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 |
|---|---|---|---|---|
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,064.70 | $2,535.00 | $547.23 – $794.48 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $942.48 | $2,244.00 | $547.23 – $794.48 | 2 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $1,101.95 – $1,101.95 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $516.35 – $516.35 | 1 |
| X-ray wrist 2 views (both sides) CPT 73100 | $284.34 | $677.00 | $247.94 – $347.97 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $547.23 – $794.48 | 2 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $471.14 – $471.14 | 1 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $308.47 – $308.47 | 1 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $8.23 – $13,211.71 | 2 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $28.19 – $56.29 | 2 |
| Xyntha inj HCPCS J7185 | not published | not published | $3.78 – $5.39 | 4 |
| Yersinia antibody CPT 86793 | not published | not published | $28.80 – $57.51 | 2 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $203,962.06 – $217,744.56 | 2 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $291.12 – $1,788.85 | 2 |
| Ziconotide injection HCPCS J2278 | not published | not published | $20.87 – $35.45 | 4 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $214.10 | $509.77 | $5.30 – $5.74 | 4 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.08 – $1.16 | 2 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $112.05 – $223.71 | 2 |
| Zika virus igm antibody CPT 86794 | not published | not published | $36.79 – $73.47 | 2 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | $25.17 | $59.93 | $1.69 – $1.69 | 1 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $472.76 | $1,125.62 | $10.98 – $99.18 | 4 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $11,032.56 | $26,268.00 | $27.66 – $63.44 | 4 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | $21,168.00 | $50,400.00 | $117.45 – $117.45 | 1 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $680.45 | $1,620.12 | $18.21 – $27.40 | 4 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $511.40 – $849.13 | 3 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $422.05 – $3,311.55 | 2 |
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.