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 |
|---|---|---|---|---|
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $327.61 – $654.00 | 2 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $1,152.88 – $2,301.51 | 2 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $262.08 – $523.20 | 2 |
| Med genetics&genetic counseling svcs each 30 min CPT 96041 | $63.00 | $150.00 | not published | 0 |
| Medial canthopexy CPT 21280 | not published | not published | $2,750.00 – $17,789.31 | 6 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $3,720.70 – $10,295.80 | 3 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $3,720.70 – $10,295.80 | 3 |
| Medical testimony CPT 99075 | not published | not published | $467.00 – $467.00 | 1 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $388.84 – $3,909.39 | 2 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $386.13 | $919.35 | $0.79 – $2.01 | 3 |
| Megestrol 20 mg tabs 100 each bottle HCPCS S0179 | not published | not published | $0.34 – $0.36 | 2 |
| Meg evoked each addl CPT 95967 | not published | not published | $656.25 – $656.25 | 1 |
| Meg evoked single CPT 95966 | not published | not published | $750.88 – $750.88 | 1 |
| Meg spontaneous CPT 95965 | not published | not published | $1,483.32 – $1,483.32 | 1 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $26.29 – $49.02 | 3 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $2,975.28 | $7,084.00 | $823.11 – $1,366.71 | 2 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $13,762.02 | $32,766.72 | $480.17 – $504.94 | 2 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | $3,239.96 | $7,714.20 | $95.59 – $129.58 | 2 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $637.63 – $640.83 | 2 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | not published | not published | $142,789.46 – $256,139.76 | 3 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $576.92 – $576.92 | 1 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $106.35 – $288.45 | 3 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | $30,618.03 | $72,900.08 | $209.34 – $297.69 | 2 |
| Menacwy-tt menb-fhbp vacc im CPT 90623 | not published | not published | $856.76 – $1,048.80 | 2 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $5,128.10 – $12,741.55 | 3 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $57.96 | $138.00 | $6.81 – $54.93 | 4 |
| Meperidine/promethazine inj HCPCS J2180 | not published | not published | $28.61 – $28.61 | 1 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $21,274.42 | $50,653.38 | $106.10 – $115.94 | 4 |
| Mercaptopurine 50 mg HCPCS S0108 | not published | not published | $8.83 – $9.42 | 2 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $88.75 | $211.30 | $1.53 – $8.82 | 4 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $3,300.00 – $8,068.00 | 2 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $240.66 | $573.00 | $4.67 – $28.27 | 4 |
| Metabolic Blood Panel (Basic) CPT 80048 | $502.74 | $1,197.00 | $18.49 – $36.89 | 2 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $565.32 | $1,346.00 | $23.06 – $46.04 | 2 |
| Metabolic panel ionized ca CPT 80047 | $502.74 | $1,197.00 | $29.97 – $59.86 | 2 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | not published | not published | $2.81 – $6.05 | 4 |
| Methadone injection HCPCS J1230 | $132.48 | $315.43 | $45.25 – $80.20 | 4 |
| Methadone oral 5mg HCPCS S0109 | not published | not published | $0.07 – $0.08 | 2 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $145.29 | $345.94 | $16.75 – $50.27 | 4 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $21.89 | $52.13 | $0.69 – $8.19 | 4 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $248.64 | $592.00 | $4.45 – $11.51 | 4 |
| Methotrexate therapeutic drug level CPT 80204 | $401.52 | $956.00 | $84.23 – $168.17 | 2 |
| Methyl aminolevulinate, top HCPCS J7309 | not published | not published | $294.08 – $313.95 | 2 |
| Methyldopate hcl injection HCPCS J0210 | not published | not published | $149.60 – $190.00 | 3 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $220.06 | $523.95 | $4.34 – $30.21 | 3 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $163.89 | $390.22 | $51.09 – $77.20 | 4 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | not published | not published | $3.59 – $4.56 | 3 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $12.31 | $29.30 | $0.82 – $1.48 | 4 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $115.35 | $274.65 | $0.42 – $0.42 | 1 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $442.13 | $1,052.70 | $0.91 – $0.91 | 1 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $56.70 | $135.00 | $3.49 – $6.07 | 4 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | not published | not published | $0.47 – $0.47 | 1 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $69.30 | $165.00 | $0.07 – $0.10 | 3 |
| Metyrapone panel CPT 80436 | not published | not published | $199.08 – $397.46 | 2 |
| Mgmt promoter methylation analysis CPT 81287 | not published | not published | $543.43 – $543.43 | 1 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $1,371.37 | $3,265.17 | $1.08 – $7.47 | 4 |
| Microalbumin urine screen CPT 82044 | not published | not published | $13.61 – $27.16 | 2 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $87.73 – $175.14 | 2 |
| Microdissection laser CPT 88380 | not published | not published | $172.24 – $344.13 | 2 |
| Microdissection manual CPT 88381 | not published | not published | $393.22 – $567.24 | 2 |
| Microfluid analy tears CPT 83861 | not published | not published | $49.09 – $98.01 | 2 |
| Microsatellite instability CPT 81301 | not published | not published | $761.24 – $1,519.72 | 2 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Microvolt t-wave assess CPT 93025 | not published | not published | $390.79 – $390.79 | 1 |
| Microwave bronch, 3d, ebus HCPCS C9751 | not published | not published | $8,068.00 – $17,573.57 | 2 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $158.03 | $376.27 | $0.30 – $0.56 | 4 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | not published | not published | $0.59 – $1.27 | 3 |
| Middle cerebral artery echo CPT 76821 | $140.28 | $334.00 | $333.97 – $488.67 | 2 |
| Mifepristone 200 mg ta HCPCS S0190 | not published | not published | $248.34 – $265.12 | 2 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $133.06 | $316.82 | $4.91 – $7.03 | 4 |
| Minocycline hydrochloride HCPCS J2265 | not published | not published | $6.06 – $9.39 | 3 |
| Minoxidil, 10 mg HCPCS S0139 | not published | not published | $1.38 – $1.48 | 2 |
| Miroderm HCPCS Q4175 | not published | not published | $237.01 – $241.98 | 2 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | not published | not published | $243.32 – $273.96 | 3 |
| Misoprostol, oral, 200 mcg HCPCS S0191 | not published | not published | $2.84 – $3.03 | 2 |
| Mitochondrial gene CPT 81440 | not published | not published | $7,259.62 – $14,492.64 | 2 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $8,036.58 | $19,134.72 | $98.95 – $339.14 | 4 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $1,110.97 – $1,254.20 | 4 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $1,995.47 | $4,751.11 | $103.60 – $165.60 | 4 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $3,439.39 – $6,222.43 | 2 |
| Mlh1 gene CPT 81288 | not published | not published | $420.04 – $838.52 | 2 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $442.04 – $882.46 | 2 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $1,475.08 – $2,944.74 | 2 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $722.90 – $1,443.16 | 2 |
| Mlt fam grp bhv train 1st 60 CPT 96202 | $47.04 | $112.00 | $78.67 – $78.67 | 1 |
| Mlt fam grp bhv train ea add CPT 96203 | $47.04 | $112.00 | $22.13 – $22.13 | 1 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $2,600.00 – $25,348.51 | 6 |
| Mnl appl strs jt radiography CPT 77071 | $284.76 | $678.00 | $247.94 – $347.97 | 2 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $2,444.00 – $2,444.00 | 1 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $1,000.00 – $4,579.48 | 6 |
| Mnpj elbow under anes CPT 24300 | $2,021.04 | $4,812.00 | $1,357.89 – $2,886.98 | 3 |
| Mnpj of tmj w/anesth CPT 21073 | $2,011.38 | $4,789.00 | $310.12 – $2,444.00 | 3 |
| Mnt subs tx for change dx HCPCS G0270 | not published | not published | $100.77 – $100.77 | 1 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $148.81 – $269.45 | 2 |
| Modification of contact lens CPT 92325 | not published | not published | $371.79 – $371.79 | 1 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,674.47 – $3,004.51 | 2 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $714.84 – $1,290.40 | 2 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $52.54 – $52.54 | 1 |
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.