Supplies, drugs & other prices at Covenant Hospital Levelland
Levelland, TX · every code in this section with a posted price and a Medicare benchmark.
14 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Ca screen;pelvic/breast exam (G0101) | $96.18 | $229 | 0.9× |
| Catheterize for urine spec (P9612) | $36.12 | $86 | 3.9× |
| Depression screen annual (G0444) | $18.90 | $45 | 0.5× |
| Destruction neurofibromata, extensive, (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) | $772.80 | $1,840 | 1.0× |
| Destruction neurofibromata, extensive, (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) | $772.80 | $1,840 | 1.0× |
| Direct refer hospital observ (G0379) | $21 | $50 | 0.0× |
| Ekg tracing for initial prev (G0404) | $23.10 | $55 | 0.8× |
| Hospital outpt clinic visit (G0463) | $175.56 | $418 | 1.3× |
| Initial preventive exam (G0402) | $116.76 | $278 | 0.9× |
| Obtaining screen pap smear (Q0091) | $10.50 | $25 | 0.4× |
| Ppps, initial visit (G0438) | $141.12 | $336 | 0.8× |
| Ppps, subseq visit (G0439) | $95.34 | $227 | 0.7× |
| Tomosynthesis, mammo (G0279) | $57.54 | $137 | 4.5× |
| Trauma respons w/hosp criti (G0390) | $4,033.68 | $9,604 | 3.0× |