Prices / Houston–Pasadena–The Woodlands, TX / Hospitals
Shriners Hospitals For Children
815 Market Street, Galveston, TX 77550 · CCN 453311
Source: the hospital's standard-charges file dated 2026-03-18 (original file, csv_wide, 204 MB), checked by us on 2026-10-06. 100 of 300 common services found in it.
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Evaluation & Management
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| New Patient Office Or Other Outpatient Visit, Typically 30 Min | CPT 99203 | $279.40 | $37.83 – $99.26 – $166.58 7 insurers | $378.74 |
| New Patient Office Or Other Outpatient Visit, Typically 45 Min | CPT 99204 | $355.70 | $56.77 – $162.48 – $282.04 7 insurers | $614.54 |
| New Patient Office Or Other Outpatient Visit, Typically 60 Min | CPT 99205 | $526.10 | $12.00 – $189.92 – $368.06 8 insurers | $835.87 |
| Patient Office Consultation, Typically 60 Min | CPT 99244 | $467.14 | $194.49 – $247.40 – $300.31 2 insurers | $467.14 |
Laboratory & Pathology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Automated Urinalysis Test | CPT 81002 | $19.10 | $2.92 – $3.66 – $6.68 11 insurers | $19.10 |
| Automated Urinalysis Test | CPT 81003 | $16.90 | $1.91 – $2.81 – $4.32 11 insurers | $16.90 |
| Basic Metabolic Panel | CPT 80048 | $63.30 | $7.53 – $10.58 – $16.24 11 insurers | $63.30 |
| Blood Test, Clotting Time | CPT 85610 | $29.50 | $3.67 – $5.36 – $8.24 11 insurers | $29.50 |
| Blood Test, Comprehensive Group of Blood Chemicals | CPT 80053 | $79.20 | $9.39 – $13.20 – $20.28 11 insurers | $79.20 |
| Blood Test, Lipids (Cholesterol and Triglycerides) | CPT 80061 | $100.40 | $11.91 – $16.74 – $25.71 11 insurers | $100.40 |
| Blood Test, Thyroid Stimulating Hormone (Tsh) | CPT 84443 | $125.90 | $14.94 – $21.00 – $32.26 11 insurers | $125.90 |
| Coagulation Assessment Blood Test | CPT 85730 | $45.00 | $5.25 – $7.51 – $11.54 11 insurers | $45.00 |
| Complete Blood Cell Count, With Differential White Blood Cells, Automated | CPT 85025 | $58.30 | $6.60 – $9.71 – $14.92 11 insurers | $58.30 |
| Complete Blood Count, Automated | CPT 85027 | $48.50 | $5.75 – $8.09 – $12.42 11 insurers | $76.40 |
| Kidney Function Panel Test | CPT 80069 | $65.10 | $7.72 – $10.85 – $16.67 11 insurers | $65.10 |
| Liver Function Blood Test Panel | CPT 80076 | $61.30 | $7.27 – $10.21 – $15.69 11 insurers | $61.30 |
| Manual Urinalysis Test With Examination Using Microscope | CPT 81001 | $23.80 | $2.82 – $3.96 – $6.09 11 insurers | $23.80 |
Medicine & Surgery
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Cardiac Valve and Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc | MS-DRG 216 | not published | $2,061.14 – $42,695.55 – $126,440.00 9 insurers | — |
| Cervical Spinal Fusion Without Cc Or Mcc | MS-DRG 473 | not published | $2,061.14 – $9,971.96 – $31,015.00 9 insurers | — |
| Injection of Substance Into Spinal Canal of Lower Back Or Sacrum Using Imaging Guidance | CPT 62322 | $3,810.00 | $67.88 – $290.00 – $1,513.49 12 insurers | $3,810.00 |
| Injections of Anesthetic and/Or Steroid Drug Into Lower Or Sacral Spine Nerve Root Using Imaging Guidance | CPT 64483 | $3,646.90 | $95.75 – $300.00 – $1,513.49 12 insurers | $3,646.90 |
| Major Joint Replacement Or Reattachment of Lower Extremity Without Mcc | MS-DRG 470 | not published | $2,061.14 – $8,176.50 – $24,704.00 9 insurers | — |
| Spinal Fusion Except Cervical Without Mcc | MS-DRG 460 | not published | $2,061.14 – $2,061.14 – $29,047.38 5 insurers | — |
| Uterine and Adnexa Procedures For Non-Malignancy Without Cc Or Mcc | MS-DRG 743 | not published | $2,061.14 – $4,692.60 – $15,704.00 9 insurers | — |
Radiology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Ct Scan, Head Or Brain, Without Contrast | CPT 70450 | $1,029.80 | $90.39 – $137.86 – $265.85 9 insurers | $1,029.80 |
| Ct Scan of Abdomen and Pelvis With Contrast | CPT 74177 | $2,942.20 | $206.27 – $423.85 – $733.15 9 insurers | $2,942.20 |
| Ct Scan, Pelvis, With Contrast | CPT 72193 | $1,568.20 | $153.29 – $224.13 – $445.05 9 insurers | $1,568.20 |
| Mri Scan of Brain Before and After Contrast | CPT 70553 | $2,826.80 | $269.20 – $469.68 – $892.83 9 insurers | $2,826.80 |
| Mri Scan of Leg Joint | CPT 73721 | $1,845.30 | $171.28 – $285.97 – $483.44 9 insurers | $1,845.30 |
| Mri Scan of Lower Spinal Canal | CPT 72148 | $5,143.70 | $161.72 – $281.65 – $604.30 9 insurers | $5,143.70 |
| Ultrasound of Abdomen | CPT 76700 | $616.40 | $56.00 – $137.86 – $215.19 9 insurers | $616.40 |
| X-Ray, Lower Back, Minimum Four Views | CPT 72110 | $397.20 | $40.00 – $124.41 – $215.19 9 insurers | $397.20 |
Inpatient (volume)
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Cardiac Arrhythmia and Conduction Disorders With Cc | MS-DRG 309 | not published | $2,061.14 – $2,975.52 – $9,686.00 9 insurers | — |
| Chest Pain | MS-DRG 313 | not published | $2,061.14 – $2,833.40 – $9,346.00 9 insurers | — |
| Other Disorders of Nervous System With Cc | MS-DRG 092 | not published | $2,061.14 – $4,302.91 – $13,872.00 9 insurers | — |
Outpatient/professional (volume)
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| 3d Radiographic Procedure | CPT 76376 | $499.60 | $13.06 – $20.00 – $109.50 7 insurers | $499.60 |
| Aspiration and/Or Injection of Fluid From Large Joint | CPT 20610 | $1,163.55 | $16.00 – $16.00 – $988.00 12 insurers | $1,163.55 |
| Cell Examination of Specimen, Selective Cellular Enhancement Technique | CPT 88112 | $188.70 | $33.17 – $34.93 – $73.29 3 insurers | $188.70 |
| Complete Ultrasound Scan Behind Abdominal Cavity | CPT 76770 | $616.40 | $44.00 – $137.86 – $215.19 9 insurers | $616.40 |
| Ct Scan of Abdomen and Pelvis Before and After Contrast | CPT 74178 | $2,942.20 | $272.95 – $423.85 – $733.15 9 insurers | $2,942.20 |
| Ct Scan of Abdomen and Pelvis Without Contrast | CPT 74176 | $2,074.10 | $108.30 – $258.67 – $483.44 9 insurers | $2,074.10 |
| Ct Scan of Blood Vessels of Chest With Contrast | CPT 71275 | $1,797.40 | $180.34 – $224.13 – $395.23 9 insurers | $1,797.40 |
| Ct Scan of Blood Vessels of Head With Contrast | CPT 70496 | $1,797.40 | $153.29 – $224.13 – $387.50 9 insurers | $1,797.40 |
| Ct Scan of Blood Vessels of Neck With Contrast | CPT 70498 | $1,797.40 | $153.29 – $224.13 – $387.04 9 insurers | $1,797.40 |
| Ct Scan of Chest With Contrast | CPT 71260 | $1,568.20 | $140.75 – $224.13 – $445.05 9 insurers | $1,568.20 |
| Ct Scan of Chest Without Contrast | CPT 71250 | $1,029.80 | $106.88 – $137.86 – $265.85 9 insurers | $1,029.80 |
| Ct Scan of Face Without Contrast | CPT 70486 | $1,029.80 | $90.85 – $137.86 – $265.85 9 insurers | $1,029.80 |
| Ct Scan of Leg Without Contrast | CPT 73700 | $1,029.80 | $90.85 – $137.86 – $215.19 9 insurers | $1,029.80 |
| Ct Scan of Lower Spine Without Contrast | CPT 72131 | $3,089.60 | $90.85 – $137.86 – $215.19 9 insurers | $3,089.60 |
| Ct Scan of Upper Spine Without Contrast | CPT 72125 | $3,089.60 | $106.88 – $137.86 – $215.19 9 insurers | $3,089.60 |
| Destruction of Precancer Skin Growth, 2-14 Growths | CPT 17003 | $386.40 | $1.75 – $22.88 – $988.00 5 insurers | $386.40 |
| Diagnostic Exam of Bladder and Urethra Using An Endoscope | CPT 52000 | $3,048.72 | $69.12 – $284.00 – $1,134.70 12 insurers | $3,048.72 |
| Dxa Bone Density Measurement of Hip, Pelvis, Spine | CPT 77080 | $382.80 | $32.16 – $58.81 – $212.68 9 insurers | $382.80 |
| Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More | CPT 99215 | $347.00 | $56.77 – $216.58 – $2,765.00 8 insurers | $355.70 |
| Established Patient Office Or Other Outpatient Visit With Low Level Od Decision Making, If Using Time, 20 Minutes Or More | CPT 99213 | $242.80 | $37.83 – $89.87 – $2,765.00 8 insurers | $248.90 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More | CPT 99214 | $242.80 | $56.77 – $117.74 – $2,765.00 8 insurers | $248.90 |
| Established Patient Office Or Other Outpatient Visit With Straightforward Medical Decision Making, If Using Time, 10 Minutes Or More | CPT 99212 | $213.00 | $30.53 – $49.82 – $2,765.00 8 insurers | $218.30 |
| Evaluation of Fine Needle Aspirate With Interpretation and Report | CPT 88173 | $192.80 | $66.39 – $73.29 – $84.10 3 insurers | $192.80 |
| Imaging For Evaluation of Swallowing Function | CPT 74230 | $462.10 | $29.00 – $191.33 – $356.04 9 insurers | $462.10 |
| Injection of Anesthetic Agent and/Or Steroid Into Thigh Nerve (Femoral Nerve) | CPT 64447 | $592.75 | $38.00 – $38.00 – $2,747.00 12 insurers | $592.75 |
| Injection of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Level | CPT 64493 | $3,646.90 | $78.31 – $300.00 – $1,513.49 12 insurers | $3,646.90 |
| Limited Ultrasound Scan of Abdomen | CPT 76705 | $513.60 | $20.00 – $124.41 – $215.19 9 insurers | $513.60 |
| Microscopic Genetic Analysis of Tumor, Manual | CPT 88360 | $188.70 | $59.68 – $220.99 – $275.52 7 insurers | $188.70 |
| Mri Scan of Abdomen Before and After Contrast | CPT 74183 | $2,826.80 | $284.31 – $469.68 – $955.20 9 insurers | $2,826.80 |
| Mri Scan of Brain Without Contrast | CPT 70551 | $1,845.30 | $166.04 – $281.65 – $604.30 9 insurers | $1,845.30 |
| Mri Scan of Upper Spinal Canal Without Contrast | CPT 72141 | $5,272.30 | $161.19 – $281.65 – $604.30 9 insurers | $5,272.30 |
| Pathology Examination of Tissue Using A Microscope, Intermediate Complexity | CPT 88305 | $188.70 | $28.85 – $30.36 – $73.29 3 insurers | $188.70 |
| Pathology Examination of Tissue Using A Microscope, Moderately High Complexity | CPT 88307 | $285.70 | $155.59 – $168.02 – $504.11 3 insurers | $285.70 |
| Pathology Examination of Tissue Using A Microscope, Moderately Low Complexity | CPT 88304 | $188.70 | $25.61 – $27.00 – $73.29 3 insurers | $188.70 |
| Preparation of Tissue For Examination By Removing Any Calcium Present | CPT 88311 | $54.90 | $6.36 – $6.72 – $15.88 3 insurers | $54.90 |
| Removal of Skin and Tissue, 20.0 Sq Cm Or Less | CPT 11042 | $1,596.55 | $52.14 – $221.00 – $1,486.00 12 insurers | $1,596.55 |
| Special Stained Specimen Slides To Examine Tissue, Each Additional Procedure | CPT 88341 | $144.20 | $37.45 – $46.16 – $55.86 3 insurers | $144.20 |
| Special Stained Specimen Slides To Examine Tissue Including Interpretation and Report | CPT 88313 | $88.50 | $52.51 – $56.91 – $187.11 3 insurers | $88.50 |
| Special Stained Specimen Slides To Examine Tissue, Initial Procedure | CPT 88342 | $188.70 | $39.60 – $150.64 – $275.52 10 insurers | $188.70 |
| Special Stained Specimen Slides To Identify Organisms Including Interpretation and Report | CPT 88312 | $88.50 | $65.99 – $69.57 – $73.29 3 insurers | $88.50 |
| Test To Determine Lung Volumes Using Sensors | CPT 94726 | $284.10 | $44.22 – $485.95 – $544.95 7 insurers | $284.10 |
| Test To Examine How Well The Lungs Exchange Gases | CPT 94729 | $311.30 | $13.06 – $80.71 – $100.73 6 insurers | $311.30 |
| Test To Measure Expiratory Airflow and Volume Changes Before and After Medication Administration | CPT 94060 | $503.30 | $32.25 – $101.50 – $544.95 7 insurers | $503.30 |
| Ultrasonic Guidance For Blood Vessel Access | CPT 76937 | $103.00 | $17.63 – $24.38 – $60.82 7 insurers | $103.00 |
| Ultrasonic Guidance For Needle Placement | CPT 76942 | $103.00 | $26.49 – $43.96 – $94.54 6 insurers | $103.00 |
| Ultrasound Scan of Head and Neck Soft Tissue | CPT 76536 | $513.60 | $54.00 – $137.86 – $215.19 9 insurers | $513.60 |
| Ultrasound Study of Arm Or Leg Veins With Compression and Maneuvers | CPT 93970 | $818.70 | $42.00 – $314.15 – $410.92 7 insurers | $818.70 |
| Ultrasound Study of One Arm Or Leg Veins With Compression and Maneuvers | CPT 93971 | $513.60 | $73.00 – $180.78 – $215.41 7 insurers | $513.60 |
| Use of A Drug To Induce Depression of Consciousness By Physician Performing A Procedure (5 Years Or Older), Initial 15 Minutes | CPT 99152 | $407.30 | $10.47 – $24.46 – $67.81 3 insurers | $407.30 |
| X-Ray of Abdomen, 1 View | CPT 74018 | $237.00 | $20.26 – $83.80 – $176.10 9 insurers | $237.00 |
| X-Ray of Ankle, Minimum of 3 Views | CPT 73610 | $370.40 | $18.00 – $104.16 – $176.10 9 insurers | $370.40 |
| X-Ray of Chest, 1 View | CPT 71045 | $237.00 | $11.86 – $83.80 – $176.10 9 insurers | $237.00 |
| X-Ray of Chest, 2 Views | CPT 71046 | $284.40 | $21.87 – $83.80 – $176.10 9 insurers | $284.40 |
| X-Ray of Foot, Minimum of 3 Views | CPT 73630 | $370.40 | $28.00 – $98.17 – $176.10 9 insurers | $370.40 |
| X-Ray of Hand, Minimum of 3 Views | CPT 73130 | $370.40 | $25.00 – $88.59 – $176.10 9 insurers | $370.40 |
| X-Ray of Hip, 2-3 Views | CPT 73502 | $158.40 | $27.84 – $83.80 – $176.10 9 insurers | $158.40 |
| X-Ray of Knee, 1-2 Views | CPT 73560 | $237.00 | $21.02 – $93.38 – $176.10 9 insurers | $237.00 |
| X-Ray of Knee, 3 Views | CPT 73562 | $296.40 | $33.47 – $98.17 – $176.10 9 insurers | $296.40 |
| X-Ray of Knee, 4 Or More Views | CPT 73564 | $370.40 | $37.00 – $137.86 – $215.19 9 insurers | $370.40 |
| X-Ray of Lower and Sacral Spine, 2-3 Views | CPT 72100 | $237.00 | $28.00 – $124.41 – $215.19 9 insurers | $237.00 |
| X-Ray of Lower Leg, 2 Views | CPT 73590 | $296.40 | $25.00 – $83.80 – $176.10 9 insurers | $296.40 |
| X-Ray of Pelvis, 1-2 Views | CPT 72170 | $237.00 | $21.00 – $132.33 – $215.19 9 insurers | $237.00 |
| X-Ray of Shoulder, Minimum of 2 Views | CPT 73030 | $296.40 | $20.00 – $98.17 – $176.10 9 insurers | $296.40 |
| X-Ray of Thigh Bone, Minimum 2 Views | CPT 73552 | $120.70 | $21.18 – $93.38 – $176.10 9 insurers | $120.70 |
| X-Ray of Wrist, Minimum of 3 Views | CPT 73110 | $370.40 | $23.00 – $86.20 – $176.10 9 insurers | $370.40 |