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 |
|---|---|---|---|---|
| Mayo lamotrigine therapeutic drug level CPT 80175 | $129.21 | $219.00 | $12.84 – $205.86 | 17 |
| Mayo leptospira antibody igm CPT 86720 | $102.66 | $174.00 | $15.70 – $163.56 | 17 |
| Mayo lipoprotein electrophoresis CPT 83700 | $23.60 | $40.00 | $9.20 – $40.00 | 17 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $90.27 | $153.00 | $15.01 – $143.82 | 17 |
| Mayo manganese CPT 83785 | $27.73 | $47.00 | $10.81 – $59.16 | 17 |
| Mayo metanephrines plasma CPT 83835 | $188.21 | $319.00 | $16.41 – $203.98 | 17 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $125.67 | $213.00 | $48.99 – $200.22 | 7 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $83.78 | $142.00 | $14.10 – $142.00 | 17 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $215.94 | $366.00 | $18.06 – $189.88 | 17 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $47.79 | $81.00 | $18.63 – $179.82 | 13 |
| Mayo muramidase CPT 85549 | $84.96 | $144.00 | $18.17 – $144.00 | 17 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $125.67 | $213.00 | $48.99 – $200.22 | 7 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $119.18 | $202.00 | $17.49 – $202.00 | 17 |
| Mayo myoglobin CPT 83874 | $107.38 | $182.00 | $12.52 – $171.08 | 17 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $96.76 | $164.00 | $37.72 – $154.16 | 7 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $28.91 | $49.00 | $11.27 – $46.06 | 7 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $139.24 | $236.00 | $20.55 – $221.84 | 17 |
| Mayo oxalate 24 hour urine CPT 83945 | $34.22 | $58.00 | $13.34 – $58.00 | 17 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $159.89 | $271.00 | $11.17 – $254.74 | 17 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $96.17 | $163.00 | $14.57 – $163.00 | 17 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $94.40 | $160.00 | $11.68 – $150.40 | 17 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $310.93 | $527.00 | $34.01 – $495.38 | 17 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $119.18 | $202.00 | $17.42 – $202.00 | 17 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $65.49 | $111.00 | $13.33 – $111.00 | 17 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $61.36 | $104.00 | $8.18 – $97.76 | 17 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $63.72 | $108.00 | $16.08 – $108.00 | 17 |
| Mayo proinsulin CPT 84206 | $51.92 | $88.00 | $20.24 – $88.00 | 17 |
| Mayo psaft prostate specific antigen free CPT 84154 | $58.41 | $99.00 | $17.82 – $99.00 | 17 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $174.05 | $295.00 | $17.83 – $277.30 | 17 |
| Mayo receptor assay transferrin soluble CPT 84238 | $104.43 | $177.00 | $35.43 – $177.00 | 17 |
| Mayo renin CPT 84244 | $113.87 | $193.00 | $21.31 – $193.00 | 17 |
| Mayo repu protein electrophoresis urine CPT 84166 | $125.08 | $212.00 | $17.28 – $212.00 | 17 |
| Mayo selenium CPT 84255 | $70.80 | $120.00 | $24.73 – $120.00 | 17 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | $424.21 | $719.00 | $15.02 – $675.86 | 17 |
| Mayo serotonin CPT 84260 | $68.44 | $116.00 | $26.68 – $116.00 | 17 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $90.27 | $153.00 | $18.75 – $143.82 | 17 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $85.55 | $145.00 | $13.30 – $145.00 | 17 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $109.74 | $186.00 | $42.78 – $174.84 | 7 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $51.33 | $87.00 | $4.14 – $81.78 | 17 |
| Mayo tgrp testosterone free CPT 84402 | $126.85 | $215.00 | $24.68 – $215.00 | 17 |
| Mayo tgrp testosterone total CPT 84403 | $87.32 | $148.00 | $25.01 – $148.00 | 17 |
| Mayo thyroglobulin CPT 84432 | $91.45 | $155.00 | $15.57 – $155.00 | 17 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $68.44 | $116.00 | $12.01 – $116.00 | 17 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $59.00 | $100.00 | $13.72 – $94.00 | 17 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $154.58 | $262.00 | $13.12 – $246.28 | 17 |
| Mayo vasoactive intestinal peptide CPT 84586 | $158.12 | $268.00 | $34.23 – $268.00 | 17 |
| Mayo vitamin b3 (niacin) CPT 84591 | $212.40 | $360.00 | $16.53 – $141.94 | 17 |
| Mayo vitamin k CPT 84597 | $112.10 | $190.00 | $13.29 – $178.60 | 17 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $105.02 | $178.00 | $12.84 – $167.32 | 17 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $684.60 – $1,519.25 | 4 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $957.60 – $957.60 | 1 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $1,024.49 – $1,024.49 | 1 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,084.69 – $1,084.69 | 1 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $1,738.38 – $1,738.38 | 1 |
| Measure kidney pressure CPT 50396 | not published | not published | $218.95 – $218.95 | 1 |
| Measurement post void urine by ultrasound CPT 51798 | $187.03 | $317.00 | $21.02 – $297.98 | 7 |
| Measure ureter pressure CPT 50686 | not published | not published | $167.08 – $167.08 | 1 |
| #mec-opiates CPT 80356 | $28.91 | $49.00 | $11.27 – $46.06 | 7 |
| Medial canthopexy CPT 21280 | not published | not published | $1,125.58 – $1,125.58 | 1 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $716.92 – $716.92 | 1 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $551.10 – $551.10 | 1 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $38.86 | $65.85 | $0.58 – $45.26 | 8 |
| Melphalan oral 2 mg HCPCS J8600 | $6.36 | $10.78 | $2.48 – $10.14 | 10 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $849.60 | $1,440.00 | $62.10 – $253.80 | 12 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $3,089.88 – $3,089.88 | 1 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $3.84 | $6.51 | $0.44 – $1.89 | 12 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $2,176.41 | $3,688.83 | $31.03 – $2,872.02 | 14 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $16.87 | $28.59 | $0.05 – $0.20 | 12 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $466.64 – $466.64 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $3.73 | $6.31 | $1.46 – $5.94 | 12 |
| Metabolic Blood Panel (Basic) CPT 80048 | $108.56 | $184.00 | $8.20 – $172.96 | 17 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $138.06 | $234.00 | $10.23 – $219.96 | 17 |
| Metatarsal joint implant HCPCS L8641 | $1,328.83 | $2,252.25 | $115.00 – $470.00 | 11 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $79.65 | $135.00 | $1.42 – $6.45 | 12 |
| Methadone injection HCPCS J1230 | $12.68 | $21.49 | $4.95 – $21.49 | 12 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $0.54 | $0.92 | $0.22 – $0.92 | 12 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $1.28 | $2.16 | $0.24 – $2.04 | 12 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $2.71 | $4.59 | $0.55 – $2.37 | 12 |
| Methotrexate therapeutic drug level CPT 80204 | $142.78 | $242.00 | $37.37 – $227.48 | 13 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $113.35 | $192.12 | $1.23 – $5.55 | 9 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $12.06 | $20.44 | $4.71 – $20.44 | 12 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $152.83 | $259.03 | $2.57 – $243.48 | 7 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $0.73 | $1.23 | $0.20 – $0.79 | 12 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $10.39 | $17.61 | $1.41 – $5.76 | 7 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $0.38 | $0.64 | $0.01 – $0.01 | 12 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.02 | $0.03 | $0.01 – $0.03 | 7 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $42.10 | $71.34 | $0.43 – $15.10 | 12 |
| Microdissection manual CPT 88381 | $114.46 | $194.00 | $44.62 – $194.00 | 11 |
| Microsatellite instability CPT 81301 | $411.82 | $698.00 | $160.54 – $773.80 | 17 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $371.85 – $371.85 | 1 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $1.87 | $3.17 | $0.01 – $0.01 | 12 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $0.13 | $0.22 | $0.04 – $0.16 | 7 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $0.31 | $0.53 | $0.04 – $0.16 | 12 |
| Minocycline hydrochloride HCPCS J2265 | $116.76 | $197.90 | $2.47 – $186.03 | 9 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | $191.38 | $324.36 | $74.61 – $304.90 | 7 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $693.10 | $1,174.73 | $51.18 – $231.39 | 14 |
| Mitomycin instillation HCPCS J9281 | $685.20 | $1,161.35 | $267.12 – $1,091.67 | 14 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $4.82 | $8.17 | $1.88 – $8.49 | 14 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $2,211.51 – $2,254.88 | 3 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,973.14 – $1,973.14 | 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.