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 |
|---|---|---|---|---|
| Implant ureth bulk agent HCPCS L8606 | $1,902.99 | $2,292.75 | $292.62 – $1,311.42 | 16 |
| Incise bile duct sphincter CPT 47460 | $2,836.11 | $3,417.00 | $731.93 – $3,280.32 | 16 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $1,216.78 | $1,466.00 | $102.39 – $458.88 | 16 |
| Incision of anal sphincter CPT 46080 | $673.96 | $812.00 | $173.94 – $779.52 | 16 |
| Incision of breast lesion CPT 19020 | $2,083.30 | $2,510.00 | $280.61 – $1,257.60 | 16 |
| Incision of eardrum CPT 69420 | $443.22 | $534.00 | $114.39 – $512.64 | 16 |
| Incision of tongue fold CPT 41010 | $991.02 | $1,194.00 | $255.76 – $1,146.24 | 16 |
| Incision of windpipe CPT 31601 | $1,030.86 | $1,242.00 | $266.04 – $1,192.32 | 16 |
| Incision of windpipe CPT 31610 | $2,232.70 | $2,690.00 | $576.20 – $2,582.40 | 16 |
| Incisn of toe tndn CPT 28010 | $544.48 | $656.00 | $140.52 – $629.76 | 16 |
| Incisn windpipe CPT 31600 | $688.90 | $830.00 | $177.79 – $796.80 | 16 |
| Incobotulinumtoxin a HCPCS J0588 | $407.17 | $490.56 | $105.08 – $470.94 | 16 |
| Infec agen detec ampli probe HCPCS U0005 | $24.90 | $30.00 | $6.43 – $28.80 | 16 |
| Infect ag eia influenza a or b ea CPT 87400 | $31.54 | $38.00 | $8.14 – $36.48 | 16 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $227.42 | $274.00 | $16.50 – $73.92 | 16 |
| Infect ag ia optc obs influenza CPT 87804 | $84.66 | $102.00 | $8.14 – $36.74 | 16 |
| Infect ag na hpv high-risk types CPT 87624 | $92.96 | $112.00 | $15.64 – $77.90 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $105.41 | $127.00 | $8.14 – $36.48 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $207.50 | $250.00 | $13.42 – $240.00 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $147.74 | $178.00 | $8.14 – $36.48 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $97.94 | $118.00 | $8.14 – $36.48 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $211.65 | $255.00 | $7.72 – $34.56 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $68.89 | $83.00 | $10.33 – $79.68 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $64.74 | $78.00 | $10.33 – $74.88 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $170.15 | $205.00 | $16.50 – $73.92 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $576.85 | $695.00 | $8.14 – $36.48 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $172.64 | $208.00 | $11.98 – $199.68 | 16 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $61.42 | $74.00 | $11.98 – $55.68 | 16 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $265.60 | $320.00 | $20.78 – $93.12 | 16 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $147.74 | $178.00 | $35.09 – $170.88 | 16 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $92.96 | $112.00 | $21.85 – $97.92 | 16 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,357.05 | $1,635.00 | $350.22 – $1,569.60 | 16 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $299.63 | $361.00 | $35.09 – $346.56 | 16 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $151.89 | $183.00 | $35.09 – $175.68 | 16 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $493.02 | $594.00 | $41.68 – $570.24 | 16 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $147.74 | $178.00 | $35.09 – $170.88 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $156.87 | $189.00 | $40.49 – $181.44 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $384.29 | $463.00 | $99.18 – $444.48 | 16 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $83.00 | $100.00 | $21.42 – $96.00 | 16 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $166.00 | $200.00 | $35.09 – $192.00 | 16 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,049.12 | $1,264.00 | $270.75 – $1,213.44 | 16 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $386.78 | $466.00 | $42.84 – $272.64 | 16 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $287.18 | $346.00 | $42.84 – $332.16 | 16 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $156.04 | $188.00 | $29.35 – $131.52 | 16 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $1,321.36 | $1,592.00 | $85.10 – $1,528.32 | 16 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $479.74 | $578.00 | $123.81 – $554.88 | 16 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $934.91 | $1,126.39 | $241.28 – $1,081.34 | 16 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $380.27 | $458.15 | $98.14 – $439.83 | 16 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $407.44 | $490.88 | $105.15 – $471.25 | 16 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | $21.13 | $25.45 | $5.46 – $24.44 | 16 |
| Initial observation care CPT 99218 | $226.59 | $273.00 | $58.48 – $262.08 | 16 |
| Initial observation care CPT 99219 | $308.76 | $372.00 | $79.69 – $357.12 | 16 |
| Initial observation care CPT 99220 | $418.32 | $504.00 | $107.96 – $483.84 | 16 |
| Initiation & management bipap/cpap initial day CPT 94660 | $835.81 | $1,007.00 | $215.70 – $966.72 | 16 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | $1,322.89 | $1,593.85 | $341.41 – $1,530.09 | 16 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $2,116.62 | $2,550.14 | $409.69 – $1,836.11 | 16 |
| Inj alymsys 10 mg HCPCS Q5126 | $75.29 | $90.71 | $19.44 – $87.09 | 16 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $2,170.19 | $2,614.69 | $560.07 – $2,510.11 | 16 |
| Inj, artesunate, 1mg HCPCS J0391 | $4,464.16 | $5,378.50 | $1,152.08 – $5,163.36 | 16 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $8,266.80 | $9,960.00 | $2,133.44 – $9,561.60 | 16 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $1,616.35 | $1,947.40 | $417.14 – $1,869.51 | 16 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $4,711.71 | $5,676.75 | $1,104.53 – $4,950.27 | 16 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $3,154.00 | $3,800.00 | $813.96 – $3,648.00 | 16 |
| Inj, bortezomib freseniuskab HCPCS J9048 | $973.93 | $1,173.40 | $251.35 – $1,126.47 | 16 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $0.10 | $0.12 | $0.03 – $0.10 | 16 |
| Inj cefazolin (wg crit care) HCPCS J0687 | $2.72 | $3.28 | $0.33 – $1.45 | 16 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $0.45 | $0.54 | $0.10 – $0.42 | 16 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $22.66 | $27.31 | $3.86 – $17.28 | 16 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $176.76 | $212.96 | $45.62 – $204.45 | 16 |
| Inj ceftolozane tazobactam HCPCS J0695 | $132.36 | $159.47 | $34.16 – $153.10 | 16 |
| Inj, clevidipine butyrate HCPCS C9248 | $1.32 | $1.58 | $0.34 – $1.52 | 16 |
| Inj, clindamycin (baxter) HCPCS J0737 | $0.20 | $0.24 | $0.03 – $0.13 | 16 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $963.56 | $1,160.91 | $248.67 – $1,114.48 | 16 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $28.87 | $34.79 | $7.46 – $33.40 | 16 |
| Inj dx for sinogram CPT 20501 | $313.74 | $378.00 | $80.97 – $362.88 | 16 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $873.16 | $1,052.00 | $225.34 – $1,009.92 | 16 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $543.65 | $655.00 | $140.31 – $628.80 | 16 |
| Injection, burosumab-twza 1m HCPCS J0584 | $10,556.28 | $12,718.40 | $1,816.19 – $8,139.75 | 16 |
| Injection, cangrelor HCPCS C9460 | $758.51 | $913.87 | $195.76 – $877.32 | 16 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $6,577.75 | $7,925.00 | $1,697.54 – $7,608.00 | 16 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $160.19 | $193.00 | $41.35 – $185.28 | 16 |
| Injection, daratumumab 10 mg HCPCS J9145 | $127.67 | $153.81 | $32.95 – $147.66 | 16 |
| Injection, doxercalciferol HCPCS J1270 | $2.65 | $3.19 | $0.69 – $3.07 | 16 |
| Injection, edaravone, 1 mg HCPCS J1301 | $4.79 | $5.77 | $1.24 – $5.54 | 16 |
| Injection epidural blood patch or clot CPT 62273 | $737.87 | $889.00 | $60.84 – $272.64 | 16 |
| Injection for arthrography wrist (both sides) CPT 25246 | $448.20 | $540.00 | $115.67 – $518.40 | 16 |
| Injection for bladder x-ray CPT 51600 | $590.13 | $711.00 | $152.30 – $682.56 | 16 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $424.96 | $512.00 | $109.68 – $491.52 | 16 |
| Injection for ureter x-ray CPT 50690 | $646.57 | $779.00 | $166.87 – $747.84 | 16 |
| Injection, fulvestrant HCPCS J9395 | $147.20 | $177.35 | $37.99 – $170.26 | 16 |
| Injection, glucarpidase HCPCS C9293 | $34,174.42 | $41,174.00 | $8,819.48 – $39,527.04 | 16 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $1,871.06 | $2,254.28 | $482.87 – $2,164.11 | 16 |
| Injection into brain canal CPT 61026 | $730.40 | $880.00 | $188.50 – $844.80 | 16 |
| Injection into hemorrhoid(s) CPT 46500 | $748.66 | $902.00 | $193.21 – $865.92 | 16 |
| Injection, isavuconazonium HCPCS J1833 | $299.00 | $360.24 | $77.17 – $345.84 | 16 |
| Injection, necitumumab, 1 mg HCPCS J9295 | $71.88 | $86.60 | $18.55 – $83.14 | 16 |
| Injection,onabotulinumtoxina HCPCS J0585 | $1,072.36 | $1,292.00 | $138.38 – $620.16 | 16 |
| Injection, peramivir HCPCS J2547 | $13.15 | $15.84 | $3.40 – $15.21 | 16 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $760.28 | $916.00 | $196.21 – $879.36 | 16 |
| Injection, renflexis HCPCS Q5104 | $291.03 | $350.63 | $75.11 – $336.61 | 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.