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 |
|---|---|---|---|---|
| Mrgfus strtctc ablt trgt icr CPT 61715 | $39,564.44 | $47,668.00 | $631.68 – $2,831.04 | 16 |
| MRI brain without dye CPT 70557 | $676.45 | $815.00 | $174.58 – $782.40 | 16 |
| MRI chest without contrast CPT 71550 | $2,724.89 | $3,283.00 | $703.22 – $3,151.68 | 16 |
| MRI chest without & w/contrast CPT 71552 | $3,715.91 | $4,477.00 | $958.98 – $4,297.92 | 16 |
| MRI chest w IV cont CPT 71551 | $1,845.09 | $2,223.00 | $476.17 – $2,134.08 | 16 |
| MRI loex nonjt w IV cont CPT 73719 | $2,675.92 | $3,224.00 | $690.59 – $3,095.04 | 16 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,649.36 | $3,192.00 | $683.73 – $3,064.32 | 16 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $3,629.59 | $4,373.00 | $936.70 – $4,198.08 | 16 |
| MRI orbit/face/neck without contrast CPT 70540 | $2,499.13 | $3,011.00 | $644.96 – $2,890.56 | 16 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,811.21 | $3,387.00 | $725.50 – $3,251.52 | 16 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,753.79 | $2,113.00 | $452.61 – $2,028.48 | 16 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,387.91 | $2,877.00 | $616.26 – $2,761.92 | 16 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,130.76 | $3,772.00 | $807.97 – $3,621.12 | 16 |
| MRI upper extremity w/dye CPT 73219 | $2,065.04 | $2,488.00 | $532.93 – $2,388.48 | 16 |
| MRI w/cont, breast, bi HCPCS C8906 | $1,196.03 | $1,441.00 | $308.67 – $1,383.36 | 16 |
| MRI without fol w/cont, breast HCPCS C8908 | $3,158.98 | $3,806.00 | $815.25 – $3,653.76 | 16 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $2,920.77 | $3,519.00 | $753.77 – $3,378.24 | 16 |
| Mthfr gene analy common variants CPT 81291 | $43.16 | $52.00 | $11.14 – $115.44 | 16 |
| Mucin synovial fluid CPT 83872 | $56.44 | $68.00 | $5.86 – $65.28 | 16 |
| Multiple sleep latency test CPT 95805 | $4,003.09 | $4,823.00 | $1,033.09 – $4,630.08 | 16 |
| Mumps antibody igg CPT 86735 | $131.14 | $158.00 | $4.07 – $28.97 | 16 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3.58 | $4.31 | $0.13 – $0.57 | 16 |
| Mycophenolic acid HCPCS J7518 | $4.43 | $5.33 | $1.15 – $5.12 | 16 |
| Mycoplasma antibody igm CPT 86738 | $123.67 | $149.00 | $13.24 – $143.04 | 16 |
| Myelography via inj w/s&i cervical CPT 62302 | $1,759.60 | $2,120.00 | $454.11 – $2,035.20 | 16 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $1,754.62 | $2,114.00 | $452.82 – $2,029.44 | 16 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,759.60 | $2,120.00 | $454.11 – $2,035.20 | 16 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $1,218.44 | $1,468.00 | $11.53 – $94.08 | 16 |
| Myocrd img pet 1 std w/ct CPT 78429 | $2,018.56 | $2,432.00 | $520.94 – $2,334.72 | 16 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $4.19 | $5.05 | $1.07 – $4.77 | 16 |
| Naltrexone, depot form HCPCS J2315 | $1,283.17 | $1,545.98 | $331.15 – $1,484.15 | 16 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $443.22 | $534.00 | $45.84 – $205.44 | 16 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $301.29 | $363.00 | $77.76 – $348.48 | 16 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $472.43 | $569.19 | $121.93 – $546.43 | 16 |
| Natriuretic peptide CPT 83880 | $238.21 | $287.00 | $24.21 – $108.48 | 16 |
| Natural killer cells total count CPT 86357 | $9.96 | $12.00 | $2.58 – $26.64 | 16 |
| Navigational bronchoscopy 31627 CPT 31627 | $1,275.71 | $1,537.00 | $329.23 – $1,475.52 | 16 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $39.84 | $48.00 | $10.29 – $46.08 | 16 |
| Ndl insj without njx 3+ musc CPT 20561 | $55.61 | $67.00 | $14.36 – $64.32 | 16 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,601.22 | $3,134.00 | $671.31 – $3,008.64 | 16 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $2,454.31 | $2,957.00 | $633.39 – $2,838.72 | 16 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $4,186.52 | $5,044.00 | $1,080.43 – $4,842.24 | 16 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $3,014.56 | $3,632.00 | $777.98 – $3,486.72 | 16 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $3,349.05 | $4,035.00 | $864.30 – $3,873.60 | 16 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,848.56 | $3,432.00 | $735.14 – $3,294.72 | 16 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,683.39 | $3,233.00 | $692.51 – $3,103.68 | 16 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,503.28 | $3,016.00 | $646.03 – $2,895.36 | 16 |
| Needle emg guid w/chemodenervation add-on CPT 95874 | $48.14 | $58.00 | $12.43 – $55.68 | 16 |
| Neg pres wound ther drsg set HCPCS A6550 | $2,026.23 | $2,441.23 | $13.46 – $60.30 | 16 |
| Nelarabine injection HCPCS J9261 | $2.75 | $3.32 | $0.72 – $3.19 | 16 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $2.72 | $3.27 | $0.52 – $2.30 | 16 |
| Nerve conduction 7-8 studies CPT 95910 | $1,048.29 | $1,263.00 | $110.10 – $493.44 | 16 |
| Nerve conduction studies 11-12 CPT 95912 | $1,455.82 | $1,754.00 | $375.71 – $1,683.84 | 16 |
| Nerve conduction studies 1-2 CPT 95907 | $325.36 | $392.00 | $56.13 – $251.52 | 16 |
| Nerve conduction studies 13+ CPT 95913 | $2,006.94 | $2,418.00 | $517.94 – $2,321.28 | 16 |
| Nerve conduction studies 3-4 CPT 95908 | $560.25 | $675.00 | $70.05 – $313.92 | 16 |
| Nerve conduction studies 5-6 CPT 95909 | $817.55 | $985.00 | $83.97 – $376.32 | 16 |
| Nerve conduction studies 9-10 CPT 95911 | $1,284.84 | $1,548.00 | $132.81 – $595.20 | 16 |
| Neuromatrix nerve cuff, cm HCPCS C9355 | $2,112.15 | $2,544.75 | $434.30 – $1,946.40 | 16 |
| New Patient Office Visit (level 2) CPT 99202 | $208.33 | $251.00 | $40.27 – $180.48 | 16 |
| New Patient Office Visit (level 3) CPT 99203 | $273.07 | $329.00 | $67.26 – $301.44 | 16 |
| New Patient Office Visit (level 4) CPT 99204 | $419.98 | $506.00 | $100.68 – $451.20 | 16 |
| New Patient Office Visit (level 5) CPT 99205 | $517.09 | $623.00 | $133.24 – $597.12 | 16 |
| Nfct ds bv&vaginitis dna alg CPT 81514 | $460.65 | $555.00 | $118.89 – $583.84 | 16 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $1.75 | $2.10 | $0.05 – $0.23 | 16 |
| Nintedanib 150 mg capsule HCPCS J8999 | $0.27 | $0.32 | $0.04 – $0.18 | 16 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $1.01 | $1.21 | $0.02 – $0.07 | 16 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $264.04 | $318.11 | $60.51 – $271.19 | 16 |
| Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution HCPCS J9298 | $603.10 | $726.63 | $155.65 – $697.57 | 16 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | $873.16 | $1,052.00 | $225.34 – $1,009.92 | 16 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $2,153.02 | $2,594.00 | $555.64 – $2,490.24 | 16 |
| Nm imaging bone/joint whole body CPT 78306 | $1,794.46 | $2,162.00 | $463.11 – $2,075.52 | 16 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,758.77 | $2,119.00 | $453.89 – $2,034.24 | 16 |
| Nm imaging gastric emptying study CPT 78264 | $1,787.82 | $2,154.00 | $461.39 – $2,067.84 | 16 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,474.91 | $1,777.00 | $380.64 – $1,705.92 | 16 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,777.86 | $2,142.00 | $458.82 – $2,056.32 | 16 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,791.14 | $2,158.00 | $462.25 – $2,071.68 | 16 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $2,131.44 | $2,568.00 | $550.07 – $2,465.28 | 16 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,140.42 | $1,374.00 | $294.32 – $1,319.04 | 16 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $1,579.49 | $1,903.00 | $407.63 – $1,826.88 | 16 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $3,166.45 | $3,815.00 | $817.18 – $3,662.40 | 16 |
| Nuclear Stress Test (Heart) CPT 78452 | $4,260.39 | $5,133.00 | $46.70 – $209.28 | 16 |
| Nursing facility discharge management 30 min/less than 99315 CPT 99315 | $168.49 | $203.00 | $43.49 – $194.88 | 16 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $178.72 | $215.32 | $46.13 – $206.71 | 16 |
| Observation care discharge CPT 99217 | $166.83 | $201.00 | $43.06 – $192.96 | 16 |
| Observation/inpatient hospital care hi severity 99236 CPT 99236 | $493.85 | $595.00 | $127.45 – $571.20 | 16 |
| Observation/inpatient hospital care low severity 99234 CPT 99234 | $302.12 | $364.00 | $77.97 – $349.44 | 16 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $385.95 | $465.00 | $99.61 – $446.40 | 16 |
| Obstetric panel inc HIV tstg CPT 80081 | $288.01 | $347.00 | $74.33 – $333.12 | 16 |
| Obstetrics panel CPT 80055 | $131.97 | $159.00 | $30.21 – $135.36 | 16 |
| Obtaining screen pap smear HCPCS Q0091 | $84.66 | $102.00 | $21.85 – $97.92 | 16 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $1,636.29 | $1,971.43 | $422.29 – $1,892.58 | 16 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $20.79 | $25.05 | $0.73 – $3.26 | 16 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $5,194.97 | $6,259.00 | $895.33 – $4,012.66 | 16 |
| Office consultation CPT 99241 | $84.66 | $102.00 | $21.85 – $97.92 | 16 |
| Off/op cnsltj new/est low 30 CPT 99243 | $218.29 | $263.00 | $56.34 – $252.48 | 16 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $327.02 | $394.00 | $84.40 – $378.24 | 16 |
| Off/op consltj new/est hi 55 CPT 99245 | $399.23 | $481.00 | $103.04 – $461.76 | 16 |
| Off/op consltj new/est sf 20 CPT 99242 | $159.36 | $192.00 | $41.13 – $184.32 | 16 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $37.07 | $44.66 | $9.57 – $42.88 | 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.