Hospital Episcopal San Lucas II

917 Ave Tito Castro, Ponce, PR 00716 · (787) 844-2080

Acute Care HospitalsVoluntary non-profit - PrivateWebsite ↗

Price file

Prices published

File dated 2026-03-30

215 price rows for 43 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048

$60

cash

$8 to $8

1 negotiated rates

$75

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177

$231

cash

$134 to $134

1 negotiated rates

$330

list

CT scan of the head, no contrast

CPT 70450

$210

cash

$71 to $71

1 negotiated rates

$300

list

CT scan of the pelvis, with contrast

CPT 72193

$210

cash

$115 to $115

1 negotiated rates

$300

list

Cataract surgery with lens implant

CPT 66984

$1,000

cash

$709 to $709

1 negotiated rates

$1,500

list

Colonoscopy (diagnostic)

CPT 45378

$378

cash

$268 to $268

1 negotiated rates

$540

list

Colonoscopy with biopsy

CPT 45380

$378

cash

$352 to $352

1 negotiated rates

$540

list

Colonoscopy with polyp removal

CPT 45385

$378

cash

$352 to $352

1 negotiated rates

$540

list

Complete blood count (CBC) with differential

CPT 85025

$20

cash

$8 to $8

1 negotiated rates

$25

list

Comprehensive metabolic panel (blood test)

CPT 80053

$120

cash

$18 to $18

1 negotiated rates

$150

list

Diagnostic mammogram (both breasts)

CPT 77066

$100

cash

$96 to $96

1 negotiated rates

$121

list

Gallbladder removal (laparoscopic)

CPT 47562

$1,000

cash

$795 to $795

1 negotiated rates

$1,693

list

Inguinal hernia repair (age 5 and up)

CPT 49505

$1,000

cash

$795 to $795

1 negotiated rates

$1,089

list

Knee arthroscopy with meniscus repair

CPT 29881

$1,000

cash

$909 to $909

1 negotiated rates

$1,200

list

Left heart catheterization

CPT 93452

$1,225

cash

$999 to $999

1 negotiated rates

$1,750

list

Lipid panel (cholesterol test)

CPT 80061

$48

cash

$28 to $28

1 negotiated rates

$60

list

Liver function panel

CPT 80076

$56

cash

$14 to $14

1 negotiated rates

$70

list

MRI of the brain, with and without contrast

CPT 70553

$980

cash

$241 to $241

1 negotiated rates

$1,400

list

MRI of the knee or other lower joint, no contrast

CPT 73721

$525

cash

$147 to $147

1 negotiated rates

$750

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148

$630

cash

$147 to $147

1 negotiated rates

$900

list

MRI of the neck (cervical spine), no contrast

CPT 72141

$595

cash

$147 to $147

1 negotiated rates

$850

list

Nerve block injection, lower back, with imaging guidance

CPT 64483

$650

cash

$513 to $513

1 negotiated rates

$800

list

New patient office visit (about 30 minutes)

CPT 99203

$104

cash

$77 to $77

1 negotiated rates

$115

list

New patient office visit (about 45 minutes)

CPT 99204

$158

cash

$132 to $132

1 negotiated rates

$175

list

New patient office visit (about 60 minutes)

CPT 99205

$194

cash

$173 to $173

1 negotiated rates

$215

list

PSA test (prostate)

CPT 84153

$31

cash

$25 to $25

1 negotiated rates

$39

list

Partial thromboplastin time (blood clotting test)

CPT 85730

$16

cash

$6 to $6

1 negotiated rates

$20

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110

$16

cash

$15 to $15

1 negotiated rates

$23

list

Pregnancy ultrasound (after first trimester)

CPT 76805

$49

cash

$39 to $39

1 negotiated rates

$70

list

Prostate biopsy

CPT 55700

$1,000

cash

$798 to $798

1 negotiated rates

$1,117

list

Prostate removal (laparoscopic)

CPT 55866

$1,000

cash

$795 to $795

1 negotiated rates

$2,948

list

Prothrombin time (blood clotting test)

CPT 85610

$24

cash

$4 to $4

1 negotiated rates

$30

list

Removal of a breast lump (biopsy by excision)

CPT 19120

$1,200

cash

$1,006 to $1,006

1 negotiated rates

$1,750

list

Screening mammogram (both breasts)

CPT 77067

$81

cash

$33 to $33

1 negotiated rates

$115

list

Shoulder arthroscopy with decompression

CPT 29826

$1,000

cash

$909 to $909

1 negotiated rates

$1,200

list

Spinal injection, lower back, no imaging guidance

CPT 62322

$245

cash

$219 to $219

1 negotiated rates

$350

list

TSH test (thyroid)

CPT 84443

$48

cash

$30 to $30

1 negotiated rates

$60

list

Tonsils and adenoids removal (under age 12)

CPT 42820

$1,500

cash

$1,200 to $1,200

1 negotiated rates

$1,800

list

Transvaginal ultrasound

CPT 76830

$49

cash

$39 to $39

1 negotiated rates

$70

list

Ultrasound of the abdomen (complete)

CPT 76700

$42

cash

$39 to $39

1 negotiated rates

$60

list

Upper endoscopy (EGD)

CPT 43235

$357

cash

$275 to $275

1 negotiated rates

$510

list

Upper endoscopy with biopsy

CPT 43239

$357

cash

$275 to $275

1 negotiated rates

$510

list

X-ray of the lower spine (4 or more views)

CPT 72110

$88

cash

$71 to $71

1 negotiated rates

$125

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://hospitalsanlucastorage.blob.core.windows.net/images/price-transparency/66-0589727-Saint-Lukes-Memorial-Hospital-Inc-standardcharges.csv
St. Luke's Memorial Hospital Inc. · discovered · wide v3.0.0 · file dated 2026-03-30 · 0.3 MB · 215 price rows read · read Sep 2026