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 |
|---|---|---|---|---|
| Derm autograft face/nck/hf/g CPT 15135 | not published | not published | $1,660.87 – $6,341.63 | 4 |
| Derm autograft trnk/arm/leg CPT 15130 | not published | not published | $2,150.00 – $4,524.00 | 4 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $380.10 – $441.79 | 2 |
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $106.35 – $6,042.00 | 3 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | not published | not published | $2,239.24 – $3,992.45 | 2 |
| Description not available HCPCS S0013 | not published | not published | $448.80 – $479.13 | 2 |
| Design custom breast implant CPT 19396 | not published | not published | $3,555.31 – $6,452.94 | 3 |
| Design mlc device for imrt CPT 77338 | $2,016.00 | $4,800.00 | $1,096.27 – $1,096.27 | 1 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $150.62 | $358.61 | $8.08 – $24.05 | 4 |
| Desoxycorticosterone CPT 82633 | not published | not published | $67.68 – $135.07 | 2 |
| Des thora aorta/ea add prox prosth 33884 CPT 33884 | not published | not published | $515.31 – $875.88 | 2 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | not published | not published | $1,924.30 – $3,426.72 | 2 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | not published | not published | $1,393.77 – $2,480.98 | 2 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $143.04 – $2,444.00 | 3 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $67.09 – $2,444.00 | 3 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $94.50 – $2,444.00 | 3 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $94.50 – $2,444.00 | 3 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $1,734.76 – $3,662.22 | 3 |
| Destroy cth facet jnt addl 64634 CPT 64634 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $171.72 – $2,444.00 | 3 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $254.52 | $606.00 | $50.21 – $2,444.00 | 3 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $1,519.61 – $11,141.85 | 6 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $81.44 – $2,444.00 | 4 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $94.50 – $2,444.00 | 3 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $183.09 – $2,444.00 | 3 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $525.42 | $1,251.00 | $183.09 – $2,444.00 | 3 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $183.09 – $2,444.00 | 3 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $214.34 – $4,524.00 | 3 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $1,000.00 – $4,993.10 | 6 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $525.42 | $1,251.00 | $183.09 – $2,444.00 | 3 |
| Destruction benign lesions < 14 lesions CPT 17110 | $254.52 | $606.00 | $116.22 – $2,444.00 | 3 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $793.08 – $7,034.24 | 6 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $1,734.76 – $3,662.22 | 3 |
| Destruction ciliary body CPT 66700 | not published | not published | $887.63 – $7,034.24 | 6 |
| Destruction ciliary body CPT 66720 | not published | not published | $1,811.03 – $7,034.24 | 6 |
| Destruction ciliary body CPT 66740 | not published | not published | $1,811.03 – $7,034.24 | 6 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $94.50 – $4,524.00 | 3 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $1,000.00 – $4,993.10 | 4 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $101.26 – $2,444.00 | 3 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $146.84 – $2,444.00 | 3 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $165.40 – $2,444.00 | 3 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $94.50 – $2,444.00 | 3 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $162.45 – $4,524.00 | 3 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $94.50 – $680.56 | 2 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $1,000.00 – $4,579.48 | 6 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $113.50 – $2,444.00 | 3 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $2,291.04 – $7,034.24 | 6 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $1,000.00 – $5,320.95 | 6 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $74.26 – $2,444.00 | 3 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $83.54 – $169.89 | 2 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $65.59 – $130.93 | 2 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $95.39 – $190.40 | 2 |
| Determination venous press CPT 93770 | $105.00 | $250.00 | $28.27 – $28.27 | 1 |
| Determine refractive state CPT 92015 | not published | not published | $67.59 – $67.59 | 1 |
| Developmental screen/score/document 96110 CPT 96110 | $7.98 | $19.00 | $34.41 – $34.41 | 1 |
| Devel tst phys/qhp 1st hr CPT 96112 | $180.60 | $430.00 | $471.77 – $471.77 | 1 |
| Device ablt adv novasure HCPCS C1886 | $6,148.80 | $14,640.00 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $5,386.50 | $12,825.00 | $13.79 – $13.79 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $3,399.55 – $5,274.97 | 3 |
| Device sut capio slim opn HCPCS C2631 | $1,825.12 | $4,345.53 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $10,602.90 | $25,245.00 | not published | 0 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $154.85 – $154.85 | 1 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,731.95 – $3,153.44 | 2 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $267.82 – $267.82 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $90.30 | $215.00 | $202.76 – $202.76 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $102.15 – $247.94 | 2 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $355.20 – $632.70 | 4 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $4.45 – $10.30 | 3 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $215.35 | $512.73 | $0.04 – $0.30 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $56.70 | $135.00 | $0.07 – $0.46 | 4 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $712.43 – $781.32 | 4 |
| Dexamethasone panel CPT 80420 | not published | not published | $353.55 – $705.80 | 2 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $2.21 – $2.74 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $2,003.27 | $4,769.69 | $112.30 – $756.86 | 4 |
| Dextran 40 infusion HCPCS J7100 | $75.41 | $179.54 | $99.22 – $178.03 | 3 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $4.68 – $4.99 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $49.79 | $118.54 | $4.74 – $6.71 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $47.27 | $112.54 | $18.51 – $22.61 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $51.89 | $123.54 | $7.09 – $30.26 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | $47.69 | $113.54 | $10.64 – $60.53 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $48.56 – $96.92 | 2 |
| Diabetes (HbA1c) Test CPT 83036 | $315.84 | $752.00 | $21.20 – $42.34 | 2 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $93.23 – $93.23 | 1 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $254.81 – $254.81 | 1 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $40.86 – $40.86 | 1 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $40.86 – $40.86 | 1 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $40.86 – $40.86 | 1 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $52.86 – $52.86 | 1 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $84.95 – $84.95 | 1 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $40.86 – $40.86 | 1 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,245.13 – $4,524.00 | 4 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $2,300.00 – $10,295.80 | 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.