CHI Health St. Francis
2620 West Faidley Avenue, Grand Island, NE · Chihealth · · NPI 1982675955
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $90.27 | $153.00 | $35.19 – $143.82 | 13 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $220.66 | $374.00 | $86.02 – $351.56 | 13 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $34.81 | $59.00 | $13.57 – $77.90 | 17 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $120.36 | $204.00 | $34.01 – $204.00 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $561.68 | $952.00 | $218.96 – $952.00 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $538.08 | $912.00 | $41.51 – $857.28 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $352.82 | $598.00 | $41.51 – $562.12 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $321.55 | $545.00 | $41.51 – $515.23 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $543.98 | $922.00 | $82.47 – $922.00 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $394.12 | $668.00 | $138.21 – $668.00 | 17 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $664.58 | $1,126.39 | $32.31 – $1,058.81 | 14 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $270.31 | $458.15 | $22.30 – $430.67 | 14 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $289.62 | $490.88 | $10.86 – $461.43 | 14 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | $15.02 | $25.45 | $5.86 – $26.47 | 13 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,681.46 – $2,734.04 | 3 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,539.65 – $2,589.44 | 3 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $149.27 | $253.00 | $58.19 – $237.82 | 7 |
| Initiation & management bipap/cpap initial day CPT 94660 | $707.41 | $1,199.00 | $63.43 – $1,127.06 | 7 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | $940.37 | $1,593.85 | $366.59 – $1,498.21 | 7 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $1,504.59 | $2,550.14 | $7.03 – $1,797.86 | 14 |
| Inj alymsys 10 mg HCPCS Q5126 | $53.52 | $90.71 | $20.87 – $85.27 | 7 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $1,542.67 | $2,614.69 | $601.38 – $2,457.81 | 7 |
| Inj, artesunate, 1mg HCPCS J0391 | $3,173.32 | $5,378.50 | $1,237.06 – $5,055.79 | 7 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $5,876.40 | $9,960.00 | $2,290.80 – $9,362.40 | 7 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $1,148.97 | $1,947.40 | $447.91 – $1,830.56 | 7 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $3,349.29 | $5,676.75 | $171.40 – $4,847.14 | 14 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $2,242.00 | $3,800.00 | $39.26 – $3,572.00 | 14 |
| Inj, bortezomib freseniuskab HCPCS J9048 | $692.31 | $1,173.40 | $269.89 – $1,103.00 | 7 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $0.07 | $0.12 | $0.03 – $0.10 | 7 |
| Inj cefazolin (wg crit care) HCPCS J0687 | $1.94 | $3.28 | $0.35 – $1.42 | 7 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $0.32 | $0.54 | $0.10 – $0.41 | 7 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $16.11 | $27.31 | $4.14 – $16.92 | 7 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $125.65 | $212.96 | $48.99 – $200.19 | 7 |
| Inj ceftolozane tazobactam HCPCS J0695 | $94.09 | $159.47 | $8.40 – $149.91 | 12 |
| Inj, clevidipine butyrate HCPCS C9248 | $0.94 | $1.58 | $0.37 – $1.49 | 7 |
| Inj, clindamycin (baxter) HCPCS J0737 | $0.15 | $0.24 | $0.03 – $0.13 | 7 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $216.53 | $367.00 | $75.64 – $344.98 | 7 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $684.94 | $1,160.91 | $267.01 – $1,207.35 | 14 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $272.58 – $272.58 | 1 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $20.53 | $34.79 | $8.01 – $32.71 | 7 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $121.93 – $121.93 | 1 |
| Inj dx for sinogram CPT 20501 | $317.42 | $538.00 | $68.86 – $505.72 | 7 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $157.27 – $157.27 | 1 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $591.18 | $1,002.00 | $127.85 – $941.88 | 7 |
| Injection, burosumab-twza 1m HCPCS J0584 | $7,503.86 | $12,718.40 | $437.97 – $7,970.17 | 14 |
| Injection, cangrelor HCPCS C9460 | $539.19 | $913.87 | $210.20 – $859.04 | 7 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $4,675.75 | $7,925.00 | $1,822.75 – $7,449.50 | 7 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $105.40 – $105.40 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | $90.75 | $153.81 | $35.38 – $144.59 | 14 |
| Injection, doxercalciferol HCPCS J1270 | $1.88 | $3.19 | $0.33 – $3.00 | 12 |
| Injection during cath supravalvular aortography CPT 93567 | $843.11 | $1,429.00 | $66.61 – $1,343.26 | 11 |
| Injection, edaravone, 1 mg HCPCS J1301 | $3.40 | $5.77 | $1.33 – $6.00 | 14 |
| Injection epidural blood patch or clot CPT 62273 | $851.96 | $1,444.00 | $215.50 – $1,357.36 | 7 |
| Injection eye drug CPT 67028 | not published | not published | $174.47 – $174.47 | 1 |
| Injection for arthrography wrist (both sides) CPT 25246 | $150.45 | $255.00 | $58.65 – $239.70 | 7 |
| Injection for bladder x-ray CPT 51600 | $487.34 | $826.00 | $81.94 – $776.44 | 7 |
| Injection for hip x-ray CPT 27095 | not published | not published | $152.50 – $152.50 | 1 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $481.44 | $816.00 | $94.19 – $767.04 | 7 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $245.83 – $245.83 | 1 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $98.09 – $98.09 | 1 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $96.39 – $96.39 | 1 |
| Injection for ureter x-ray CPT 50690 | $1,054.33 | $1,787.00 | $132.09 – $1,679.78 | 7 |
| Injection, fulvestrant HCPCS J9395 | $104.64 | $177.35 | $8.52 – $166.71 | 14 |
| Injection, glucarpidase HCPCS C9293 | $24,292.66 | $41,174.00 | $9,470.02 – $38,703.56 | 7 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $1,330.03 | $2,254.28 | $518.49 – $2,119.03 | 7 |
| Injection into brain canal CPT 61026 | not published | not published | $198.98 – $198.98 | 1 |
| Injection into brain canal CPT 61055 | not published | not published | $217.29 – $217.29 | 1 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $348.31 – $348.31 | 1 |
| Injection into spinal artery CPT 62294 | not published | not published | $1,689.79 – $1,689.79 | 1 |
| Injection into vocal cord CPT 31513 | not published | not published | $246.73 – $246.73 | 1 |
| Injection intraop add-on CPT 48400 | not published | not published | $100.23 – $189.74 | 4 |
| Injection, isavuconazonium HCPCS J1833 | $212.55 | $360.24 | $1.02 – $338.63 | 9 |
| Injection jaw joint x-ray CPT 21116 | $517.43 | $877.00 | $84.48 – $824.38 | 7 |
| Injection, necitumumab, 1 mg HCPCS J9295 | $51.10 | $86.60 | $5.59 – $81.41 | 14 |
| Injection of sinus tract CPT 20500 | $650.18 | $1,102.00 | $170.60 – $1,035.88 | 7 |
| Injection,onabotulinumtoxina HCPCS J0585 | $762.28 | $1,292.00 | $6.28 – $607.24 | 14 |
| Injection, peramivir HCPCS J2547 | $9.35 | $15.84 | $3.35 – $14.89 | 7 |
| Injection px peyronie ds CPT 54200 | not published | not published | $166.91 – $166.91 | 1 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $603.57 | $1,023.00 | $60.25 – $961.62 | 7 |
| Injection, renflexis HCPCS Q5104 | $206.88 | $350.63 | $30.47 – $329.60 | 14 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,539.31 | $2,609.00 | $120.92 – $2,452.46 | 7 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $853.73 | $1,447.00 | $79.30 – $1,156.20 | 7 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,420.72 | $2,408.00 | $212.60 – $2,263.52 | 7 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $585.28 | $992.00 | $112.54 – $932.48 | 7 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,581.79 | $2,681.00 | $200.80 – $2,520.14 | 7 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,748.76 | $2,964.00 | $96.71 – $2,786.16 | 7 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,748.76 | $2,964.00 | $172.60 – $2,786.16 | 7 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $880.87 | $1,493.00 | $204.90 – $1,403.42 | 7 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $880.87 | $1,493.00 | $189.34 – $1,403.42 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $215.94 | $366.00 | $73.21 – $344.04 | 7 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $252.52 | $428.00 | $69.76 – $402.32 | 7 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $321.55 | $545.00 | $79.30 – $512.30 | 7 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $177.00 | $300.00 | $29.15 – $252.86 | 7 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $140.42 | $238.00 | $18.38 – $223.72 | 7 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $454.30 | $770.00 | $69.55 – $723.80 | 7 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $208.86 | $354.00 | $27.30 – $231.24 | 7 |
| Injection treatment of eye CPT 66020 | not published | not published | $250.43 – $250.43 | 1 |
| Injection treatment of eye CPT 66030 | not published | not published | $212.54 – $212.54 | 1 |
| Injection treatment of nerve CPT 64605 | not published | not published | $748.29 – $748.29 | 1 |
| Injection treatment of nerve CPT 64610 | not published | not published | $859.70 – $859.70 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.