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 |
|---|---|---|---|---|
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $2,150.00 – $7,034.24 | 4 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $2,501.10 | $5,955.00 | $1,660.87 – $11,141.85 | 6 |
| Functional brain mapping CPT 96020 | not published | not published | $573.90 – $573.90 | 1 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $371.79 – $371.79 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $56.70 | $135.00 | $0.07 – $0.07 | 1 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $2.17 – $5.79 | 3 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $3,975.85 – $7,249.52 | 2 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,687.99 – $3,060.55 | 2 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $1,815.66 – $3,116.59 | 2 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $1,710.40 – $3,105.84 | 2 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $1,606.82 – $2,898.59 | 2 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $1,807.20 – $3,283.16 | 2 |
| Fuse/graft added joint CPT 26863 | not published | not published | $2,300.00 – $11,141.85 | 4 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $1,868.50 – $3,404.44 | 2 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $3,725.17 – $6,752.87 | 2 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $2,041.82 – $3,701.54 | 2 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $1,605.13 – $2,906.26 | 2 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,337.96 – $2,424.17 | 2 |
| Fuse upper gi structures CPT 47721 | not published | not published | $1,657.55 – $3,020.64 | 2 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $2,300.00 – $12,741.55 | 6 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $2,600.00 – $25,348.51 | 6 |
| Fusion of big toe joint CPT 28750 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion of big toe joint CPT 28755 | not published | not published | $2,057.49 – $15,638.81 | 6 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $1,402.22 – $2,824.12 | 2 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $2,150.00 – $7,034.24 | 4 |
| Fusion of finger joint CPT 26860 | $4,192.86 | $9,983.00 | $2,300.00 – $11,141.85 | 6 |
| Fusion of finger tendons CPT 26471 | not published | not published | $1,449.53 – $7,034.24 | 6 |
| Fusion of finger tendons CPT 26474 | not published | not published | $1,449.53 – $7,034.24 | 6 |
| Fusion of foot bones CPT 28730 | not published | not published | $2,600.00 – $25,348.51 | 6 |
| Fusion of foot bones CPT 28735 | not published | not published | $2,600.00 – $25,348.51 | 6 |
| Fusion of foot bones CPT 28740 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion of hand joint CPT 26843 | not published | not published | $2,300.00 – $12,741.55 | 6 |
| Fusion of knee CPT 27580 | not published | not published | $1,750.55 – $6,725.00 | 3 |
| Fusion of knuckle CPT 26850 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $1,000.00 – $5,830.77 | 6 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $2,300.00 – $12,741.55 | 6 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion of skull arteries CPT 61711 | not published | not published | $3,247.90 – $5,819.42 | 2 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $2,138.51 – $15,638.81 | 6 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $2,138.51 – $15,638.81 | 6 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Fusion of thumb CPT 26841 | not published | not published | $2,600.00 – $15,638.81 | 6 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $2,600.00 – $25,348.51 | 6 |
| Fusion of toes CPT 28280 | not published | not published | $2,057.49 – $7,034.24 | 6 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,708.29 – $3,114.29 | 2 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $1,496.07 – $2,723.57 | 2 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $1,399.68 – $2,563.14 | 2 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $600.23 – $1,198.26 | 2 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $299.21 – $597.32 | 2 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $600.23 – $1,198.26 | 2 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $404.48 – $807.47 | 2 |
| G0180 home health certification HCPCS G0180 | not published | not published | $184.34 – $184.34 | 1 |
| G6pc gene CPT 81250 | not published | not published | $127.75 – $255.02 | 2 |
| G6pd full gene sequence CPT 81249 | not published | not published | $1,310.40 – $2,616.00 | 2 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $381.79 – $762.17 | 2 |
| G6pd known familial variant CPT 81248 | not published | not published | $819.53 – $1,636.09 | 2 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | not published | not published | $447.64 – $477.89 | 2 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $241.45 – $257.77 | 2 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $92.61 | $220.50 | $0.92 – $1.56 | 3 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $37.80 | $90.00 | $5.16 – $7.07 | 3 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.40 – $0.80 | 3 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $165.44 | $393.90 | $51.46 – $65.68 | 4 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $46.04 – $91.87 | 2 |
| Galactokinase - sendout CPT 82759 | not published | not published | $46.91 – $93.65 | 2 |
| Galactose transferase test CPT 82776 | not published | not published | $25.63 – $51.19 | 2 |
| Galectin-3 CPT 82777 | not published | not published | $96.63 – $192.93 | 2 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $4,459.99 – $10,295.80 | 3 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $32.31 – $34.50 | 2 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $241.45 – $241.45 | 1 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $241.45 – $241.45 | 1 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $2,501.09 – $2,501.09 | 1 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $2,980.03 – $2,980.03 | 1 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $4.98 – $7.95 | 3 |
| Galsulfase injection HCPCS J1458 | not published | not published | $1,392.33 – $1,769.27 | 4 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $584.72 – $1,927.59 | 4 |
| Gamma globulin 1 cc inj HCPCS J1460 | $3,547.91 | $8,447.40 | $111.19 – $192.77 | 4 |
| Gammaglobulin iga CPT 82784 | $218.82 | $521.00 | $20.33 – $40.55 | 2 |
| Gammaglobulin ige CPT 82785 | $173.46 | $413.00 | $35.96 – $71.77 | 2 |
| Gamma glutamyltransferase CPT 82977 | $242.76 | $578.00 | $15.72 – $31.39 | 2 |
| Gammagraft HCPCS Q4111 | not published | not published | $24.91 – $30.94 | 4 |
| Gammaplex injection HCPCS J1557 | not published | not published | $209.57 – $254.58 | 4 |
| Gamunex-c/gammaked HCPCS J1561 | $17,168.14 | $40,876.52 | $168.11 – $189.20 | 4 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $263.39 | $627.12 | $138.67 – $170.70 | 4 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $15,789.91 – $63,628.08 | 3 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $76.64 – $152.99 | 2 |
| Gardner vag dna quant CPT 87512 | not published | not published | $91.20 – $182.07 | 2 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $14.65 – $29.26 | 2 |
| Gastric emptying imag study CPT 78265 | not published | not published | $1,541.43 – $1,541.43 | 1 |
| Gastric emptying imag study CPT 78266 | not published | not published | $1,896.56 – $1,896.56 | 1 |
| Gastric motility studies CPT 91020 | not published | not published | $599.72 – $2,444.00 | 2 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $787.24 – $787.24 | 1 |
| Gastrin test CPT 82938 | not published | not published | $38.65 – $77.13 | 2 |
| Gastroduodenostomy CPT 43810 | not published | not published | $1,247.08 – $2,257.61 | 2 |
| Gastroesophageal reflux study CPT 78262 | $1,666.14 | $3,967.00 | $944.33 – $944.33 | 1 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $484.19 – $484.19 | 1 |
| Gastrointestinal repair CPT 43360 | not published | not published | $2,921.12 – $5,007.27 | 2 |
| Gastrointestinal repair CPT 43361 | not published | not published | $3,151.51 – $6,012.86 | 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.