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 |
|---|---|---|---|---|
| Bacterial vaginosis pcr CPT 87801 | $476.42 | $574.00 | $47.77 – $214.08 | 16 |
| Bactericidal level serum CPT 87197 | $46.48 | $56.00 | $12.00 – $53.76 | 16 |
| Bard marquee Ultrasound biopsy device HCPCS A4649 | $71.87 | $86.58 | $0.16 – $0.70 | 16 |
| Bausch health Ultrasound surg HCPCS V2788 | $825.85 | $995.00 | $213.13 – $955.20 | 16 |
| B cells total count CPT 86355 | $16.60 | $20.00 | $4.29 – $44.40 | 16 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $141.47 | $170.44 | $36.51 – $163.63 | 16 |
| Bebtelovimab injection HCPCS M0222 | $453.18 | $546.00 | $116.96 – $524.16 | 16 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $805.01 | $969.88 | $207.75 – $931.09 | 16 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $1,696.17 | $2,043.57 | $126.28 – $565.94 | 16 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | $1,816.04 | $2,188.00 | $119.55 – $535.80 | 16 |
| Benign lesion paring 2-4 CPT 11056 | $208.33 | $251.00 | $50.34 – $225.60 | 16 |
| Benign lesion paring 4+ CPT 11057 | $223.27 | $269.00 | $57.62 – $258.24 | 16 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $17.84 | $21.50 | $4.61 – $20.64 | 16 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $53.12 | $64.00 | $13.71 – $61.44 | 16 |
| Beta-2 microglobulin CPT 82232 | $49.80 | $60.00 | $12.86 – $57.60 | 16 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $6.20 | $7.47 | $1.61 – $7.18 | 16 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $176.39 | $212.52 | $45.53 – $204.02 | 16 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $132.67 | $159.84 | $34.24 – $153.45 | 16 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $98.90 | $119.16 | $25.53 – $114.40 | 16 |
| Bevacizumab injection HCPCS C9257 | $176.39 | $212.52 | $45.53 – $204.02 | 16 |
| Bfb train ea addl 15 min 90913 CPT 90913 | $144.42 | $174.00 | $37.28 – $167.04 | 16 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $1,924.77 | $2,319.00 | $496.73 – $2,226.24 | 16 |
| Bilateral n block inj occipital 64405 CPT 64405 | $651.55 | $785.00 | $168.15 – $753.60 | 16 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $436.58 | $526.00 | $67.05 – $300.48 | 16 |
| Bilicheck CPT 88720 | $60.59 | $73.00 | $5.02 – $70.08 | 16 |
| Bilirubin direct CPT 82248 | $14.11 | $17.00 | $1.50 – $11.14 | 16 |
| Bilirubin total CPT 82247 | $5.81 | $7.00 | $1.50 – $11.14 | 16 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $34.03 | $40.99 | $4.08 – $18.27 | 16 |
| Biofeedback, pt CPT 90901 | $80.51 | $97.00 | $20.78 – $93.12 | 16 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $429.94 | $518.00 | $110.96 – $497.28 | 16 |
| Biopsy/excision of lymph node(s); open deep 38530 CPT 38530 | $1,272.39 | $1,533.00 | $328.37 – $1,471.68 | 16 |
| Biopsy external ear 69100 CPT 69100 | $323.70 | $390.00 | $83.54 – $374.40 | 16 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,923.94 | $2,318.00 | $106.89 – $479.04 | 16 |
| Biopsy muscle percutaneous needle CPT 20206 | $1,113.03 | $1,341.00 | $287.25 – $1,287.36 | 16 |
| Biopsy needle lymph node superficial CPT 38505 | $1,586.96 | $1,912.00 | $108.82 – $487.68 | 16 |
| Biopsy of prostate CPT 55700 | $786.01 | $947.00 | $202.85 – $909.12 | 16 |
| Biopsy of salivary gland 42400 CPT 42400 | $981.06 | $1,182.00 | $253.19 – $1,134.72 | 16 |
| Biopsy/removal lymph nodes CPT 38525 | $987.70 | $1,190.00 | $254.90 – $1,142.40 | 16 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | $1,054.93 | $1,271.00 | $272.25 – $1,220.16 | 16 |
| Biopsy roof of mouth CPT 42100 | $1,093.11 | $1,317.00 | $282.11 – $1,264.32 | 16 |
| Biopsy skin incisional single lesion CPT 11106 | $934.58 | $1,126.00 | $241.19 – $1,080.96 | 16 |
| Biopsy tongue anterior two-thirds CPT 41100 | $970.27 | $1,169.00 | $250.40 – $1,122.24 | 16 |
| Biopsy vestibule of mouth 40808 CPT 40808 | $395.91 | $477.00 | $102.18 – $457.92 | 16 |
| Biotinidase - quest CPT 82261 | $6.64 | $8.00 | $1.72 – $17.76 | 16 |
| Biovance 1 square cm HCPCS Q4154 | $6,166.49 | $7,429.50 | $508.73 – $2,280.00 | 16 |
| Bivalirudin HCPCS J0583 | $90.87 | $109.47 | $0.30 – $1.33 | 16 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $253.15 | $305.00 | $46.06 – $206.40 | 16 |
| Bld prd mix CPT 86965 | $45.65 | $55.00 | $11.79 – $52.80 | 16 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $71.04 | $85.58 | $9.88 – $44.27 | 16 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $3,520.95 | $4,242.10 | $908.66 – $4,072.42 | 16 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $19,899.25 | $23,975.00 | $6.99 – $31.30 | 16 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $7,292.59 | $8,786.25 | $21.41 – $95.94 | 16 |
| Bln dil 900ml preperitnl HCPCS C1727 | $1,796.95 | $2,165.00 | $93.18 – $417.60 | 16 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $4,708.59 | $5,673.00 | $64.26 – $288.00 | 16 |
| Bln press regulation 71-80cm HCPCS C1815 | $8,228.42 | $9,913.75 | $856.80 – $3,840.00 | 16 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $6,531.27 | $7,869.00 | $471.24 – $2,112.00 | 16 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | $105.75 | $127.40 | $6.14 – $27.51 | 16 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | $3,860.33 | $4,651.00 | $996.25 – $4,464.96 | 16 |
| Block plantar digital nerve CPT 64455 | $327.85 | $395.00 | $84.61 – $379.20 | 16 |
| Block tap inj(s) w/wo img uni CPT 64486 | $1,589.45 | $1,915.00 | $410.20 – $1,838.40 | 16 |
| Blood Clotting (PT/INR) Test CPT 85610 | $83.00 | $100.00 | $2.58 – $11.52 | 16 |
| Blood Clotting (PTT) Test CPT 85730 | $78.02 | $94.00 | $6.01 – $90.24 | 16 |
| Blood Count (CBC) Test CPT 85025 | $116.20 | $140.00 | $3.22 – $17.25 | 16 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $88.81 | $107.00 | $4.50 – $20.16 | 16 |
| Blood Culture Test CPT 87040 | $241.53 | $291.00 | $7.07 – $31.68 | 16 |
| Blood draw capillary 36416 CPT 36416 | $26.56 | $32.00 | $6.86 – $30.72 | 16 |
| Blood gases o2 saturation direct measurement CPT 82805 | $43.16 | $52.00 | $11.14 – $115.44 | 16 |
| Blood gases ph venous CPT 82800 | $106.24 | $128.00 | $11.00 – $57.60 | 16 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $64.74 | $78.00 | $11.57 – $51.84 | 16 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $40.67 | $49.00 | $1.72 – $9.39 | 16 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $24.90 | $30.00 | $1.72 – $9.72 | 16 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $37.35 | $45.00 | $1.72 – $11.81 | 16 |
| Blood smear interpretation CPT 85060 | $58.10 | $70.00 | $15.00 – $67.20 | 16 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $55.61 | $67.00 | $3.80 – $64.32 | 16 |
| Blood typing abo CPT 86900 | $73.04 | $88.00 | $1.93 – $8.64 | 16 |
| Blood typing ag donor ea ag CPT 86902 | $83.00 | $100.00 | $6.35 – $96.00 | 16 |
| Blood typing patient serum CPT 86904 | $39.84 | $48.00 | $10.29 – $46.08 | 16 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $48.97 | $59.00 | $3.83 – $56.64 | 16 |
| Blood typing rh (d) CPT 86901 | $68.89 | $83.00 | $1.93 – $8.64 | 16 |
| Blood typing rh phenotype complete reference CPT 86906 | $109.56 | $132.00 | $7.75 – $126.72 | 16 |
| Bone biopsy open superficial CPT 20240 | $2,489.17 | $2,999.00 | $642.39 – $2,879.04 | 16 |
| Bone Density Scan (DEXA) CPT 77080 | $1,132.12 | $1,364.00 | $22.28 – $99.84 | 16 |
| Bone/joint imaging ltd area CPT 78300 | $932.92 | $1,124.00 | $240.77 – $1,079.04 | 16 |
| Bone marrow;aspiration only 38220 CPT 38220 | $367.69 | $443.00 | $89.33 – $400.32 | 16 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $405.87 | $489.00 | $98.75 – $442.56 | 16 |
| Bone void filler nanoss 10cc HCPCS C9362 | $539.50 | $650.00 | $139.23 – $624.00 | 16 |
| Boot j walker l HCPCS L4386 | $127.47 | $153.57 | $32.90 – $147.43 | 16 |
| Boot mlti podous univ xlg HCPCS L4396 | $352.89 | $425.16 | $38.56 – $172.80 | 16 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $62.78 | $75.63 | $16.20 – $72.61 | 16 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $128.65 | $155.00 | $17.03 – $148.80 | 16 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $1,330.49 | $1,603.00 | $2.71 – $12.12 | 16 |
| (both sides) smear without diff wbc count CPT 85008 | $29.05 | $35.00 | $3.43 – $33.60 | 16 |
| Bowel imaging CPT 78290 | $1,050.78 | $1,266.00 | $271.18 – $1,215.36 | 16 |
| Brace afo lg left 6607 HCPCS L1930 | $1,365.38 | $1,645.03 | $16.20 – $72.61 | 16 |
| Brace ank air stirrup univ HCPCS L4350 | $154.24 | $185.82 | $39.81 – $178.39 | 16 |
| Brace knee extender plus 22-30in HCPCS L1832 | $676.06 | $814.53 | $17.76 – $79.58 | 16 |
| Brace wrist classic lft sm HCPCS L3908 | $34.06 | $41.03 | $7.28 – $32.60 | 16 |
| Brachy src nonstrand hdr ir-192 HCPCS C1717 | $464.80 | $560.00 | $119.96 – $537.60 | 16 |
| Brachy src stranded c-131 HCPCS C2642 | $68,267.50 | $82,250.00 | $1,981.35 – $8,880.00 | 16 |
| Braf gene CPT 81210 | $661.51 | $797.00 | $170.72 – $765.12 | 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.