Covenant Children's Hospital
4015 22nd Pl, Lubbock, TX · Providence · · NPI 1437171568
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 |
|---|---|---|---|---|
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $496.23 – $496.23 | 1 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $153.08 – $433.75 | 2 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $153.08 – $6,725.00 | 3 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $215.69 – $215.69 | 1 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $1,605.05 – $1,605.05 | 1 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $595.83 – $595.83 | 1 |
| Unlisted special svc px/rprt CPT 99199 | $63.00 | $150.00 | not published | 0 |
| Unlisted surgical path px CPT 88399 | not published | not published | $108.06 – $215.69 | 2 |
| Unlisted transfusion med px CPT 86999 | not published | not published | $50.20 – $100.24 | 2 |
| Unlisted ultrasound procedure CPT 76999 | $847.56 | $2,018.00 | $247.94 – $347.97 | 2 |
| Unlisted urinalysis px CPT 81099 | not published | not published | $77.24 – $77.24 | 1 |
| Unlisted vasc endoscopy px CPT 37501 | not published | not published | $1,342.99 – $2,562.81 | 2 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $1,605.05 – $1,605.05 | 1 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $3,560.22 – $10,295.80 | 3 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $3,560.22 – $10,295.80 | 3 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $5,449.92 | $12,976.00 | $2,182.50 – $2,182.50 | 1 |
| Upgrade pm system CPT 33214 | not published | not published | $8,068.00 – $21,836.63 | 3 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $7,208.88 | $17,164.00 | $931.71 – $1,666.92 | 2 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $5,715.78 | $13,609.00 | $931.71 – $1,473.55 | 2 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $5,339.88 | $12,714.00 | $568.62 – $988.29 | 2 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,040.34 | $2,477.00 | $879.87 – $4,579.48 | 6 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $1,040.34 | $2,477.00 | $879.87 – $7,034.24 | 6 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $315.79 – $570.35 | 2 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $879.87 – $4,524.00 | 4 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Urea nitrogen CPT 84520 | $132.72 | $316.00 | $8.64 – $17.22 | 2 |
| Urea nitrogen 24 hour urine CPT 84540 | $128.94 | $307.00 | $12.13 – $24.24 | 2 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $15.72 – $31.39 | 2 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $11.19 – $22.37 | 2 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Ureteral reflux study CPT 78740 | $1,666.14 | $3,967.00 | $865.81 – $865.81 | 1 |
| Ureter endoscopy CPT 50970 | not published | not published | $647.78 – $6,429.49 | 6 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $647.78 – $6,429.49 | 6 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $1,347.69 – $2,454.89 | 2 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $1,372.64 – $2,505.56 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $942.48 | $2,244.00 | $705.32 – $1,016.05 | 2 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $2,961.49 – $6,725.00 | 3 |
| Urethrocystography void s&i CPT 74455 | $1,018.92 | $2,426.00 | $705.32 – $1,016.05 | 2 |
| Uric acid blood CPT 84550 | $186.90 | $445.00 | $9.88 – $19.71 | 2 |
| Uric acid urine CPT 84560 | $124.32 | $296.00 | $11.09 – $22.15 | 2 |
| Urinalysis glass test CPT 81020 | not published | not published | $10.29 – $20.49 | 2 |
| Urinalysis microscopic only CPT 81015 | $118.86 | $283.00 | $6.66 – $13.30 | 2 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $4.74 – $9.46 | 2 |
| Urinalysis (with microscopy) CPT 81001 | $162.96 | $388.00 | $6.93 – $13.82 | 2 |
| Urinalysis (without microscopy) CPT 81003 | $121.80 | $290.00 | $4.91 – $9.81 | 2 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $312.70 – $312.70 | 1 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $4.24 – $4.24 | 1 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $8.03 – $8.03 | 1 |
| Urinary reflex study CPT 51792 | not published | not published | $73.22 – $117.17 | 2 |
| Urinary suspensory HCPCS A5105 | not published | not published | $54.48 – $54.48 | 1 |
| Urine Culture Test CPT 87086 | $382.20 | $910.00 | $17.64 – $35.19 | 2 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $155.48 – $232.23 | 2 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $8.71 – $8.71 | 1 |
| Urine pregnancy test CPT 81025 | $207.06 | $493.00 | $18.82 – $37.54 | 2 |
| Urine screen for bacteria CPT 81007 | not published | not published | $65.49 – $130.71 | 2 |
| Urine shunt to intestine CPT 50815 | not published | not published | $1,483.38 – $2,715.11 | 2 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $6.55 – $2,444.00 | 2 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $227.70 – $499.69 | 3 |
| Urography, antegrade CPT 74425 | $660.24 | $1,572.00 | $1,128.24 – $1,664.87 | 2 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $427.41 – $547.23 | 2 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $1,608.54 – $1,717.23 | 2 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $32.16 – $34.34 | 2 |
| Use 1st target lesion CPT 76982 | not published | not published | $333.97 – $488.67 | 2 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $13,907.19 | $33,112.36 | $44.73 – $47.96 | 4 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $44,889.99 | $106,880.92 | $585.05 – $947.91 | 3 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $2,245.95 – $25,348.51 | 2 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | $122.57 | $291.84 | $554.50 – $565.78 | 2 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | $122.57 | $291.84 | $514.71 – $554.50 | 2 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | $110.12 | $262.20 | $498.18 – $545.63 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | $73.74 | $175.56 | $307.23 – $333.56 | 2 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | $54.90 | $130.72 | $229.43 – $249.09 | 2 |
| Vaccine dtap < 7 years im CPT 90700 | $216.06 | $514.42 | $103.45 – $131.18 | 3 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $346.36 – $432.48 | 3 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $228.07 – $561.30 | 3 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $1,368.91 – $1,368.91 | 1 |
| Vaccine dtap-ipv/hib im CPT 90698 | $578.25 | $1,376.78 | $420.68 – $500.35 | 3 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $220.12 | $524.10 | $109.66 – $134.90 | 3 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $106.75 | $254.16 | $47.46 – $58.06 | 3 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $531.14 | $1,264.63 | $251.18 – $268.15 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $776.33 | $1,848.40 | $375.31 – $491.45 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $219.01 | $521.45 | $142.91 – $158.27 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $111.99 – $111.99 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $219.65 – $285.57 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $353.44 | $841.53 | $212.81 – $267.44 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $1,011.16 | $2,407.53 | $428.38 – $621.44 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $151.91 | $361.68 | $85.38 – $116.93 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $2,359.28 | $5,617.34 | $762.66 – $1,310.58 | 3 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $404.40 – $636.44 | 3 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $161.31 – $292.22 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $508.57 | $1,210.89 | $165.23 – $292.22 | 3 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $49.78 – $76.50 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $128.02 | $304.82 | $48.53 – $78.23 | 4 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $58.98 – $79.34 | 3 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | $525.18 | $1,250.44 | $62.91 – $293.97 | 3 |
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.