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 |
|---|---|---|---|---|
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $700.52 | $844.00 | $180.79 – $810.24 | 16 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $770.24 | $928.00 | $198.78 – $890.88 | 16 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $508.79 | $613.00 | $73.90 – $331.20 | 16 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $2,452.65 | $2,955.00 | $131.95 – $591.36 | 16 |
| Clsd tx nose fx without manip 21310 CPT 21310 | $230.74 | $278.00 | $31.92 – $143.04 | 16 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $854.07 | $1,029.00 | $73.90 – $331.20 | 16 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $756.13 | $911.00 | $128.31 – $575.04 | 16 |
| Clsd tx pelvic ring fx CPT 27197 | $243.19 | $293.00 | $62.77 – $281.28 | 16 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,007.62 | $1,214.00 | $65.34 – $292.80 | 16 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $465.63 | $561.00 | $120.17 – $538.56 | 16 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $614.20 | $740.00 | $74.12 – $332.16 | 16 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,035.01 | $1,247.00 | $123.81 – $554.88 | 16 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $546.14 | $658.00 | $45.84 – $205.44 | 16 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,001.81 | $1,207.00 | $83.54 – $374.40 | 16 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,272.39 | $1,533.00 | $83.54 – $374.40 | 16 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,279.18 | $2,746.00 | $71.98 – $322.56 | 16 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $328.68 | $396.00 | $84.83 – $380.16 | 16 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $282.20 | $340.00 | $56.98 – $255.36 | 16 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $768.58 | $926.00 | $117.60 – $527.04 | 16 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,128.80 | $1,360.00 | $57.41 – $257.28 | 16 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $614.20 | $740.00 | $121.88 – $546.24 | 16 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $715.46 | $862.00 | $184.65 – $827.52 | 16 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $768.58 | $926.00 | $45.84 – $205.44 | 16 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $679.77 | $819.00 | $74.12 – $332.16 | 16 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $1,136.27 | $1,369.00 | $90.61 – $406.08 | 16 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,283.18 | $1,546.00 | $106.68 – $478.08 | 16 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $817.55 | $985.00 | $71.98 – $322.56 | 16 |
| Cltx lunate dislc w/mnpj CPT 25690 | $1,130.46 | $1,362.00 | $57.41 – $257.28 | 16 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $1,630.12 | $1,964.00 | $390.49 – $1,750.08 | 16 |
| Cltx palatal/max fx wire fix CPT 21421 | $2,736.51 | $3,297.00 | $392.85 – $1,760.64 | 16 |
| Cltx post ankle fx w/mnpj CPT 27768 | $1,028.37 | $1,239.00 | $57.41 – $257.28 | 16 |
| #cmvcul-virus inoculation shell CPT 87254 | $82.17 | $99.00 | $19.56 – $95.04 | 16 |
| Cmv pcr-sendout CPT 87496 | $222.44 | $268.00 | $35.09 – $257.28 | 16 |
| Co2 monitor per day CPT 94681 | $346.94 | $418.00 | $89.54 – $401.28 | 16 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $9,120.04 | $10,988.00 | $514.08 – $2,304.00 | 16 |
| Coagulation time activated teg CPT 85347 | $62.25 | $75.00 | $4.28 – $72.00 | 16 |
| Cocaine 4 % nasal solution HCPCS C9046 | $68.14 | $82.09 | $17.59 – $78.81 | 16 |
| Cold agglutinin titer CPT 86157 | $63.08 | $76.00 | $8.06 – $72.96 | 16 |
| Colistimethate sodium inj HCPCS J0770 | $21.69 | $26.13 | $5.60 – $25.09 | 16 |
| Collagenase, clost hist inj HCPCS J0775 | $4,344.13 | $5,233.89 | $1,121.10 – $5,024.54 | 16 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $489.89 | $590.22 | $2.25 – $10.06 | 16 |
| Collar cerv ascend 172 reg HCPCS L0172 | $586.80 | $706.98 | $4.51 – $20.17 | 16 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $140.27 | $169.00 | $36.20 – $162.24 | 16 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $8.30 | $10.00 | $2.15 – $9.60 | 16 |
| Collection of venous blood by venipuncture CPT 36415 | $92.13 | $111.00 | $1.50 – $15.54 | 16 |
| Colonoscopy (diagnostic) CPT 45378 | $622.50 | $750.00 | $160.65 – $720.00 | 16 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $1,168.64 | $1,408.00 | $301.60 – $1,351.68 | 16 |
| Colonoscopy for bleeding 44391 CPT 44391 | $1,550.44 | $1,868.00 | $400.13 – $1,793.28 | 16 |
| Colonoscopy for foreign body CPT 44390 | $968.61 | $1,167.00 | $249.98 – $1,120.32 | 16 |
| Colonoscopy & polypectomy 44392 CPT 44392 | $915.49 | $1,103.00 | $236.27 – $1,058.88 | 16 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | $1,048.29 | $1,263.00 | $270.54 – $1,212.48 | 16 |
| Colonoscopy submucous njx CPT 45381 | $1,066.55 | $1,285.00 | $275.25 – $1,233.60 | 16 |
| Colonoscopy thru stoma spx CPT 44388 | $750.32 | $904.00 | $193.64 – $867.84 | 16 |
| Colonoscopy w/ablation CPT 45388 | $6,076.43 | $7,321.00 | $1,568.16 – $7,028.16 | 16 |
| Colonoscopy w/balloon dilat CPT 45386 | $1,483.21 | $1,787.00 | $382.78 – $1,715.52 | 16 |
| Colonoscopy w/control bleed CPT 45382 | $1,616.84 | $1,948.00 | $417.27 – $1,870.08 | 16 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | $596.77 | $719.00 | $154.01 – $690.24 | 16 |
| Colonoscopy w/endoscopic fnb CPT 45392 | $703.01 | $847.00 | $181.43 – $813.12 | 16 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | $670.64 | $808.00 | $173.08 – $775.68 | 16 |
| Colonoscopy w/fb removal CPT 45379 | $1,040.82 | $1,254.00 | $268.61 – $1,203.84 | 16 |
| Colonoscopy with ablation CPT 44401 | $5,888.02 | $7,094.00 | $1,519.54 – $6,810.24 | 16 |
| Colonoscopy (with biopsy) CPT 45380 | $1,044.97 | $1,259.00 | $269.68 – $1,208.64 | 16 |
| Colonoscopy with biopsy CPT 44389 | $989.36 | $1,192.00 | $255.33 – $1,144.32 | 16 |
| Colonoscopy (with polyp removal) CPT 45385 | $1,087.30 | $1,310.00 | $280.61 – $1,257.60 | 16 |
| Colonoscopy w/stent plcmt CPT 44402 | $605.90 | $730.00 | $156.37 – $700.80 | 16 |
| Colpocentesis 57020 CPT 57020 | $790.16 | $952.00 | $76.47 – $342.72 | 16 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $1,996.15 | $2,405.00 | $199.00 – $891.84 | 16 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $141.10 | $170.00 | $36.42 – $163.20 | 16 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $285.52 | $344.00 | $73.69 – $330.24 | 16 |
| Colposcopy vulva w/biopsy 56821 CPT 56821 | $212.48 | $256.00 | $54.84 – $245.76 | 16 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $285.52 | $344.00 | $73.69 – $330.24 | 16 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $453.18 | $546.00 | $116.96 – $524.16 | 16 |
| Compatibility test each unit electronic CPT 86923 | $244.85 | $295.00 | $63.19 – $283.20 | 16 |
| Compatibility test each unit immediate spin technique CPT 86920 | $204.18 | $246.00 | $52.70 – $236.16 | 16 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $925.45 | $1,115.00 | $238.84 – $1,070.40 | 16 |
| Complement antigen each component c3 CPT 86160 | $96.28 | $116.00 | $12.00 – $111.36 | 16 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $835.81 | $1,007.00 | $127.24 – $570.24 | 16 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $935.41 | $1,127.00 | $127.24 – $570.24 | 16 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $992.68 | $1,196.00 | $127.24 – $570.24 | 16 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $1,166.15 | $1,405.00 | $122.74 – $550.08 | 16 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $493.02 | $594.00 | $110.75 – $496.32 | 16 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $912.17 | $1,099.00 | $127.24 – $570.24 | 16 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $1,108.88 | $1,336.00 | $127.24 – $570.24 | 16 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $475.59 | $573.00 | $101.32 – $454.08 | 16 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $475.59 | $573.00 | $76.26 – $341.76 | 16 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $801.78 | $966.00 | $127.24 – $570.24 | 16 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $493.02 | $594.00 | $70.05 – $313.92 | 16 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | $771.74 | $929.80 | $174.28 – $781.06 | 16 |
| Condylomata destruction 56420 CPT 56420 | $585.98 | $706.00 | $113.10 – $506.88 | 16 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $286.10 | $344.69 | $73.84 – $330.91 | 16 |
| Connect omega .5mm HCPCS L8613 | $812.12 | $978.45 | $76.48 – $342.74 | 16 |
| Connector tis 2x10mm HCPCS C9352 | $3,535.18 | $4,259.25 | $602.44 – $2,700.00 | 16 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $17.43 | $21.00 | $4.50 – $20.16 | 16 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $34.86 | $42.00 | $9.00 – $40.32 | 16 |
| Contact layer >16<= 48 sq in HCPCS A6207 | $68.06 | $82.00 | $17.57 – $78.72 | 16 |
| Contrast baths charges CPT 97034 | $83.00 | $100.00 | $14.78 – $66.24 | 16 |
| Contrast x-ray of hip CPT 73525 | $626.65 | $755.00 | $161.73 – $724.80 | 16 |
| Contrast x-ray of knee joint CPT 73580 | $960.31 | $1,157.00 | $247.83 – $1,110.72 | 16 |
| Contrast x-ray of wrist CPT 73115 | $516.26 | $622.00 | $133.24 – $597.12 | 16 |
| Controller infinity pt dbs HCPCS C1787 | $4,556.70 | $5,490.00 | $25.07 – $112.32 | 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.