Covenant Hospital Levelland
1900 College Ave, Levelland, TX · Providence · · NPI 1225146400
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ghs sensitivity (per antimicro) CPT 87184 | $45.36 | $108.00 | $7.26 – $7.89 | 4 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $588.84 | $1,402.00 | $396.12 – $2,150.00 | 6 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $618.24 | $1,472.00 | $396.12 – $2,150.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $745.92 | $1,776.00 | $396.12 – $2,150.00 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $673.68 | $1,604.00 | $396.12 – $2,150.00 | 6 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $588.42 | $1,401.00 | $195.50 – $418.52 | 5 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $541.80 | $1,290.00 | $195.50 – $418.52 | 5 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $605.64 | $1,442.00 | $195.50 – $621.00 | 5 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $774.06 | $1,843.00 | $195.50 – $2,150.00 | 6 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $676.20 | $1,610.00 | $195.50 – $2,150.00 | 6 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $210.40 – $279.59 | 5 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $210.40 – $255.52 | 5 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $646.94 – $910.10 | 5 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $46.30 – $116.49 | 5 |
| Ghs sphenopalatine ganglion block CPT 64505 | $361.62 | $861.00 | $223.35 – $325.31 | 5 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $129.64 – $285.64 | 5 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $96.85 – $242.32 | 5 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $36.40 – $93.92 | 5 |
| Ghs strapping shoulder - 29240 CPT 29240 | $318.36 | $758.00 | $129.64 – $222.54 | 5 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $70.66 – $157.66 | 5 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $65.10 | $155.00 | $33.39 – $49.63 | 5 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $315.84 | $752.00 | $207.26 – $425.61 | 5 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $373.38 | $889.00 | $720.17 – $1,827.73 | 6 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $496.02 | $1,181.00 | $396.12 – $1,000.00 | 6 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $471.24 | $1,122.00 | $1,000.00 – $2,747.88 | 6 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.08 – $7.70 | 4 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $430.92 | $1,026.00 | $240.36 – $908.63 | 5 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $275.52 | $656.00 | $240.36 – $718.52 | 5 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $23.57 – $25.64 | 4 |
| Ghs urine, porphyrins quant CPT 84120 | not published | not published | $14.27 – $15.52 | 4 |
| Ghs vaginal delivery only CPT 59409 | $3,760.68 | $8,954.00 | $2,613.00 – $7,845.12 | 5 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $363.61 – $395.48 | 4 |
| Ghs windowing of cast CPT 29730 | $193.62 | $461.00 | $116.28 – $172.22 | 5 |
| Giardia ag if CPT 87269 | not published | not published | $13.20 – $14.36 | 4 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.28 – $15.53 | 4 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $232.50 – $252.87 | 4 |
| Gi inhouse confirmation CPT 87045 | $57.12 | $136.00 | $9.16 – $9.96 | 4 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $1,125.81 – $3,513.75 | 5 |
| Gi protein loss CPT 78282 | not published | not published | $389.55 – $423.68 | 4 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $883.78 – $1,541.64 | 5 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $906.17 – $985.58 | 4 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $883.78 – $1,496.61 | 5 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $883.78 – $2,146.65 | 5 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $98.09 – $106.68 | 4 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $59.67 – $64.90 | 4 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $33.95 – $36.92 | 4 |
| Glassia injection HCPCS J0257 | not published | not published | $5.49 – $5.97 | 4 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $28.18 – $118.83 | 5 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $36.40 – $98.62 | 5 |
| Glaucoma surgery CPT 66150 | not published | not published | $2,600.00 – $7,447.48 | 6 |
| Glaucoma surgery CPT 66155 | not published | not published | $2,600.00 – $7,447.48 | 6 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,150.00 – $7,447.48 | 6 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,248.79 – $7,447.48 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,056.12 | $4,895.52 | $141.94 – $154.38 | 4 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $130.95 – $142.42 | 4 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $13.86 – $15.08 | 4 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $44.69 – $48.60 | 4 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $48.98 – $53.28 | 4 |
| Glucagon tolerance test CPT 82946 | not published | not published | $17.24 – $18.75 | 4 |
| Glucose 1 hr post dose CPT 82950 | $25.62 | $61.00 | $4.61 – $5.01 | 4 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.87 – $6.38 | 4 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $17.64 | $42.00 | $3.18 – $3.46 | 4 |
| Glucose blood quantitative CPT 82947 | $21.00 | $50.00 | $3.81 – $4.15 | 4 |
| Glucose body fluid CPT 82945 | $21.00 | $50.00 | $3.81 – $4.15 | 4 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $57.48 – $62.52 | 4 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $69.30 | $165.00 | $12.48 – $13.58 | 4 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $21.00 | $50.00 | $3.80 – $4.14 | 4 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $56.70 | $135.00 | $2.52 – $2.52 | 1 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $53.91 – $53.91 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $10.95 – $11.91 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $99.96 | $238.00 | $18.02 – $19.60 | 4 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $143.96 – $156.57 | 4 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $99.54 | $237.00 | $17.96 – $19.54 | 4 |
| Gonioscopy CPT 92020 | not published | not published | $112.87 – $141.01 | 5 |
| Goniotomy CPT 65820 | not published | not published | $1,000.00 – $7,447.48 | 6 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $2,168.01 – $2,168.01 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $3,202.29 | $7,624.50 | $121.26 – $131.89 | 4 |
| Graft axiofill 1000mg HCPCS J3590 | $4,121.90 | $9,814.05 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $11.25 – $131.89 | 4 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $20,895.93 | $49,752.22 | not published | 0 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,300.00 – $9,391.50 | 6 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $34,943.93 | $83,199.83 | $121.26 – $131.89 | 4 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $3,797.74 – $3,797.74 | 1 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $44,940.00 | $107,000.00 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $40,989.02 | $97,592.90 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $35,468.43 | $84,448.64 | $121.26 – $131.89 | 4 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $9,889.61 | $23,546.70 | $121.26 – $131.89 | 4 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $4,077.05 – $4,808.72 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $17,161.20 | $40,860.00 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $121.26 – $131.89 | 4 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $43,599.44 | $103,808.19 | not published | 0 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | not published | not published | $11.25 – $131.89 | 4 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $5,817.42 | $13,851.00 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $54,040.64 | $128,668.20 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $4,134.06 | $9,843.00 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $31.54 – $31.54 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $1.97 – $1.97 | 1 |
| Great toe-hand transfer CPT 26551 | not published | not published | $6,794.00 – $14,438.36 | 5 |
| Great toe with reduction 28495 CPT 28495 | $390.18 | $929.00 | $240.36 – $497.90 | 5 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $2,010.50 – $2,186.68 | 4 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.