How many shoppable procedure prices are published for Covenant Childrens Hospital?

Covenant Childrens Hospital in Lubbock, TX currently has 121 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Covenant Childrens Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Covenant Childrens Hospital's median negotiated commercial rate is 2.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Private 184 Beds · urban Updated: 2026-04-01

Covenant Childrens Hospital

4015 22Nd Place, Lubbock, TX 79410 · 121 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.80×vs. Fair Market Price

Typical commercial prices here are +180% above the fair benchmark (2.80×) even after accounting for local nurse/doctor wages and patient complexity.

74/100 · Corroborated

74/100Self-Pay Cash Beats Insurance 40% of the Time

File Completeness66

Price Logic66

Peer Alignment73

Clean Billing73

Real Cash Discount100

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintUpper-Quartile Spread · +28% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Covenant Childrens Hospital prices routine shoppable procedures at 3.6× Medicare (median 3.17× Fair BaseRate) while upper-quartile commercial rates jump +28% to 4.06× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#298 of 307 in TX · 96th State Percentile#3,311 of 3,385 in U.S. · 97th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.96× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 40% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (27.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
Commercial insurance median sits at 3.17× Fair BaseRate (3.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 4.06×) jump +28% above the median procedure ratio (Q50 3.17×)
Consolidated metro market (HHI 3,009) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

3.6× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.81× Divergence

2.9× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+28% Upper Tail

Q25 1.96× · Q50 3.17× · Q75 4.06×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

3.6× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

1.3× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

5.5× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

2.6× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

7.0× MedicareWatchout

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

3.5× MedicareElevated

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

40% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Covenant Childrens Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 121 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$47,202	$30,775	1.5×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$41,247	$19,432	2.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$38,175	$19,087	2.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$35,110	$17,936	2.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$15,127	$8,223	1.8×
Total hip replacement CPT Code: `27130`	—	$9,496	$13,413	0.7×
Total knee replacement CPT Code: `27447`	—	$9,496	$13,523	0.7×
Rabies immune globulin HCPCS Code: `90375`	$9,113	$9,113	$322	28.3×
Trauma team activation HCPCS Code: `G0390`	$8,878	$8,878	$1,453	6.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$8,707	$6,109	1.4×
Inguinal hernia repair CPT Code: `49505`	$4,989	$6,623	$3,629	1.8×
Breast lump removal CPT Code: `19120`	—	$6,453	$3,875	1.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,831	$3,372	1.7×
Bunion correction surgery CPT Code: `28296`	$4,193	$5,831	$3,446	1.7×
C-section delivery (full package) CPT Code: `59510`	—	$5,143	$2,975	1.7×
Vaginal delivery (full package) CPT Code: `59400`	—	$4,639	$2,680	1.7×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,307	$2,540	1.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,521	$2,224	$1,021	2.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,150	$1,256	1.7×
Upper endoscopy with biopsy CPT Code: `43239`	$1,040	$1,981	$987	2.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,047	$1,925	$981	2.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$495	$1,875	$511	3.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$460	$1,806	$448	4.0×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,331	$855	1.6×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,241	$1,241	$151	8.2×
MRI, lower back (no contrast) CPT Code: `72148`	$3,180	$1,144	$338	3.4×
MRI, brain (no contrast) CPT Code: `70551`	$690	$1,144	$343	3.3×
MRI, knee or other leg joint CPT Code: `73721`	$2,408	$1,144	$369	3.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$310	$1,102	$303	3.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,956	$895	$242	3.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,381	$895	$258	3.5×
Breathing treatment (nebulizer) CPT Code: `94640`	$698	$817	$201	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$647	$705	$272	2.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$379	$591	$148	4.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,895	$602	$583	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$565	$86	6.6×
X-ray, lower back CPT Code: `72110`	$675	$550	$112	4.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$684	$550	$126	4.4×
Ultrasound, pelvis CPT Code: `76856`	$755	$550	$130	4.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$683	$550	$132	4.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$859	$550	$134	4.1×
CT scan, head (no contrast) CPT Code: `70450`	$140	$530	$160	3.3×
CT scan, pelvis CPT Code: `72192`	$1,476	$530	$163	3.3×
CT scan, sinuses CPT Code: `70486`	$1,442	$530	$166	3.2×
CT scan, chest (no contrast) CPT Code: `71250`	$300	$530	$167	3.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,476	$530	$168	3.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,563	$530	$169	3.1×
X-ray, pelvis CPT Code: `72170`	$459	$550	$110	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$163	$488	$123	4.0×
X-ray, chest (single view) CPT Code: `71045`	$323	$392	$92	4.3×
X-ray, foot CPT Code: `73630`	$433	$392	$92	4.3×
X-ray, chest (two views) CPT Code: `71046`	$351	$392	$93	4.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$568	$392	$93	4.2×
X-ray, hand CPT Code: `73130`	$462	$392	$93	4.2×
X-ray, shoulder CPT Code: `73030`	$449	$392	$92	unverified
X-ray, hip CPT Code: `73502`	$595	$392	$93	unverified
X-ray, ankle CPT Code: `73610`	$448	$392	$93	unverified
New patient office visit (30-44 min) CPT Code: `99203`	—	$344	$110	3.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$355	$123	2.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$230	$87	2.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$325	$244	$64	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$125	$158	$38	4.2×
Occupational therapy (self-care training) CPT Code: `97535`	$109	$155	$38	4.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$125	$139	$35	4.0×
Neurobehavioral status check CPT Code: `96116`	$159	$159	$231	0.7×
Physical therapy (gait training) CPT Code: `97116`	$125	$125	$33	3.8×
Physical therapy (manual therapy) CPT Code: `97140`	$132	$126	$34	3.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$70	$124	$35	3.5×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$125	$125	$40	3.1×
Speech therapy (language evaluation) CPT Code: `92507`	$125	$125	$86	1.5×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$84	$25	3.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$108	$108	$38	2.8×
Group therapy session CPT Code: `90853`	$104	$104	$100	1.0×
Psychological testing evaluation CPT Code: `96136`	$64	$102	$128	0.8×
Orthotic fitting and training CPT Code: `97760`	$123	$123	$51	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$94	$94	$166	0.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$94	$94	$181	0.5×
Family therapy session CPT Code: `90847`	$86	$86	$173	0.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$86	$86	$185	0.5×
Psychological testing by technician CPT Code: `96138`	$207	$102	$395	0.3×
Typhoid vaccine HCPCS Code: `90675`	$2,202	$2,202	$347	6.3×
Hepatitis C antibody test CPT Code: `86803`	$1,355	$1,355	$15	90.3×
Pneumococcal vaccine HCPCS Code: `90732`	$773	$773	$140	5.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$612	$612	$14	43.7×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$1,083	$600	$203	3.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$315	$315	$11	28.6×
Blood test, ferritin (iron stores) CPT Code: `82728`	$314	$314	$14	22.4×
Blood test, liver function panel CPT Code: `80076`	$279	$279	$9	31.0×
Blood test, basic metabolic panel CPT Code: `80048`	$277	$277	$9	30.8×
Culture, blood CPT Code: `87040`	$270	$270	$11	24.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$685	$266	$111	2.4×
Culture, bacterial CPT Code: `87070`	$224	$224	$9	24.9×
Blood antibody screen CPT Code: `86850`	$316	$236	$46	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$192	$192	$19	10.1×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$149	$149	$3	49.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$165	$165	$18	9.2×
Blood test, vitamin B12 CPT Code: `82607`	$142	$142	$16	8.9×
Blood test, vitamin D CPT Code: `82306`	$164	$164	$31	5.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$183	$183	$10	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$136	$136	$8	17.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$304	$148	$56	2.6×
Blood test, lipase CPT Code: `83690`	$112	$112	$7	16.0×
Blood test, amylase CPT Code: `82150`	$107	$107	$7	15.3×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$190	$105	$39	2.7×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$77	$77	$4	19.3×
Blood test, magnesium CPT Code: `83735`	$101	$101	$7	14.4×
Hepatitis B vaccine HCPCS Code: `90744`	$114	$91	$37	2.5×
Flu vaccine injection HCPCS Code: `G0008`	$124	$106	$48	2.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$80	$80	$5	16.0×
Blood test, calcium CPT Code: `82310`	$77	$77	$5	15.4×
Blood test, hemoglobin CPT Code: `85018`	$51	$51	$3	17.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$72	$72	$5	14.4×
Blood test, potassium CPT Code: `84132`	$67	$67	$5	13.4×
Blood transfusion CPT Code: `36430`	$645	$75	$498	0.2×
Blood test, glucose (blood sugar) CPT Code: `82947`	$49	$49	$4	12.3×
Blood test, sodium CPT Code: `84295`	$55	$55	$5	11.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$61	$61	$6	10.2×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$64	$14	4.6×
Flu vaccine (high dose) HCPCS Code: `90656`	$73	$64	$25	2.6×
Care planning with family CPT Code: `90887`	$16	$16	$107	0.1×
Review of medical records for care CPT Code: `90889`	$8	$8	$114	0.1×

Showing top 25 high-impact procedures of 121 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 27.6%

Audit a Bill or Quote at Covenant Childrens Hospital (Zero PHI Required)

CMS CCN: 453306

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $47,202

1. Amount on Your Bill or Quote ($) Pre-filled with Covenant Childrens Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $31,323 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $31,323

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (27.6% of gross = $31,323).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Covenant Childrens Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$82,510 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($113,285) is $82,510 above the denoised Fair BaseRate ($30,775) and 4.8× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 752428911

Filing Period: 199212

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (27.6% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Covenant Childrens Hospital.

Price Index: 1.49× regional baseline

Quality: 54/100 CMS composite

Median Household Income$63,367U.S. Census ACS

Local Uninsured Share13.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 74/100 · Corroborated CMS CCN 453306 EIN 752428911

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 453306) ↗ Verify IRS Form 990 (EIN 752428911) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows524 (CMS v3.0.0)

File Integrity DigestVerified · CCN 453306

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy