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 |
|---|---|---|---|---|
| Ghs refill of implantable pump CPT 95990 | $1,273.86 | $3,033.00 | $321.97 – $321.97 | 1 |
| Ghs removal intranasal foreign body CPT 30300 | $545.16 | $1,298.00 | $155.48 – $232.23 | 2 |
| Ghs removal pharyngeal foreign body CPT 42809 | $405.72 | $966.00 | $155.48 – $2,444.00 | 3 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $2,021.04 | $4,812.00 | $1,449.53 – $11,141.85 | 6 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $4,192.86 | $9,983.00 | $2,600.00 – $15,638.81 | 6 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $34.71 – $69.28 | 2 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $9.41 – $18.79 | 2 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $28.98 | $69.00 | $30.37 – $60.65 | 2 |
| Ghs sedimentation rate CPT 85651 | $163.38 | $389.00 | $9.35 – $18.62 | 2 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $26.88 – $53.67 | 2 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $21.50 – $42.90 | 2 |
| Ghs sensitivity (per antimicro) CPT 87184 | $369.18 | $879.00 | $16.34 – $32.61 | 2 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $1,670.34 | $3,977.00 | $172.46 – $7,034.24 | 6 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $921.06 | $2,193.00 | $172.46 – $7,034.24 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $1,938.30 | $4,615.00 | $259.54 – $7,034.24 | 6 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $1,040.76 | $2,478.00 | $172.46 – $7,034.24 | 6 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $812.28 | $1,934.00 | $116.22 – $2,444.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $798.00 | $1,900.00 | $116.22 – $2,444.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $860.58 | $2,049.00 | $172.46 – $2,444.00 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $2,108.82 | $5,021.00 | $172.46 – $7,034.24 | 6 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $1,089.48 | $2,594.00 | $172.46 – $7,034.24 | 6 |
| Ghs sleep study unattended CPT 95800 | $140.00 | $737.00 | $441.19 – $441.19 | 1 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $347.79 – $347.79 | 1 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,838.36 | $6,758.00 | $1,040.90 – $1,040.90 | 1 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $180.66 – $180.66 | 1 |
| Ghs sphenopalatine ganglion block CPT 64505 | $383.46 | $913.00 | $62.02 – $2,444.00 | 3 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $371.79 – $371.79 | 1 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $378.51 – $378.51 | 1 |
| Ghs st - eval for alt comm CPT 92567 | $49.98 | $119.00 | $114.00 – $114.00 | 1 |
| Ghs strapping shoulder - 29240 CPT 29240 | $336.42 | $801.00 | $61.80 – $232.23 | 2 |
| Ghs st - re-eval for alt comm CPT 92597 | $807.66 | $1,923.00 | $253.16 – $253.16 | 1 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $53.76 | $128.00 | $54.08 – $54.08 | 1 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $262.50 | $625.00 | $576.36 – $576.36 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $562.80 | $1,340.00 | $507.58 – $4,579.48 | 6 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $525.42 | $1,251.00 | $259.54 – $4,579.48 | 6 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $2,011.38 | $4,789.00 | $763.11 – $2,874.09 | 4 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $15.96 – $31.83 | 2 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $811.02 | $1,931.00 | $252.34 – $459.31 | 2 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $291.90 | $695.00 | $199.54 – $4,524.00 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $53.09 – $105.95 | 2 |
| Ghs urine, porphyrins quant CPT 84120 | not published | not published | $32.12 – $64.14 | 2 |
| Ghs vaginal delivery only CPT 59409 | $4,096.68 | $9,754.00 | $2,178.67 – $5,320.95 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $1,655.93 – $1,655.93 | 1 |
| Ghs windowing of cast CPT 29730 | $205.38 | $489.00 | $40.92 – $69.18 | 2 |
| Giardia ag if CPT 87269 | not published | not published | $29.74 – $59.34 | 2 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $32.16 – $64.18 | 2 |
| Gi endoscopic ultrasound CPT 76975 | $323.82 | $771.00 | $705.32 – $1,016.05 | 2 |
| Gi inhouse confirmation CPT 87045 | $341.88 | $814.00 | $20.64 – $41.16 | 2 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $312.65 – $713.36 | 2 |
| Gi protein loss CPT 78282 | not published | not published | $1,541.43 – $1,541.43 | 1 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $5,201.70 | $12,385.00 | $2,596.75 – $2,596.75 | 1 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $3,680.01 – $3,680.01 | 1 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $2,596.75 – $2,596.75 | 1 |
| Gi wireless capsule measure CPT 91112 | $4,001.34 | $9,527.00 | $4,019.84 – $4,019.84 | 1 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $220.86 – $440.88 | 2 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $134.36 – $268.23 | 2 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $76.44 – $152.60 | 2 |
| Glassia injection HCPCS J0257 | $11,068.03 | $26,352.45 | $18.81 – $20.33 | 4 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $194.17 – $194.17 | 1 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $145.03 – $145.03 | 1 |
| Glaucoma surgery CPT 66150 | not published | not published | $2,068.23 – $15,638.81 | 6 |
| Glaucoma surgery CPT 66155 | not published | not published | $2,068.23 – $15,638.81 | 6 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,068.23 – $7,034.24 | 6 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,068.23 – $15,638.81 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,048.46 | $4,877.28 | $309.07 – $715.81 | 4 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $904.99 | $2,154.74 | $470.55 – $674.51 | 3 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $31.22 – $62.30 | 2 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $100.63 – $200.87 | 2 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $110.31 – $220.18 | 2 |
| Glucagon tolerance test CPT 82946 | not published | not published | $38.80 – $77.48 | 2 |
| Glucose 1 hr post dose CPT 82950 | $136.50 | $325.00 | $10.39 – $20.71 | 2 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $13.21 – $26.38 | 2 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $35.28 | $84.00 | $7.16 – $14.30 | 2 |
| Glucose blood quantitative CPT 82947 | $76.86 | $183.00 | $8.56 – $17.13 | 2 |
| Glucose body fluid CPT 82945 | $98.70 | $235.00 | $8.56 – $17.13 | 2 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $191.71 – $191.71 | 1 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $418.32 | $996.00 | $28.13 – $56.11 | 2 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $85.26 | $203.00 | $8.56 – $17.09 | 2 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $56.70 | $135.00 | $1.52 – $2.54 | 3 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $51.03 – $58.01 | 3 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $12,077.17 | $28,755.17 | $38.60 – $141.14 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $268.38 | $639.00 | $40.59 – $81.01 | 2 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $324.14 – $647.07 | 2 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $296.10 | $705.00 | $40.45 – $80.75 | 2 |
| Gonioscopy CPT 92020 | not published | not published | $371.79 – $371.79 | 1 |
| Goniotomy CPT 65820 | not published | not published | $1,000.00 – $8,133.04 | 4 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $13,568.86 | $32,306.82 | $2,185.54 – $2,569.53 | 4 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $3,202.29 | $7,624.50 | $106.06 – $136.47 | 4 |
| Graft axiofill 1000mg HCPCS J3590 | $24,066.00 | $57,300.00 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $11.76 – $5,560.43 | 3 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $20,895.93 | $49,752.22 | $232.11 – $754.34 | 2 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $34,943.93 | $83,199.83 | $131.98 – $140.90 | 2 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $3,828.45 – $7,590.50 | 3 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $44,940.00 | $107,000.00 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $40,989.02 | $97,592.90 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $35,468.43 | $84,448.64 | $148.43 – $228.92 | 4 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $9,889.61 | $23,546.70 | $154.56 – $394.33 | 3 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $1,335.43 – $2,425.73 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $17,161.20 | $40,860.00 | $476.62 – $518.02 | 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.