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 |
|---|---|---|---|---|
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $87.36 | $208.00 | $36.40 – $39.58 | 4 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $175.98 | $419.00 | $50.78 – $55.23 | 4 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $175.98 | $419.00 | $50.78 – $55.23 | 4 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,029.42 | $2,451.00 | $349.28 – $379.88 | 4 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $2,319.24 | $5,522.00 | $785.07 – $853.87 | 4 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $2,828.01 – $3,665.01 | 2 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $3,187.30 – $4,152.73 | 2 |
| Surgical revision intestine CPT 44680 | not published | not published | $2,250.66 – $2,901.00 | 2 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $7.88 – $131.89 | 4 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $1,000.00 – $5,092.98 | 6 |
| Susceptibility agar dilution per agent CPT 87181 | $33.18 | $79.00 | $4.61 – $5.01 | 4 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $7.14 | $17.00 | $4.61 – $5.01 | 4 |
| Susceptibility mic per plate CPT 87186 | $60.06 | $143.00 | $8.39 – $9.13 | 4 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $6.44 – $7.01 | 4 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $2,112.31 – $2,775.08 | 2 |
| Suspension of testis CPT 54620 | not published | not published | $2,300.00 – $4,753.93 | 6 |
| Suspension of uterus CPT 58410 | not published | not published | $1,650.87 – $2,143.56 | 2 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $919.98 – $7,187.00 | 3 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $2,224.59 – $2,880.33 | 2 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $2,879.43 – $3,736.42 | 2 |
| Svc venogram s&i CPT 75827 | $3,296.58 | $7,849.00 | $1,533.89 – $1,668.30 | 4 |
| Sweat collection by iontophoresis CPT 89230 | $137.34 | $327.00 | $50.78 – $55.23 | 4 |
| Sympathectomy cervical CPT 64802 | not published | not published | $1,902.77 – $3,630.85 | 6 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $1,902.77 – $3,630.85 | 5 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $1,495.13 – $1,633.49 | 2 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $3,188.30 – $5,797.82 | 5 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $2,247.76 – $3,025.97 | 2 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $21.26 – $21.26 | 1 |
| Synthetic sentence id test CPT 92576 | not published | not published | $36.40 – $93.92 | 5 |
| Synvisc or synvisc-one HCPCS J7325 | $5.50 | $13.09 | $6.75 – $7.35 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $36.54 | $87.00 | $4.27 – $4.64 | 4 |
| System cardiomems hosp electronics HCPCS C2624 | $42,700.77 | $101,668.50 | not published | 0 |
| System pacing micra av HCPCS C1786 | $26,599.86 | $63,333.00 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $7,795.20 | $18,560.00 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | not published | not published | $3.51 – $3.51 | 1 |
| System sealant biosentry tract HCPCS C2613 | $1,197.76 | $2,851.80 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | not published | not published | $16.43 – $17.87 | 4 |
| T3 (triiodothyronine) total CPT 84480 | $83.58 | $199.00 | $13.75 – $14.96 | 4 |
| T4 (thyroxine) free CPT 84439 | $53.34 | $127.00 | $8.75 – $9.52 | 4 |
| T4 (thyroxine) total CPT 84436 | $40.74 | $97.00 | $6.66 – $7.25 | 4 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $1.74 – $1.74 | 1 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $4.82 – $4.82 | 1 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $9.99 | $23.79 | $13.47 – $13.47 | 1 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $252.16 – $274.25 | 4 |
| Tacrolimus therapeutic drug level CPT 80197 | $31.08 | $74.00 | $13.32 – $14.49 | 4 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $13.74 – $14.95 | 4 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $4,634.62 – $5,941.07 | 2 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $4,268.07 – $5,478.72 | 2 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $2,578.09 – $8,624.00 | 3 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $71.72 – $78.01 | 4 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $2.04 – $2.04 | 1 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $4,837.00 – $4,837.00 | 1 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $4,837.00 – $4,837.00 | 1 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.50 – $0.50 | 1 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $736.74 – $801.30 | 4 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,832.01 – $3,080.18 | 4 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $579.97 – $630.80 | 4 |
| Tas congenital car anomal CPT 33741 | not published | not published | $1,115.04 – $1,115.04 | 1 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $276.38 – $783.27 | 5 |
| Tavr perq femoral CPT 33361 | not published | not published | $2,859.87 – $3,715.74 | 2 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.24 – $0.26 | 4 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $132.89 – $144.54 | 4 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $145.32 – $145.32 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $36.32 – $36.32 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $84.80 – $92.23 | 4 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $84.80 – $92.23 | 4 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $97.00 – $105.50 | 4 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | not published | not published | $60.12 – $65.39 | 4 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $4,581.85 – $4,581.85 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $752.25 – $818.17 | 4 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $258.66 – $258.66 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $906.11 – $985.51 | 4 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $5,380.02 – $5,380.02 | 1 |
| Tc-99m labeled rbc HCPCS A9560 | not published | not published | $345.14 – $345.14 | 1 |
| Tc-99m maa HCPCS A9540 | not published | not published | $110.85 – $110.85 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | not published | not published | $204.42 – $204.42 | 1 |
| Tc-99m medronate HCPCS A9503 | not published | not published | $48.04 – $48.04 | 1 |
| Tc-99m mertiatide HCPCS A9562 | not published | not published | $2,862.93 – $2,862.93 | 1 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $162.57 – $162.57 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $115.79 – $115.79 | 1 |
| Tc-99m pertechnetate per mci HCPCS A9512 | not published | not published | $14.58 – $14.58 | 1 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $184.76 – $184.76 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | not published | not published | $505.04 – $505.04 | 1 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $640.13 – $696.23 | 4 |
| Tc-99m sulfur colloid HCPCS A9541 | not published | not published | $197.59 – $197.59 | 1 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $360.13 – $360.13 | 1 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $1,735.98 – $1,735.98 | 1 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $210.07 – $783.27 | 5 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $101.87 – $629.86 | 5 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $101.87 – $610.45 | 5 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $491.71 – $526.57 | 2 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $429.89 – $1,647.94 | 5 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $403.62 | $961.00 | $45.57 – $49.56 | 4 |
| T cells absolute cd 4 count CPT 86361 | $230.16 | $548.00 | $25.98 – $28.25 | 4 |
| T cells total count CPT 86359 | $324.24 | $772.00 | $36.60 – $39.81 | 4 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $53.24 – $228.84 | 5 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $210.40 – $396.10 | 5 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $210.40 – $228.84 | 4 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $978.65 – $1,287.44 | 2 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $2,164.47 – $2,881.27 | 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.