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 |
|---|---|---|---|---|
| Doppler echo complete CPT 93320 | $366.86 | $442.00 | $94.68 – $424.32 | 16 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $663.17 | $799.00 | $171.15 – $767.04 | 16 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $498.83 | $601.00 | $49.27 – $220.80 | 16 |
| Dornhoffer fixed part w/window HCPCS L8614 | $22,783.61 | $27,450.13 | $5,476.84 – $24,546.04 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $940.93 | $1,133.64 | $242.83 – $1,088.30 | 16 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $161.04 | $194.02 | $0.13 – $0.56 | 16 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $38.11 | $45.91 | $9.84 – $44.08 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $480.57 | $579.00 | $47.56 – $213.12 | 16 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $553.61 | $667.00 | $58.05 – $260.16 | 16 |
| Drainage external ear simple 69000 CPT 69000 | $436.58 | $526.00 | $58.05 – $260.16 | 16 |
| Drainage mouth roof lesion CPT 42000 | $411.68 | $496.00 | $97.25 – $435.84 | 16 |
| Drainage of arm bursa 23931 CPT 23931 | $711.31 | $857.00 | $183.57 – $822.72 | 16 |
| Drainage of nose lesion sept 30020 CPT 30020 | $641.59 | $773.00 | $134.74 – $603.84 | 16 |
| Drainage of rectal abscess CPT 45005 | $893.08 | $1,076.00 | $193.64 – $867.84 | 16 |
| Drain blood from under nail 11740 CPT 11740 | $133.63 | $161.00 | $20.35 – $91.20 | 16 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,430.39 | $4,133.00 | $885.29 – $3,967.68 | 16 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $832.49 | $1,003.00 | $214.85 – $962.88 | 16 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $182.54 | $219.92 | $36.17 – $162.09 | 16 |
| Drain finger abscess;simple 26010 CPT 26010 | $822.53 | $991.00 | $68.55 – $307.20 | 16 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,226.89 | $2,683.00 | $400.13 – $1,793.28 | 16 |
| Drain thyroid/tongue cyst CPT 60000 | $920.47 | $1,109.00 | $110.75 – $496.32 | 16 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $419.98 | $506.00 | $94.04 – $421.44 | 16 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $287.18 | $346.00 | $50.56 – $226.56 | 16 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $626.65 | $755.00 | $116.96 – $524.16 | 16 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $675.62 | $814.00 | $174.36 – $781.44 | 16 |
| Drng appendix abscess open 44900 CPT 44900 | $1,752.96 | $2,112.00 | $452.40 – $2,027.52 | 16 |
| Drng of eyelid abscess 67700 CPT 67700 | $675.62 | $814.00 | $94.04 – $421.44 | 16 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,334.64 | $1,608.00 | $138.59 – $621.12 | 16 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $2.64 | $3.18 | $0.69 – $3.06 | 16 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $3.50 | $4.21 | $0.91 – $4.05 | 16 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $992.89 | $1,196.25 | $125.44 – $562.18 | 16 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $3,857.33 | $4,647.38 | $9.87 – $44.21 | 16 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $3,044.16 | $3,667.66 | $785.62 – $3,520.96 | 16 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $12,637.53 | $15,225.93 | $2,671.32 – $11,972.27 | 16 |
| Drug assay voriconazole CPT 80285 | $189.24 | $228.00 | $27.11 – $218.88 | 16 |
| Drug of abuse screen urine CPT 80305 | $170.15 | $205.00 | $12.60 – $196.80 | 16 |
| Drug test prsmv instrmnt CPT 80306 | $33.20 | $40.00 | $8.57 – $38.40 | 16 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $588.47 | $709.00 | $8.57 – $88.80 | 16 |
| Drvvt confirm - quest CPT 85597 | $22.41 | $27.00 | $5.79 – $39.92 | 16 |
| Dry needling (97799) CPT 97799 | $31.54 | $38.00 | $8.14 – $36.48 | 16 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $2,403.68 | $2,896.00 | $620.33 – $2,780.16 | 16 |
| Duplex scan bilateral study 93985 CPT 93985 | $3,044.44 | $3,668.00 | $147.16 – $659.52 | 16 |
| Duplex scan unilateral study 93986 CPT 93986 | $232.40 | $280.00 | $37.92 – $169.92 | 16 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $693.05 | $835.00 | $178.86 – $801.60 | 16 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,184.41 | $1,427.00 | $305.67 – $1,369.92 | 16 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $2,644.38 | $3,186.00 | $682.45 – $3,058.56 | 16 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $349.47 | $421.05 | $90.19 – $404.21 | 16 |
| Dxa bone density axl vrt fx CPT 77085 | $441.56 | $532.00 | $113.96 – $510.72 | 16 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,906.51 | $2,297.00 | $492.02 – $2,205.12 | 16 |
| Dx bronchoscope/wash 31622 CPT 31622 | $1,723.08 | $2,076.00 | $150.59 – $674.88 | 16 |
| Ear irrigation 69209 CPT 69209 | $253.15 | $305.00 | $9.00 – $40.32 | 16 |
| Ecg 12 lead tracing only CPT 93005 | $298.80 | $360.00 | $4.07 – $18.24 | 16 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $163.51 | $197.00 | $42.20 – $189.12 | 16 |
| Ecg < 30 days transmission & analysis CPT 93271 | $1,020.90 | $1,230.00 | $263.47 – $1,180.80 | 16 |
| Ecg external < 48 hours recording CPT 93225 | $523.73 | $631.00 | $17.14 – $76.80 | 16 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $1,502.30 | $1,810.00 | $24.00 – $107.52 | 16 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $221.61 | $267.00 | $23.14 – $103.68 | 16 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $544.48 | $656.00 | $31.49 – $141.12 | 16 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,062.55 | $2,485.00 | $121.46 – $544.32 | 16 |
| Echocardiography doppler color flow mapping CPT 93325 | $346.11 | $417.00 | $89.33 – $400.32 | 16 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,454.31 | $2,957.00 | $633.39 – $2,838.72 | 16 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $880.63 | $1,061.00 | $15.21 – $68.16 | 16 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,426.77 | $1,719.00 | $368.21 – $1,650.24 | 16 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $232.40 | $280.00 | $59.98 – $268.80 | 16 |
| Echo guide for amniocentesis CPT 76946 | $1,802.76 | $2,172.00 | $465.25 – $2,085.12 | 16 |
| Echo stress CPT 93350 | $1,398.55 | $1,685.00 | $360.93 – $1,617.60 | 16 |
| Echo tee guidance CPT 93355 | $2,818.68 | $3,396.00 | $727.43 – $3,260.16 | 16 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,206.97 | $2,659.00 | $569.56 – $2,552.64 | 16 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,382.78 | $1,666.00 | $356.86 – $1,599.36 | 16 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $1,226.74 | $1,478.00 | $316.59 – $1,418.88 | 16 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $772.73 | $931.00 | $199.43 – $893.76 | 16 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $1,068.21 | $1,287.00 | $275.68 – $1,235.52 | 16 |
| Eeg recording awake and asleep CPT 95819 | $870.67 | $1,049.00 | $224.70 – $1,007.04 | 16 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | $256.91 | $309.52 | $66.30 – $297.14 | 16 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $523.73 | $631.00 | $135.17 – $605.76 | 16 |
| Egd control bleeding any CPT 43255 | $1,528.86 | $1,842.00 | $394.56 – $1,768.32 | 16 |
| Egd dilate stricture CPT 43245 | $1,448.35 | $1,745.00 | $373.78 – $1,675.20 | 16 |
| Egd endo mucosal resection CPT 43254 | $625.82 | $754.00 | $161.51 – $723.84 | 16 |
| Egd endoscopic stent place CPT 43266 | $501.32 | $604.00 | $129.38 – $579.84 | 16 |
| Egd guide wire insertion CPT 43248 | $998.49 | $1,203.00 | $257.69 – $1,154.88 | 16 |
| Egd injection varices CPT 43243 | $546.97 | $659.00 | $141.16 – $632.64 | 16 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | $327.85 | $395.00 | $84.61 – $379.20 | 16 |
| Egd optical endomicroscopy CPT 43252 | $811.74 | $978.00 | $209.49 – $938.88 | 16 |
| Egd remove foreign body CPT 43247 | $1,148.72 | $1,384.00 | $237.77 – $1,065.60 | 16 |
| Egd remove lesion snare CPT 43251 | $1,201.84 | $1,448.00 | $310.17 – $1,390.08 | 16 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $1,092.28 | $1,316.00 | $281.89 – $1,263.36 | 16 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | $522.90 | $630.00 | $134.95 – $604.80 | 16 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | $537.84 | $648.00 | $138.81 – $622.08 | 16 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | $608.39 | $733.00 | $157.01 – $703.68 | 16 |
| Egd varices ligation CPT 43244 | $567.72 | $684.00 | $146.52 – $656.64 | 16 |
| Egd w/thrml txmnt gerd CPT 43257 | $535.35 | $645.00 | $138.16 – $619.20 | 16 |
| Egd w/transmural drain cyst CPT 43240 | $906.36 | $1,092.00 | $233.91 – $1,048.32 | 16 |
| Electrd sq emblem s-icd HCPCS C1896 | $21,061.25 | $25,375.00 | $2,020.45 – $9,055.20 | 16 |
| Electrolyte panel CPT 80051 | $90.47 | $109.00 | $5.36 – $24.00 | 16 |
| Elotuzumab 300 mg intravenous solution HCPCS J9176 | $2,420.58 | $2,916.36 | $468.52 – $2,099.80 | 16 |
| Emb without cervical dilation 58100 CPT 58100 | $462.31 | $557.00 | $119.31 – $534.72 | 16 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $390.10 | $470.00 | $100.68 – $451.20 | 16 |
| Emg needle test 1-extremity CPT 95860 | $269.75 | $325.00 | $69.62 – $312.00 | 16 |
| Endocerv curettage w/scope 57456 CPT 57456 | $285.52 | $344.00 | $73.69 – $330.24 | 16 |
| Endoscopic Ultrasound exam esoph CPT 43237 | $453.18 | $546.00 | $116.96 – $524.16 | 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.