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 |
|---|---|---|---|---|
| Intro catheter aorta CPT 36200 | $3,625.86 | $8,633.00 | $4,524.00 – $4,524.00 | 1 |
| Intro cath svc/ivc CPT 36010 | $3,032.40 | $7,220.00 | $2,444.00 – $2,444.00 | 1 |
| Intro long gi tube CPT 44500 | $1,162.98 | $2,769.00 | $575.95 – $1,674.01 | 2 |
| Intro long gi tube w/mult fluo CPT 74340 | $1,695.12 | $4,036.00 | $120.99 – $120.99 | 1 |
| Intro windpipe wire/tube CPT 31730 | $2,316.30 | $5,515.00 | $455.98 – $4,579.48 | 6 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,449.86 | $5,833.00 | $2,444.00 – $2,444.00 | 1 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $645.12 | $1,536.00 | $2,444.00 – $2,444.00 | 1 |
| Intubation endotracheal emergency procedure CPT 31500 | $1,338.96 | $3,188.00 | $153.08 – $2,444.00 | 3 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $112.07 – $232.23 | 2 |
| Iodine i-123 sod iodide mil HCPCS A9509 | not published | not published | $6,736.75 – $7,191.98 | 2 |
| Iodine i-131 iobenguane 1mci HCPCS A9590 | not published | not published | $1,124.95 – $1,200.97 | 2 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $41.48 – $77.21 | 2 |
| Ionm in operatng room 15 min CPT 95940 | $575.40 | $1,370.00 | $114.30 – $114.30 | 1 |
| Ionm remote/>1 pt or per hr CPT 95941 | $341.88 | $814.00 | $631.67 – $631.67 | 1 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $41.10 | $97.86 | $1.05 – $1.56 | 4 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $83.03 | $197.70 | $0.46 – $1.28 | 4 |
| Io radiation tx management CPT 77469 | not published | not published | $1,271.45 – $1,271.45 | 1 |
| Io rad tx deliver by elctrns CPT 77425 | not published | not published | $1,025.63 – $1,025.63 | 1 |
| Io rad tx delivery by x-ray CPT 77424 | not published | not published | $946.52 – $946.52 | 1 |
| Ioxaglate 39.3%-19.6% inj 200 ml HCPCS Q9964 | not published | not published | $1.20 – $1.28 | 2 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $68,111.44 | $162,170.10 | $547.76 – $655.20 | 4 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | not published | not published | $399.41 – $399.41 | 1 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | not published | not published | $580.04 – $580.04 | 1 |
| Ip/obs consltj new/est hi 80 CPT 99255 | not published | not published | $698.03 – $698.03 | 1 |
| Ip/obs consltj new/est sf 35 CPT 99252 | not published | not published | $259.30 – $259.30 | 1 |
| Ipratropium bromide non-comp HCPCS J7644 | $4.62 | $11.00 | $1.22 – $2.04 | 4 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $813.75 | $1,937.50 | $4.89 – $11.42 | 4 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $13,396.43 | $31,896.27 | $159.59 – $235.68 | 4 |
| Iron CPT 83540 | $252.00 | $600.00 | $14.15 – $28.21 | 2 |
| Iron binding capacity CPT 83550 | $237.72 | $566.00 | $19.08 – $38.11 | 2 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $75.16 | $178.95 | $50.86 – $65.82 | 4 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $15.02 – $30.00 | 2 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $130.53 | $310.79 | $0.78 – $1.40 | 4 |
| Irradiation of blood product each unit reference CPT 86945 | not published | not published | $66.30 – $145.75 | 2 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $114.66 | $273.00 | $187.58 – $187.58 | 1 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $418.15 – $2,444.00 | 3 |
| Irrigation syringe HCPCS A4322 | not published | not published | $3.76 – $3.76 | 1 |
| Irrigation tray HCPCS A4320 | not published | not published | $6.07 – $6.07 | 1 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $28.28 – $117.17 | 2 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $277.58 – $296.34 | 4 |
| Island pedicle flap graft CPT 15740 | not published | not published | $1,660.87 – $7,034.24 | 6 |
| Ivc venogram s&i CPT 75825 | $7,103.46 | $16,913.00 | $8,770.58 – $12,082.78 | 2 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $309.19 – $330.08 | 2 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $244.02 | $581.00 | $108.13 – $108.13 | 1 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $304.50 | $725.00 | $72.50 – $72.50 | 1 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $321.30 | $765.00 | $74.95 – $74.95 | 1 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $433.02 | $1,031.00 | $248.25 – $248.25 | 1 |
| IV inj ra drug dx study CPT 78808 | not published | not published | $1,605.05 – $1,605.05 | 1 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $155.48 – $2,444.00 | 3 |
| Ivp w/nephrotomography CPT 74415 | not published | not published | $529.52 – $547.23 | 2 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,726.20 | $4,110.00 | $417.95 – $547.23 | 2 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $16,416.75 | $39,087.49 | $358.07 – $486.67 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $404.48 – $807.47 | 2 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $2,300.00 – $5,830.77 | 4 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $1,474.39 – $7,034.24 | 6 |
| John cunningham antibody CPT 86711 | not published | not published | $36.90 – $73.64 | 2 |
| J-tube placement CPT 44015 | not published | not published | $175.02 – $317.03 | 2 |
| Kafo femoral fx cast rigid HCPCS L2136 | $2,107.32 | $5,017.43 | not published | 0 |
| Keratomileusis CPT 65760 | not published | not published | $1,785.22 – $8,068.00 | 3 |
| Keratophakia CPT 65765 | not published | not published | $1,952.63 – $8,068.00 | 3 |
| Keratoprosthesis CPT 65770 | not published | not published | $3,300.00 – $20,628.27 | 6 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $2,266.32 – $2,266.32 | 1 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $33.81 – $67.45 | 2 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | not published | not published | $17.84 – $35.62 | 2 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $56.70 | $135.00 | $0.67 – $1.86 | 4 |
| Kidney endoscopy CPT 50551 | not published | not published | $647.78 – $9,013.35 | 6 |
| Kidney endoscopy CPT 50553 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Kidney endoscopy CPT 50570 | not published | not published | $647.78 – $6,429.49 | 5 |
| Kidney endoscopy CPT 50575 | not published | not published | $3,674.49 – $9,013.35 | 2 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $647.78 – $17,184.69 | 6 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $647.78 – $4,579.48 | 5 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $1,000.00 – $17,184.69 | 6 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $1,000.00 – $9,013.35 | 6 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $1,447.90 – $9,013.35 | 5 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $1,447.90 – $9,013.35 | 5 |
| Kidney function study CPT 78725 | $1,666.14 | $3,967.00 | $406.96 – $406.96 | 1 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $791.78 – $791.78 | 1 |
| Kidney imaging morphology CPT 78700 | $532.56 | $1,268.00 | $675.67 – $675.67 | 1 |
| Kidney imag w/bld flow multi CPT 78709 | $907.20 | $2,160.00 | $1,360.76 – $1,360.76 | 1 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $658.98 | $1,569.00 | $843.79 – $843.79 | 1 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,034.46 | $2,463.00 | $333.97 – $488.67 | 2 |
| Kit case 4.2mm spinejack HCPCS C1062 | not published | not published | $6,623.83 – $6,623.83 | 1 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $49.19 – $49.19 | 1 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $12.34 | $29.38 | $9.34 – $9.34 | 1 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,159.36 | $21,808.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | not published | not published | $272.73 – $544.43 | 2 |
| Kit hfx iq ipg bundle HCPCS C1822 | $27,909.00 | $66,450.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $46,737.60 | $111,280.00 | not published | 0 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $16.03 – $16.03 | 1 |
| Kit lead specify 5-6-5 HCPCS C1778 | $34,886.25 | $83,062.50 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $2,021.99 | $4,814.25 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $5,628.61 | $13,401.45 | $91.30 – $185.50 | 4 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $10,895.93 | $25,942.68 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,725.63 | $6,489.60 | not published | 0 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $21.91 – $21.91 | 1 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $2,539.02 – $15,638.81 | 6 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $2,300.00 – $11,141.85 | 6 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $2,539.02 – $15,638.81 | 6 |
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.