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 |
|---|---|---|---|---|
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $207.50 | $250.00 | $42.84 – $240.00 | 16 |
| Mayo inhab inhibin a CPT 86336 | $97.11 | $117.00 | $15.59 – $112.32 | 16 |
| Mayo insft insulin free CPT 83527 | $127.82 | $154.00 | $12.95 – $147.84 | 16 |
| Mayo insulin antibodies CPT 86337 | $553.61 | $667.00 | $21.41 – $640.32 | 16 |
| Mayo iodine CPT 83789 | $63.91 | $77.00 | $16.50 – $73.92 | 16 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $366.03 | $441.00 | $27.11 – $423.36 | 16 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $214.97 | $259.00 | $13.25 – $248.64 | 16 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $58.93 | $71.00 | $12.79 – $68.16 | 16 |
| Mayo legionella antibody CPT 86713 | $78.85 | $95.00 | $15.30 – $91.20 | 16 |
| Mayo leptospira antibody igm CPT 86720 | $73.04 | $88.00 | $16.20 – $84.48 | 16 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $119.52 | $144.00 | $4.93 – $34.39 | 16 |
| Mayo manganese CPT 83785 | $49.80 | $60.00 | $12.86 – $59.16 | 16 |
| Mayo metanephrines plasma CPT 83835 | $92.96 | $112.00 | $4.72 – $37.61 | 16 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $103.75 | $125.00 | $26.78 – $120.00 | 16 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $175.96 | $212.00 | $45.42 – $203.52 | 16 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $109.56 | $132.00 | $10.29 – $46.08 | 16 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $366.03 | $441.00 | $1.72 – $17.76 | 16 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $5.81 | $7.00 | $1.50 – $15.54 | 16 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $182.60 | $220.00 | $47.13 – $211.20 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $91.30 | $110.00 | $18.05 – $105.60 | 16 |
| Mayo myoglobin CPT 83874 | $156.04 | $188.00 | $12.92 – $180.48 | 16 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $23.24 | $28.00 | $6.00 – $26.88 | 16 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $23.24 | $28.00 | $6.00 – $26.88 | 16 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $211.65 | $255.00 | $21.21 – $244.80 | 16 |
| Mayo oxalate 24 hour urine CPT 83945 | $173.47 | $209.00 | $14.45 – $200.64 | 16 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $261.45 | $315.00 | $11.53 – $302.40 | 16 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $163.51 | $197.00 | $15.03 – $189.12 | 16 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $122.01 | $147.00 | $8.14 – $36.48 | 16 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $405.87 | $489.00 | $35.09 – $469.44 | 16 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $22.41 | $27.00 | $5.79 – $39.92 | 16 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $8.30 | $10.00 | $2.15 – $22.20 | 16 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $134.46 | $162.00 | $8.44 – $155.52 | 16 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $6.64 | $8.00 | $1.72 – $17.76 | 16 |
| Mayo proinsulin CPT 84206 | $63.08 | $76.00 | $16.28 – $72.96 | 16 |
| Mayo psaft prostate specific antigen free CPT 84154 | $175.96 | $212.00 | $13.07 – $58.56 | 16 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $55.61 | $67.00 | $14.36 – $64.32 | 16 |
| Mayo receptor assay transferrin soluble CPT 84238 | $244.02 | $294.00 | $36.57 – $282.24 | 16 |
| Mayo renin CPT 84244 | $201.69 | $243.00 | $21.99 – $233.28 | 16 |
| Mayo repu protein electrophoresis urine CPT 84166 | $133.63 | $161.00 | $34.49 – $154.56 | 16 |
| Mayo selenium CPT 84255 | $68.06 | $82.00 | $17.57 – $78.72 | 16 |
| Mayo serotonin CPT 84260 | $78.02 | $94.00 | $20.14 – $90.24 | 16 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $117.03 | $141.00 | $19.35 – $135.36 | 16 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $209.99 | $253.00 | $13.73 – $242.88 | 16 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $154.38 | $186.00 | $39.85 – $178.56 | 16 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $62.25 | $75.00 | $2.58 – $11.52 | 16 |
| Mayo tgrp testosterone free CPT 84402 | $150.23 | $181.00 | $18.00 – $80.64 | 16 |
| Mayo tgrp testosterone total CPT 84403 | $137.78 | $166.00 | $17.57 – $78.72 | 16 |
| Mayo thyroglobulin CPT 84432 | $97.94 | $118.00 | $16.06 – $113.28 | 16 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $73.04 | $88.00 | $10.18 – $84.48 | 16 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $80.51 | $97.00 | $14.16 – $93.12 | 16 |
| Mayo vasoactive intestinal peptide CPT 84586 | $122.01 | $147.00 | $31.49 – $141.12 | 16 |
| Mayo vitamin b3 (niacin) CPT 84591 | $55.61 | $67.00 | $7.93 – $37.87 | 16 |
| Mayo vitamin k CPT 84597 | $107.90 | $130.00 | $13.72 – $124.80 | 16 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $214.97 | $259.00 | $13.25 – $248.64 | 16 |
| Measurement post void urine by ultrasound CPT 51798 | $259.79 | $313.00 | $6.22 – $27.84 | 16 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $54.66 | $65.85 | $10.32 – $46.22 | 16 |
| Melphalan oral 2 mg HCPCS J8600 | $8.95 | $10.78 | $2.31 – $10.35 | 16 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $5.40 | $6.51 | $0.41 – $1.82 | 16 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $3,061.73 | $3,688.83 | $654.46 – $2,933.13 | 16 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $23.73 | $28.59 | $0.05 – $0.20 | 16 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $5.24 | $6.31 | $1.36 – $6.06 | 16 |
| Metabolic Blood Panel (Basic) CPT 80048 | $131.14 | $158.00 | $6.22 – $27.84 | 16 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $141.10 | $170.00 | $7.50 – $33.60 | 16 |
| Metatarsal joint implant HCPCS L8641 | $1,869.37 | $2,252.25 | $107.10 – $480.00 | 16 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $112.05 | $135.00 | $1.47 – $6.59 | 16 |
| Methadone injection HCPCS J1230 | $17.84 | $21.49 | $4.61 – $20.64 | 16 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $0.76 | $0.92 | $0.20 – $0.89 | 16 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $1.79 | $2.16 | $0.47 – $2.08 | 16 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $3.81 | $4.59 | $0.51 – $2.28 | 16 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $159.46 | $192.12 | $1.15 – $5.13 | 16 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $16.96 | $20.44 | $4.38 – $19.63 | 16 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $215.00 | $259.03 | $55.49 – $248.66 | 16 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $1.02 | $1.23 | $0.18 – $0.80 | 16 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $14.62 | $17.61 | $1.32 – $5.88 | 16 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $0.54 | $0.64 | $0.01 – $0.01 | 16 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.03 | $0.03 | $0.01 – $0.03 | 16 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $59.22 | $71.34 | $3.45 – $15.42 | 16 |
| Microalbumin urine screen CPT 82044 | $13.28 | $16.00 | $2.79 – $13.83 | 16 |
| Microdissection laser CPT 88380 | $268.09 | $323.00 | $69.19 – $310.08 | 16 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $2.63 | $3.17 | $0.01 – $0.01 | 16 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $0.18 | $0.22 | $0.04 – $0.17 | 16 |
| Middle cerebral artery echo CPT 76821 | $288.84 | $348.00 | $74.55 – $334.08 | 16 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $0.44 | $0.53 | $0.04 – $0.16 | 16 |
| Minocycline hydrochloride HCPCS J2265 | $164.26 | $197.90 | $42.40 – $189.99 | 16 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | $269.22 | $324.36 | $69.48 – $311.39 | 16 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $975.03 | $1,174.73 | $47.66 – $213.60 | 16 |
| Mitomycin instillation HCPCS J9281 | $963.93 | $1,161.35 | $248.77 – $1,114.90 | 16 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $6.78 | $8.17 | $1.76 – $7.85 | 16 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $710.48 | $856.00 | $183.36 – $821.76 | 16 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $8,403.75 | $10,125.00 | $1,922.99 – $8,618.40 | 16 |
| Monovisc inj per dose HCPCS J7327 | $168.51 | $203.02 | $43.49 – $194.90 | 16 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $5.15 | $6.20 | $0.17 – $0.76 | 16 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $3.47 | $4.18 | $0.35 – $1.54 | 16 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $12.54 | $15.11 | $0.45 – $1.98 | 16 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $746.17 | $899.00 | $192.57 – $863.04 | 16 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $135.29 | $163.00 | $34.92 – $156.48 | 16 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $324.53 | $391.00 | $83.76 – $375.36 | 16 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $746.17 | $899.00 | $79.69 – $357.12 | 16 |
| M/phmtrc alysishquant/semiq CPT 88369 | $703.01 | $847.00 | $181.43 – $813.12 | 16 |
| MRA abdomen post contrast CPT 74185 | $3,587.26 | $4,322.00 | $925.78 – $4,149.12 | 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.