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 |
|---|---|---|---|---|
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $1,041.60 | $1,240.00 | $756.40 – $1,679.21 | 19 |
| Exc neck tum deep < 5 cm CPT 21556 | $1,220.52 | $1,453.00 | $886.33 – $1,967.66 | 19 |
| Exc neck tum deep 5 cm/> CPT 21554 | $1,505.28 | $1,792.00 | $1,093.12 – $2,426.73 | 19 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $850.92 | $1,013.00 | $617.93 – $1,371.81 | 19 |
| Exc prtl bn phlnx toe CPT 28124 | $1,865.64 | $2,221.00 | $1,354.81 – $3,007.68 | 19 |
| Exc rect tum transanal part CPT 45171 | $1,438.08 | $1,712.00 | $1,044.32 – $2,318.40 | 19 |
| Exc sacral pr ulc prim sutr CPT 15931 | $1,598.52 | $1,903.00 | $1,160.83 – $2,577.05 | 19 |
| Exc sacral pr ulc skn flap CPT 15934 | $2,174.76 | $2,589.00 | $1,579.29 – $3,506.03 | 19 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $1,041.60 | $1,240.00 | $433.71 – $962.84 | 19 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $1,926.96 | $2,294.00 | $575.23 – $1,277.02 | 19 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | $2,527.56 | $3,009.00 | $1,835.49 – $4,074.79 | 19 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | $2,054.64 | $2,446.00 | $824.11 – $1,829.53 | 19 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $1,020.60 | $1,215.00 | $741.15 – $1,645.36 | 19 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $1,674.12 | $1,993.00 | $1,215.73 – $2,698.93 | 19 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | $2,073.96 | $2,469.00 | $1,506.09 – $3,343.52 | 19 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | $960.96 | $1,144.00 | $697.84 – $1,549.21 | 19 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | $1,764.84 | $2,101.00 | $1,281.61 – $2,845.18 | 19 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | $1,696.80 | $2,020.00 | $1,232.20 – $2,735.49 | 19 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $2,745.96 | $3,269.00 | $151.25 – $592.90 | 19 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $1,926.96 | $2,294.00 | $1,399.34 – $3,106.54 | 19 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $4,150.44 | $4,941.00 | $364.17 – $808.46 | 19 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $4,961.25 | $5,906.25 | $48.32 – $107.26 | 19 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $1,327.20 | $1,580.00 | $380.03 – $843.67 | 19 |
| Explore wound abdomen 20102 CPT 20102 | $1,695.12 | $2,018.00 | $436.75 – $1,712.06 | 19 |
| Explore woundchest 20101 CPT 20101 | $1,407.00 | $1,675.00 | $1,021.75 – $2,268.29 | 19 |
| Explore wound neck 20100 CPT 20100 | $1,375.08 | $1,637.00 | $998.57 – $2,216.83 | 19 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | $2,076.15 | $2,471.60 | $1,507.68 – $3,347.05 | 19 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $483.00 | $575.00 | $350.75 – $778.67 | 19 |
| Ext ecg>48hr<7d rev&interpj CPT 93244 | $58.80 | $70.00 | $42.70 – $94.80 | 19 |
| Ext ecg>7d<15d rev&interpj CPT 93248 | $64.68 | $77.00 | $46.97 – $104.28 | 19 |
| Extensive testis surgery CPT 54535 | $1,738.80 | $2,070.00 | $1,262.70 – $2,803.20 | 19 |
| Extensive thyroid surgery CPT 60254 | $3,826.20 | $4,555.00 | $2,778.55 – $6,168.39 | 19 |
| External chromosome analysis 20-25 cells CPT 88264 | $635.04 | $756.00 | $144.61 – $740.88 | 19 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $74.76 | $89.00 | $54.29 – $120.53 | 19 |
| External recharg sys intern HCPCS L8689 | $4,611.60 | $5,490.00 | $915.00 – $2,031.30 | 19 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $987.84 | $1,176.00 | $143.75 – $1,152.48 | 19 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $222.60 | $265.00 | $17.93 – $259.70 | 19 |
| F-18 fdg pet diag HCPCS A9552 | $437.64 | $521.00 | $317.81 – $705.54 | 19 |
| Fabrication & fitting HCPCS V2628 | $184.47 | $219.60 | $44.66 – $99.13 | 19 |
| Facial bones <3 CPT 70140 | $186.48 | $222.00 | $135.42 – $300.64 | 19 |
| Facility svs dental rehab HCPCS G0330 | $1,722.84 | $2,051.00 | $1,251.11 – $2,777.47 | 19 |
| Factor ix CPT 85250 | $622.44 | $741.00 | $19.04 – $726.18 | 19 |
| Factor ix complex HCPCS J7194 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Factor ix recombinant nos HCPCS J7195 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Factor viii CPT 85240 | $244.44 | $291.00 | $17.90 – $285.18 | 19 |
| Factor viii HCPCS J7190 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Factor viii recombinant nos HCPCS J7192 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Family therapy without pt 50min 90846 CPT 90846 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Family therapy with patient 50 min 90847 CPT 90847 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $12,282.82 | $14,622.40 | $8,919.67 – $19,801.66 | 19 |
| Fat/lipids feces qualitative CPT 82705 | $40.32 | $48.00 | $5.10 – $47.04 | 19 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | $30,240.00 | $36,000.00 | $21,960.00 – $48,751.20 | 19 |
| #fecal-sodium CPT 84302 | $53.76 | $64.00 | $4.86 – $62.72 | 19 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $350.28 | $417.00 | $18.64 – $408.66 | 19 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $283.50 | $337.50 | $60.70 – $134.75 | 19 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $3,433.25 | $4,087.20 | $547.72 – $1,215.94 | 19 |
| Ferritin CPT 82728 | $229.32 | $273.00 | $13.63 – $41.16 | 19 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $768.27 | $914.60 | $460.28 – $1,021.82 | 19 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $477.96 | $569.00 | $347.09 – $770.54 | 19 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $302.40 | $360.00 | $219.60 – $487.52 | 19 |
| Fetal fibronectin CPT 82731 | $433.44 | $516.00 | $64.41 – $505.68 | 19 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $348.60 | $415.00 | $7.73 – $406.70 | 19 |
| Fetal hemoglobin rosette CPT 85461 | $126.84 | $151.00 | $9.36 – $147.98 | 19 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $36.12 | $43.00 | $19.32 – $42.89 | 19 |
| Fetal monitor w/report CPT 59050 | $125.16 | $149.00 | $90.89 – $201.78 | 19 |
| Fetal non stress test CPT 59025 | $362.04 | $431.00 | $32.75 – $128.38 | 19 |
| Fibrin degradation d dimer quantitative CPT 85379 | $164.64 | $196.00 | $10.18 – $22.60 | 19 |
| Fibrin degradation products CPT 85362 | $137.76 | $164.00 | $6.89 – $160.72 | 19 |
| Fibrin degrade semiquant CPT 85378 | $107.52 | $128.00 | $9.72 – $21.58 | 19 |
| Fibrinogen activity CPT 85384 | $110.04 | $131.00 | $9.72 – $128.38 | 19 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $263.76 | $314.00 | $15.48 – $307.72 | 19 |
| Fibrinolytic antiplasmin CPT 85410 | $177.24 | $211.00 | $7.71 – $206.78 | 19 |
| Fibrinolytic plasminogen CPT 85415 | $225.96 | $269.00 | $17.19 – $263.62 | 19 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $233.52 | $278.00 | $6.53 – $272.44 | 19 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $527.74 | $628.26 | $239.52 – $531.72 | 19 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1,880.60 | $2,238.80 | $582.89 – $1,294.01 | 19 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $6,802.11 | $8,097.75 | $1,052.25 – $2,336.00 | 19 |
| Filter vena cava fem denali HCPCS C1880 | $4,596.23 | $5,471.70 | $70.76 – $157.09 | 19 |
| Fine needle asp without image guide 10021 CPT 10021 | $310.80 | $370.00 | $71.50 – $280.28 | 19 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $4,711.93 | $5,609.43 | $316.23 – $702.02 | 19 |
| Fitting of diaphragm/cap 57170 CPT 57170 | $1,337.28 | $1,592.00 | $14.03 – $31.15 | 19 |
| Fl exam g/colon tube w contrast CPT 49465 | $165.48 | $197.00 | $120.17 – $266.78 | 19 |
| Flexible Sigmoidoscopy CPT 45330 | $449.40 | $535.00 | $93.94 – $208.55 | 19 |
| Floor of mouth biopsy 41108 CPT 41108 | $1,207.92 | $1,438.00 | $877.18 – $1,947.34 | 19 |
| Flow cytometry marker each additional CPT 88185 | $126.84 | $151.00 | $21.35 – $47.40 | 19 |
| Flow cytometry one marker technical component CPT 88184 | $703.08 | $837.00 | $18.30 – $40.63 | 19 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $1,044.38 | $1,243.30 | $102.21 – $226.90 | 19 |
| Fluidotherapy charges pt CPT 97022 | $71.40 | $85.00 | $37.82 – $83.97 | 19 |
| Fluid pressure muscle 20950 CPT 20950 | $694.68 | $827.00 | $188.00 – $736.96 | 19 |
| Fluorescent antibody titer dna CPT 86256 | $163.80 | $195.00 | $12.05 – $191.10 | 19 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $420.84 | $501.00 | $305.61 – $678.46 | 19 |
| Fluoroguide needle placement CPT 77002 | $948.36 | $1,129.00 | $669.78 – $1,486.92 | 19 |
| Fluoroscopy up to 1 hour CPT 76000 | $561.96 | $669.00 | $73.20 – $162.51 | 19 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $249.48 | $297.00 | $60.70 – $134.75 | 19 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $232.68 | $277.00 | $105.99 – $235.30 | 19 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | $74.60 | $88.80 | $12.83 – $28.48 | 19 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $20.50 | $24.40 | $6.96 – $15.44 | 19 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | $24.11 | $28.70 | $17.51 – $38.87 | 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.