CHI Health Plainview
704 N 3rd St, Plainview, NE · Chihealth · · NPI 1861765034
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $98.28 | $117.00 | $29.28 – $114.66 | 19 |
| 17-hydroxypregnenolone CPT 84143 | $88.20 | $105.00 | $22.81 – $102.90 | 19 |
| 17-ketosteroids CPT 83586 | $357.84 | $426.00 | $12.80 – $417.48 | 19 |
| 1st psyc collab care mgmt CPT 99492 | $93.24 | $111.00 | $67.71 – $150.32 | 19 |
| 3d recon without postprocess indpndt CPT 76376 | $538.44 | $641.00 | $391.01 – $868.05 | 19 |
| 5' nucleotidase - sendout CPT 83915 | $70.56 | $84.00 | $11.15 – $82.32 | 19 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $151.20 | $180.00 | $109.80 – $243.76 | 19 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $6,134.90 | $7,303.45 | $2,961.01 – $6,573.43 | 19 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $16.80 | $20.00 | $12.01 – $26.66 | 19 |
| Abd aorta w/runoff s&i CPT 75630 | $2,802.24 | $3,336.00 | $2,034.96 – $4,517.62 | 19 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,669.12 | $4,368.00 | $2,664.48 – $5,915.15 | 19 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,957.64 | $3,521.00 | $2,147.81 – $4,768.14 | 19 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,736.72 | $3,258.00 | $1,987.38 – $4,411.99 | 19 |
| Abdominal MRI (with and without contrast) CPT 74183 | $4,229.40 | $5,035.00 | $3,071.35 – $6,818.40 | 19 |
| Abdominal MRI (with contrast) CPT 74182 | $3,679.20 | $4,380.00 | $2,671.80 – $5,931.40 | 19 |
| Abdominal MRI (without contrast) CPT 74181 | $2,918.16 | $3,474.00 | $2,119.14 – $4,704.50 | 19 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,097.88 | $1,307.00 | $212.75 – $833.98 | 19 |
| Abdominal Ultrasound (complete) CPT 76700 | $965.16 | $1,149.00 | $675.46 – $1,555.98 | 19 |
| Abdominal Ultrasound (limited) CPT 76705 | $511.56 | $609.00 | $371.49 – $824.71 | 19 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $878.64 | $1,046.00 | $152.25 – $596.82 | 19 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $6,027.00 | $7,175.00 | $4,376.75 – $9,716.39 | 19 |
| Ablate pulm tumor perq crybl CPT 32994 | $7,396.20 | $8,805.00 | $5,371.05 – $11,923.74 | 19 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $285.60 | $340.00 | $29.89 – $66.36 | 19 |
| Ablation cryo abd perit om CPT 49999 | $2,367.96 | $2,819.00 | $1,719.59 – $3,817.49 | 19 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $5,585.16 | $6,649.00 | $4,055.89 – $9,004.08 | 19 |
| Ablation of upper extremity nerves rf CPT 64999 | $65.52 | $78.00 | $47.58 – $105.63 | 19 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,656.48 | $1,972.00 | $1,202.92 – $2,670.49 | 19 |
| Abscess imaging ltd area CPT 78805 | $1,305.36 | $1,554.00 | $947.94 – $2,104.43 | 19 |
| Abscess imaging whole body CPT 78806 | $1,666.56 | $1,984.00 | $1,210.24 – $2,686.74 | 19 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $185.64 | $221.00 | $60.70 – $134.75 | 19 |
| Acetaminophen level CPT 80143 | $437.64 | $521.00 | $18.64 – $510.58 | 19 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $159.90 | $190.35 | $60.70 – $134.75 | 19 |
| Acetone qualitative CPT 82009 | $49.56 | $59.00 | $4.52 – $57.82 | 19 |
| Acetylcholine receptor modulating antibody CPT 86043 | $170.52 | $203.00 | $123.83 – $274.91 | 19 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $795.06 | $946.50 | $2.60 – $5.76 | 19 |
| Acne surgery 10040 CPT 10040 | $95.76 | $114.00 | $69.54 – $154.38 | 19 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $147.00 | $175.00 | $106.75 – $236.99 | 19 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $311.64 | $371.00 | $226.31 – $502.41 | 19 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $30.24 | $36.00 | $21.96 – $48.76 | 19 |
| Actigraphy testing CPT 95803 | $293.16 | $349.00 | $212.89 – $472.62 | 19 |
| Acute hepatitis panel CPT 80074 | $645.96 | $769.00 | $47.63 – $126.42 | 19 |
| Acyclovir 400 mg tablet HCPCS J8499 | $67.54 | $80.40 | $28.55 – $63.38 | 19 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Adapter b 8 channel 10cm HCPCS C1883 | $4,061.29 | $4,834.86 | $301.95 – $670.33 | 19 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $368.81 | $439.05 | $60.70 – $134.75 | 19 |
| Adenovirus ag ia CPT 87301 | $133.56 | $159.00 | $11.98 – $155.82 | 19 |
| Adenovirus antibody,serum - quest CPT 86603 | $138.60 | $165.00 | $12.87 – $161.70 | 19 |
| Adh-sendout CPT 84588 | $152.04 | $181.00 | $33.94 – $177.38 | 19 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $1,373.78 | $1,635.45 | $14.74 – $32.71 | 19 |
| Admin ecg contrast agent CPT 93352 | $106.68 | $127.00 | $77.47 – $171.99 | 19 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $441.84 | $526.00 | $320.86 – $712.31 | 19 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $320.04 | $381.00 | $209.84 – $465.85 | 19 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $417.48 | $497.00 | $272.67 – $605.33 | 19 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $320.04 | $381.00 | $209.84 – $465.85 | 19 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $190.68 | $227.00 | $132.98 – $295.22 | 19 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $190.68 | $227.00 | $132.98 – $295.22 | 19 |
| Administration immunization 1 vaccine CPT 90471 | $99.96 | $119.00 | $11.59 – $25.73 | 19 |
| Administration immunization each additional vaccine CPT 90472 | $244.44 | $291.00 | $177.51 – $394.08 | 19 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $26,152.52 | $31,133.95 | $11,869.84 – $26,351.04 | 19 |
| Adrenal cortex & medulla img CPT 78075 | $2,249.52 | $2,678.00 | $1,633.58 – $3,626.55 | 19 |
| Adrenalin epinephrine inject HCPCS J0171 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| _afb id by dna probe rflx ast CPT 87149 | $196.56 | $234.00 | $20.05 – $229.32 | 19 |
| #afb mycobacteria suscep. #1 CPT 87190 | $55.44 | $66.00 | $7.31 – $64.68 | 19 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $804.72 | $958.00 | $115.36 – $938.84 | 19 |
| Afo tibial fracture soft HCPCS L2112 | $127.94 | $152.30 | $92.91 – $206.25 | 19 |
| After cataract laser surgery CPT 66821 | $866.88 | $1,032.00 | $419.68 – $931.69 | 19 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $28,950.39 | $34,464.75 | $3,002.85 – $6,666.33 | 19 |
| Air conduction bilat CPT 92552 | $157.08 | $187.00 | $114.07 – $253.24 | 19 |
| Albumin body fluid quantitative each specimen CPT 82042 | $75.60 | $90.00 | $7.78 – $88.20 | 19 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $270.15 | $321.60 | $126.12 – $279.99 | 19 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $468.72 | $558.00 | $81.74 – $181.47 | 19 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $117.60 | $140.00 | $5.78 – $17.64 | 19 |
| Albumin serum plasma or whole blood CPT 82040 | $91.56 | $109.00 | $4.95 – $15.68 | 19 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $335.16 | $399.00 | $17.27 – $391.02 | 19 |
| Alginate dressing <=16 sq in HCPCS A6196 | $6.47 | $7.70 | $4.70 – $10.43 | 19 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | $61.74 | $73.50 | $14.10 – $31.29 | 19 |
| Alginate drsg wound filler HCPCS A6199 | $34.57 | $41.15 | $25.11 – $55.73 | 19 |
| Alkaline phosphatase CPT 84075 | $99.96 | $119.00 | $5.18 – $16.66 | 19 |
| Allergen egg white ige CPT 86003 | $101.64 | $121.00 | $5.22 – $118.58 | 19 |
| Allergy injections; 2 or more 95117 CPT 95117 | $47.04 | $56.00 | $34.16 – $75.84 | 19 |
| Allergy injection; single 95115 CPT 95115 | $296.52 | $353.00 | $20.13 – $44.69 | 19 |
| Allergy Skin Testing CPT 95004 | $472.08 | $562.00 | $342.82 – $761.07 | 19 |
| Allg patch or app # of tests 95044 CPT 95044 | $664.44 | $791.00 | $482.51 – $1,071.18 | 19 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $4,347.00 | $5,175.00 | $346.15 – $768.45 | 19 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $7,257.60 | $8,640.00 | $1,369.76 – $3,040.86 | 19 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $11,585.70 | $13,792.49 | $503.99 – $1,118.85 | 19 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $9,346.18 | $11,126.40 | $610.00 – $1,354.20 | 19 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $7,938.00 | $9,450.00 | $484.95 – $1,076.59 | 19 |
| All tstg perq&iq drugs/biol CPT 95018 | $37.80 | $45.00 | $27.45 – $60.94 | 19 |
| All tstg perq&iq w/venoms CPT 95017 | $37.80 | $45.00 | $27.45 – $60.94 | 19 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Alpha-fetoprotein amniotic CPT 82106 | $144.48 | $172.00 | $17.00 – $168.56 | 19 |
| Alpha-fetoprotein tumor marker CPT 82105 | $175.56 | $209.00 | $16.77 – $49.98 | 19 |
| Alprostadil for injection HCPCS J0270 | $505.39 | $601.65 | $304.00 – $674.88 | 19 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $35,667.87 | $42,461.75 | $455.19 – $1,010.51 | 19 |
| Alt/sgpt CPT 84460 | $128.52 | $153.00 | $5.30 – $16.66 | 19 |
| Aluminum - quest CPT 82108 | $128.52 | $153.00 | $25.48 – $149.94 | 19 |
| Amantadine (symmetrel)-sendout CPT 80375 | $341.88 | $407.00 | $248.27 – $551.16 | 19 |
| Amifostine HCPCS J0207 | $12,570.99 | $14,965.46 | $3,049.52 – $6,769.92 | 19 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
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.