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 |
|---|---|---|---|---|
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $2,045.09 | $2,463.96 | $527.79 – $2,365.41 | 16 |
| Sarscov coronavirus ag ia CPT 87426 | $92.96 | $112.00 | $16.93 – $78.43 | 16 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $351.92 | $424.00 | $70.29 – $407.04 | 16 |
| S bowel endoscope w/stent CPT 44379 | $947.03 | $1,141.00 | $244.41 – $1,095.36 | 16 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $211.65 | $255.00 | $54.63 – $244.80 | 16 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,259.94 | $1,518.00 | $33.42 – $149.76 | 16 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $794.31 | $957.00 | $23.14 – $103.68 | 16 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $554.44 | $668.00 | $22.28 – $99.84 | 16 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,033.35 | $1,245.00 | $13.93 – $62.40 | 16 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,013.43 | $1,221.00 | $261.54 – $1,172.16 | 16 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,202.67 | $1,449.00 | $33.42 – $149.76 | 16 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,245.00 | $1,500.00 | $22.50 – $100.80 | 16 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,045.80 | $1,260.00 | $13.71 – $61.44 | 16 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,071.53 | $1,291.00 | $276.54 – $1,239.36 | 16 |
| Scope plantar fasciotomy CPT 29893 | $1,561.23 | $1,881.00 | $402.92 – $1,805.76 | 16 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,801.25 | $3,375.00 | $511.68 – $2,293.20 | 16 |
| Screening Mammogram CPT 77067 | $411.68 | $496.00 | $81.96 – $476.16 | 16 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $25,399.05 | $30,601.26 | $0.01 – $0.04 | 16 |
| Sedimentation rate erythrocyte automated CPT 85652 | $43.16 | $52.00 | $1.72 – $7.68 | 16 |
| Semen analysis presence/motility CPT 89321 | $78.02 | $94.00 | $12.05 – $90.24 | 16 |
| Sertraline (zoloft) - sendout CPT 80332 | $208.33 | $251.00 | $53.77 – $240.96 | 16 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $363.54 | $438.00 | $93.82 – $420.48 | 16 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $253.15 | $305.00 | $57.41 – $257.28 | 16 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $144.42 | $174.00 | $37.28 – $167.04 | 16 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,579.32 | $9,131.70 | $1,771.78 – $7,940.74 | 16 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $740.36 | $892.00 | $191.07 – $856.32 | 16 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $740.36 | $892.00 | $191.07 – $856.32 | 16 |
| Sho arthrs srg rpr slap les CPT 29807 | $2,343.92 | $2,824.00 | $604.91 – $2,711.04 | 16 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $4,163.28 | $5,016.00 | $1,074.43 – $4,815.36 | 16 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $1,410.17 | $1,699.00 | $363.93 – $1,631.04 | 16 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,861.99 | $4,653.00 | $996.68 – $4,466.88 | 16 |
| Shoulder MRI (with contrast) CPT 73222 | $3,403.83 | $4,101.00 | $878.44 – $3,936.96 | 16 |
| Shoulder MRI (without contrast) CPT 73221 | $2,413.64 | $2,908.00 | $622.90 – $2,791.68 | 16 |
| Shoulder X-ray CPT 73030 | $292.99 | $353.00 | $5.57 – $24.96 | 16 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $4,765.86 | $5,742.00 | $975.95 – $4,374.00 | 16 |
| Sigmoidoscopy and biopsy CPT 45331 | $693.88 | $836.00 | $179.08 – $802.56 | 16 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $264.77 | $319.00 | $68.33 – $306.24 | 16 |
| Sigmoidoscopy for bleeding CPT 45334 | $1,205.16 | $1,452.00 | $311.02 – $1,393.92 | 16 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $705.50 | $850.00 | $182.07 – $816.00 | 16 |
| Sigmoidoscopy w/ablation CPT 45346 | $5,700.44 | $6,868.00 | $1,471.13 – $6,593.28 | 16 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $665.66 | $802.00 | $171.79 – $769.92 | 16 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $356.07 | $429.00 | $91.90 – $411.84 | 16 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $719.61 | $867.00 | $185.72 – $832.32 | 16 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $287.18 | $346.00 | $74.12 – $332.16 | 16 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $392.59 | $473.00 | $101.32 – $454.08 | 16 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $795.14 | $958.00 | $205.21 – $919.68 | 16 |
| Sig w/tndsc balloon dilation CPT 45340 | $1,118.84 | $1,348.00 | $288.75 – $1,294.08 | 16 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $299.63 | $361.00 | $26.08 – $116.85 | 16 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,806.23 | $3,381.00 | $724.22 – $3,245.76 | 16 |
| Sinus CT scan (with contrast) CPT 70487 | $2,255.94 | $2,718.00 | $582.20 – $2,609.28 | 16 |
| Sinus CT scan (without contrast) CPT 70486 | $1,834.30 | $2,210.00 | $473.39 – $2,121.60 | 16 |
| Sirolimus, oral HCPCS J7520 | $24.62 | $29.66 | $0.92 – $4.08 | 16 |
| Skin Biopsy CPT 11102 | $232.40 | $280.00 | $59.98 – $268.80 | 16 |
| Skyla, 13.5 mg HCPCS J7301 | $755.50 | $910.24 | $194.98 – $873.84 | 16 |
| Sleep study attended CPT 95807 | $1,879.95 | $2,265.00 | $485.17 – $2,174.40 | 16 |
| Sleep Study (Polysomnography) CPT 95810 | $3,563.19 | $4,293.00 | $919.57 – $4,121.28 | 16 |
| Sleep study unattended CPT 95806 | $517.92 | $624.00 | $133.67 – $599.04 | 16 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $14.30 | $17.22 | $3.69 – $16.54 | 16 |
| Sling suprapubic suburetheral HCPCS C1771 | $7,833.34 | $9,437.75 | $131.74 – $590.40 | 16 |
| Slp eval non-spch gen comm dev CPT 92605 | $297.14 | $358.00 | $76.69 – $343.68 | 16 |
| Slp pure tone screening CPT 92551 | $197.54 | $238.00 | $50.98 – $228.48 | 16 |
| Small bowel endoscopy CPT 44360 | $332.00 | $400.00 | $85.68 – $384.00 | 16 |
| Small bowel endoscopy CPT 44364 | $472.27 | $569.00 | $121.88 – $546.24 | 16 |
| Small bowel endoscopy CPT 44366 | $555.27 | $669.00 | $143.30 – $642.24 | 16 |
| Small bowel endoscopy CPT 44369 | $568.55 | $685.00 | $146.73 – $657.60 | 16 |
| Small bowel endoscopy CPT 44376 | $658.19 | $793.00 | $169.87 – $761.28 | 16 |
| Small bowel endoscopy CPT 44378 | $891.42 | $1,074.00 | $230.06 – $1,031.04 | 16 |
| Small bowel endoscopy CPT 44382 | $725.42 | $874.00 | $187.22 – $839.04 | 16 |
| Small bowel endoscopy CPT 44384 | $356.07 | $429.00 | $91.90 – $411.84 | 16 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $443.22 | $534.00 | $114.39 – $512.64 | 16 |
| Small bowel endoscopy 44365 CPT 44365 | $420.81 | $507.00 | $108.60 – $486.72 | 16 |
| Small bowel endoscopy/biopsy CPT 44361 | $366.86 | $442.00 | $94.68 – $424.32 | 16 |
| Small bowel endoscopy/biopsy CPT 44377 | $692.22 | $834.00 | $178.65 – $800.64 | 16 |
| Small bowel endoscopy br/wa CPT 44380 | $468.95 | $565.00 | $121.03 – $542.40 | 16 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $616.69 | $743.00 | $159.16 – $713.28 | 16 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | $0.01 | $0.01 | $0.01 – $0.01 | 16 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $79.68 | $96.00 | $5.39 – $92.16 | 16 |
| Smear gram stain CPT 87205 | $49.80 | $60.00 | $3.00 – $13.44 | 16 |
| Smear nasal eosinophil CPT 89190 | $43.99 | $53.00 | $5.79 – $50.88 | 16 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $39.01 | $47.00 | $10.07 – $45.12 | 16 |
| Smear wet mount CPT 87210 | $82.17 | $99.00 | $3.00 – $13.44 | 16 |
| Sock fracture or equal each HCPCS L3995 | $35.60 | $42.89 | $9.19 – $41.18 | 16 |
| Sodium 24 hour urine CPT 84300 | $60.59 | $73.00 | $5.06 – $70.08 | 16 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $0.01 | $0.01 | $0.01 – $0.01 | 16 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $0.01 | $0.02 | $0.01 – $0.02 | 16 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $0.01 | $0.02 | $0.01 – $0.02 | 16 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $4.83 | $5.82 | $1.25 – $5.59 | 16 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $75.05 | $90.42 | $19.37 – $86.81 | 16 |
| Sodium serum/plasma/whole blood CPT 84295 | $100.43 | $121.00 | $3.43 – $15.36 | 16 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1.65 | $1.98 | $0.43 – $1.91 | 16 |
| Somatropin injection HCPCS J2941 | $232.28 | $279.85 | $59.95 – $268.66 | 16 |
| Special physics consult CPT 77370 | $1,088.96 | $1,312.00 | $281.04 – $1,259.52 | 16 |
| Specific gravity body fluid CPT 84315 | $27.39 | $33.00 | $3.28 – $31.68 | 16 |
| Specimen fat stain CPT 89125 | $28.22 | $34.00 | $5.88 – $32.64 | 16 |
| Speech evaluation complex CPT 70371 | $489.70 | $590.00 | $126.38 – $566.40 | 16 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $873.16 | $1,052.00 | $225.34 – $1,009.92 | 16 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $698.86 | $842.00 | $180.36 – $808.32 | 16 |
| Splenectomy total open 38100 CPT 38100 | $2,564.70 | $3,090.00 | $661.88 – $2,966.40 | 16 |
| Srs cranial lesion simple CPT 61796 | $1,411.00 | $1,700.00 | $364.14 – $1,632.00 | 16 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $269.75 | $325.00 | $69.62 – $312.00 | 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.