St. Luke's Health Memorial San Augustine
511 E. Hospital Street, San Augustine, TX 75972
This hospital publishes its prices in a machine-readable file, as federal law requires. Below are the consumer procedures we track from that file. Prices come from the file dated February 28, 2026. See the hospital's own source file.
Procedures and cash prices (38)
| Procedure | Cash price | List price |
|---|---|---|
| CT abdomen and pelvis with contrast CPT 74177 | $2,042.40 | $13,616 |
| CT abdomen and pelvis without contrast CPT 74176 | $1,672.82 | $11,152.07 |
| CT chest with contrast CPT 71260 | $918.45 | $6,123 |
| CT chest without contrast CPT 71250 | $728.90 | $4,859.28 |
| CT head with contrast CPT 70460 | $1,141.50 | $7,610 |
| CT head without contrast CPT 70450 | $815.40 | $5,436 |
| Colonoscopy CPT 45378 | Not published | Not published |
| Colonoscopy with biopsy CPT 45380 | Not published | Not published |
| Complete blood count (CBC) CPT 85025 | $53.86 | $359.04 |
| Comprehensive metabolic panel CPT 80053 | $199.35 | $1,329 |
| ER visit level 3 CPT 99283 | $51.61 | $344.04 |
| ER visit level 4 CPT 99284 | $481.35 | $3,209 |
| ER visit level 5 CPT 99285 | $697.50 | $4,650 |
| Echocardiogram complete CPT 93306 | $935.70 | $6,238 |
| Electrocardiogram (ECG) CPT 93005 | $176.85 | $1,179 |
| Hemoglobin A1c (diabetes) CPT 83036 | $57.90 | $386 |
| Lipid panel (cholesterol) CPT 80061 | $102.36 | $682.38 |
| MRA head without contrast CPT 70544 | $981.87 | $6,545.76 |
| MRI brain with and without contrast CPT 70553 | $2,177.25 | $14,515 |
| MRI brain with contrast CPT 70552 | $1,843.35 | $12,289 |
| MRI brain without contrast CPT 70551 | $1,335.69 | $8,904.60 |
| MRI cervical spine without contrast CPT 72141 | $1,229.40 | $8,196 |
| MRI knee without contrast CPT 73721 | $1,606.80 | $10,712 |
| MRI lumbar spine without contrast CPT 72148 | $1,177.19 | $7,847.88 |
| MRI thoracic spine with and without contrast CPT 72157 | $2,534.40 | $16,896 |
| Office visit established patient level 3 CPT 99213 | $12.30 | $82 |
| Office visit established patient level 4 CPT 99214 | $73.75 | $491.64 |
| Physical therapy evaluation CPT 97161 | $100.35 | $669 |
| TSH (thyroid) CPT 84443 | $5.25 | $35 |
| Therapeutic exercises (per session) CPT 97110 | $42.90 | $286 |
| Ultrasound abdomen complete CPT 76700 | $520.50 | $3,470 |
| Ultrasound pelvis complete CPT 76856 | $605.55 | $4,037 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | Not published | Not published |
| Urinalysis CPT 81001 | $2.55 | $17 |
| X-ray chest 1 view CPT 71045 | $152.55 | $1,017 |
| X-ray chest 2 views CPT 71046 | $199.95 | $1,333 |
| X-ray knee 3 views CPT 73562 | $194.30 | $1,295.27 |
| X-ray lumbar spine 2-3 views CPT 72100 | $396.60 | $2,644 |