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 |
|---|---|---|---|---|
| Cath pezzer 34fr drain bardex propor head mushrm ltx HCPCS A4340 | $131.63 | $158.58 | $7.96 – $35.66 | 16 |
| Cath steerable flex adv 12f HCPCS C1766 | $6,084.32 | $7,330.50 | $288.53 – $1,293.12 | 16 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $2,419.37 | $2,914.90 | $3.57 – $15.99 | 16 |
| Cath w/drainage 2-way latex HCPCS A4314 | $59.76 | $72.00 | $15.43 – $69.12 | 16 |
| Cauterization chemical granulation tissue CPT 17250 | $208.33 | $251.00 | $48.41 – $216.96 | 16 |
| Cciiv4 vac no prsv 0.5 ml im CPT 90674 | $35.88 | $43.22 | $9.26 – $41.50 | 16 |
| Cdna analysis for variants CPT 81403 | $24.07 | $29.00 | $6.22 – $64.38 | 16 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $211.65 | $255.00 | $0.03 – $0.14 | 16 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $7.44 | $8.97 | $0.01 – $0.01 | 16 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $25.47 | $30.68 | $1.95 – $8.74 | 16 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $156.36 | $188.38 | $40.36 – $180.85 | 16 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $17.00 | $20.48 | $0.89 – $3.98 | 16 |
| Ceftazidime and avibactam HCPCS J0714 | $299.55 | $360.90 | $77.31 – $346.47 | 16 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $27.67 | $33.33 | $0.29 – $1.30 | 16 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $4.02 | $4.84 | $0.41 – $1.81 | 16 |
| Cell count body fluid CPT 89050 | $59.76 | $72.00 | $2.36 – $10.56 | 16 |
| Cell count w differential body fluid CPT 89051 | $143.59 | $173.00 | $3.65 – $16.32 | 16 |
| Cell marker study CPT 88182 | $170.98 | $206.00 | $44.13 – $197.76 | 16 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | $1,221.03 | $1,471.12 | $315.12 – $1,412.28 | 16 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $4,962.10 | $5,978.43 | $1,221.50 – $5,474.51 | 16 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $13.01 | $15.68 | $3.36 – $15.06 | 16 |
| #cf-97variants CPT 81220 | $48.97 | $59.00 | $12.64 – $130.98 | 16 |
| Change cystostomy tube; complex 51710 CPT 51710 | $266.43 | $321.00 | $68.76 – $308.16 | 16 |
| Change cystostomy tube simple CPT 51705 | $266.43 | $321.00 | $58.27 – $261.12 | 16 |
| Change of windpipe airway 31502 CPT 31502 | $80.51 | $97.00 | $20.78 – $93.12 | 16 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $527.88 | $636.00 | $136.24 – $610.56 | 16 |
| Chemodenerv musc migraine 64615 CPT 64615 | $268.09 | $323.00 | $69.19 – $310.08 | 16 |
| Chemotherapy injection 96542 CPT 96542 | $297.97 | $359.00 | $76.90 – $344.64 | 16 |
| Chest apical lordotic proj CPT 71047 | $291.33 | $351.00 | $75.19 – $336.96 | 16 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,406.32 | $4,104.00 | $879.08 – $3,939.84 | 16 |
| Chest CT scan (with contrast) CPT 71260 | $2,543.95 | $3,065.00 | $656.53 – $2,942.40 | 16 |
| Chest CT scan (without contrast) CPT 71250 | $2,155.51 | $2,597.00 | $556.28 – $2,493.12 | 16 |
| Chest X-ray CPT 71046 | $262.28 | $316.00 | $14.78 – $66.24 | 16 |
| Chest X-ray (single view) CPT 71045 | $239.04 | $288.00 | $12.00 – $53.76 | 16 |
| Chg pr pul rehab for copd patients CPT 94626 | $225.76 | $272.00 | $44.34 – $198.72 | 16 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $255.64 | $308.00 | $65.98 – $295.68 | 16 |
| Chlamydia culture CPT 87110 | $190.07 | $229.00 | $19.60 – $219.84 | 16 |
| Chlamydia type CPT 87140 | $44.82 | $54.00 | $3.86 – $17.28 | 16 |
| Chloramphenicol sodium injec HCPCS J0720 | $30.14 | $36.32 | $7.78 – $34.87 | 16 |
| Chloride CPT 82435 | $29.88 | $36.00 | $4.60 – $32.64 | 16 |
| Chloride 24 hour urine CPT 82436 | $26.56 | $32.00 | $5.75 – $30.72 | 16 |
| Chloroprocaine hcl injection HCPCS J2401 | $0.81 | $0.98 | $0.20 – $0.90 | 16 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $75.77 | $91.28 | $19.56 – $87.63 | 16 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $20.84 | $25.11 | $5.38 – $24.11 | 16 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $561.91 | $677.00 | $145.02 – $649.92 | 16 |
| Cholecystectomy expl duct 47612 CPT 47612 | $2,838.60 | $3,420.00 | $732.57 – $3,283.20 | 16 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | $2,518.22 | $3,034.00 | $649.89 – $2,912.64 | 16 |
| Cholesterol CPT 82465 | $22.41 | $27.00 | $3.22 – $14.40 | 16 |
| Cholesterol body fluid CPT 84999 | $3,771.52 | $4,544.00 | $973.33 – $4,362.24 | 16 |
| Cholesterol (Lipid) Test CPT 80061 | $113.71 | $137.00 | $1.72 – $17.76 | 16 |
| Cholinesterase CPT 82480 | $26.56 | $32.00 | $6.86 – $30.72 | 16 |
| Cholinesterase challenge CPT 95857 | $151.89 | $183.00 | $38.35 – $171.84 | 16 |
| Chromatography CPT 83021 | $75.53 | $91.00 | $12.43 – $55.68 | 16 |
| Chromosome analysis 15-20 cell count CPT 88262 | $989.36 | $1,192.00 | $125.49 – $1,144.32 | 16 |
| Chromosome karyotype study CPT 88280 | $156.04 | $188.00 | $33.47 – $180.48 | 16 |
| Chylomicron screen, bf - sendout CPT 82664 | $36.52 | $44.00 | $9.43 – $97.68 | 16 |
| Cidofovir injection HCPCS J0740 | $119.11 | $143.50 | $30.74 – $137.76 | 16 |
| Cilastatin sodium injection HCPCS J0743 | $24.79 | $29.87 | $1.22 – $5.47 | 16 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $0.02 | $0.03 | $0.01 – $0.02 | 16 |
| Circumcision (newborn) CPT 54150 | $265.60 | $320.00 | $68.55 – $307.20 | 16 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $379.56 | $457.30 | $0.13 – $0.58 | 16 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $11.95 | $14.40 | $3.09 – $13.83 | 16 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $26,611.88 | $32,062.50 | $294.53 – $1,320.00 | 16 |
| Clearance of airways CPT 31720 | $138.61 | $167.00 | $7.93 – $35.52 | 16 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $1.26 | $1.51 | $0.02 – $0.07 | 16 |
| Clip ligating vesolock lg HCPCS C1760 | $835.40 | $1,006.50 | $14.10 – $63.16 | 16 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $9.16 | $11.03 | $0.34 – $1.52 | 16 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $971.10 | $1,170.00 | $97.25 – $435.84 | 16 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $1,002.64 | $1,208.00 | $102.18 – $457.92 | 16 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $1,139.59 | $1,373.00 | $280.18 – $1,255.68 | 16 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $774.39 | $933.00 | $74.12 – $332.16 | 16 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,163.66 | $1,402.00 | $238.62 – $1,069.44 | 16 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $355.24 | $428.00 | $56.98 – $255.36 | 16 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,645.06 | $1,982.00 | $344.65 – $1,544.64 | 16 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $560.25 | $675.00 | $97.25 – $435.84 | 16 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $551.95 | $665.00 | $126.60 – $567.36 | 16 |
| Clos txnose fx without stablz 21315 CPT 21315 | $352.75 | $425.00 | $91.04 – $408.00 | 16 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $1,578.66 | $1,902.00 | $188.50 – $844.80 | 16 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $755.30 | $910.00 | $57.62 – $258.24 | 16 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $781.03 | $941.00 | $112.25 – $503.04 | 16 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $809.25 | $975.00 | $122.53 – $549.12 | 16 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $593.45 | $715.00 | $144.38 – $647.04 | 16 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $553.61 | $667.00 | $55.27 – $247.68 | 16 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $833.32 | $1,004.00 | $57.62 – $258.24 | 16 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $516.26 | $622.00 | $57.62 – $258.24 | 16 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $434.92 | $524.00 | $85.68 – $384.00 | 16 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $983.55 | $1,185.00 | $65.34 – $292.80 | 16 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $737.87 | $889.00 | $65.12 – $291.84 | 16 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $512.11 | $617.00 | $64.05 – $287.04 | 16 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,723.08 | $2,076.00 | $203.92 – $913.92 | 16 |
| Clsd tx fracture of radius 25500 CPT 25500 | $662.34 | $798.00 | $70.26 – $314.88 | 16 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $470.61 | $567.00 | $121.46 – $544.32 | 16 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $381.80 | $460.00 | $62.12 – $278.40 | 16 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $787.67 | $949.00 | $203.28 – $911.04 | 16 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,245.83 | $1,501.00 | $72.40 – $324.48 | 16 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $674.79 | $813.00 | $112.67 – $504.96 | 16 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,199.35 | $1,445.00 | $119.96 – $537.60 | 16 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $940.39 | $1,133.00 | $133.02 – $596.16 | 16 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $886.44 | $1,068.00 | $89.11 – $399.36 | 16 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $839.96 | $1,012.00 | $213.56 – $957.12 | 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.