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 |
|---|---|---|---|---|
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $818.38 | $986.00 | $24.42 – $109.44 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $818.38 | $986.00 | $45.84 – $205.44 | 16 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,108.05 | $1,335.00 | $151.23 – $677.76 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,147.06 | $1,382.00 | $296.03 – $1,326.72 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,794.46 | $2,162.00 | $463.11 – $2,075.52 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,172.79 | $1,413.00 | $55.05 – $246.72 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,185.24 | $1,428.00 | $106.46 – $477.12 | 16 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,291.48 | $1,556.00 | $105.82 – $474.24 | 16 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,201.84 | $1,448.00 | $104.11 – $466.56 | 16 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $252.32 | $304.00 | $34.28 – $153.60 | 16 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $250.66 | $302.00 | $18.43 – $82.56 | 16 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $808.42 | $974.00 | $1.03 – $4.61 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $144.42 | $174.00 | $32.56 – $145.92 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $126.16 | $152.00 | $30.85 – $138.24 | 16 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $263.11 | $317.00 | $32.56 – $145.92 | 16 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $202.52 | $244.00 | $35.99 – $161.28 | 16 |
| Inject sacroiliac joint CPT 27096 | $1,189.39 | $1,433.00 | $67.91 – $304.32 | 16 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | $2,337.79 | $2,816.61 | $603.32 – $2,703.95 | 16 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,098.09 | $1,323.00 | $81.83 – $366.72 | 16 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $826.68 | $996.00 | $74.76 – $335.04 | 16 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $135.71 | $163.50 | $35.03 – $156.96 | 16 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $250.22 | $301.47 | $64.58 – $289.42 | 16 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $8.33 | $10.04 | $2.16 – $9.64 | 16 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $9.65 | $11.62 | $2.49 – $11.16 | 16 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | $848.18 | $1,021.90 | $218.90 – $981.03 | 16 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | $1.54 | $1.85 | $0.40 – $1.78 | 16 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | $1,380.54 | $1,663.30 | $356.28 – $1,596.77 | 16 |
| Inj., guselkumab, 1 mg HCPCS J1628 | $11,666.99 | $14,056.61 | $148.58 – $665.90 | 16 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $239.91 | $289.05 | $61.92 – $277.49 | 16 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $119.52 | $144.00 | $30.85 – $138.24 | 16 |
| Inj ivig privigen 500 mg HCPCS J1459 | $6.05 | $7.28 | $1.56 – $6.99 | 16 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $105.75 | $127.41 | $27.30 – $122.32 | 16 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $5.91 | $7.12 | $1.53 – $6.84 | 16 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $10.84 | $13.06 | $2.80 – $12.54 | 16 |
| Inj, levothyroxine, hikma HCPCS J0652 | $42.89 | $51.67 | $11.07 – $49.61 | 16 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $0.78 | $0.94 | $0.03 – $0.14 | 16 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $155.70 | $187.58 | $40.18 – $180.08 | 16 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $0.26 | $0.32 | $0.05 – $0.19 | 16 |
| Inj, meropenem (b. braun) HCPCS J2184 | $15.57 | $18.75 | $4.02 – $18.00 | 16 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $147.64 | $177.88 | $38.11 – $170.77 | 16 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | $530.83 | $639.55 | $137.00 – $613.97 | 16 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $0.14 | $0.17 | $0.04 – $0.17 | 16 |
| Inj multihance HCPCS A9577 | $1.30 | $1.57 | $0.34 – $1.51 | 16 |
| Inj. mycophenolate mofetil HCPCS J7519 | $55.36 | $66.69 | $14.29 – $64.03 | 16 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $2.73 | $3.29 | $0.71 – $3.16 | 16 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | $1,489.74 | $1,794.87 | $384.47 – $1,723.08 | 16 |
| Inj ogivri 10 mg HCPCS Q5114 | $1,238.58 | $1,492.26 | $114.16 – $511.64 | 16 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $1,577.00 | $1,900.00 | $406.98 – $1,824.00 | 16 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | $152.10 | $183.26 | $39.26 – $175.93 | 16 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | $1.89 | $2.27 | $0.49 – $2.18 | 16 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | $133.15 | $160.42 | $34.37 – $154.01 | 16 |
| Inj proc ankle arthr CPT 27648 | $535.35 | $645.00 | $138.16 – $619.20 | 16 |
| Inj progesterone per 50 mg HCPCS J2675 | $2.30 | $2.77 | $0.60 – $2.66 | 16 |
| Inj, releuko 1 mcg HCPCS Q5125 | $148.08 | $178.40 | $38.22 – $171.27 | 16 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $291.73 | $351.47 | $3.77 – $16.88 | 16 |
| Inj secretin synthetic human HCPCS J2850 | $548.63 | $661.00 | $141.59 – $634.56 | 16 |
| Inj secukinumab intrav 1mg HCPCS J3247 | $3,056.12 | $3,682.07 | $91.52 – $410.15 | 16 |
| Inj, spesolimab-sbzo, 1 mg HCPCS J1747 | $2,829.36 | $3,408.87 | $730.18 – $3,272.52 | 16 |
| Inj teplizumab mzwv 5 mcg HCPCS J9381 | $4,495.01 | $5,415.67 | $1,160.04 – $5,199.05 | 16 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $12,841.43 | $15,471.60 | $3,314.02 – $14,852.74 | 16 |
| Inj testosterone cypionate HCPCS J1071 | $16.65 | $20.06 | $0.75 – $3.36 | 16 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | $11,053.78 | $13,317.80 | $2,852.68 – $12,785.09 | 16 |
| Inj, tofidence, 1 mg HCPCS Q5133 | $92.13 | $111.00 | $23.78 – $106.56 | 16 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $74.48 | $89.73 | $19.22 – $86.14 | 16 |
| Inj, uzedy, 1 mg HCPCS J2799 | $6,622.84 | $7,979.33 | $0.01 – $0.01 | 16 |
| Inj w/fluor eval cv device CPT 36598 | $553.61 | $667.00 | $142.88 – $640.32 | 16 |
| Inpatient consultation CPT 99251 | $87.98 | $106.00 | $22.71 – $101.76 | 16 |
| Ins cerv dilator (sep proc) CPT 59200 | $328.68 | $396.00 | $84.83 – $380.16 | 16 |
| Insert cath pleura with image CPT 32557 | $1,612.69 | $1,943.00 | $416.20 – $1,865.28 | 16 |
| Insert cath pleura without image CPT 32556 | $1,801.93 | $2,171.00 | $465.03 – $2,084.16 | 16 |
| Insert intrauterine device iud CPT 58300 | $249.83 | $301.00 | $64.48 – $288.96 | 16 |
| Insertion catheter bladder non indwelling CPT 51701 | $220.78 | $266.00 | $26.78 – $120.00 | 16 |
| Insertion catheter bladder temporary simple CPT 51702 | $221.61 | $267.00 | $37.28 – $167.04 | 16 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $1,927.26 | $2,322.00 | $497.38 – $2,229.12 | 16 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $2,397.87 | $2,889.00 | $131.52 – $589.44 | 16 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $3,558.21 | $4,287.00 | $55.70 – $249.60 | 16 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,426.77 | $1,719.00 | $177.79 – $796.80 | 16 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $5,558.51 | $6,697.00 | $92.75 – $415.68 | 16 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $3,282.65 | $3,955.00 | $616.47 – $2,762.88 | 16 |
| Insert tunneled cv 2cath 2sits without port/pmp 36565 CPT 36565 | $1,969.59 | $2,373.00 | $508.30 – $2,278.08 | 16 |
| Insert tunneled cv cath CPT 36560 | $2,984.68 | $3,596.00 | $770.27 – $3,452.16 | 16 |
| Insert tunneled cv cath CPT 36563 | $2,695.84 | $3,248.00 | $695.73 – $3,118.08 | 16 |
| Insitu hybridization manual CPT 88368 | $668.98 | $806.00 | $172.65 – $773.76 | 16 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $556.10 | $670.00 | $143.52 – $643.20 | 16 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $528.71 | $637.00 | $136.45 – $611.52 | 16 |
| Ins picad w subq port 5yr> CPT 36571 | $3,100.05 | $3,735.00 | $800.04 – $3,585.60 | 16 |
| Insti hexaminolevulinate hcl HCPCS A9589 | $1,053.27 | $1,269.00 | $271.82 – $1,218.24 | 16 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $610.05 | $735.00 | $157.44 – $705.60 | 16 |
| Instill, bupivac and meloxic HCPCS C9088 | $16.63 | $20.04 | $4.25 – $19.02 | 16 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | $10,439.74 | $12,578.00 | $2,694.21 – $12,074.88 | 16 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,021.05 | $2,435.00 | $521.58 – $2,337.60 | 16 |
| Insulin total CPT 83525 | $82.17 | $99.00 | $11.43 – $95.04 | 16 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $8,479.58 | $10,216.35 | $2,188.35 – $9,807.70 | 16 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $205.80 | $247.95 | $53.12 – $238.04 | 16 |
| Interdiscal perq aspir dx CPT 62267 | $236.55 | $285.00 | $61.05 – $273.60 | 16 |
| Interrogate subq defib CPT 93261 | $135.29 | $163.00 | $34.92 – $156.48 | 16 |
| Interrog dev eval scrms ip CPT 93291 | $144.42 | $174.00 | $37.28 – $167.04 | 16 |
| Interrog device eval heart CPT 93289 | $190.07 | $229.00 | $49.06 – $219.84 | 16 |
| Interrog evl pm/ldls pm ip CPT 93288 | $154.38 | $186.00 | $39.85 – $178.56 | 16 |
| Intranasal biopsy 30100 CPT 30100 | $334.49 | $403.00 | $86.33 – $386.88 | 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.