Shoppable services price list
Standard charges for 300 scheduled, non-emergency services at Sanavate Hospital, including the hospital items and services usually provided with each one. No account or personal information is required.
Insurance and negotiated rates
Sanavate Hospital does not have negotiated rates with any insurance company or health plan. Original Medicare pays rates set by the federal government, which are not negotiated rates. For that reason, every service below shows no payer-specific negotiated charge and no lowest or highest negotiated charge.
If you have insurance, what you owe depends on your plan's coverage, network, and deductible. For help understanding your costs, call (832) 303-2273.
Find a service
Search by plain-language name or billing code, or filter by category and setting.
300 services found · showing 25
Psychotherapy, 30 minutes
Primary code: CPT/HCPCS 90832
Therapy & Rehabilitation · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$600.25Discounted cash price
- Discounted cash price
- $600.25
- Gross charge
- $600.25
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- Psychotherapy, 30 minutes x1
Psychotherapy, 45 minutes
Primary code: CPT/HCPCS 90834
Therapy & Rehabilitation · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$781.25Discounted cash price
- Discounted cash price
- $781.25
- Gross charge
- $781.25
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- Psychotherapy, 38-52 minutes with patient x1
Psychotherapy, 60 minutes
Primary code: CPT/HCPCS 90837
Therapy & Rehabilitation · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$967.00Discounted cash price
- Discounted cash price
- $967.00
- Gross charge
- $967.00
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- Psychotherapy, 53+ minutes with patient x1
New patient low complexity, 30 minutes
Primary code: CPT/HCPCS 99203
Other Clinical Services · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$895.00Discounted cash price
- Discounted cash price
- $895.00
- Gross charge
- $895.00
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (3)
- Office/other outpatient E/M — new patient
- low MDM
- 30-44 min x1
New-patient outpatient visit, typically 45 minutes
Primary code: CPT/HCPCS 99204
Hospital Services · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$1,235.85Discounted cash price
- Discounted cash price
- $1,235.85
- Gross charge
- $1,235.85
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (3)
- Office/other outpatient E/M — new patient
- moderate MDM
- 45-59 min x1
New patient high complexity, 60 minutes
Primary code: CPT/HCPCS 99205
Other Clinical Services · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$1,575.38Discounted cash price
- Discounted cash price
- $1,575.38
- Gross charge
- $1,575.38
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (3)
- Office/other outpatient E/M — new patient
- high MDM
- 60-74 min x1
Basic Metabolic Panel
Primary code: CPT/HCPCS 80048
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$1,604.34Discounted cash price
- Discounted cash price
- $1,604.34
- Gross charge
- $1,604.34
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Basic Metabolic Panel (Send-out
- performed by reference laboratory) x1
Comprehensive Metabolic Panel
Primary code: CPT/HCPCS 80053
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$2,069.00Discounted cash price
- Discounted cash price
- $2,069.00
- Gross charge
- $2,069.00
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Comprehensive Metabolic Panel (Send-out
- performed by reference laboratory) x1
Liver-function panel
Primary code: CPT/HCPCS 80076
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$1,604.34Discounted cash price
- Discounted cash price
- $1,604.34
- Gross charge
- $1,604.34
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Hepatic Function Panel (Send-out
- performed by reference laboratory) x1
Manual urinalysis with microscopy
Primary code: CPT/HCPCS 81001
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$593.68Discounted cash price
- Discounted cash price
- $593.68
- Gross charge
- $593.68
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Urinalysis, Complete With Microscopic Examination (Send-out
- performed by reference laboratory) x1
Automated urinalysis
Primary code: CPT/HCPCS 81003
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$259.05Discounted cash price
- Discounted cash price
- $259.05
- Gross charge
- $259.05
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- Laboratory: Urinalysis, automated x1
Thyroid-stimulating hormone blood test
Primary code: CPT/HCPCS 84443
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$1,594.42Discounted cash price
- Discounted cash price
- $1,594.42
- Gross charge
- $1,594.42
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Thyroid Stimulating Hormone (TSH) (Send-out
- performed by reference laboratory) x1
Complete blood count with differential
Primary code: CPT/HCPCS 85025
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$329.37Discounted cash price
- Discounted cash price
- $329.37
- Gross charge
- $329.37
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: CBC w/ Differential (Send-out
- performed by reference laboratory) x1
Complete blood count
Primary code: CPT/HCPCS 85027
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$756.98Discounted cash price
- Discounted cash price
- $756.98
- Gross charge
- $756.98
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: CBC w/o Differential (Send-out
- performed by reference laboratory) x1
Prothrombin time and INR blood test
Primary code: CPT/HCPCS 85610
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$673.81Discounted cash price
- Discounted cash price
- $673.81
- Gross charge
- $673.81
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Prothrombin Time / INR (Send-out
- performed by reference laboratory) x1
Activated partial thromboplastin time blood test
Primary code: CPT/HCPCS 85730
Laboratory · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
Send-out lab · billed by Sanavate Hospital, no separate lab bill$793.24Discounted cash price
- Discounted cash price
- $793.24
- Gross charge
- $793.24
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Laboratory: Partial Thromboplastin Time, Activated (Send-out
- performed by reference laboratory) x1
CT of the head or brain without contrast
Primary code: CPT/HCPCS 70450
Imaging · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$8,768.02Discounted cash price
- Discounted cash price
- $8,768.02
- Gross charge
- $8,768.02
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Computed tomography, brain
- without contrast material x1
Lower-back X-ray, at least four views
Primary code: CPT/HCPCS 72110
Imaging · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$3,609.15Discounted cash price
- Discounted cash price
- $3,609.15
- Gross charge
- $3,609.15
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- X-ray, Lumbar Spine — 4–5 views x1
Left shoulder arthroscopic subacromial decompression/acromioplasty
Primary code: CPT/HCPCS 29826
Pain & Interventional · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$49,937.02Discounted cash price
- Discounted cash price
- $49,937.02
- Gross charge
- $49,937.02
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (9)
- Arthroscopy shoulder, surgical decompression of subacromial space with partial acromioplasty, with procedure x1
- Med-Surg Supplies - Shoulder Arthroscopy Disposable Set (per case) x1
- Pharmacy - Shoulder anesthesia & peri op meds (per case) x1
- Med-Surg Supplies - Elastic Bandage Wrap (ACE) 4" x 5 yd x1
- PACU Recovery - 30 min block x4
- Anesthesia Services - Level 3 - General Anesthesia (Airway Management), 30 minutes x1
- Anesthesia Services - Level 3 - General Anesthesia (Airway Management) - Each Additional 30 Minutes x1
- Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint
- not otherwise specified x9
Knee arthroscopy with meniscectomy, unilateral
Primary code: CPT/HCPCS 29881
Surgery · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$55,485.02Discounted cash price
- Discounted cash price
- $55,485.02
- Gross charge
- $55,485.02
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (8)
- Arthroscopy, knee, surgical
- with meniscectomy x1
- Med-Surg Supplies - Knee arthroscopy disposable set (per case) x1
- Pharmacy - Knee anesthesia & peri op meds (per case) x1
- PACU Recovery - 30 min block x4
- Anesthesia Services - Level 3 - General Anesthesia (Airway Management), 30 minutes x1
- Anesthesia Services - Level 3 - General Anesthesia (Airway Management) - Each Additional 30 Minutes x1
- Anesthesia for open/surgical arthroscopic procedures on the knee joint x8
Diagnostic upper gastrointestinal endoscopy
Primary code: CPT/HCPCS 43235
Surgery · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$11,838.00Discounted cash price
- Discounted cash price
- $11,838.00
- Gross charge
- $11,838.00
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Esophagogastroduodenoscopy, flexible, transoral
- diagnostic, including collection of specimen(s) by brushing or washing, when performed x1
Lumbar epidural steroid injection at L6-S1 with imaging guidance
Primary code: CPT/HCPCS 62323
Pain & Interventional · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$24,919.96Discounted cash price
- Discounted cash price
- $24,919.96
- Gross charge
- $24,919.96
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (9)
- Injection(s), of diagnostic or therapeutic substance(s), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal), with imaging x1
- Diagnostic Radiology - Fluoroscopy (C-arm), intra-op, up to 1 hour x1
- Med-Surg Supplies - ESI Sterile Procedure Pack x1
- Pharmacy - Steroid bundle (dexamethasone up to 10 mg + PF local anesthetic)
- billed under J1100 (dex) + J3490 (LA) x1
- Contrast - ESI Epidurography x1
- PACU Recovery - 30 min block x1
- Anesthesia Services - Level 2 - Monitored Anesthesia Care (MAC), 30 minutes x1
- Anesthesia for percutaneous image-guided injection/drainage/aspiration, lumbar/sacral spine x6
Right L4-L5 and L5-S1 transforaminal epidural steroid injections with imaging guidance
Primary code: CPT/HCPCS 64483 · Other codes: 64484
Pain & Interventional · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$33,676.96Discounted cash price
- Discounted cash price
- $33,676.96
- Gross charge
- $33,676.96
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (12)
- Injection(s), anesthetic agent(s) and/or steroid
- transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, single level x1
- Diagnostic Radiology - Fluoroscopy (C-arm), intra-op, up to 1 hour x1
- Med-Surg Supplies - ESI Sterile Procedure Pack x1
- Contrast - ESI Epidurography x1
- Pharmacy - Steroid bundle (dexamethasone up to 10 mg + PF local anesthetic)
- billed under J1100 (dex) + J3490 (LA) x1
- PACU Recovery - 30 min block x1
- Injection(s), anesthetic agent and/or steroid, transoraminal epidural, with imaging guidance (fluoroscopy or CT)
- lumbar or sacral, each additional level x1
- Anesthesia Services - Level 2 - Monitored Anesthesia Care (MAC), 30 minutes x1
- Anesthesia for percutaneous image-guided injection/drainage/aspiration, lumbar/sacral spine x6
12-lead electrocardiogram
Primary code: CPT/HCPCS 93000
Cardiology · Sanavate Hospital, 17400 Red Oak Drive · Inpatient
$850.00Discounted cash price
- Discounted cash price
- $850.00
- Gross charge
- $850.00
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (1)
- EKG - 12 lead x1
Therapeutic exercise, each 15 minutes
Primary code: CPT/HCPCS 97110
Therapy & Rehabilitation · Sanavate Hospital, 17400 Red Oak Drive · Outpatient
$392.42Discounted cash price
- Discounted cash price
- $392.42
- Gross charge
- $392.42
- Payer-specific negotiated charge
- None (no payer contracts)
- Lowest / highest negotiated charge
- None / None
Included hospital services (2)
- Therapeutic procedure, 1 or more areas, each 15 minutes
- therapeutic exercises to develop strength and endurance, range of motion and flexibility x1
CMS-specified services Sanavate does not offer
CMS lists these 21 services among its required shoppable services. Sanavate Hospital does not offer them, so no standard charge is shown.
Obstetric blood-test panel
CPT/HCPCS 80055 · CMS #16
MRI of the brain before and after contrast
CPT/HCPCS 70553 · CMS #29
MRI of the lower spinal canal
CPT/HCPCS 72148 · CMS #31
MRI of a leg joint
CPT/HCPCS 73721 · CMS #33
Obstetric ultrasound at 14 or more weeks, single or first fetus
CPT/HCPCS 76805 · CMS #36
Transvaginal pelvic ultrasound
CPT/HCPCS 76830 · CMS #37
Diagnostic mammogram of one breast
CPT/HCPCS 77065 · CMS #38
Diagnostic mammogram of both breasts
CPT/HCPCS 77066 · CMS #39
Screening mammogram of both breasts
CPT/HCPCS 77067 · CMS #40
Major cardiac-valve or cardiothoracic procedure with catheterization and MCC
MS-DRG 216 · CMS #41
Uterine or adnexa procedure for non-malignancy without CC or MCC
MS-DRG 743 · CMS #45
Open removal of one or more breast growths
CPT/HCPCS 19120 · CMS #46
Removal of tonsils and adenoids for a patient under age 12
CPT/HCPCS 42820 · CMS #49
Biopsy of the prostate gland
CPT/HCPCS 55700 · CMS #58
Radical prostatectomy with surrounding lymph-node removal
CPT/HCPCS 55866 · CMS #59
Routine obstetric care for vaginal delivery
CPT/HCPCS 59400 · CMS #60
Routine obstetric care for cesarean delivery
CPT/HCPCS 59510 · CMS #61
Routine obstetric care for vaginal delivery after prior cesarean
CPT/HCPCS 59610 · CMS #62
Laser removal of a recurring cataract
CPT/HCPCS 66821 · CMS #65
Cataract removal with lens insertion
CPT/HCPCS 66984 · CMS #66
Sleep study
CPT/HCPCS 95810 · CMS #69
About these prices
- Prices are Sanavate Hospital's standard charges. Sanavate currently uses the same amount for its gross charge and its discounted cash price.
- Independent physician and other professional fees may be billed separately unless listed as included.
- Your final bill can differ if the service, supplies, medications, procedure time, or care setting changes.
- Do not delay emergency care to look up a price. If you believe you are having a medical emergency, call 911.
