (U0002) | $92.05 | $263 | 1.8× |
| Cysto impl 4 or more (C9740) unusually low: confirm this is the full procedure |
$4,077.26 | $11,649.30 | 0.4× |
| Cystoscopy prostatic imp 1-3 (C9739) | $3,816.86 | $10,905.30 | 0.7× |
| Diab manage trn per indiv (G0108) | $34.65 | $99 | 0.6× |
| Diab manage trn ind/group (G0109) | $22.05 | $63 | 1.4× |
| Direct refer hospital observ (G0379) | $189.35 | $541 | 0.3× |
| Drug test def 1-7 classes (G0480) | $69.93 | $199.80 | 0.6× |
| Drug test def 15-21 classes (G0482) | $59.50 | $170 | 0.3× |
| Drug test def 22+ classes (G0483) | $77 | $220 | 0.3× |
| Drug test def 8-14 classes (G0481) | $44.10 | $126 | 0.3× |
| Elec stim other than wound (G0283) | $95.64 | $273.24 | 7.5× |
| Elisa hiv-1/hiv-2 screen (G0433) | $140.70 | $402 | 7.7× |
| Hbot, full body chamber, 30m (G0277) | $301.44 | $861.25 | 2.2× |
| Home sleep test/type 3 porta (G0399) | $330.86 | $945.30 | 1.5× |
| Hospital outpt clinic visit (G0463) | $219.45 | $627 | 1.6× |
| Inj for sacroiliac jt anesth (G0260) | $2,000.57 | $5,715.90 | 2.8× |
| Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg,… (0263T) | $781.20 | $2,232 | 0.2× |
| Mra w/cont, abd (C8900) | $812.07 | $2,320.20 | 2.3× |
| Mra w/cont, chest (C8909) | $1,532.48 | $4,378.50 | 4.4× |
| Mra w/cont, lwr ext (C8912) | $1,516.73 | $4,333.50 | 4.3× |
| Mra w/cont, pelvis (C8918) | $1,565.20 | $4,472 | 4.5× |
| Mra w/o cont, abd (C8901) | $2,050.65 | $5,859 | 8.6× |
| Mra w/o cont, chest (C8910) | $1,654.38 | $4,726.80 | 6.9× |
| Mra w/o cont, lwr ext (C8913) | $1,516.73 | $4,333.50 | 6.3× |
| Mra w/o cont, pelvis (C8919) | $1,565.24 | $4,472.10 | 6.5× |
| Mra w/o fol w/cont, abd (C8902) | $2,050.65 | $5,859 | 5.9× |
| Mra w/o fol w/cont, chest (C8911) | $1,654.38 | $4,726.80 | 4.7× |
| Mra w/o fol w/cont, lwr ext (C8914) | $1,516.73 | $4,333.50 | 4.3× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,234.49 | $3,527.10 | 3.5× |
| Mra, w/dye, spinal canal (C8931) | $890.82 | $2,545.20 | 2.5× |
| Mra, w/dye, upper extremity (C8934) | $1,055.57 | $3,015.90 | 3.0× |
| Mra, w/o dye, spinal canal (C8932) | $890.82 | $2,545.20 | 3.7× |
| Mra, w/o dye, upper extr (C8935) | $1,055.57 | $3,015.90 | 4.4× |
| Mra, w/o&w/dye, spinal canal (C8933) | $833.18 | $2,380.50 | 2.4× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,055.57 | $3,015.90 | 3.0× |
| Njx pltlt plasma w/img harvest/preparation (0232T) | $646.38 | $1,846.80 | 1.4× |
| Oral hiv-1/hiv-2 screen (G0435) | $92.56 | $264.45 | 7.7× |
| Oth resp proc, group (G0239) | $166.95 | $477 | 4.4× |
| Oth resp proc, indiv (G0238) | $132.30 | $378 | 4.6× |
| Perc d-e cor revasc chro sin (C9607) unusually low: confirm this is the full procedure |
$8,161.30 | $23,318 | 0.4× |
| Perc d-e cor revasc t cabg s (C9604) | $6,894.65 | $19,699 | 0.6× |
| Perc d-e cor stent ather s (C9602) | $13,507.90 | $38,594 | 0.7× |
| Perc drug-el cor stent sing (C9600) | $14,070.70 | $40,202 | 1.2× |
| Perq Sacral Augmt Bilat Inj (0201T) likely a partial charge, not the full procedure |
$1,832.67 | $5,236.20 | 0.3× |
| Prolonged iv inf, req pump (C8957) | $138.29 | $395.10 | 0.6× |
| Revasc intra lithotrip-ather (C9766) | $13,792.12 | $39,406.03 | 0.7× |
| Trluml peripheral atherectomy iliac artery ea (0238T) unusually low: confirm this is the full procedure |
$6,599.88 | $18,856.80 | 0.4× |
| Unsched dialysis esrd pt hos (G0257) | $1,125.18 | $3,214.80 | 1.6× |
| Urine specimen collect mult (P9615) | $6.62 | $18.90 | 0.7× |