Covenant Specialty Hospital
3815 20th St, Lubbock, TX · Providence · · NPI 1013941780
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 |
|---|---|---|---|---|
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $304.50 | $725.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $321.30 | $765.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $433.02 | $1,031.00 | not published | 0 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,726.20 | $4,110.00 | not published | 0 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $56.70 | $135.00 | not published | 0 |
| Kidney function study CPT 78725 | $407.46 | $970.15 | not published | 0 |
| Kidney imag w/bld flow multi CPT 78709 | $907.30 | $2,160.23 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $659.10 | $1,569.29 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,034.46 | $2,463.00 | not published | 0 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $12.34 | $29.38 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $9,159.36 | $21,808.00 | not published | 0 |
| 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 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 | not published | 0 |
| 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 |
| Knee MRI (with and without contrast) CPT 73723 | $4,883.76 | $11,628.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $4,307.10 | $10,255.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $3,127.32 | $7,446.00 | not published | 0 |
| Knee X-ray CPT 73564 | $724.92 | $1,726.00 | not published | 0 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $117.60 | $280.00 | not published | 0 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $117.60 | $280.00 | not published | 0 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $56.70 | $135.00 | not published | 0 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $182.18 | $433.76 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $204.12 | $486.00 | not published | 0 |
| Lactated ringers intravenous solution HCPCS J7120 | $46.43 | $110.54 | not published | 0 |
| Lactic acid CPT 83605 | $221.76 | $528.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $115.08 | $274.00 | not published | 0 |
| Laparo cholecystectomy/graph CPT 47563 | $7,552.02 | $17,981.00 | not published | 0 |
| Largsc w/removal lesion CPT 31578 | $5,471.76 | $13,028.00 | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $619.08 | $1,474.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $2,624.16 | $6,248.00 | not published | 0 |
| Laryngoscopy w/fb removal CPT 31530 | $2,624.16 | $6,248.00 | not published | 0 |
| Laryngoscopy with biopsy CPT 31576 | $2,624.16 | $6,248.00 | not published | 0 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $619.08 | $1,474.00 | not published | 0 |
| Lateral canthopexy CPT 21282 | $4,122.30 | $9,815.00 | not published | 0 |
| Lb with mastopexy 15839 CPT 15839 | $3,743.04 | $8,912.00 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $3,934.60 | $9,368.10 | not published | 0 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $4,851.42 | $11,551.00 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,601.96 | $13,338.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $766.50 | $1,825.00 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,716.35 | $6,467.50 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $2,716.35 | $6,467.50 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $377.71 | $899.30 | not published | 0 |
| Levalbuterol non-comp unit HCPCS J7614 | $13.94 | $33.18 | not published | 0 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $56.70 | $135.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $82.03 | $195.30 | not published | 0 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $616.56 | $1,467.99 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $41,854.20 | $99,652.85 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $47.16 | $112.29 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $2,112.60 | $5,030.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $127.68 | $304.00 | not published | 0 |
| Ligation major artery neck CPT 37615 | $4,551.54 | $10,837.00 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $233.42 | $555.75 | not published | 0 |
| Lipase CPT 83690 | $187.32 | $446.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $197.40 | $470.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $154.56 | $368.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $292.32 | $696.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $687.12 | $1,636.00 | not published | 0 |
| Liver elastography 91200 CPT 91200 | $285.18 | $679.00 | not published | 0 |
| Liver Function Test CPT 80076 | $466.20 | $1,110.00 | not published | 0 |
| Liver imaging CPT 78201 | $2,162.04 | $5,147.71 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,666.02 | $3,966.71 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $57.96 | $138.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5271 | $818.58 | $1,949.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5273 | $2,431.38 | $5,789.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5275 | $818.58 | $1,949.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5277 | $818.58 | $1,949.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,268.86 | $7,783.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,230.62 | $5,311.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,226.84 | $5,302.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $7,386.54 | $17,587.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $6,543.60 | $15,580.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $6,102.60 | $14,530.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $804.72 | $1,916.00 | not published | 0 |
| Low frequency non-thermal Ultrasound CPT 97610 | $252.00 | $600.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $352.38 | $839.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,693.95 | $4,033.21 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,583.97 | $3,771.36 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $2,162.04 | $5,147.71 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $3,966.06 | $9,443.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $4,233.60 | $10,080.00 | not published | 0 |
| Magnesium CPT 83735 | $166.32 | $396.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $105.26 | $250.63 | not published | 0 |
| Mammosite ced HCPCS C1728 | $5,386.50 | $12,825.00 | not published | 0 |
| Manipulate wrist w/anesthes CPT 25259 | $2,021.04 | $4,812.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $254.94 | $607.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $332.22 | $791.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $266.70 | $635.00 | not published | 0 |
| Map tachycard site(s) CPT 93609 | $7,507.08 | $17,874.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $5,682.67 | $13,530.16 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $2,533.17 | $6,031.35 | not published | 0 |
| Mastoids complete CPT 70130 | $383.46 | $913.00 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $8,953.23 | $21,317.22 | not published | 0 |
| Mayo c1 esterase inhibitor CPT 83883 | $79.80 | $190.00 | not published | 0 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $128.94 | $307.00 | not published | 0 |
| Mayo efpo chloride stool CPT 82438 | $227.64 | $542.00 | not published | 0 |
| Mayo factor viii vw factor antigen CPT 85246 | $170.52 | $406.00 | not published | 0 |
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.