St. Luke's Health - Patients Medical Center — price list
← Hospital overviewVerified from St. Luke's Health - Patients Medical Center’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
397 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Adm sarscov2 30mcg/0.3ml 1st Inpatient | 0001A CPT | $101 | $35.35 | $65.65 – $75.75 | — | |
| Adm sarscov2 30mcg/0.3ml 1st Outpatient | 0001A CPT | $101 | $35.35 | $37.00 – $100 | — | |
| Adm sarscov2 30mcg/0.3ml 2nd Inpatient | 0002A CPT | $101 | $35.35 | $65.65 – $75.75 | — | |
| Adm sarscov2 30mcg/0.3ml 2nd Outpatient | 0002A CPT | $101 | $35.35 | $37.00 – $100 | — | |
| Admin covid vac moderna boost Inpatient | 0064A CPT | $101 | $35.35 | $65.65 – $75.75 | — | |
| Admin covid vac moderna boost Outpatient | 0064A CPT | $101 | $35.35 | $37.00 – $100 | — | |
| Admin covid vaccin moderna 1st Inpatient | 0011A CPT | $90.00 | $31.50 | $58.50 – $67.50 | — | |
| Admin covid vaccin moderna 1st Outpatient | 0011A CPT | $90.00 | $31.50 | $37.00 – $90.00 | — | |
| Admin covid vaccin moderna 2nd Inpatient | 0012A CPT | $90.00 | $31.50 | $58.50 – $67.50 | — | |
| Admin covid vaccin moderna 2nd Outpatient | 0012A CPT | $90.00 | $31.50 | $37.00 – $90.00 | — | |
| Admin covid vaccin moderna 3rd Inpatient | 0013A CPT | $101 | $35.35 | $65.65 – $75.75 | — | |
| Admin covid vaccin moderna 3rd Outpatient | 0013A CPT | $101 | $35.35 | $37.00 – $100 | — | |
| Admin covid vaccine j&j Inpatient | 0031A CPT | $127 | $44.45 | $82.55 – $95.25 | — | |
| Admin covid vaccine j&j Outpatient | 0031A CPT | $127 | $44.45 | $37.00 – $100 | — | |
| Allogeneic bone marrow transplant Inpatient | 0071 APR-DRG | — | — | $38,956 – $151,722 | — | |
| Allogeneic bone marrow transplant Inpatient | 0072 APR-DRG | — | — | $59,327 – $231,061 | — | |
| Allogeneic bone marrow transplant Inpatient | 0073 APR-DRG | — | — | $88,298 – $343,897 | — | |
| Allogeneic bone marrow transplant Inpatient | 0074 APR-DRG | — | — | $250,233 – $974,591 | — | |
| Allogeneic bone marrow transplant Inpatient | 014 MS-DRG | — | — | $90,949 – $308,560 | — | |
| Alteration in consciousness Inpatient | 0521 APR-DRG | — | — | $2,549 – $9,927 | — | |
| Alteration in consciousness Inpatient | 0522 APR-DRG | — | — | $3,274 – $12,750 | — | |
| Alteration in consciousness Inpatient | 0523 APR-DRG | — | — | $4,165 – $16,221 | — | |
| Alteration in consciousness Inpatient | 0524 APR-DRG | — | — | $11,272 – $43,901 | — | |
| Anoxic and other severe brain damage Inpatient | 0591 APR-DRG | — | — | $5,810 – $22,629 | — | |
| Anoxic and other severe brain damage Inpatient | 0592 APR-DRG | — | — | $7,201 – $28,046 | — | |
| Anoxic and other severe brain damage Inpatient | 0593 APR-DRG | — | — | $10,828 – $42,173 | — | |
| Anoxic and other severe brain damage Inpatient | 0594 APR-DRG | — | — | $18,747 – $73,016 | — | |
| Antibody sars-cov-2 titer(s) Inpatient | 0224U CPT | $244 | $85.40 | $159 – $183 | — | |
| Antibody sars-cov-2 titer(s) Outpatient | 0224U CPT | $244 | $85.40 | $51.43 – $216 | — | |
| Atherectomy visceral Inpatient | 0235T CPT | $10,380 | $3,633 | $6,747 – $7,785 | — |