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 |
|---|---|---|---|---|
| Place gastrostomy tube open 43832 CPT 43832 | $2,329.81 | $2,807.00 | $601.26 – $2,694.72 | 16 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,131.29 | $1,363.00 | $146.09 – $654.72 | 16 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $402.55 | $485.00 | $91.25 – $408.96 | 16 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,628.46 | $1,962.00 | $232.63 – $1,042.56 | 16 |
| Placement of seton CPT 46020 | $262.28 | $316.00 | $67.69 – $303.36 | 16 |
| Plasma cryoprecipitate reduced each unit HCPCS P9044 | $244.02 | $294.00 | $60.62 – $271.68 | 16 |
| Plastic mod low ext pad/line HCPCS L2275 | $275.13 | $331.47 | $71.01 – $318.22 | 16 |
| Platelet automated CPT 85049 | $55.61 | $67.00 | $4.48 – $64.32 | 16 |
| Platelets pheresis leukocytes reduced cmv negative irradiated each unit HCPCS P9053 | $853.24 | $1,028.00 | $220.20 – $986.88 | 16 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $913.83 | $1,101.00 | $235.84 – $1,056.96 | 16 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,166.98 | $1,406.00 | $301.17 – $1,349.76 | 16 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $653.21 | $787.00 | $168.58 – $755.52 | 16 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $1,210.97 | $1,459.00 | $312.52 – $1,400.64 | 16 |
| Plc pq device breast ea addl lesion stereo guide CPT 19284 | $621.67 | $749.00 | $118.46 – $530.88 | 16 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $742.85 | $895.00 | $191.71 – $859.20 | 16 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $908.02 | $1,094.00 | $234.34 – $1,050.24 | 16 |
| Pm device progr eval dual CPT 93280 | $146.91 | $177.00 | $37.92 – $169.92 | 16 |
| Pm device progr eval multi CPT 93281 | $151.89 | $183.00 | $39.20 – $175.68 | 16 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $38.18 | $46.00 | $9.86 – $57.88 | 16 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $14,997.55 | $18,069.33 | $829.39 – $3,717.13 | 16 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $3,790.61 | $4,567.00 | $978.26 – $4,384.32 | 16 |
| Positional nystagmus test CPT 92532 | $66.40 | $80.00 | $17.14 – $76.80 | 16 |
| Postop app non-wgt bear dsg HCPCS L5450 | $583.11 | $702.54 | $150.49 – $674.44 | 16 |
| Postpartum Care Only CPT 59430 | $1,882.44 | $2,268.00 | $485.81 – $2,177.28 | 16 |
| Potassium 24 hour urine CPT 84133 | $54.78 | $66.00 | $4.73 – $63.36 | 16 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $0.76 | $0.91 | $0.01 – $0.01 | 16 |
| Potassium serum/plasma/whole blood CPT 84132 | $97.11 | $117.00 | $3.43 – $15.36 | 16 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | $4.48 | $5.39 | $1.16 – $5.18 | 16 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $65.82 | $79.30 | $16.99 – $76.13 | 16 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $1,636.76 | $1,972.00 | $359.86 – $1,612.80 | 16 |
| Pr application of long arm splint CPT 29105 | $358.56 | $432.00 | $47.77 – $214.08 | 16 |
| Pr application splint static short arm CPT 29125 | $307.93 | $371.00 | $38.35 – $171.84 | 16 |
| Pr biopsy skin punch single lesion CPT 11104 | $466.46 | $562.00 | $120.39 – $539.52 | 16 |
| Pr correction hammertoe CPT 28285 | $1,250.81 | $1,507.00 | $322.80 – $1,446.72 | 16 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $26.56 | $32.00 | $6.86 – $30.72 | 16 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $239.04 | $288.00 | $32.35 – $144.96 | 16 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $166.00 | $200.00 | $42.84 – $192.00 | 16 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $245.68 | $296.00 | $63.41 – $284.16 | 16 |
| Prealbumin CPT 84134 | $80.51 | $97.00 | $10.29 – $46.08 | 16 |
| Pr ecg 12 lead report only CPT 93010 | $19.92 | $24.00 | $5.15 – $23.04 | 16 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | $44.82 | $54.00 | $11.57 – $51.84 | 16 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $0.50 | $0.60 | $0.05 – $0.20 | 16 |
| Prednisone 1 mg tablet HCPCS J7512 | $0.36 | $0.43 | $0.03 – $0.14 | 16 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $457.33 | $551.00 | $118.03 – $528.96 | 16 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $888.10 | $1,070.00 | $213.56 – $957.12 | 16 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,008.45 | $1,215.00 | $260.26 – $1,166.40 | 16 |
| Pressure max expiratory/inspiratory CPT 94799 | $224.10 | $270.00 | $6.86 – $30.72 | 16 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $135.29 | $163.00 | $34.92 – $156.48 | 16 |
| Pretreat rbc absorption reference CPT 86978 | $146.08 | $176.00 | $37.70 – $168.96 | 16 |
| Pretreat rbc density gradient separation reference CPT 86972 | $71.38 | $86.00 | $18.43 – $82.56 | 16 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $80.51 | $97.00 | $20.78 – $93.12 | 16 |
| Pretreat rbc w enzyme reference CPT 86971 | $50.63 | $61.00 | $13.07 – $58.56 | 16 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $300.46 | $362.00 | $77.55 – $347.52 | 16 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $1,982.87 | $2,389.00 | $134.52 – $602.88 | 16 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $478.91 | $577.00 | $67.69 – $303.36 | 16 |
| Prgrmg dev eval impltbl sys CPT 93260 | $135.29 | $163.00 | $34.92 – $156.48 | 16 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $124.50 | $150.00 | $32.13 – $144.00 | 16 |
| Prgrmg dev eval scrms ip CPT 93285 | $212.48 | $256.00 | $54.84 – $245.76 | 16 |
| Prgrmg eval implantable dfb CPT 93282 | $190.07 | $229.00 | $49.06 – $219.84 | 16 |
| Prgrmg eval implantable dfb CPT 93283 | $192.56 | $232.00 | $49.70 – $222.72 | 16 |
| Prgrmg eval implantable dfb CPT 93284 | $224.93 | $271.00 | $58.05 – $260.16 | 16 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $462.31 | $557.00 | $119.31 – $534.72 | 16 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $313.74 | $378.00 | $80.97 – $362.88 | 16 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $123.67 | $149.00 | $31.92 – $143.04 | 16 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $249.00 | $300.00 | $64.26 – $288.00 | 16 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $166.00 | $200.00 | $42.84 – $192.00 | 16 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $89.64 | $108.00 | $23.14 – $103.68 | 16 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $1,300.61 | $1,567.00 | $127.88 – $573.12 | 16 |
| Pr incision & drainage abscess simple/single CPT 10060 | $345.28 | $416.00 | $75.19 – $336.96 | 16 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $346.94 | $418.00 | $89.54 – $401.28 | 16 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $375.16 | $452.00 | $90.83 – $407.04 | 16 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $207.50 | $250.00 | $22.92 – $102.72 | 16 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $5,593.17 | $6,738.75 | $650.64 – $2,916.00 | 16 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $216.35 | $260.67 | $1.03 – $4.60 | 16 |
| Procalcitonin CPT 84145 | $236.55 | $285.00 | $27.22 – $273.60 | 16 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $7.03 | $8.46 | $1.82 – $8.13 | 16 |
| Proctosigmoidoscopy ablate CPT 45320 | $527.05 | $635.00 | $136.02 – $609.60 | 16 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | $523.73 | $631.00 | $135.17 – $605.76 | 16 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | $2,323.17 | $2,799.00 | $599.55 – $2,687.04 | 16 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $1,121.33 | $1,351.00 | $78.62 – $352.32 | 16 |
| Proctosigmoidoscopy removal CPT 45308 | $483.06 | $582.00 | $124.67 – $558.72 | 16 |
| Proctosigmoidoscopy removal CPT 45309 | $498.00 | $600.00 | $128.52 – $576.00 | 16 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | $537.01 | $647.00 | $138.59 – $621.12 | 16 |
| Proctosigmoidoscopy volvul CPT 45321 | $229.08 | $276.00 | $59.12 – $264.96 | 16 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | $429.94 | $518.00 | $110.96 – $497.28 | 16 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $1,358.71 | $1,637.00 | $130.24 – $583.68 | 16 |
| Proctosigmoidoscopy w/stent CPT 45327 | $258.13 | $311.00 | $66.62 – $298.56 | 16 |
| Progesterone CPT 84144 | $141.10 | $170.00 | $20.86 – $163.20 | 16 |
| Prolactin CPT 84146 | $167.66 | $202.00 | $13.93 – $62.40 | 16 |
| Prolng ip/obs e/m ea 15 min CPT 99418 | $73.04 | $88.00 | $18.85 – $84.48 | 16 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | $107.90 | $130.00 | $27.85 – $124.80 | 16 |
| Promethazine hcl injection HCPCS J2550 | $2.63 | $3.17 | $0.48 – $2.12 | 16 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $0.11 | $0.13 | $0.03 – $0.13 | 16 |
| _propoxygc/msur CPT 80367 | $23.24 | $28.00 | $6.00 – $26.88 | 16 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $8.72 | $10.50 | $0.05 – $0.20 | 16 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $1.66 | $2.00 | $0.43 – $1.92 | 16 |
| Protect body sock ea pre ots HCPCS L0984 | $120.25 | $144.87 | $31.04 – $139.08 | 16 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $3,404.91 | $4,102.29 | $390.54 – $1,750.32 | 16 |
| Protein c activity CPT 85303 | $214.97 | $259.00 | $13.84 – $248.64 | 16 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $107.90 | $130.00 | $7.72 – $34.56 | 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.