Covenant Hospital Plainview
2601 Dimmitt Rd, Plainview, TX · Providence · · NPI 1073580726
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 |
|---|---|---|---|---|
| Clot factor xiii fibrin scrn CPT 85291 | not published | not published | $8.84 – $9.61 | 4 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $15.85 – $17.24 | 4 |
| Clotting assay whole blood CPT 85396 | not published | not published | $77.33 – $77.33 | 1 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $1.74 – $1.74 | 1 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $1,385.16 | $3,298.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $460.32 | $1,096.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $275.94 | $657.00 | $219.01 – $261.42 | 5 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $1,912.68 | $4,554.00 | $1,000.00 – $3,442.27 | 6 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,912.68 | $4,554.00 | $1,000.00 – $1,871.09 | 6 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $275.94 | $657.00 | $219.01 – $261.42 | 5 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $460.32 | $1,096.00 | $219.01 – $261.42 | 5 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $1,091.58 | $2,599.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $653.10 | $1,555.00 | $112.44 – $261.42 | 5 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,814.00 | $6,700.00 | $1,566.86 – $3,442.27 | 6 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | $1,912.68 | $4,554.00 | $1,566.86 – $3,222.30 | 6 |
| Clsd tx fracture of radius 25500 CPT 25500 | $460.32 | $1,096.00 | $219.01 – $261.42 | 5 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $275.94 | $657.00 | $198.77 – $261.42 | 5 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $459.90 | $1,095.00 | $212.54 – $275.76 | 5 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $761.04 | $1,812.00 | $219.01 – $307.37 | 5 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $2,961.42 | $7,051.00 | $1,566.86 – $2,300.00 | 6 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $488.88 | $1,164.00 | $219.01 – $261.42 | 5 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $2,961.42 | $7,051.00 | $560.95 – $2,150.00 | 6 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $460.32 | $1,096.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $460.32 | $1,096.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $460.32 | $1,096.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $320.04 | $762.00 | $233.40 – $320.97 | 5 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $609.42 | $1,451.00 | $525.53 – $2,300.00 | 6 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $459.90 | $1,095.00 | $219.01 – $307.37 | 5 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $842.10 | $2,005.00 | $240.36 – $2,150.00 | 6 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $3,969.00 | $9,450.00 | $2,150.00 – $3,467.69 | 6 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $712.32 | $1,696.00 | $219.01 – $307.37 | 5 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $2,876.58 | $6,849.00 | $2,150.00 – $3,513.75 | 6 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $340.29 – $2,150.00 | 3 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,889.18 | $6,879.00 | $1,566.86 – $3,442.27 | 6 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $1,010.94 | $2,407.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx pelvic ring fx CPT 27197 | $275.94 | $657.00 | $240.36 – $524.01 | 5 |
| Clsd tx pelvic ring fx CPT 27198 | $275.94 | $657.00 | $240.36 – $524.01 | 5 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $3,141.18 | $7,479.00 | $1,000.00 – $1,871.09 | 6 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $275.94 | $657.00 | $219.01 – $261.42 | 5 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,912.68 | $4,554.00 | $560.95 – $1,704.16 | 6 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,912.68 | $4,554.00 | $1,566.86 – $2,150.00 | 6 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,912.68 | $4,554.00 | $560.95 – $2,150.00 | 6 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,494.80 | $5,940.00 | $1,000.00 – $3,018.60 | 6 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $3,969.00 | $9,450.00 | $1,000.00 – $3,467.69 | 6 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $897.54 | $2,137.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $275.94 | $657.00 | $138.55 – $261.42 | 5 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $2,079.42 | $4,951.00 | $1,000.00 – $1,871.09 | 6 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $275.94 | $657.00 | $219.01 – $261.42 | 5 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $300.72 | $716.00 | $240.36 – $1,000.00 | 6 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $275.94 | $657.00 | $240.36 – $2,150.00 | 6 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $275.94 | $657.00 | $219.01 – $307.37 | 5 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $275.94 | $657.00 | $240.36 – $2,150.00 | 6 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $1,912.68 | $4,554.00 | $1,566.86 – $2,150.00 | 6 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $1,912.68 | $4,554.00 | $1,566.86 – $3,442.27 | 6 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,912.68 | $4,554.00 | $560.95 – $1,704.16 | 6 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Cltx lunate dislc w/mnpj CPT 25690 | $1,912.68 | $4,554.00 | $1,000.00 – $3,442.27 | 6 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $7,119.42 | $16,951.00 | $2,300.00 – $9,785.04 | 6 |
| Cltx mndblr fx w/mnpj CPT 21451 | $2,876.58 | $6,849.00 | $1,511.89 – $3,323.37 | 6 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $4,134.48 | $9,844.00 | $1,025.72 – $3,513.75 | 5 |
| Cltx palatal/max fx wire fix CPT 21421 | $4,134.48 | $9,844.00 | $2,600.00 – $9,785.04 | 6 |
| Cltx post ankle fx CPT 27767 | $275.94 | $657.00 | $219.01 – $261.42 | 5 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,889.18 | $6,879.00 | $443.58 – $1,704.16 | 5 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,912.68 | $4,554.00 | $560.95 – $1,704.16 | 6 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $275.94 | $657.00 | $240.36 – $1,000.00 | 6 |
| Cltx thigh fx CPT 27267 | $4,326.00 | $10,300.00 | $2,613.00 – $3,467.69 | 5 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $1,511.89 – $5,105.49 | 6 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $2,750.00 – $10,438.65 | 6 |
| C motor evoked lwr limbs CPT 95929 | not published | not published | $205.90 – $395.48 | 5 |
| C motor evoked uppr limbs CPT 95928 | not published | not published | $298.84 – $910.10 | 5 |
| C motor evoked upr&lwr limbs CPT 95939 | not published | not published | $833.35 – $910.10 | 5 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $57.48 – $112.87 | 5 |
| Cmptr ophth img optic nerve CPT 92133 | $33.60 | $80.00 | $57.48 – $112.87 | 5 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $13.65 – $14.84 | 4 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $8.54 – $9.28 | 4 |
| #cmvcul-virus inoculation shell CPT 87254 | not published | not published | $18.97 – $20.64 | 4 |
| Cmv pcr-sendout CPT 87496 | not published | not published | $34.04 – $37.02 | 4 |
| Co2 monitor per day CPT 94681 | not published | not published | $349.66 – $395.48 | 5 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $30,871.79 | $73,504.26 | $2.56 – $2.79 | 4 |
| Coagulation time activated teg CPT 85347 | not published | not published | $4.15 – $4.52 | 4 |
| Coagulation time otr method CPT 85348 | not published | not published | $4.36 – $4.74 | 4 |
| Cocaine 4 % nasal solution HCPCS C9046 | not published | not published | $4.49 – $4.49 | 1 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $125.38 – $255.72 | 5 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $125.38 – $255.72 | 5 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $4.67 – $4.67 | 1 |
| Cold agglutinin screen (arc) CPT 86156 | not published | not published | $7.83 – $8.51 | 4 |
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.