Does Covenant Childrens Hospital have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Covenant Childrens Hospital. In a medical emergency, call 911.

Where is Covenant Childrens Hospital?

4015 22nd Place, Lubbock, TX 79410, in Lubbock County, Texas.

What is the phone number of Covenant Childrens Hospital?

(806) 725-7975, as listed by Medicare (CMS).

What is the Medicare star rating of Covenant Childrens Hospital?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Covenant Childrens Hospital — Lubbock, TX

Quick answers

Does Covenant Childrens Hospital have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Covenant Childrens Hospital. In a medical emergency, call 911.
Where is Covenant Childrens Hospital?: 4015 22nd Place, Lubbock, TX 79410, in Lubbock County, Texas.
What is the phone number of Covenant Childrens Hospital?: (806) 725-7975, as listed by Medicare (CMS).
What is the Medicare star rating of Covenant Childrens Hospital?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[5][6][12][14][15][17]}

Pediatric cardiology
Pediatric ear, nose and throat
Pediatric endocrinology and diabetes
Pediatric gastroenterology
Pediatric infectious disease
Pediatric neurology and neurosurgery
Pediatric oncology
Pediatric orthopedics
Pediatric urology
Adolescent medicine and eating disorders
Pediatric rehabilitation
Radiology
Anesthesiology
Surgical services
Women's care
Pediatric emergency medicine
Pediatric neurosurgery
Pediatric otolaryngology (ENT)
Pediatric hospitalist medicine
Pediatric trauma surgery

Conditions treated^[5][12][18]

Seizures
Headaches
Head injury
Brain tumor
Broken bones
Bone conditions present at birth
Diabetes

Treatments^[9][16]

Pediatric cardiovascular surgery
Speech, occupational and physical therapy

Procedures^[6]

Trauma surgery
Neurosurgery
Orthopedic surgery
Pediatric anesthesia

Programs and centers^{[5][6][8][10][11][17]}

Neonatal intensive care unit
Pediatric intensive care unit
Pediatric trauma
Infant follow-up developmental clinic
Integrative care
Relational Health Center
Pediatric emergency center
Obstetric emergency department
Obstetric hospitalist program
Neonatal and pediatric transport program
Safe Haven Baby Box drop-off
Condition H patient safety program

Emergency care (hospital website)^{[4][5][6][14]}

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level II pediatric trauma center

Visiting and practical information

Parking	Surface parking is free for patients and guests, in front of the main entrance (24th and Nashville lot); RV parking is $10 per day^[7]
Interpreters and languages	Interpreter service for non-English-speaking patients and family; ask your nurse or call 806-725-3041 in advance^[10]
Patient portal	MyChart

Recognition^[4]

Press Ganey award (2022)
Practice Greenhealth Partner for Change Award (2023)

Doctors and clinicians (358)

358 doctors and other clinicians list Covenant Childrens Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 334 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Covenant Medical Center0.6 mi · Lubbock, TX · Acute Care Hospital
University Medical Center1.4 mi · Lubbock, TX · Acute Care Hospital
Lubbock Heart Hospital LP2.1 mi · Lubbock, TX · Acute Care Hospital
Grace Surgical Hospital2.6 mi · Lubbock, TX · Acute Care Hospital
Exceptional Community Hospital Lubbock7.8 mi · Lubbock, TX · Acute Care Hospital

Other hospitals nearby

Covenant Specialty Hospital0.3 mi · Lubbock, TX · Long-Term Acute Care Hospital
South Plains Rehabilitation Hospital An Affiliate2.4 mi · Lubbock, TX · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Lubbock Health Care Center0.1 mi · Lubbock, TX · 3 of 5 stars
Lakeside Rehabilitation and Care Center0.1 mi · Lubbock, TX · 1 of 5 stars
Southern Specialty Rehab & Nursing0.3 mi · Lubbock, TX · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Covenant Health at Home With Compassus, Hospice of Lubbock0.6 mi · Lubbock, TX · 5 of 5 stars
Accentcare Health2.1 mi · Lubbock, TX
Grayce Enhanced Hospice Care2.1 mi · Lubbock, TX

All hospice providers in the state →

Home health agencies

Accentcare Health2.1 mi · Lubbock, TX · 4 of 5 stars
Cuidado Casero Home Health Lubbock3.0 mi · Lubbock, TX · 5 of 5 stars
American Star Home Health & Hospice Care Inc3.2 mi · Lubbock, TX

All home health agencies in the state →

Dialysis facilities

USRC Lubbock0.6 mi · Lubbock, TX · 1 of 5 stars
Dialysis Center of Lubbock2.1 mi · Lubbock, TX · 1 of 5 stars
Fresenius Medical Care Lubbock2.5 mi · Lubbock, TX · 2 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Covenant High Plains Surgery Center0.6 mi · Lubbock, TX
Covenant Surgicenter, Ltd0.6 mi · Lubbock, TX
Hub City Surgery Center0.6 mi · Lubbock, TX

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

CHCL Medical Plaza1.1 mi · Lubbock, TX · Community health center
CHCL West Medical and Dental Clinic1.7 mi · Lubbock, TX · Community health center
CHCL 96 West2.3 mi · Lubbock, TX · Community health center

Clinics and urgent care

West Texas Urgent Care LLC0.6 mi · Lubbock, TX · Urgent care center
American Current Care P.A.9.6 mi · Lubbock, TX · Urgent care center
Slaton Family Medical, PLLC.18 mi · Slaton, TX · Rural health clinic

Pharmacies

Covenant Medical Center0.6 mi · Lubbock, TX · Community/retail pharmacy
JPM Healthcare LLC0.6 mi · Lubbock, TX · Community/retail pharmacy
Rxvip Texas 2 LLC0.6 mi · Lubbock, TX · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Adams Alc and Memory Care2.1 mi · Lubbock, TX
Angel's Arms Assisted Living2.1 mi · Lubbock, TX
Brookdale Monterey2.1 mi · Lubbock, TX
Callander House LLC2.1 mi · Lubbock, TX

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Covenant Childrens Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Not reported to Medicare

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Lubbock Best hospitals in Lubbock

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 87 common services exactly as Covenant Childrens Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 2 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$264.21 – $403.67
New patient office visit (about 30–44 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $264.21 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $380.43 Bcbs — Par Traditional: $307.60 Bcbs — Ppo: $403.67
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$447.32 – $683.45
New patient office visit (about 45–59 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $447.32 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $644.09 Bcbs — Par Traditional: $520.78 Bcbs — Ppo: $683.45
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit new	Not listed in the file	Not listed in the file	$583.76 – $891.90
New patient office visit (about 60–74 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $583.76 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $840.54 Bcbs — Par Traditional: $679.62 Bcbs — Ppo: $891.90
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$176.98 – $270.40
Established patient office visit (about 20–29 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $176.98 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $254.83 Bcbs — Par Traditional: $206.04 Bcbs — Ppo: $270.40
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office/outpatient visit est	Not listed in the file	Not listed in the file	$272.83 – $416.85
Established patient office visit (about 30–39 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $272.83 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $392.85 Bcbs — Par Traditional: $317.64 Bcbs — Ppo: $416.85
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$331.83 – $506.99
Office consultation with a specialist (moderate): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $331.83 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $477.79 Bcbs — Par Traditional: $386.32 Bcbs — Ppo: $506.99
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Office consultation	Not listed in the file	Not listed in the file	$533.36 – $814.90
Office consultation with a specialist (moderate to high): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $533.36 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $767.97 Bcbs — Par Traditional: $620.95 Bcbs — Ppo: $814.90
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 18-39	Not listed in the file	Not listed in the file	$339.19 – $518.24
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $339.19 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $488.40 Bcbs — Par Traditional: $394.90 Bcbs — Ppo: $518.24
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prev visit new age 40-64	Not listed in the file	Not listed in the file	$412.92 – $630.88
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $412.92 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $594.55 Bcbs — Par Traditional: $480.73 Bcbs — Ppo: $630.88
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$761.59 – $1,163.60
Emergency room visit (moderate): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $761.59 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,096.60 Bcbs — Par Traditional: $886.66 Bcbs — Ppo: $1,163.60
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED OB FAC E&M VISIT LEVEL 3 CDM	$1,845	$774.90	Not listed in the file
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED FAC E&M VISIT LEVEL 3 CDM	$2,233	$937.86	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$1,199.60 – $1,832.83
Emergency room visit (moderately high): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $1,199.60 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,727.29 Bcbs — Par Traditional: $1,396.61 Bcbs — Ppo: $1,832.83
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED OB FAC E&M VISIT LEVEL 4 CDM	$3,357	$1,409.94	Not listed in the file
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED SEXUAL ASSAULT EXAM CDM	$1 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	$0.42 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.)	Not listed in the file
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Emergency dept visit	Not listed in the file	Not listed in the file	$1,720.38 – $2,628.50
Emergency room visit (high): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $1,720.38 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $2,477.14 Bcbs — Par Traditional: $2,002.90 Bcbs — Ppo: $2,628.50
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED OB FAC E&M VISIT LEVEL 5 CDM	$6,358	$2,670.36	Not listed in the file
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED FAC E&M VISIT LEVEL 5 CDM	$7,693	$3,231.06	Not listed in the file

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic panel total ca	Not listed in the file	Not listed in the file	$18.49 – $41.54
Basic metabolic panel (blood test): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $41.54 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $41.54 Bcbs — Par Traditional: $36.89 Bcbs — Ppo: $40.44 Cigna — New Buisness Other Commercial Plan: $18.49
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL	$1,197	$502.74	Not listed in the file
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BASIC METABOLIC PANEL	$123	$51.66	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen metabolic panel	Not listed in the file	Not listed in the file	$23.06 – $51.85
Comprehensive metabolic panel (blood test): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $51.85 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $51.85 Bcbs — Par Traditional: $46.04 Bcbs — Ppo: $50.48 Cigna — New Buisness Other Commercial Plan: $23.06
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$1,346	$565.32	Not listed in the file
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPREHEN METABOLIC PANEL	$154	$64.68	Not listed in the file
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetric panel	Not listed in the file	Not listed in the file	$104.43 – $234.75
Obstetric blood test panel: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $234.75 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $234.75 Bcbs — Par Traditional: $208.45 Bcbs — Ppo: $228.53 Cigna — New Buisness Other Commercial Plan: $104.43
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid panel	Not listed in the file	Not listed in the file	$29.24 – $65.74
Cholesterol panel (lipid panel): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $65.74 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $65.74 Bcbs — Par Traditional: $58.38 Bcbs — Ppo: $64 Cigna — New Buisness Other Commercial Plan: $29.24
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LIPID PROFILE	$2,717	$1,141.14	Not listed in the file
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC LIPID PROFILE	$195	$81.90	Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal function panel	Not listed in the file	Not listed in the file	$18.95 – $42.62
Kidney function panel: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $42.62 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $42.62 Bcbs — Par Traditional: $37.84 Bcbs — Ppo: $41.49 Cigna — New Buisness Other Commercial Plan: $18.95
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL CDM	$1,148	$482.16	Not listed in the file
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC RENAL FUNCTION PANEL CDM	$126	$52.92	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic function panel	Not listed in the file	Not listed in the file	$17.84 – $40.11
Liver function panel: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $40.11 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $40.11 Bcbs — Par Traditional: $35.62 Bcbs — Ppo: $39.05 Cigna — New Buisness Other Commercial Plan: $17.84
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL CDM	$1,208	$507.36	Not listed in the file
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC HEPATIC FUNCTION PANEL CDM	$119	$49.98	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/scope	Not listed in the file	Not listed in the file	$6.93 – $15.56
Urine test (automated, with microscope): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $15.56 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $15.56 Bcbs — Par Traditional: $13.82 Bcbs — Ppo: $15.15 Cigna — New Buisness Other Commercial Plan: $6.93
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$354	$148.68	Not listed in the file
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB	$57	$23.94	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis nonauto w/o scope	Not listed in the file	Not listed in the file	$7.60 – $17.09
Urine test (manual, without microscope): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $17.09 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $17.09 Bcbs — Par Traditional: $15.17 Bcbs — Ppo: $16.63 Cigna — New Buisness Other Commercial Plan: $7.60
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$253	$106.26	Not listed in the file
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP LAB	$253	$106.26	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis auto w/o scope	Not listed in the file	Not listed in the file	$4.91 – $11.05
Urine test (automated, without microscope): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $11.05 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $11.05 Bcbs — Par Traditional: $9.81 Bcbs — Ppo: $10.76 Cigna — New Buisness Other Commercial Plan: $4.91
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$264	$110.88	Not listed in the file
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB	$41	$17.22	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay of psa total	Not listed in the file	Not listed in the file	$40.15 – $90.29
PSA (prostate specific antigen) blood test: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $90.29 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $90.29 Bcbs — Par Traditional: $80.18 Bcbs — Ppo: $87.90 Cigna — New Buisness Other Commercial Plan: $40.15
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$686	$288.12	Not listed in the file
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$230	$96.60	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Assay thyroid stim hormone	Not listed in the file	Not listed in the file	$36.69 – $82.49
Thyroid stimulating hormone (TSH) test: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $82.49 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $82.49 Bcbs — Par Traditional: $73.25 Bcbs — Ppo: $80.30 Cigna — New Buisness Other Commercial Plan: $36.69
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$575	$241.50	Not listed in the file
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB	$210	$88.20	Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc w/auto diff wbc	Not listed in the file	Not listed in the file	$16.97 – $38.15
Complete blood count (CBC) with differential: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $38.15 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $38.15 Bcbs — Par Traditional: $33.88 Bcbs — Ppo: $37.14 Cigna — New Buisness Other Commercial Plan: $16.97
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CBC WITH DIFF AUTO	$541	$227.22	Not listed in the file
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CBC WITH DIFF AUTO	$105	$44.10	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Complete cbc automated	Not listed in the file	Not listed in the file	$14.15 – $31.77
Complete blood count (CBC), automated: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $31.77 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $31.77 Bcbs — Par Traditional: $28.21 Bcbs — Ppo: $30.93 Cigna — New Buisness Other Commercial Plan: $14.15
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: HC BLOOD COUNT COMPLETE AUTOMATED	$521	$218.82	Not listed in the file
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC BLOOD COUNT COMPLETE AUTOMATED	$87	$36.54	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prothrombin time	Not listed in the file	Not listed in the file	$9.37 – $21.06
Blood clotting time test (prothrombin time, PT): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $21.06 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $21.06 Bcbs — Par Traditional: $18.70 Bcbs — Ppo: $20.51 Cigna — New Buisness Other Commercial Plan: $9.37
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PROTHROMBIN TIME LAB	$286	$120.12	Not listed in the file
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PROTHROMBIN TIME LAB	$58	$24.36	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Thromboplastin time partial	Not listed in the file	Not listed in the file	$13.13 – $29.51
Blood clotting test (partial thromboplastin time, PTT): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $29.51 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $29.51 Bcbs — Par Traditional: $26.20 Bcbs — Ppo: $28.73 Cigna — New Buisness Other Commercial Plan: $13.13
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$208	$87.36	Not listed in the file
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB	$81	$34.02	Not listed in the file

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct head/brain w/o dye	Not listed in the file	Not listed in the file	$273.48 – $764.58
CT scan of the head or brain, without contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $550.31 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $550.31 Bcbs — Par Traditional: $273.48 Bcbs — Ppo: $530.14 Scott And White — Group Bsw Plus All Commercial Plans: $764.58 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $500.97 Scott And White — Individual Bsw Premier Exchange: $414.14
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT HEAD/BRAIN WO CONTRAST	$5,765	$140	Not listed in the file
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT HEAD/BRAIN WO CONTRAST	$994	$140	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri brain stem w/o & w/dye	Not listed in the file	Not listed in the file	$931.71 – $3,077.43
MRI of the brain, before and after contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $1,874.88 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,874.88 Bcbs — Par Traditional: $931.71 Bcbs — Ppo: $1,806.15 Scott And White — Group Bsw Plus All Commercial Plans: $3,077.43 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,016.42 Scott And White — Individual Bsw Premier Exchange: $1,666.92
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI BRAIN W/O & W/DYE	$9,970	$495	Not listed in the file
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI BRAIN W/O & W/DYE	$5,456	$495	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam chest 2 views	Not listed in the file	Not listed in the file	$247.94 – $438.96
Chest X-ray, 2 views: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $391.87 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $391.87 Bcbs — Par Traditional: $347.97 Bcbs — Ppo: $438.96 Cigna — New Buisness Other Commercial Plan: $247.94
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: HC XR CHEST 2 VIEWS	$1,247	$523.74	Not listed in the file
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC XR CHEST 2 VIEWS	$423	$177.66	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-ray exam l-2 spine 4/>vws	Not listed in the file	Not listed in the file	$333.97 – $616.44
X-ray of the lower spine, at least 4 views: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $550.31 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $550.31 Bcbs — Par Traditional: $488.67 Bcbs — Ppo: $616.44 Cigna — New Buisness Other Commercial Plan: $333.97
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC SPINE LUMBOSACRAL MIN 4 VIEWS	$2,303	$967.26	Not listed in the file
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC SPINE LUMBOSACRAL MIN 4 VIEWS	$913	$383.46	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri lumbar spine w/o dye	Not listed in the file	Not listed in the file	$568.62 – $1,824.55
MRI of the lower back (lumbar spine), without contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $1,144.23 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,144.23 Bcbs — Par Traditional: $568.62 Bcbs — Ppo: $1,102.28 Scott And White — Group Bsw Plus All Commercial Plans: $1,824.55 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $1,195.50 Scott And White — Individual Bsw Premier Exchange: $988.29
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE W/O DYE	$14,530	$6,102.60	Not listed in the file
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LUMBAR SPINE W/O DYE	$1,784	$749.28	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct pelvis w/dye	Not listed in the file	Not listed in the file	$444.62 – $1,534.76
CT scan of the pelvis, with contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $894.70 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $894.70 Bcbs — Par Traditional: $444.62 Bcbs — Ppo: $861.90 Scott And White — Group Bsw Plus All Commercial Plans: $1,534.76 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $1,005.62 Scott And White — Individual Bsw Premier Exchange: $831.32
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$7,913	$3,323.46	Not listed in the file
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT PELVIS W CONTRAST	$1,792	$752.64	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Mri jnt of lwr extre w/o dye	Not listed in the file	Not listed in the file	$568.62 – $1,824.55
MRI of a leg joint (such as the knee), without contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $1,144.23 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,144.23 Bcbs — Par Traditional: $568.62 Bcbs — Ppo: $1,102.28 Scott And White — Group Bsw Plus All Commercial Plans: $1,824.55 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $1,195.50 Scott And White — Individual Bsw Premier Exchange: $988.29
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$7,446	$3,127.32	Not listed in the file
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$1,784	$749.28	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ct abd & pelv w/contrast	Not listed in the file	Not listed in the file	$931.71 – $2,392.54
CT scan of the abdomen and pelvis, with contrast: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $1,874.88 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,874.88 Bcbs — Par Traditional: $931.71 Bcbs — Ppo: $1,806.15 Scott And White — Group Bsw Plus All Commercial Plans: $2,392.54 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $1,567.66 Scott And White — Individual Bsw Premier Exchange: $1,295.94
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$15,893	$460	Not listed in the file
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CT ABDOMEN & PELVIS W CONTRAST	$3,694	$460	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Us exam abdom complete	Not listed in the file	Not listed in the file	$333.97 – $616.44
Ultrasound of the abdomen, complete: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $550.31 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $550.31 Bcbs — Par Traditional: $488.67 Bcbs — Ppo: $616.44 Cigna — New Buisness Other Commercial Plan: $333.97
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$2,999	$1,259.58	Not listed in the file
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US EXAM ABDOMEN COMPLETE	$1,093	$459.06	Not listed in the file
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ob us >/= 14 wks sngl fetus	Not listed in the file	Not listed in the file	$333.97 – $503.47
Pregnancy ultrasound (after the first trimester): rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $449.46 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $449.46 Bcbs — Par Traditional: $399.11 Bcbs — Ppo: $503.47 Cigna — New Buisness Other Commercial Plan: $333.97
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$2,049	$860.58	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Transvaginal us non-ob	Not listed in the file	Not listed in the file	$333.97 – $485.65
Transvaginal ultrasound: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $433.55 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $433.55 Bcbs — Par Traditional: $384.99 Bcbs — Ppo: $485.65 Cigna — New Buisness Other Commercial Plan: $333.97
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON-OB	$2,920	$1,226.40	Not listed in the file
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC US TRANSVAGINAL NON-OB	$1,093	$459.06	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad uni	Not listed in the file	Not listed in the file	$292.92 – $517.33
Diagnostic mammogram, one breast: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $461.83 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $461.83 Bcbs — Par Traditional: $410.10 Bcbs — Ppo: $517.33 Cigna — New Buisness Other Commercial Plan: $292.92
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO DIAG UNI W CAD	$753	$316.26	Not listed in the file
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO DIAG UNI W CAD	$750	$315	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Dx mammo incl cad bi	Not listed in the file	Not listed in the file	$374.65 – $662.04
Diagnostic mammogram, both breasts: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $591.02 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $591.02 Bcbs — Par Traditional: $524.81 Bcbs — Ppo: $662.04 Cigna — New Buisness Other Commercial Plan: $374.65
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO DIAG BIL W CAD	$1,003	$421.26	Not listed in the file
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC MAMMO DIAG BIL W CAD	$801	$336.42	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Scr mammo bi incl cad	Not listed in the file	Not listed in the file	$309.71 – $547.09
Screening mammogram, both breasts: rates for 5 insurance plans Bcbs — Blue Essentials Hmo: $488.40 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $488.40 Bcbs — Par Traditional: $433.69 Bcbs — Ppo: $547.09 Cigna — New Buisness Other Commercial Plan: $309.71
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO SCREEN BIL W CAD	$802	$200	Not listed in the file
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: HC MAMMO SCREEN UNIL/BIL W CAD	$802	$125	Not listed in the file

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrocardiogram complete	Not listed in the file	Not listed in the file	$75.43 – $84.94
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $84.94 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $84.94 Bcbs — Par Traditional: $75.43 Bcbs — Ppo: $82.69
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left hrt cath w/ventrclgrphy	Not listed in the file	Not listed in the file	$3,040.29 – $10,967
Left heart catheterization (diagnostic): rates for 10 insurance plans Aetna — All Commercial Plans: $10,967 Aetna — New Business Tier 1 Other Commercial Plan: $8,068 Aetna — Preferred Other Commercial Plan: $9,922 Bcbs — Blue Essentials Hmo: $6,070.39 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $6,070.39 Bcbs — Par Traditional: $6,070.39 Bcbs — Ppo: $7,181.87 Scott And White — Group Bsw Plus All Commercial Plans: $5,311.51 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $3,677.73 Scott And White — Individual Bsw Premier Exchange: $3,040.29
Left heart catheterization (diagnostic) CPT 93452 · Inpatient or outpatient · Hospital (facility) fee In the file: HC LEFT HRT CATH W/VENTRCLGRPHY	$34,883	$14,650.86	Not listed in the file
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Electrophysiology evaluation	Not listed in the file	Not listed in the file	$8,068 – $30,664.55
Heart rhythm study (electrophysiology evaluation): rates for 7 insurance plans Aetna — All Commercial Plans: $10,967 Aetna — New Business Tier 1 Other Commercial Plan: $8,068 Aetna — Preferred Other Commercial Plan: $9,922 Bcbs — Blue Essentials Hmo: $20,070.27 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $28,898.84 Bcbs — Par Traditional: $23,366.27 Bcbs — Ppo: $30,664.55
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION	$20,980	$8,811.60	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx atrial fib pulm vein isol	Not listed in the file	Not listed in the file	$8,068 – $106,467.76
Heart rhythm study with ablation for atrial fibrillation: rates for 10 insurance plans Aetna — All Commercial Plans: $10,967 Aetna — New Business Tier 1 Other Commercial Plan: $8,068 Aetna — Preferred Other Commercial Plan: $9,922 Bcbs — Blue Essentials Hmo: $69,684.27 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $43,527.13 Bcbs — Par Traditional: $81,128.02 Bcbs — Ppo: $51,496.88 Scott And White — Group Bsw Plus All Commercial Plans: $29,609.88 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $20,502.12 Scott And White — Individual Bsw Premier Exchange: $16,948.60
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Inpatient or outpatient · Hospital (facility) fee In the file: HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$85,881	$36,070.02	Not listed in the file
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION	$71,606	$30,074.52	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Polysom 6/> yrs 4/> param	Not listed in the file	Not listed in the file	$1,708.21 – $2,609.90
Sleep study (overnight, in a sleep lab): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $1,708.21 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $2,459.62 Bcbs — Par Traditional: $1,988.73 Bcbs — Ppo: $2,609.90
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: HC POLYSOMNOGRAPHY 4 OR MORE	$20,789	$850	Not listed in the file
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC POLYSOMNOGRAPHY 4 OR MORE	$7,502	$850	Not listed in the file

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Therapeutic exercises	Not listed in the file	Not listed in the file	$106.90 – $163.33
Physical therapy: therapeutic exercise (each 15 minutes): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $106.90 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $153.93 Bcbs — Par Traditional: $124.46 Bcbs — Ppo: $163.33
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$450	$125	Not listed in the file
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$162	$125	Not listed in the file
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval low complex 20 min	Not listed in the file	Not listed in the file	$294.93 – $450.61
Physical therapy evaluation (low complexity): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $294.93 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $424.67 Bcbs — Par Traditional: $343.37 Bcbs — Ppo: $450.61
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION LOW COMPLEX CDM	$592	$175	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval mod complex 30 min	Not listed in the file	Not listed in the file	$294.93 – $450.61
Physical therapy evaluation (moderate complexity): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $294.93 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $424.67 Bcbs — Par Traditional: $343.37 Bcbs — Ppo: $450.61
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION MOD COMPLEX CDM	$707	$175	Not listed in the file
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVALUATION MOD COMPLEX CDM	$546	$175	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Pt eval high complex 45 min	Not listed in the file	Not listed in the file	$294.93 – $450.61
Physical therapy evaluation (high complexity): rates for 4 insurance plans Bcbs — Blue Essentials Hmo: $294.93 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $424.67 Bcbs — Par Traditional: $343.37 Bcbs — Ppo: $450.61
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: HC PT EVALUATION HIGH COMPLEX	$1,061	$445.62	Not listed in the file
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PT EVALUATION HIGH COMPLEX	$560	$235.20	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PR 90832 PSYTX W PT 30 MIN RHC	$185	$77.70	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 30 MIN PHP/IOP CDM	$224	$94.08	Not listed in the file
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 30 MIN IOP CDM	$224	$94.08	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PR 90834 PSYTX W PT 45 MIN RHC	$185	$77.70	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN PHP/IOP CDM	$224	$94.08	Not listed in the file
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 45 MIN IOP CDM	$224	$94.08	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PR 90837 PSYTX W PT 60 MIN RHC	$185	$77.70	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN PHP/IOP CDM	$224	$94.08	Not listed in the file
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX W PT 60 MIN IOP CDM	$224	$94.08	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$185	$77.70	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX FAMILY WO PT 50 MIN PHP/IOP CDM	$224	$94.08	Not listed in the file
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSTX FAMILY WO PT 50 MIN CDM	$224	$94.08	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$185	$77.70	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CD PHP TX FAMILY W PATIENT	$224	$94.08	Not listed in the file
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX FAMILY W PT 50 MIN IOP CDM	$224	$94.08	Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSY TX GROUP NON PHP	$117	$49.14	Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC CD PHP TX GROUP	$117	$49.14	Not listed in the file
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HC PSYTX GROUP IOP CDM	$117	$49.14	Not listed in the file

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Removal of breast lesion	Not listed in the file	Not listed in the file	$2,300 – $11,141.85
Removal of breast growth (open surgery): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $7,151 Aetna — New Business Tier 1 Other Commercial Plan: $5,260 Aetna — Preferred Other Commercial Plan: $6,469 Bcbs — Blue Essentials Hmo: $6,452.94 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $6,452.94 Bcbs — Par Traditional: $6,452.94 Bcbs — Ppo: $7,634.47 Capstar — All Commercial Plans: $11,141.85 Covenant Preferred — All Commercial Plans: $5,098 Phcs — All Commercial Plans: $2,300
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$1,656.29 – $29,275.75
Total hip replacement: rates for 10 insurance plans Aetna — All Commercial Plans: $9,971 Aetna — New Business Tier 1 Other Commercial Plan: $7,334 Aetna — Preferred Other Commercial Plan: $9,020 Bcbs — Blue Essentials Hmo: $25,348.51 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $25,348.51 Bcbs — Par Traditional: $25,348.51 Bcbs — Ppo: $29,275.75 Scott And White — Group Bsw Plus All Commercial Plans: $2,893.60 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,003.55 Scott And White — Individual Bsw Premier Exchange: $1,656.29
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$1,655.86 – $29,275.75
Total knee replacement: rates for 10 insurance plans Aetna — All Commercial Plans: $9,971 Aetna — New Business Tier 1 Other Commercial Plan: $7,334 Aetna — Preferred Other Commercial Plan: $9,020 Bcbs — Blue Essentials Hmo: $25,348.51 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $25,348.51 Bcbs — Par Traditional: $25,348.51 Bcbs — Ppo: $29,275.75 Scott And White — Group Bsw Plus All Commercial Plans: $2,892.86 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,003.04 Scott And White — Individual Bsw Premier Exchange: $1,655.86
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Shoulder arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,300 – $11,141.85
Shoulder arthroscopy: shaving of shoulder bone: rates for 6 insurance plans Aetna — All Commercial Plans: $7,151 Aetna — New Business Tier 1 Other Commercial Plan: $5,260 Aetna — Preferred Other Commercial Plan: $6,469 Capstar — All Commercial Plans: $11,141.85 Covenant Preferred — All Commercial Plans: $5,098 Phcs — All Commercial Plans: $2,300
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Knee arthroscopy/surgery	Not listed in the file	Not listed in the file	$2,539.02 – $15,638.81
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $8,639 Aetna — New Business Tier 1 Other Commercial Plan: $6,355 Aetna — Preferred Other Commercial Plan: $7,816 Bcbs — Blue Essentials Hmo: $5,830.77 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $5,830.77 Bcbs — Par Traditional: $5,830.77 Bcbs — Ppo: $6,898.37 Capstar — All Commercial Plans: $15,638.81 Covenant Preferred — All Commercial Plans: $7,156 Phcs — All Commercial Plans: $2,600
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Remove tonsils and adenoids	Not listed in the file	Not listed in the file	$2,296.68 – $12,223.34
Removal of tonsils and adenoids (under age 12): 10 of 11 insurance plan rates Aetna — All Commercial Plans: $7,151 Aetna — New Business Tier 1 Other Commercial Plan: $5,260 Aetna — Preferred Other Commercial Plan: $6,469 Bcbs — Blue Essentials Hmo: $10,331.63 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $10,331.63 Bcbs — Par Traditional: $10,331.63 Bcbs — Ppo: $12,223.34 Phcs — All Commercial Plans: $2,300 Scott And White — Group Bsw Plus All Commercial Plans: $4,012.38 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,778.21
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd diagnostic brush wash	Not listed in the file	Not listed in the file	$879.87 – $4,579.48
Upper GI endoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $3,322 Aetna — New Business Tier 1 Other Commercial Plan: $2,444 Aetna — Preferred Other Commercial Plan: $3,006 Bcbs — Blue Essentials Hmo: $1,674.01 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,674.01 Bcbs — Par Traditional: $1,674.01 Bcbs — Ppo: $1,980.52 Capstar — All Commercial Plans: $4,579.48 Covenant Preferred — All Commercial Plans: $2,095 Phcs — All Commercial Plans: $1,000
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM	$2,477	$1,040.34	Not listed in the file
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Egd biopsy single/multiple	Not listed in the file	Not listed in the file	$879.87 – $7,034.24
Upper GI endoscopy with biopsy: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $1,674.01 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,674.01 Bcbs — Par Traditional: $1,674.01 Bcbs — Ppo: $1,980.52 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM	$2,477	$1,040.34	Not listed in the file
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Diagnostic colonoscopy	Not listed in the file	Not listed in the file	$932.10 – $7,034.24
Colonoscopy (diagnostic): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $1,627.06 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,627.06 Bcbs — Par Traditional: $1,627.06 Bcbs — Ppo: $1,924.98 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM	$2,493	$1,047.06	Not listed in the file
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy and biopsy	Not listed in the file	Not listed in the file	$932.10 – $7,034.24
Colonoscopy with biopsy: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $2,138.99 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $2,138.99 Bcbs — Par Traditional: $2,138.99 Bcbs — Ppo: $2,530.63 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/lesion removal	Not listed in the file	Not listed in the file	$932.10 – $7,034.24
Colonoscopy with removal of polyps (snare): 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $2,138.99 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $2,138.99 Bcbs — Par Traditional: $2,138.99 Bcbs — Ppo: $2,530.63 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colonoscopy w/endoscope us	Not listed in the file	Not listed in the file	$932.10 – $6,149
Ultrasound of the lower bowel by endoscope: 10 of 11 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $2,138.99 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $2,138.99 Bcbs — Par Traditional: $2,138.99 Bcbs — Ppo: $2,530.63 Phcs — All Commercial Plans: $2,150 Scott And White — Group Bsw Plus All Commercial Plans: $1,628.41 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $1,127.53
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$773 – $6,149
Screening colonoscopy (not high risk): 10 of 11 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $1,627.06 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,627.06 Bcbs — Par Traditional: $1,627.06 Bcbs — Ppo: $1,924.98 Phcs — All Commercial Plans: $2,150 Scott And White — Group Bsw Plus All Commercial Plans: $1,350.46 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $935.07
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparoscopic cholecystectomy	Not listed in the file	Not listed in the file	$4,459.99 – $12,180.95
Gallbladder removal by laparoscope: rates for 10 insurance plans Aetna — All Commercial Plans: $9,142 Aetna — New Business Tier 1 Other Commercial Plan: $6,725 Aetna — Preferred Other Commercial Plan: $8,271 Bcbs — Blue Essentials Hmo: $10,295.80 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $10,295.80 Bcbs — Par Traditional: $10,295.80 Bcbs — Ppo: $12,180.95 Scott And White — Group Bsw Plus All Commercial Plans: $7,791.79 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $5,395.10 Scott And White — Individual Bsw Premier Exchange: $4,459.99
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Prp i/hern init reduc >5 yr	Not listed in the file	Not listed in the file	$2,600 – $15,638.81
Groin (inguinal) hernia repair, age 5 or older: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $8,639 Aetna — New Business Tier 1 Other Commercial Plan: $6,355 Aetna — Preferred Other Commercial Plan: $7,816 Bcbs — Blue Essentials Hmo: $6,622.89 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $6,622.89 Bcbs — Par Traditional: $6,622.89 Bcbs — Ppo: $7,835.54 Capstar — All Commercial Plans: $15,638.81 Covenant Preferred — All Commercial Plans: $7,156 Phcs — All Commercial Plans: $2,600
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM	$11,879	$4,989.18	Not listed in the file
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Biopsy of prostate	Not listed in the file	Not listed in the file	$1,725.63 – $7,034.24
Prostate biopsy: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $3,773.40 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $3,773.40 Bcbs — Par Traditional: $3,773.40 Bcbs — Ppo: $4,464.31 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Laparo radical prostatectomy	Not listed in the file	Not listed in the file	$2,103.96 – $21,201.04
Prostate removal by laparoscope (radical prostatectomy): rates for 10 insurance plans Aetna — All Commercial Plans: $9,142 Aetna — New Business Tier 1 Other Commercial Plan: $6,725 Aetna — Preferred Other Commercial Plan: $8,271 Bcbs — Blue Essentials Hmo: $17,919.92 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $17,919.92 Bcbs — Par Traditional: $17,919.92 Bcbs — Ppo: $21,201.04 Scott And White — Group Bsw Plus All Commercial Plans: $3,675.71 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,545.09 Scott And White — Individual Bsw Premier Exchange: $2,103.96
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$2,178.67 – $7,151
Hysteroscopy with biopsy of the uterus lining: 10 of 11 insurance plan rates Aetna — All Commercial Plans: $7,151 Aetna — New Business Tier 1 Other Commercial Plan: $5,260 Aetna — Preferred Other Commercial Plan: $6,469 Bcbs — Blue Essentials Hmo: $5,320.95 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $5,320.95 Bcbs — Par Traditional: $5,320.95 Bcbs — Ppo: $6,295.21 Phcs — All Commercial Plans: $2,300 Scott And White — Group Bsw Plus All Commercial Plans: $3,806.22 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $2,635.46
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Njx interlaminar lmbr/sac	Not listed in the file	Not listed in the file	$598.28 – $3,322
Spinal injection, lower back (epidural), with imaging guidance: rates for 10 insurance plans Aetna — All Commercial Plans: $3,322 Aetna — New Business Tier 1 Other Commercial Plan: $2,444 Aetna — Preferred Other Commercial Plan: $3,006 Bcbs — Blue Essentials Hmo: $1,331.36 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,331.36 Bcbs — Par Traditional: $1,331.36 Bcbs — Ppo: $1,575.13 Scott And White — Group Bsw Plus All Commercial Plans: $1,045.22 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $723.72 Scott And White — Individual Bsw Premier Exchange: $598.28
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG	$2,161	$907.62	Not listed in the file
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED INJ EPI LUMB/SACRAL W IMAGING CDM	$2,161	$907.62	Not listed in the file
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj foramen epidural l/s	Not listed in the file	Not listed in the file	$793.08 – $3,322
Nerve root injection, lower back, with imaging guidance: 10 of 11 insurance plan rates Aetna — All Commercial Plans: $3,322 Aetna — New Business Tier 1 Other Commercial Plan: $2,444 Aetna — Preferred Other Commercial Plan: $3,006 Bcbs — Blue Essentials Hmo: $1,729.67 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,729.67 Bcbs — Par Traditional: $1,729.67 Bcbs — Ppo: $2,046.37 Phcs — All Commercial Plans: $1,000 Scott And White — Group Bsw Plus All Commercial Plans: $1,385.55 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $959.36
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$1,633.31 – $7,034.24
Carpal tunnel release: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $3,662.22 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $3,662.22 Bcbs — Par Traditional: $3,662.22 Bcbs — Ppo: $4,332.76 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Carpal tunnel release CPT 64721 · Inpatient or outpatient · Hospital (facility) fee In the file: HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM	$6,029	$2,532.18	Not listed in the file
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: After cataract laser surgery	Not listed in the file	Not listed in the file	$523.52 – $7,034.24
Laser treatment of clouding after cataract surgery: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $6,149 Aetna — New Business Tier 1 Other Commercial Plan: $4,524 Aetna — Preferred Other Commercial Plan: $5,563 Bcbs — Blue Essentials Hmo: $1,079.76 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $1,079.76 Bcbs — Par Traditional: $1,079.76 Bcbs — Ppo: $1,277.46 Capstar — All Commercial Plans: $7,034.24 Covenant Preferred — All Commercial Plans: $3,218 Phcs — All Commercial Plans: $2,150
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cataract surg w/iol 1 stage	Not listed in the file	Not listed in the file	$2,068.23 – $20,628.27
Cataract removal with lens implant: 10 of 13 insurance plan rates Aetna — All Commercial Plans: $9,142 Aetna — New Business Tier 1 Other Commercial Plan: $6,725 Aetna — Preferred Other Commercial Plan: $8,271 Bcbs — Blue Essentials Hmo: $4,306.56 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $4,306.56 Bcbs — Par Traditional: $4,306.56 Bcbs — Ppo: $5,095.09 Capstar — All Commercial Plans: $20,628.27 Covenant Preferred — All Commercial Plans: $9,438 Phcs — All Commercial Plans: $3,000

Pregnancy and childbirth

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Vaginal delivery, with care before and after CPT 59400 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Obstetrical care	Not listed in the file	Not listed in the file	$2,562.64 – $5,488.16
Vaginal delivery, with care before and after: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $4,638.80 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $4,638.80 Bcbs — Par Traditional: $4,638.80 Bcbs — Ppo: $5,488.16 Scott And White — Group Bsw Plus All Commercial Plans: $4,477.04 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $3,099.94 Scott And White — Individual Bsw Premier Exchange: $2,562.64
Cesarean delivery (C-section), with care before and after CPT 59510 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cesarean delivery	Not listed in the file	Not listed in the file	$2,831.07 – $6,084.84
Cesarean delivery (C-section), with care before and after: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $5,143.14 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $5,143.14 Bcbs — Par Traditional: $5,143.14 Bcbs — Ppo: $6,084.84 Scott And White — Group Bsw Plus All Commercial Plans: $4,946 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $3,424.65 Scott And White — Individual Bsw Premier Exchange: $2,831.07
Vaginal delivery after a previous C-section, with care before and after CPT 59610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Vbac delivery	Not listed in the file	Not listed in the file	$2,684.81 – $5,758.80
Vaginal delivery after a previous C-section, with care before and after: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $4,867.56 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $4,867.56 Bcbs — Par Traditional: $4,867.56 Bcbs — Ppo: $5,758.80 Scott And White — Group Bsw Plus All Commercial Plans: $4,690.47 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $3,247.72 Scott And White — Individual Bsw Premier Exchange: $2,684.81

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc	Not listed in the file	Not listed in the file	$112,788.37 – $230,171.69
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 13 insurance plan rates Bcbs — Blue Essentials Hmo: $194,135.12 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $215,079.15 Bcbs — Par Traditional: $179,615.99 Bcbs — Ppo: $217,126.97 Capstar — All Commercial Plans: $230,171.69 Cigna — New Buisness Other Commercial Plan: $205,264.01 Imagine Health — All Commercial Plans: $129,402.21 Scott And White — Group Bsw Plus All Commercial Plans: $158,798.97 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $136,436.20 Scott And White — Individual Bsw Premier Exchange: $112,788.37
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal Fusion Except Cervical Without Mcc	Not listed in the file	Not listed in the file	$67,001.75 – $93,327.66
Spinal fusion (not neck), without major complications: rates for 7 insurance plans Bcbs — Blue Essentials Hmo: $73,307.97 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $71,778.97 Bcbs — Par Traditional: $67,001.75 Bcbs — Ppo: $93,327.66 Cigna — Oap: 61.4% (a percentage in the contract, not a dollar amount) Cigna — Ppo: 63.9% (a percentage in the contract, not a dollar amount) Unitedhealthcare — Exchange: 36% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc	Not listed in the file	Not listed in the file	$20,934.44 – $53,603.99
Hip or knee replacement (major joint of the leg), without major complications: 10 of 13 insurance plan rates Bcbs — Blue Essentials Hmo: $48,527.16 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $53,603.99 Bcbs — Par Traditional: $42,389.06 Bcbs — Ppo: $48,890.33 Capstar — All Commercial Plans: $44,971.06 Cigna — New Buisness Other Commercial Plan: $40,104.59 Imagine Health — All Commercial Plans: $25,282.67 Scott And White — Group Bsw Plus All Commercial Plans: $29,793.52 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $25,323.66 Scott And White — Individual Bsw Premier Exchange: $20,934.44
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Cervical Spinal Fusion Without Cc/Mcc	Not listed in the file	Not listed in the file	$26,282.69 – $56,460.09
Neck (cervical) spinal fusion, without complications: 10 of 13 insurance plan rates Bcbs — Blue Essentials Hmo: $49,219.38 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $54,529.36 Bcbs — Par Traditional: $45,538.32 Bcbs — Ppo: $55,048.54 Capstar — All Commercial Plans: $56,460.09 Cigna — New Buisness Other Commercial Plan: $50,350.34 Imagine Health — All Commercial Plans: $31,741.78 Scott And White — Group Bsw Plus All Commercial Plans: $37,405.05 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $31,793.25 Scott And White — Individual Bsw Premier Exchange: $26,282.69
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc	Not listed in the file	Not listed in the file	$13,307.89 – $29,647.27
Uterus and ovary surgery (not for cancer), without complications: 10 of 13 insurance plan rates Bcbs — Blue Essentials Hmo: $23,287.64 Bcbs — Ers Blue Essentials For Healthselect Members Hmo: $22,801.93 Bcbs — Par Traditional: $21,284.35 Bcbs — Ppo: $29,647.27 Capstar — All Commercial Plans: $28,587.81 Cigna — New Buisness Other Commercial Plan: $25,494.22 Imagine Health — All Commercial Plans: $16,072.03 Scott And White — Group Bsw Plus All Commercial Plans: $18,939.55 Scott And White — Group Bsw Premier/Covenant Preferred Other Commercial Plan: $16,098.08 Scott And White — Individual Bsw Premier Exchange: $13,307.89

Source: Covenant Childrens Hospital’s standard charges file (pricetransparency.providence.org, JSON, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 1, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Children's Hospital
Address	4015 22nd Place, Lubbock, TX 79410
County	Lubbock County
State	Texas
Phone	(806) 725‑7975
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	453306
Name in Medicare records	COVENANT CHILDRENS HOSPITAL
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(806) 725‑0000^[4]
Official website	providence.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Covenant Children's Hospital — providence.org
Covenant Children's Hospital departments — providence.org
Pediatric and Obstetrics Emergency Services | Covenant Children's Hospital | Lubbock, TX | Providence — providence.org
Parking | Covenant Children's Hospital | Providence — providence.org
Transfer & Transport - Pediatric & Neonatal | Covenant Children's Hospital | Providence — providence.org
Pediatric Rehabilitation Services | Covenant Children's Hospital | Lubbock, TX | Providence — providence.org
Patients and Visitors | Covenant Children's Hospital | Providence — providence.org
Safe Haven Baby Boxes | Providence — providence.org
Pediatric Neurology & Neurosurgery | Covenant Children's Hospital | Lubbock, TX | Providence — providence.org
Pediatric Trauma Center | Covenant Children's Hospital | Lubbock, TX | Providence — providence.org
Hospitalists | Covenant Children's Hospital | Providence — providence.org
Partnerships | Covenant Children's Hospital | Providence — providence.org
What Makes Us Unique | Covenant Children's Hospital | Providence — providence.org
Pediatric Orthopedics | Covenant Children's Hospital | Lubbock, TX | Providence — providence.org

Covenant Childrens Hospital

Summary

Profile from official sources

At a glance