CHI Health St. Mary's
1301 GRUNDMAN BLVD, Nebraska City, NE · Chihealth · · NPI 1528016995
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 |
|---|---|---|---|---|
| Endoscopy bowel pouch/biop CPT 44386 | $752.81 | $907.00 | $194.28 – $870.72 | 16 |
| Endoscopy of bowel pouch 44385 CPT 44385 | $512.11 | $617.00 | $132.17 – $592.32 | 16 |
| Endo, single, pulmonary HCPCS C1601 | $737.89 | $889.02 | $181.95 – $815.45 | 16 |
| Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 | $3,428.73 | $4,131.00 | $601.69 – $2,696.64 | 16 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $28.29 | $34.09 | $2.10 – $9.37 | 16 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $1,927.26 | $2,322.00 | $68.55 – $307.20 | 16 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $0.93 | $1.12 | $0.24 – $1.08 | 16 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $524.56 | $632.00 | $79.26 – $355.20 | 16 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $462.36 | $557.06 | $10.95 – $49.04 | 16 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $48.60 | $58.55 | $3.43 – $15.35 | 16 |
| Epstein barr early antigen antibody CPT 86663 | $97.11 | $117.00 | $13.12 – $112.32 | 16 |
| Epstein barr nuclear antigen antibody CPT 86664 | $97.11 | $117.00 | $15.29 – $112.32 | 16 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $93.79 | $113.00 | $18.14 – $108.48 | 16 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $1,517.10 | $1,827.83 | $391.53 – $1,754.72 | 16 |
| Ercp w/specimen collection CPT 43260 | $746.17 | $899.00 | $192.57 – $863.04 | 16 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $517.92 | $624.00 | $133.67 – $599.04 | 16 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $105.37 | $126.95 | $2.15 – $9.61 | 16 |
| ER Visit (level 1, minor) CPT 99281 | $180.94 | $218.00 | $13.07 – $58.56 | 16 |
| ER Visit (level 2) CPT 99282 | $347.77 | $419.00 | $25.49 – $114.24 | 16 |
| ER Visit (level 3) CPT 99283 | $542.82 | $654.00 | $43.27 – $193.92 | 16 |
| ER Visit (level 4) CPT 99284 | $848.26 | $1,022.00 | $73.26 – $328.32 | 16 |
| ER Visit (level 5, high severity) CPT 99285 | $1,390.25 | $1,675.00 | $106.25 – $476.16 | 16 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $61.11 | $73.63 | $15.78 – $70.69 | 16 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $0.37 | $0.44 | $0.10 – $0.43 | 16 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $1.37 | $1.65 | $0.08 – $0.36 | 16 |
| Esophagosc dilate balloon 30 CPT 43214 | $443.22 | $534.00 | $114.39 – $512.64 | 16 |
| Esophagosc flex trnsn biopsy CPT 43198 | $500.49 | $603.00 | $129.17 – $578.88 | 16 |
| Esophagoscop mucosal resect CPT 43211 | $542.82 | $654.00 | $140.09 – $627.84 | 16 |
| Esophagoscop ultrasound exam CPT 43231 | $368.52 | $444.00 | $95.11 – $426.24 | 16 |
| Esophagoscopy balloon <30mm CPT 43220 | $2,214.44 | $2,668.00 | $571.49 – $2,561.28 | 16 |
| Esophagoscopy control bleed CPT 43227 | $1,450.01 | $1,747.00 | $374.21 – $1,677.12 | 16 |
| Esophagoscopy flex biopsy CPT 43202 | $866.52 | $1,044.00 | $223.63 – $1,002.24 | 16 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $1,612.69 | $1,943.00 | $162.58 – $728.64 | 16 |
| Esophagoscopy flex dx brush CPT 43197 | $452.35 | $545.00 | $116.74 – $523.20 | 16 |
| Esophagoscopy flex remove fb CPT 43215 | $947.86 | $1,142.00 | $231.98 – $1,039.68 | 16 |
| Esophagoscopy lesion removal CPT 43216 | $997.66 | $1,202.00 | $257.47 – $1,153.92 | 16 |
| Esophagoscopy retro balloon CPT 43213 | $3,017.88 | $3,636.00 | $778.84 – $3,490.56 | 16 |
| Esophagoscopy rigid balloon CPT 43195 | $422.47 | $509.00 | $109.03 – $488.64 | 16 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | $354.41 | $427.00 | $91.47 – $409.92 | 16 |
| Esophagoscopy snare les remv CPT 43217 | $1,018.41 | $1,227.00 | $262.83 – $1,177.92 | 16 |
| Esophagoscopy w/us needle bx CPT 43232 | $462.31 | $557.00 | $119.31 – $534.72 | 16 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | $449.86 | $542.00 | $116.10 – $520.32 | 16 |
| Esophagoscp rig trnso biopsy CPT 43193 | $387.61 | $467.00 | $100.04 – $448.32 | 16 |
| Esophagoscp rig trnso inject CPT 43192 | $388.44 | $468.00 | $100.25 – $449.28 | 16 |
| Esophagoscp rig trnso rem fb CPT 43194 | $439.07 | $529.00 | $113.32 – $507.84 | 16 |
| Esophagus endoscopy/ligation CPT 43205 | $325.36 | $392.00 | $83.97 – $376.32 | 16 |
| Esoph egd dilation <30 mm CPT 43249 | $2,671.77 | $3,219.00 | $689.51 – $3,090.24 | 16 |
| Esoph endoscopy dilation CPT 43226 | $926.28 | $1,116.00 | $239.05 – $1,071.36 | 16 |
| Esoph optical endomicroscopy CPT 43206 | $726.25 | $875.00 | $187.43 – $840.00 | 16 |
| Esoph scope w/sclerosis inj CPT 43204 | $312.08 | $376.00 | $80.54 – $360.96 | 16 |
| Esoph scope w/submucous inj CPT 43201 | $620.84 | $748.00 | $160.23 – $718.08 | 16 |
| Established Patient Office Visit (level 1) CPT 99211 | $169.32 | $204.00 | $13.93 – $62.40 | 16 |
| Established Patient Office Visit (level 2) CPT 99212 | $131.14 | $158.00 | $28.71 – $128.64 | 16 |
| Established Patient Office Visit (level 3) CPT 99213 | $325.36 | $392.00 | $17.36 – $77.76 | 16 |
| Established Patient Office Visit (level 4) CPT 99214 | $357.73 | $431.00 | $77.76 – $348.48 | 16 |
| Established Patient Office Visit (level 5) CPT 99215 | $424.13 | $511.00 | $94.90 – $425.28 | 16 |
| Estradiol total CPT 82670 | $34.03 | $41.00 | $8.79 – $62.03 | 16 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $28.41 | $34.22 | $7.33 – $32.86 | 16 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $129.32 | $155.80 | $0.49 – $2.19 | 16 |
| Etoposide 50 mg cap HCPCS J8560 | $57.19 | $68.90 | $14.76 – $66.15 | 16 |
| Euflexxa inj per dose HCPCS J7323 | $44.29 | $53.36 | $11.43 – $51.23 | 16 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $337.81 | $407.00 | $87.18 – $390.72 | 16 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $202.52 | $244.00 | $52.27 – $234.24 | 16 |
| Evaluation of speech fluency 92521 CPT 92521 | $269.75 | $325.00 | $69.62 – $312.00 | 16 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | $17,894.80 | $21,560.00 | $4,618.16 – $20,697.60 | 16 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | $17,603.47 | $21,209.00 | $4,542.97 – $20,360.64 | 16 |
| Event monitor CPT 93270 | $392.59 | $473.00 | $101.32 – $454.08 | 16 |
| Evoked oa emissions ltd CPT 92587 | $405.87 | $489.00 | $104.75 – $469.44 | 16 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $371.01 | $447.00 | $95.75 – $429.12 | 16 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | $898.06 | $1,082.00 | $231.77 – $1,038.72 | 16 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $510.45 | $615.00 | $77.33 – $346.56 | 16 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $2,494.15 | $3,005.00 | $86.97 – $389.76 | 16 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $1,101.41 | $1,327.00 | $116.32 – $521.28 | 16 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $1,101.41 | $1,327.00 | $137.09 – $614.40 | 16 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $375.16 | $452.00 | $96.82 – $433.92 | 16 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $1,905.68 | $2,296.00 | $491.81 – $2,204.16 | 16 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $771.07 | $929.00 | $199.00 – $891.84 | 16 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $532.86 | $642.00 | $93.40 – $418.56 | 16 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,008.45 | $1,215.00 | $118.89 – $532.80 | 16 |
| Exc coccygl pr ulc flap clsr CPT 15922 | $1,819.36 | $2,192.00 | $469.53 – $2,104.32 | 16 |
| Exc coccygl pr ulc prim sutr CPT 15920 | $1,449.18 | $1,746.00 | $374.00 – $1,676.16 | 16 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $553.61 | $667.00 | $142.88 – $640.32 | 16 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $1,105.56 | $1,332.00 | $189.36 – $848.64 | 16 |
| Exc ischial pr ulc prim sutr CPT 15940 | $1,586.96 | $1,912.00 | $409.56 – $1,835.52 | 16 |
| Exc isch pr ulc skn flp clsr CPT 15944 | $2,131.44 | $2,568.00 | $550.07 – $2,465.28 | 16 |
| Excise pharynx lesion CPT 42808 | $2,831.96 | $3,412.00 | $139.45 – $624.96 | 16 |
| Excise/repair mouth lesion CPT 40812 | $1,813.55 | $2,185.00 | $468.03 – $2,097.60 | 16 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | $1,091.45 | $1,315.00 | $281.68 – $1,262.40 | 16 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $517.92 | $624.00 | $105.18 – $471.36 | 16 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $1,380.29 | $1,663.00 | $108.39 – $485.76 | 16 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $1,132.95 | $1,365.00 | $103.68 – $464.64 | 16 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $734.55 | $885.00 | $189.57 – $849.60 | 16 |
| Excision of anal lesion(s) CPT 46922 | $742.85 | $895.00 | $191.71 – $859.20 | 16 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | $1,726.40 | $2,080.00 | $445.54 – $1,996.80 | 16 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $475.59 | $573.00 | $122.74 – $550.08 | 16 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $1,105.56 | $1,332.00 | $161.30 – $722.88 | 16 |
| Exc malig feenl >4cm 11646 CPT 11646 | $1,167.81 | $1,407.00 | $301.38 – $1,350.72 | 16 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $1,101.41 | $1,327.00 | $178.01 – $797.76 | 16 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $544.48 | $656.00 | $140.52 – $629.76 | 16 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $1,101.41 | $1,327.00 | $284.25 – $1,273.92 | 16 |
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.