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 |
|---|---|---|---|---|
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,331.00 | $2,775.00 | $1,692.75 – $3,757.91 | 19 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $357.84 | $426.00 | $259.86 – $576.89 | 19 |
| Destruction vag lesions simple 57061 CPT 57061 | $2,268.00 | $2,700.00 | $1,647.00 – $3,656.34 | 19 |
| Detect agent nos dna dir CPT 87797 | $104.16 | $124.00 | $30.03 – $66.67 | 19 |
| Detect agnt mult dna direc CPT 87800 | $155.40 | $185.00 | $43.67 – $181.30 | 19 |
| Device ablt adv novasure HCPCS C1886 | $10,643.73 | $12,671.10 | $1,202.01 – $2,668.46 | 19 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $3,832.92 | $4,563.00 | $2,676.38 – $5,941.56 | 19 |
| Device intraute mirena HCPCS J7298 | $3,673.06 | $4,372.68 | $2,667.34 – $5,921.49 | 19 |
| Device sut capio slim opn HCPCS C2631 | $1,247.81 | $1,485.48 | $402.60 – $893.78 | 19 |
| Device tiss remov myosure reach HCPCS C1782 | $2,089.50 | $2,487.50 | $521.55 – $1,157.85 | 19 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $252.00 | $300.00 | $183.00 – $406.26 | 19 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $456.96 | $544.00 | $2.14 – $4.74 | 19 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $130.41 | $155.25 | $60.70 – $134.75 | 19 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $2,107.02 | $2,508.35 | $201.24 – $446.76 | 19 |
| Dextran 40 infusion HCPCS J7100 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Dextrose 5 % IV bolus HCPCS J7070 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $207.48 | $247.00 | $22.23 – $242.06 | 19 |
| Diabetes (HbA1c) Test CPT 83036 | $115.92 | $138.00 | $9.71 – $29.40 | 19 |
| Diab manage trn ind/group HCPCS G0109 | $27.72 | $33.00 | $20.13 – $44.69 | 19 |
| Diag bronchoscope/catheter CPT 31643 | $1,612.80 | $1,920.00 | $1,171.20 – $2,600.07 | 19 |
| Diag laparo separate proc 49320 CPT 49320 | $747.60 | $890.00 | $542.90 – $1,205.24 | 19 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $288.96 | $344.00 | $86.00 – $316.54 | 19 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $330.96 | $394.00 | $240.34 – $533.56 | 19 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $258.72 | $308.00 | $187.88 – $417.10 | 19 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $215.88 | $257.00 | $64.25 – $169.54 | 19 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $305.76 | $364.00 | $91.00 – $240.10 | 19 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $258.72 | $308.00 | $187.88 – $417.10 | 19 |
| Diagnostic Mammogram (one breast) CPT 77065 | $258.72 | $308.00 | $137.25 – $304.70 | 19 |
| Dialysis one evaluation CPT 90945 | $3,291.12 | $3,918.00 | $2,389.98 – $5,305.76 | 19 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $153.51 | $182.75 | $60.70 – $134.75 | 19 |
| Dicyclomine injection HCPCS J0500 | $322.90 | $384.40 | $60.70 – $134.75 | 19 |
| Diffusing capacity CPT 94729 | $535.08 | $637.00 | $388.57 – $862.63 | 19 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $530.98 | $632.11 | $60.70 – $134.75 | 19 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $20,159.63 | $23,999.55 | $14,639.73 – $32,500.20 | 19 |
| Digoxin total therapeutic drug level CPT 80162 | $134.40 | $160.00 | $13.28 – $40.18 | 19 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $4,703.66 | $5,599.59 | $125.06 – $277.63 | 19 |
| Dilate biliary duct/ampulla CPT 47542 | $1,706.88 | $2,032.00 | $1,239.52 – $2,751.74 | 19 |
| Dilate esophagus CPT 43453 | $678.72 | $808.00 | $492.88 – $1,094.20 | 19 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,092.84 | $1,301.00 | $135.25 – $530.18 | 19 |
| Dilate urethra stricture CPT 53600 | $363.72 | $433.00 | $62.00 – $243.04 | 19 |
| Dilate urethra stricture CPT 53601 | $277.20 | $330.00 | $59.25 – $232.26 | 19 |
| Dilation/female urethra/initial 53660 CPT 53660 | $231.84 | $276.00 | $168.36 – $373.76 | 19 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $2,298.24 | $2,736.00 | $122.00 – $478.24 | 19 |
| Dilator fascial 10fx20cm HCPCS C2627 | $816.48 | $972.00 | $73.90 – $164.05 | 19 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $2,242.47 | $2,669.60 | $1,628.46 – $3,615.18 | 19 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Disability dlco CPT 94727 | $635.88 | $757.00 | $461.77 – $1,025.13 | 19 |
| Disaccharidases CPT 82657 | $787.08 | $937.00 | $22.17 – $77.42 | 19 |
| Dna antibody native/double stranded CPT 86225 | $312.48 | $372.00 | $13.74 – $41.16 | 19 |
| Dna gardnerella CPT 87510 | $87.36 | $104.00 | $20.05 – $59.78 | 19 |
| Dna probe chlamydia CPT 87490 | $122.64 | $146.00 | $22.75 – $59.78 | 19 |
| Dna probe gc CPT 87590 | $98.28 | $117.00 | $26.88 – $59.78 | 19 |
| Dna trichomonas CPT 87660 | $206.64 | $246.00 | $20.05 – $59.78 | 19 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $2,145.50 | $2,554.16 | $60.70 – $134.75 | 19 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Doppler echo complete CPT 93320 | $311.64 | $371.00 | $226.31 – $502.41 | 19 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $713.16 | $849.00 | $517.89 – $1,149.72 | 19 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $750.96 | $894.00 | $140.30 – $311.47 | 19 |
| Dornhoffer fixed part w/window HCPCS L8614 | $23,058.11 | $27,450.13 | $8,912.56 – $19,785.87 | 19 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $47,612.84 | $56,681.95 | $34,575.99 – $76,758.70 | 19 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $814.89 | $970.10 | $60.70 – $134.75 | 19 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $6,365.52 | $7,578.00 | $364.05 – $808.19 | 19 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $486.36 | $579.00 | $121.39 – $269.49 | 19 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $560.28 | $667.00 | $148.23 – $329.08 | 19 |
| Drainage external ear simple 69000 CPT 69000 | $441.84 | $526.00 | $131.50 – $291.93 | 19 |
| Drainage mouth roof lesion CPT 42000 | $381.36 | $454.00 | $113.50 – $437.08 | 19 |
| Drainage of arm bursa 23931 CPT 23931 | $719.88 | $857.00 | $214.25 – $744.80 | 19 |
| Drainage of nose lesion sept 30020 CPT 30020 | $649.32 | $773.00 | $193.25 – $553.70 | 19 |
| Drainage of rectal abscess CPT 45005 | $812.28 | $967.00 | $226.00 – $885.92 | 19 |
| Drain blood from under nail 11740 CPT 11740 | $135.24 | $161.00 | $40.25 – $89.36 | 19 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,122.28 | $3,717.00 | $2,267.37 – $5,033.57 | 19 |
| Drain cath image guided visceral pq CPT 49405 | $1,656.48 | $1,972.00 | $1,202.92 – $2,670.49 | 19 |
| Drain chst dry seal exp thorastat HCPCS A7041 | $184.74 | $219.92 | $54.66 – $121.34 | 19 |
| Drain finger abscess;simple 26010 CPT 26010 | $832.44 | $991.00 | $175.07 – $388.66 | 19 |
| Drain lower leg lesion 27603 CPT 27603 | $3,026.52 | $3,603.00 | $2,197.83 – $4,879.19 | 19 |
| Drain neck/chest lesion 21501 CPT 21501 | $2,972.76 | $3,539.00 | $2,158.79 – $4,792.52 | 19 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,026.92 | $2,413.00 | $467.00 – $1,830.64 | 19 |
| Drain thyroid/tongue cyst CPT 60000 | $837.48 | $997.00 | $129.25 – $506.66 | 19 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $379.68 | $452.00 | $267.79 – $594.50 | 19 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $261.24 | $311.00 | $143.96 – $319.60 | 19 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $570.36 | $679.00 | $333.06 – $739.40 | 19 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $614.04 | $731.00 | $445.91 – $989.93 | 19 |
| Drng appendix abscess open 44900 CPT 44900 | $1,774.08 | $2,112.00 | $1,288.32 – $2,860.08 | 19 |
| Drng of eyelid abscess 67700 CPT 67700 | $683.76 | $814.00 | $203.50 – $451.77 | 19 |
| Drng of hydrocele 55000 CPT 55000 | $247.80 | $295.00 | $179.95 – $399.49 | 19 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,214.64 | $1,446.00 | $161.75 – $634.06 | 19 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1,360.13 | $1,619.20 | $10.44 – $23.16 | 19 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,004.85 | $1,196.25 | $181.90 – $403.81 | 19 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $3,903.80 | $4,647.38 | $1,259.96 – $2,797.11 | 19 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $3,080.84 | $3,667.66 | $994.35 – $2,207.45 | 19 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $12,789.79 | $15,225.93 | $2,537.66 – $5,633.60 | 19 |
| Drug assay caffeine CPT 80155 | $82.32 | $98.00 | $38.57 – $96.04 | 19 |
| Drug assay voriconazole CPT 80285 | $189.84 | $226.00 | $27.11 – $221.48 | 19 |
| Drug of abuse screen urine CPT 80305 | $202.44 | $241.00 | $12.60 – $236.18 | 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.