Prices / Houston–Pasadena–The Woodlands, TX / Hospitals
Elite Hospital Kingwood
23330 Highway 59 N, Kingwood, TX 77339 · CCN 670285
Source: the hospital's standard-charges file dated 2026-09-17 (original file, csv_wide, 0 MB), checked by us on 2026-10-06. 87 of 300 common services found in it.
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Evaluation & Management
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Initial New Patient Preventive Medicine Evaluation (18-39 Years) | CPT 99385 | $37.50 | — 0 insurers | $75.00 |
| Initial New Patient Preventive Medicine Evaluation (40-64 Years) | CPT 99386 | $37.50 | — 0 insurers | $75.00 |
Laboratory & Pathology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Automated Urinalysis Test | CPT 81002 | $84.18 | — 0 insurers | $168.36 |
| Automated Urinalysis Test | CPT 81003 | $119.82 | — 0 insurers | $239.64 |
| Basic Metabolic Panel | CPT 80048 | $303.28 | — 0 insurers | $606.55 |
| Blood Test, Clotting Time | CPT 85610 | $229.67 | — 0 insurers | $459.34 |
| Blood Test, Comprehensive Group of Blood Chemicals | CPT 80053 | $516.00 | — 0 insurers | $1,032.00 |
| Blood Test, Lipids (Cholesterol and Triglycerides) | CPT 80061 | $337.34 | — 0 insurers | $674.67 |
| Blood Test, Thyroid Stimulating Hormone (Tsh) | CPT 84443 | $292.84 | — 0 insurers | $585.67 |
| Coagulation Assessment Blood Test | CPT 85730 | $106.14 | — 0 insurers | $212.28 |
| Complete Blood Cell Count, With Differential White Blood Cells, Automated | CPT 85025 | $164.69 | — 0 insurers | $329.37 |
| Complete Blood Count, Automated | CPT 85027 | $97.20 | — 0 insurers | $194.40 |
| Kidney Function Panel Test | CPT 80069 | $445.91 | — 0 insurers | $891.82 |
| Liver Function Blood Test Panel | CPT 80076 | $186.18 | — 0 insurers | $372.36 |
| Manual Urinalysis Test With Examination Using Microscope | CPT 81001 | $55.86 | — 0 insurers | $111.72 |
| Psa (Prostate Specific Antigen) | CPT 84153 | $101.79 | — 0 insurers | $203.58 |
Medicine & Surgery
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Electrocardiogram, Routine, With Interpretation and Report | CPT 93000 | $162.24 | $30.24 – $30.24 – $30.24 1 insurers | $324.48 |
Radiology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Abdominal Ultrasound of Pregnant Uterus (>= 14 Weeks 0 Days) Single Or First Fetus | CPT 76805 | $713.65 | $280.40 – $280.40 – $280.40 1 insurers | $1,427.29 |
| Ct Scan, Head Or Brain, Without Contrast | CPT 70450 | $2,612.15 | $226.89 – $226.89 – $226.89 1 insurers | $5,224.29 |
| Ct Scan of Abdomen and Pelvis With Contrast | CPT 74177 | $5,992.75 | $639.25 – $639.25 – $639.25 1 insurers | $11,985.50 |
| Ct Scan, Pelvis, With Contrast | CPT 72193 | $1,868.91 | $479.14 – $479.14 – $479.14 1 insurers | $3,737.81 |
| Mammography, Screening, Bilateral | CPT 77067 | $449.04 | $267.80 – $267.80 – $267.80 1 insurers | $898.08 |
| Mri Scan of Brain Before and After Contrast | CPT 70553 | $3,650.31 | $676.87 – $676.87 – $676.87 1 insurers | $7,300.62 |
| Mri Scan of Leg Joint | CPT 73721 | $2,735.80 | $431.06 – $431.06 – $431.06 1 insurers | $5,471.59 |
| Mri Scan of Lower Spinal Canal | CPT 72148 | $4,322.43 | $406.13 – $406.13 – $406.13 1 insurers | $8,644.85 |
| Ultrasound of Abdomen | CPT 76700 | $1,040.89 | $241.16 – $241.16 – $241.16 1 insurers | $2,081.77 |
| Ultrasound Pelvis Through Vagina | CPT 76830 | $990.11 | $245.50 – $245.50 – $245.50 1 insurers | $1,980.22 |
| X-Ray, Lower Back, Minimum Four Views | CPT 72110 | $654.75 | $108.32 – $108.32 – $108.32 1 insurers | $1,309.50 |
Outpatient/professional (volume)
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| 3d Radiographic Procedure | CPT 76376 | $128.47 | $53.76 – $53.76 – $53.76 1 insurers | $256.93 |
| Aspiration and/Or Injection of Fluid From Large Joint | CPT 20610 | $734.10 | $137.86 – $137.86 – $137.86 1 insurers | $1,468.20 |
| Complete Ultrasound Scan Behind Abdominal Cavity | CPT 76770 | $658.41 | $225.07 – $225.07 – $225.07 1 insurers | $1,316.81 |
| Critical Care, Each Additional 30 Minutes | CPT 99292 | $359.25 | $254.37 – $254.37 – $254.37 1 insurers | $718.50 |
| Critical Care, First 30-74 Minutes | CPT 99291 | $3,394.84 | $582.33 – $582.33 – $582.33 1 insurers | $6,789.67 |
| Ct Scan of Abdomen and Pelvis Before and After Contrast | CPT 74178 | $6,665.25 | $715.66 – $715.66 – $715.66 1 insurers | $13,330.50 |
| Ct Scan of Abdomen and Pelvis Without Contrast | CPT 74176 | $5,115.50 | $391.35 – $391.35 – $391.35 1 insurers | $10,231.00 |
| Ct Scan of Blood Vessels of Abdomen and Pelvis With Contrast | CPT 74174 | $4,798.34 | $804.42 – $804.42 – $804.42 1 insurers | $9,596.68 |
| Ct Scan of Blood Vessels of Chest With Contrast | CPT 71275 | $2,491.35 | $562.91 – $562.91 – $562.91 1 insurers | $4,982.69 |
| Ct Scan of Blood Vessels of Head With Contrast | CPT 70496 | $2,459.17 | $555.08 – $555.08 – $555.08 1 insurers | $4,918.34 |
| Ct Scan of Blood Vessels of Neck With Contrast | CPT 70498 | $2,595.37 | $555.08 – $555.08 – $555.08 1 insurers | $5,190.74 |
| Ct Scan of Chest With Contrast | CPT 71260 | $2,301.84 | $353.97 – $353.97 – $353.97 1 insurers | $4,603.67 |
| Ct Scan of Chest Without Contrast | CPT 71250 | $1,911.50 | $282.83 – $282.83 – $282.83 1 insurers | $3,823.00 |
| Ct Scan of Face Without Contrast | CPT 70486 | $1,814.18 | $271.60 – $271.60 – $271.60 1 insurers | $3,628.35 |
| Ct Scan of Leg Without Contrast | CPT 73700 | $1,992.19 | $275.63 – $275.63 – $275.63 1 insurers | $3,984.38 |
| Ct Scan of Lower Spine Without Contrast | CPT 72131 | $3,736.77 | $274.95 – $274.95 – $274.95 1 insurers | $7,473.53 |
| Ct Scan of Upper Spine Without Contrast | CPT 72125 | $2,004.84 | $276.33 – $276.33 – $276.33 1 insurers | $4,009.67 |
| Electrocardiogram (Ecg) 1 To 3 Leads With Review By Physician Only | CPT 93042 | $20.85 | $14.36 – $14.36 – $14.36 1 insurers | $41.70 |
| Emergency Department Visit With High Level of Medical Decision Making | CPT 99285 | $2,588.57 | $374.70 – $374.70 – $374.70 1 insurers | $5,177.13 |
| Emergency Department Visit With Low Level of Medical Decision Making | CPT 99283 | $1,380.35 | $151.41 – $151.41 – $151.41 1 insurers | $2,760.69 |
| Emergency Department Visit With Moderate Level of Medical Decision Making | CPT 99284 | $2,045.13 | $258.33 – $258.33 – $258.33 1 insurers | $4,090.25 |
| Hospital Discharge Day Management, 30 Minutes Or Less | CPT 99238 | $301.00 | $172.35 – $172.35 – $172.35 1 insurers | $602.00 |
| Insertion of Artery Tube For Blood Sampling Or Infusion Through Skin | CPT 36620 | $527.66 | $92.66 – $92.66 – $92.66 1 insurers | $1,055.31 |
| Insertion of Non-Tunneled Central Venous Tube For Infusion (5 Years Or Older) | CPT 36556 | $605.43 | $434.61 – $434.61 – $434.61 1 insurers | $1,210.86 |
| Limited Ultrasound Scan of 1 Breast | CPT 76642 | $186.36 | $177.37 – $177.37 – $177.37 1 insurers | $372.72 |
| Limited Ultrasound Scan of Abdomen | CPT 76705 | $1,276.61 | $181.15 – $181.15 – $181.15 1 insurers | $2,553.21 |
| Low Dose Ct Scan of Chest For Lung Cancer Screening | CPT 71271 | $1,715.02 | $292.44 – $292.44 – $292.44 1 insurers | $3,430.03 |
| Mri Scan of Abdomen Before and After Contrast | CPT 74183 | $1,369.11 | $715.71 – $715.71 – $715.71 1 insurers | $2,738.22 |
| Mri Scan of Brain Without Contrast | CPT 70551 | $2,172.66 | $417.13 – $417.13 – $417.13 1 insurers | $4,345.32 |
| Mri Scan of Upper Spinal Canal Without Contrast | CPT 72141 | $696.93 | $404.76 – $404.76 – $404.76 1 insurers | $1,393.86 |
| Removal of Skin and Tissue, 20.0 Sq Cm Or Less | CPT 11042 | $932.40 | $270.12 – $270.12 – $270.12 1 insurers | $1,864.80 |
| Routine Electrocardiogram (Ecg) Using At Least 12 Leads With Interpretation and Report Only | CPT 93010 | $98.58 | $17.19 – $17.19 – $17.19 1 insurers | $197.16 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes | CPT 99232 | $150.00 | $168.57 – $168.57 – $168.57 1 insurers | $300.00 |
| Test To Measure Expiratory Airflow and Volume Changes Before and After Medication Administration | CPT 94060 | $448.59 | $81.34 – $81.34 – $81.34 1 insurers | $897.18 |
| Ultrasonic Guidance For Blood Vessel Access | CPT 76937 | $75.00 | $80.28 – $80.28 – $80.28 1 insurers | $150.00 |
| Ultrasonic Guidance For Needle Placement | CPT 76942 | $3.30 | $7.43 – $7.43 – $7.43 1 insurers | $6.60 |
| Ultrasound of Both Sides of Head and Neck Blood Flow | CPT 93880 | $1,357.01 | $389.66 – $389.66 – $389.66 1 insurers | $2,714.01 |
| Ultrasound of Heart, Follow-Up | CPT 93308 | $696.93 | $202.93 – $202.93 – $202.93 1 insurers | $1,393.86 |
| Ultrasound of Heart With Color-Depicted Blood Flow, Rate, Direction and Valve Function | CPT 93306 | $4,694.50 | $405.39 – $405.39 – $405.39 1 insurers | $9,389.00 |
| Ultrasound Scan of Head and Neck Soft Tissue | CPT 76536 | $343.38 | $227.79 – $227.79 – $227.79 1 insurers | $686.76 |
| Ultrasound Study of Arm Or Leg Veins With Compression and Maneuvers | CPT 93970 | $2,038.80 | $383.07 – $383.07 – $383.07 1 insurers | $4,077.60 |
| Ultrasound Study of One Arm Or Leg Veins With Compression and Maneuvers | CPT 93971 | $1,364.24 | $245.23 – $245.23 – $245.23 1 insurers | $2,728.48 |
| Use of A Drug To Induce Depression of Consciousness By Physician Performing A Procedure (5 Years Or Older), Initial 15 Minutes | CPT 99152 | $246.37 | $104.16 – $104.16 – $104.16 1 insurers | $492.73 |
| X-Ray of Abdomen, 1 View | CPT 74018 | $552.67 | $62.60 – $62.60 – $62.60 1 insurers | $1,105.34 |
| X-Ray of Ankle, Minimum of 3 Views | CPT 73610 | $604.00 | $75.63 – $75.63 – $75.63 1 insurers | $1,208.00 |
| X-Ray of Chest, 1 View | CPT 71045 | $622.84 | $54.36 – $54.36 – $54.36 1 insurers | $1,245.67 |
| X-Ray of Chest, 2 Views | CPT 71046 | $653.72 | $70.34 – $70.34 – $70.34 1 insurers | $1,307.44 |
| X-Ray of Foot, Minimum of 3 Views | CPT 73630 | $547.72 | $70.81 – $70.81 – $70.81 1 insurers | $1,095.44 |
| X-Ray of Hand, Minimum of 3 Views | CPT 73130 | $566.34 | $77.70 – $77.70 – $77.70 1 insurers | $1,132.68 |
| X-Ray of Hip, 2-3 Views | CPT 73502 | $549.51 | $99.23 – $99.23 – $99.23 1 insurers | $1,099.02 |
| X-Ray of Knee, 1-2 Views | CPT 73560 | $417.89 | $70.79 – $70.79 – $70.79 1 insurers | $835.78 |
| X-Ray of Knee, 3 Views | CPT 73562 | $623.93 | $84.63 – $84.63 – $84.63 1 insurers | $1,247.85 |
| X-Ray of Knee, 4 Or More Views | CPT 73564 | $805.73 | $98.53 – $98.53 – $98.53 1 insurers | $1,611.45 |
| X-Ray of Lower and Sacral Spine, 2-3 Views | CPT 72100 | $683.84 | $82.71 – $82.71 – $82.71 1 insurers | $1,367.67 |
| X-Ray of Lower Leg, 2 Views | CPT 73590 | $795.06 | $65.97 – $65.97 – $65.97 1 insurers | $1,590.11 |
| X-Ray of Pelvis, 1-2 Views | CPT 72170 | $429.56 | $58.44 – $58.44 – $58.44 1 insurers | $859.12 |
| X-Ray of Shoulder, Minimum of 2 Views | CPT 73030 | $632.00 | $72.23 – $72.23 – $72.23 1 insurers | $1,264.00 |
| X-Ray of Thigh Bone, Minimum 2 Views | CPT 73552 | $549.82 | $74.30 – $74.30 – $74.30 1 insurers | $1,099.64 |
| X-Ray of Wrist, Minimum of 3 Views | CPT 73110 | $528.33 | $85.95 – $85.95 – $85.95 1 insurers | $1,056.66 |