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 |
|---|---|---|---|---|
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $106.36 | $128.15 | $27.45 – $123.03 | 16 |
| Tomosynthesis breast screen bilateral CPT 77063 | $54.78 | $66.00 | $14.14 – $105.63 | 16 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $106.28 | $128.04 | $2.35 – $10.54 | 16 |
| Total Knee Replacement CPT 27447 | $2,895.04 | $3,488.00 | $747.13 – $3,348.48 | 16 |
| Toxoplasma antibody igg CPT 86777 | $50.63 | $61.00 | $13.07 – $58.56 | 16 |
| Toxoplasma antibody igm CPT 86778 | $68.06 | $82.00 | $14.41 – $78.72 | 16 |
| Tpmt gene com vrnts CPT 81335 | $189.24 | $228.00 | $48.84 – $388.08 | 16 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $2,570.75 | $3,097.28 | $663.44 – $2,973.39 | 16 |
| Transferrin CPT 84466 | $115.37 | $139.00 | $12.76 – $133.44 | 16 |
| Transfusion blood/blood component(s) CPT 36430 | $1,743.83 | $2,101.00 | $157.87 – $707.52 | 16 |
| Transparent film <= 16 sq in HCPCS A6257 | $1.27 | $1.53 | $0.33 – $1.47 | 16 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $1,293.49 | $1,558.42 | $333.82 – $1,496.09 | 16 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $2,896.24 | $3,489.44 | $266.95 – $1,196.39 | 16 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $1,790.05 | $2,156.68 | $164.99 – $739.44 | 16 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $996.00 | $1,200.00 | $90.50 – $405.60 | 16 |
| Treat ankle dislocation CPT 27842 | $1,290.65 | $1,555.00 | $294.10 – $1,318.08 | 16 |
| Treat clavicle dislocation 23545 CPT 23545 | $812.57 | $979.00 | $56.77 – $254.40 | 16 |
| Treat elbow dislocation CPT 24605 | $1,440.88 | $1,736.00 | $284.03 – $1,272.96 | 16 |
| Treat finger fracture each CPT 26742 | $869.01 | $1,047.00 | $84.40 – $378.24 | 16 |
| Treat foot bone lesion CPT 28005 | $2,856.03 | $3,441.00 | $737.07 – $3,303.36 | 16 |
| Treat foot dislocation CPT 28540 | $458.99 | $553.00 | $45.84 – $205.44 | 16 |
| Treat fracture of radius CPT 25505 | $1,167.81 | $1,407.00 | $117.60 – $527.04 | 16 |
| Treat fracture of radius CPT 25520 | $1,961.29 | $2,363.00 | $506.16 – $2,268.48 | 16 |
| Treat fracture of ulna CPT 25535 | $332.00 | $400.00 | $85.68 – $384.00 | 16 |
| Treat hip dislocation CPT 27252 | $1,717.27 | $2,069.00 | $443.18 – $1,986.24 | 16 |
| Treat hip dislocation CPT 27257 | $1,542.14 | $1,858.00 | $210.35 – $942.72 | 16 |
| Treat humerus fracture CPT 24535 | $1,424.28 | $1,716.00 | $205.85 – $922.56 | 16 |
| Treat humerus fracture CPT 24565 | $1,249.15 | $1,505.00 | $83.54 – $374.40 | 16 |
| Treat knee fracture 27530 CPT 27530 | $942.88 | $1,136.00 | $184.65 – $827.52 | 16 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $815.06 | $982.00 | $210.35 – $942.72 | 16 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $206.67 | $249.00 | $5.15 – $23.04 | 16 |
| Treatment mouth roof lesion CPT 42160 | $1,805.25 | $2,175.00 | $141.38 – $633.60 | 16 |
| Treatment of ankle fracture 27786 CPT 27786 | $731.23 | $881.00 | $65.34 – $292.80 | 16 |
| Treatment of fibula fracture 27780 CPT 27780 | $719.61 | $867.00 | $65.34 – $292.80 | 16 |
| Treatment of heel fracture 28400 CPT 28400 | $575.19 | $693.00 | $82.26 – $368.64 | 16 |
| Treatment of thigh fracture CPT 27508 | $1,209.31 | $1,457.00 | $173.29 – $776.64 | 16 |
| Treatment of thigh fracture CPT 27510 | $314.57 | $379.00 | $81.19 – $363.84 | 16 |
| Treatment of toe fracture 28510 CPT 28510 | $306.27 | $369.00 | $55.27 – $247.68 | 16 |
| Treat ulnar fracture CPT 24675 | $1,074.02 | $1,294.00 | $123.81 – $554.88 | 16 |
| Treat vaginal bleeding CPT 57180 | $567.72 | $684.00 | $121.67 – $545.28 | 16 |
| Treat wrist dislocation CPT 25675 | $1,039.16 | $1,252.00 | $128.31 – $575.04 | 16 |
| Treponema pallidum antibody CPT 86780 | $140.27 | $169.00 | $3.86 – $29.39 | 16 |
| Treprostinil injection HCPCS J3285 | $660.52 | $795.80 | $15.79 – $70.75 | 16 |
| Treprostinil, non-comp unit HCPCS J7686 | $4,053.72 | $4,884.00 | $42.94 – $192.42 | 16 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $7.22 | $8.69 | $0.48 – $2.14 | 16 |
| Triglycerides CPT 84478 | $54.78 | $66.00 | $4.07 – $18.24 | 16 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | $1,315.57 | $1,585.02 | $339.52 – $1,521.62 | 16 |
| Trimethobenzamide hcl inj HCPCS J3250 | $21.17 | $25.51 | $5.47 – $24.49 | 16 |
| Trim nondyst nails CPT 11719 | $81.34 | $98.00 | $21.00 – $94.08 | 16 |
| Triptorelin pamoate HCPCS J3315 | $496.79 | $598.54 | $128.21 – $574.60 | 16 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $2,013.58 | $2,426.00 | $458.61 – $2,055.36 | 16 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $2,295.78 | $2,766.00 | $559.28 – $2,506.56 | 16 |
| Troponin quantitative CPT 84484 | $217.46 | $262.00 | $7.07 – $31.68 | 16 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | $522.66 | $629.70 | $6.94 – $31.07 | 16 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | $212.23 | $255.69 | $19.75 – $88.48 | 16 |
| Tx closed hip disl traumatic without anes CPT 27250 | $401.72 | $484.00 | $103.68 – $464.64 | 16 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $1,930.58 | $2,326.00 | $498.23 – $2,232.96 | 16 |
| Tx closed tib shaft fx without manip CPT 27750 | $805.93 | $971.00 | $164.94 – $739.20 | 16 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $3,494.30 | $4,210.00 | $298.17 – $1,336.32 | 16 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | $6,636.68 | $7,996.00 | $323.88 – $1,451.52 | 16 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $470.61 | $567.00 | $121.46 – $544.32 | 16 |
| Ua w/micro/comp poc CPT 81000 | $8.30 | $10.00 | $2.15 – $9.60 | 16 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | $1,448.70 | $1,745.42 | $373.87 – $1,675.61 | 16 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $448.20 | $540.00 | $115.67 – $518.40 | 16 |
| Ultrasound breast complete CPT 76641 | $485.55 | $585.00 | $125.31 – $561.60 | 16 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $425.79 | $513.00 | $109.89 – $492.48 | 16 |
| Ultrasound chest CPT 76604 | $451.52 | $544.00 | $116.53 – $522.24 | 16 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $332.00 | $400.00 | $85.68 – $384.00 | 16 |
| Ultrasound encephalogram CPT 76506 | $472.27 | $569.00 | $121.88 – $546.24 | 16 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $585.15 | $705.00 | $151.02 – $676.80 | 16 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $582.66 | $702.00 | $124.88 – $559.68 | 16 |
| Ultrasound guidance for vascular access CPT 76937 | $588.47 | $709.00 | $8.36 – $37.44 | 16 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $830.00 | $1,000.00 | $191.93 – $860.16 | 16 |
| Ultrasound hips infant dynamic CPT 76885 | $413.34 | $498.00 | $106.68 – $478.08 | 16 |
| Ultrasound joint complete left CPT 76881 | $665.66 | $802.00 | $171.79 – $769.92 | 16 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $524.56 | $632.00 | $135.38 – $606.72 | 16 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $665.66 | $802.00 | $171.79 – $769.92 | 16 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $816.72 | $984.00 | $210.78 – $944.64 | 16 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,339.62 | $1,614.00 | $345.72 – $1,549.44 | 16 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $512.11 | $617.00 | $86.33 – $386.88 | 16 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $483.06 | $582.00 | $124.67 – $558.72 | 16 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $742.02 | $894.00 | $191.50 – $858.24 | 16 |
| Ultrasound prostate/transrectal CPT 76872 | $77.19 | $93.00 | $19.93 – $89.28 | 16 |
| Ultrasound retroperitoneal limited CPT 76775 | $532.03 | $641.00 | $137.31 – $615.36 | 16 |
| Ultrasound scrotum and contents CPT 76870 | $707.99 | $853.00 | $182.72 – $818.88 | 16 |
| Ultrasound spinal canal and contents CPT 76800 | $508.79 | $613.00 | $131.31 – $588.48 | 16 |
| Ultrasound transabd ea addl gest CPT 76812 | $1,339.62 | $1,614.00 | $345.72 – $1,549.44 | 16 |
| Ultrasound transvaginal non obstetric CPT 76830 | $646.57 | $779.00 | $166.87 – $747.84 | 16 |
| Ultraviolet therapy CPT 97028 | $31.54 | $38.00 | $8.14 – $36.48 | 16 |
| Unlisted orl service/px CPT 92700 | $118.69 | $143.00 | $30.64 – $137.28 | 16 |
| Unlisted px casting/strpg CPT 29799 | $132.80 | $160.00 | $34.28 – $153.60 | 16 |
| Unlisted px hands/fingers CPT 26989 | $218.29 | $263.00 | $56.34 – $252.48 | 16 |
| Unlisted px small intestine CPT 44799 | $2,774.69 | $3,343.00 | $716.08 – $3,209.28 | 16 |
| Unlisted px tongue flr mouth CPT 41599 | $191.73 | $231.00 | $49.49 – $221.76 | 16 |
| Unlisted urinalysis px CPT 81099 | $30.71 | $37.00 | $7.93 – $35.52 | 16 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $4,142.53 | $4,991.00 | $1,069.08 – $4,791.36 | 16 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,697.50 | $3,250.00 | $696.15 – $3,120.00 | 16 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $3,211.27 | $3,869.00 | $828.74 – $3,714.24 | 16 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $2,244.32 | $2,704.00 | $184.00 – $824.64 | 16 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $2,244.32 | $2,704.00 | $235.62 – $1,056.00 | 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.