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St. Luke's Health Memorial Hospital San Augustine

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St. Luke's Health Memorial Hospital San Augustine. This page also lists hospital-published cash prices for services and billing-code line items.

Overview

  • CCN451360

Procedures & prices

Hospital-published price lines. These are billing-code items from the hospital transparency file, not a personalized estimate. Cash is the self-pay price; gross is the pre-discount list price.
Price definitions
Cash
— self-pay price (no insurance)
Gross
— chargemaster list price; the pre-discount sticker rate, rarely what anyone pays
Negotiated range
— min–max of rates the hospital negotiated with insurers
Payers
— number of insurers with a published rate (“0” / “—” = none)
Available here:CashGross listInsurer-negotiated rates were not published for these rows.
  • Antb Borrelia Burgdorferi Lyme Disease
    Lab testCPT 86618Hospital-published line item
    $10
    cash
    Gross $69
  • Mycoplasma
    Lab testCPT 87109Hospital-published line item
    $10
    cash
    Gross $69
  • Assay Of Copper
    Lab testCPT 82525Hospital-published line item
    $10
    cash
    Gross $69
  • hiv-1antibody
    Lab testCPT 86701Hospital-published line item
    $10
    cash
    Gross $69
  • Immunofix E-Phoresis Serum
    Lab testCPT 86334Hospital-published line item
    $10
    cash
    Gross $69
  • Mycoplasma Antibody
    Lab testCPT 86738Hospital-published line item
    $10
    cash
    Gross $69
  • Injection, Ampicillin Sodium/Sulbactam Sodium, Per 1.5 Gm
    DrugHCPCS J0295Hospital-published line item
    $10
    cash
    Gross $69
  • Culture Type Immunologic
    Lab testCPT 87147Hospital-published line item
    $11
    cash
    Gross $70
  • Cold Agglutinin Titer
    Lab testCPT 86157Hospital-published line item
    $11
    cash
    Gross $70
  • Semen Anal Sperm Detection
    Lab testCPT 89321Hospital-published line item
    $11
    cash
    Gross $71
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