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 |
|---|---|---|---|---|
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $61.33 | $146.02 | $0.10 – $0.48 | 4 |
| #acylcarnitineprfl CPT 82017 | not published | not published | $36.86 – $73.55 | 2 |
| Acylcarnitines qual CPT 82016 | not published | not published | $36.02 – $71.90 | 2 |
| Adapt behavior tx phys/qhp CPT 97155 | $17.22 | $41.00 | $93.16 – $93.16 | 1 |
| Adapter b 8 channel 10cm HCPCS C1883 | $9,071.66 | $21,599.20 | not published | 0 |
| Adding walker to prev cast CPT 29440 | $205.38 | $489.00 | $27.00 – $46.88 | 2 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $56.70 | $135.00 | $1.60 – $5.03 | 4 |
| Adenovirus ag ia CPT 87301 | not published | not published | $26.17 – $52.23 | 2 |
| Adenovirus antibody,serum - quest CPT 86603 | not published | not published | $28.13 – $56.11 | 2 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $47.52 – $94.87 | 2 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $1,065.72 – $6,725.00 | 3 |
| Adh-sendout CPT 84588 | not published | not published | $74.13 – $147.98 | 2 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $879.87 – $2,444.00 | 3 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $9,584.82 | $22,821.00 | $2,300.00 – $12,741.55 | 4 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $2,501.10 | $5,955.00 | $1,660.87 – $11,141.85 | 6 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $165.09 | $393.06 | $0.52 – $2.13 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $610.68 | $1,454.00 | $105.68 – $105.68 | 1 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $453.60 | $1,080.00 | $235.97 – $235.97 | 1 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $828.66 | $1,973.00 | $487.90 – $487.90 | 1 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $304.92 | $726.00 | $374.83 – $374.83 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $251.16 | $598.00 | $206.20 – $206.20 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $325.08 | $774.00 | $206.20 – $206.20 | 1 |
| Administration immunization 1 vaccine CPT 90471 | $124.32 | $296.00 | $206.20 – $206.20 | 1 |
| Administration immunization each additional component CPT 90461 | not published | not published | $44.23 – $44.23 | 1 |
| Administration immunization each additional vaccine CPT 90472 | $23.52 | $56.00 | $44.23 – $44.23 | 1 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $49.17 – $49.17 | 1 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $206.20 – $206.20 | 1 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $44.23 – $44.23 | 1 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $124.32 | $296.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | not published | not published | $176.98 – $176.98 | 1 |
| Administration vaccine influenza virus HCPCS G0008 | $124.32 | $296.00 | $81.12 – $81.12 | 1 |
| Administration vaccine pneumococcal HCPCS G0009 | not published | not published | $163.44 – $163.44 | 1 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $17,506.29 | $41,681.64 | $113.73 – $146.49 | 4 |
| Adrenal cortex & medulla img CPT 78075 | $1,661.52 | $3,956.00 | $1,876.15 – $1,876.15 | 1 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $1,485.07 – $2,713.58 | 2 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $258.07 – $258.07 | 1 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $414.81 – $414.81 | 1 |
| Aep neurodiagnostic i&r CPT 92653 | $1,058.82 | $2,521.00 | $403.82 – $403.82 | 1 |
| Aep thrshld est mlt freq i&r CPT 92652 | $2,807.28 | $6,684.00 | $548.40 – $548.40 | 1 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $10,918.65 – $12,852.19 | 3 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $43.78 – $87.42 | 2 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $15.96 – $31.87 | 2 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $251.94 – $502.97 | 2 |
| Aflibercept injection HCPCS J0178 | not published | not published | $2,765.13 – $3,693.27 | 4 |
| After cataract laser surgery CPT 66821 | not published | not published | $523.52 – $7,034.24 | 6 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $40,378.30 | $96,138.82 | $622.56 – $829.69 | 4 |
| Air conduction bilat CPT 92552 | not published | not published | $371.79 – $371.79 | 1 |
| Air injection into abdomen 49400 CPT 49400 | $1,401.96 | $3,338.00 | $2,095.00 – $4,579.48 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $863.07 – $863.07 | 1 |
| Albumin body fluid quantitative each specimen CPT 82042 | $51.24 | $122.00 | $17.01 – $33.92 | 2 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $318.84 | $759.14 | $185.77 – $248.39 | 4 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $74.31 – $99.34 | 4 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $1,070.13 | $2,547.93 | $185.77 – $248.39 | 4 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $37.15 – $49.67 | 4 |
| Albumin ischemia modified CPT 82045 | not published | not published | $74.13 – $147.98 | 2 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $177.24 | $422.00 | $12.63 – $25.20 | 2 |
| Albumin serum plasma or whole blood CPT 82040 | $133.98 | $319.00 | $10.83 – $21.58 | 2 |
| Albuterol ipratrop non-comp HCPCS J7620 | $5.67 | $13.51 | $0.65 – $0.96 | 4 |
| Albuterol non-comp con HCPCS J7611 | $34.33 | $81.73 | $0.37 – $0.57 | 4 |
| Albuterol non-comp unit HCPCS J7613 | $18.52 | $44.10 | $0.15 – $0.32 | 4 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $37.73 – $75.30 | 2 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $57.77 – $57.77 | 1 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $224.89 – $224.89 | 1 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $14,983.40 – $18,569.41 | 3 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $0.00 | $0.01 | $7,298.27 – $8,832.49 | 4 |
| Alkaline phosphatase CPT 84075 | $103.32 | $246.00 | $11.33 – $22.58 | 2 |
| Allergen alpha lactalbumin ige CPT 86008 | not published | not published | $39.15 – $78.17 | 2 |
| Allergen egg white ige CPT 86003 | $51.24 | $122.00 | $11.39 – $22.76 | 2 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $17.41 – $34.75 | 2 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $129.96 – $129.96 | 1 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $129.96 – $129.96 | 1 |
| Allergy Skin Testing CPT 95004 | not published | not published | $3,099.52 – $3,099.52 | 1 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $3,099.52 – $3,099.52 | 1 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $5,128.10 – $25,348.51 | 3 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $5,705.38 | $13,584.24 | $295.11 – $297.00 | 2 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $352.50 – $431.98 | 2 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $28,035.16 | $66,750.39 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $11,021.04 | $26,240.57 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $29,442.76 | $70,101.82 | $107.44 – $116.77 | 2 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $22,300.03 | $53,095.30 | $251.61 – $576.08 | 3 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $6,058.74 | $14,425.56 | $385.48 – $518.59 | 3 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $7,740.23 | $18,429.12 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $6,000.56 | $14,287.05 | $441.22 – $1,176.71 | 2 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $6,587.41 | $15,684.32 | $251.61 – $933.93 | 3 |
| Alloskin HCPCS Q4115 | not published | not published | $46.09 – $60.01 | 4 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $114.00 – $114.00 | 1 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $78.40 – $78.40 | 1 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $16,335.47 | $38,893.97 | $17.39 – $18.57 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $140.68 – $280.83 | 2 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $37.13 – $74.12 | 2 |
| Alpha-fetoprotein tumor marker CPT 82105 | $158.34 | $377.00 | $36.63 – $73.12 | 2 |
| Alprostadil for injection HCPCS J0270 | $1,219.67 | $2,903.98 | $0.71 – $1.67 | 3 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $1,358.41 | $3,234.30 | $140.81 – $338.09 | 4 |
| Alt/sgpt CPT 84460 | $216.72 | $516.00 | $11.60 – $23.11 | 2 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $16.35 – $17.59 | 2 |
| Aluminum - quest CPT 82108 | not published | not published | $55.64 – $111.09 | 2 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $309.28 – $2,444.00 | 3 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $146.25 – $146.25 | 1 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $371.79 – $371.79 | 1 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $94.94 | $226.05 | $2.16 – $4.35 | 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.