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 |
|---|---|---|---|---|
| Clot factor xiii fibrin scrn CPT 85291 | not published | not published | $19.89 – $39.72 | 2 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $35.69 – $71.24 | 2 |
| Clotting assay whole blood CPT 85396 | not published | not published | $43.45 – $91.12 | 2 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $1.76 – $1.88 | 2 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $1,921.08 | $4,574.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $480.48 | $1,144.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $359.10 | $855.00 | $109.34 – $232.08 | 2 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $2,021.04 | $4,812.00 | $1,000.00 – $4,579.48 | 6 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $291.90 | $695.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $2,021.04 | $4,812.00 | $841.70 – $4,579.48 | 6 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $291.90 | $695.00 | $199.54 – $4,579.48 | 6 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $291.90 | $695.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $444.36 | $1,058.00 | $109.34 – $232.08 | 2 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $1,854.72 | $4,416.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $291.90 | $695.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $1,475.04 | $3,512.00 | $105.90 – $119.15 | 2 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,748.90 | $6,545.00 | $1,548.47 – $7,034.24 | 6 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | $2,021.04 | $4,812.00 | $1,449.53 – $11,141.85 | 6 |
| Clsd tx fracture of radius 25500 CPT 25500 | $459.06 | $1,093.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $304.08 | $724.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $1,283.94 | $3,057.00 | $124.05 – $2,444.00 | 3 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $879.48 | $2,094.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,554.42 | $3,701.00 | $841.70 – $11,141.85 | 6 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $727.02 | $1,731.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,406.16 | $3,348.00 | $252.34 – $7,034.24 | 6 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $291.90 | $695.00 | $138.27 – $4,579.48 | 5 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $1,917.72 | $4,566.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $829.50 | $1,975.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $780.78 | $1,859.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $746.76 | $1,778.00 | $144.38 – $247.34 | 2 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $643.44 | $1,532.00 | $428.71 – $11,141.85 | 6 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $291.90 | $695.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $803.04 | $1,912.00 | $138.27 – $232.08 | 2 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $863.52 | $2,056.00 | $252.34 – $7,034.24 | 6 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $4,192.86 | $9,983.00 | $1,548.47 – $7,034.24 | 6 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $686.70 | $1,635.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $536.76 | $1,278.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $2,412.06 | $5,743.00 | $1,495.00 – $7,034.24 | 6 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $153.08 – $7,034.24 | 5 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $3,270.96 | $7,788.00 | $1,548.47 – $7,034.24 | 6 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $1,034.04 | $2,462.00 | $199.54 – $4,579.48 | 6 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $291.90 | $695.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx pelvic ring fx CPT 27197 | $291.90 | $695.00 | $235.72 – $2,444.00 | 3 |
| Clsd tx pelvic ring fx CPT 27198 | $291.90 | $695.00 | $235.72 – $2,444.00 | 3 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,479.68 | $5,904.00 | $841.70 – $4,579.48 | 6 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $291.90 | $695.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $291.90 | $695.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $2,021.04 | $4,812.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $291.90 | $695.00 | $199.54 – $4,579.48 | 6 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $916.02 | $2,181.00 | $841.70 – $7,034.24 | 6 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $2,021.04 | $4,812.00 | $252.34 – $7,034.24 | 6 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $3,994.20 | $9,510.00 | $1,000.00 – $4,579.48 | 6 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $4,192.86 | $9,983.00 | $1,000.00 – $5,830.77 | 6 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $614.04 | $1,462.00 | $153.08 – $4,579.48 | 6 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $291.90 | $695.00 | $80.16 – $2,444.00 | 3 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $445.20 | $1,060.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $2,100.42 | $5,001.00 | $841.70 – $4,579.48 | 6 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $291.90 | $695.00 | $109.34 – $2,444.00 | 3 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $299.88 | $714.00 | $252.34 – $4,579.48 | 6 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $291.90 | $695.00 | $138.27 – $2,444.00 | 3 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $291.90 | $695.00 | $138.27 – $232.08 | 2 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $291.90 | $695.00 | $199.54 – $7,034.24 | 6 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $291.90 | $695.00 | $138.27 – $232.08 | 2 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $291.90 | $695.00 | $199.54 – $4,579.48 | 6 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $291.90 | $695.00 | $459.31 – $7,034.24 | 6 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $2,021.04 | $4,812.00 | $841.70 – $7,034.24 | 6 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $2,021.04 | $4,812.00 | $1,548.47 – $7,034.24 | 6 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $291.90 | $695.00 | $199.54 – $4,579.48 | 6 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $2,021.04 | $4,812.00 | $252.34 – $4,579.48 | 6 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $291.90 | $695.00 | $252.34 – $4,579.48 | 6 |
| Cltx lunate dislc w/mnpj CPT 25690 | $2,021.04 | $4,812.00 | $1,000.00 – $4,579.48 | 6 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $7,520.94 | $17,907.00 | $2,300.00 – $11,141.85 | 6 |
| Cltx mndblr fx w/mnpj CPT 21451 | $1,955.10 | $4,655.00 | $1,495.00 – $15,638.81 | 6 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $4,122.30 | $9,815.00 | $534.17 – $11,141.85 | 5 |
| Cltx palatal/max fx wire fix CPT 21421 | $4,122.30 | $9,815.00 | $2,600.00 – $15,638.81 | 6 |
| Cltx post ankle fx CPT 27767 | $291.90 | $695.00 | $109.34 – $2,444.00 | 3 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,949.66 | $7,023.00 | $199.54 – $2,886.98 | 3 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $2,021.04 | $4,812.00 | $252.34 – $4,579.48 | 6 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $291.90 | $695.00 | $252.34 – $4,579.48 | 6 |
| Cltx thigh fx CPT 27267 | $4,313.40 | $10,270.00 | $1,548.47 – $5,830.77 | 3 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $2,150.00 – $7,034.24 | 6 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $2,750.00 – $17,789.31 | 6 |
| C motor evoked lwr limbs CPT 95929 | $537.60 | $1,280.00 | $500.18 – $500.18 | 1 |
| C motor evoked uppr limbs CPT 95928 | not published | not published | $482.96 – $482.96 | 1 |
| C motor evoked upr&lwr limbs CPT 95939 | $793.80 | $1,890.00 | $1,367.82 – $1,367.82 | 1 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $187.58 – $187.58 | 1 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $187.58 – $187.58 | 1 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $30.74 – $61.35 | 2 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $19.22 – $38.37 | 2 |
| #cmvcul-virus inoculation shell CPT 87254 | not published | not published | $42.70 – $85.28 | 2 |
| Cmv pcr-sendout CPT 87496 | not published | not published | $76.64 – $152.99 | 2 |
| Co2 monitor per day CPT 94681 | not published | not published | $863.07 – $863.07 | 1 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $15,888.77 | $37,830.40 | $6.10 – $9.26 | 4 |
| Coagulation time activated teg CPT 85347 | $105.84 | $252.00 | $9.35 – $18.66 | 2 |
| Coagulation time otr method CPT 85348 | not published | not published | $9.81 – $19.58 | 2 |
| Cocaine 4 % nasal solution HCPCS C9046 | not published | not published | $4.53 – $4.83 | 2 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $438.73 – $438.73 | 1 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $426.45 – $426.45 | 1 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $3.72 – $5.03 | 3 |
| Cold agglutinin screen (arc) CPT 86156 | not published | not published | $17.64 – $35.19 | 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.