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 |
|---|---|---|---|---|
| Foam drsg <=16 sq in without bdr HCPCS A6209 | $31.97 | $38.05 | $6.96 – $15.44 | 19 |
| Folic acid CPT 82746 | $224.28 | $267.00 | $14.70 – $44.10 | 19 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $5,761.98 | $6,859.50 | $1,140.37 – $2,531.61 | 19 |
| Fondaparinux sodium HCPCS J1652 | $365.33 | $434.91 | $60.70 – $134.75 | 19 |
| Foot plas heel stabi pre ots HCPCS L3170 | $133.56 | $159.00 | $48.53 – $107.73 | 19 |
| Foot X-ray CPT 73630 | $355.32 | $423.00 | $35.99 – $79.90 | 19 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $286.44 | $341.00 | $208.01 – $461.79 | 19 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,285.25 | $1,530.05 | $60.70 – $134.75 | 19 |
| Foscarnet sodium injection HCPCS J1455 | $1,307.88 | $1,557.00 | $379.42 – $842.32 | 19 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $465.91 | $554.65 | $60.70 – $134.75 | 19 |
| Fracture assessment via dxa CPT 77086 | $378.84 | $451.00 | $275.11 – $610.75 | 19 |
| Frenotomy 40806 CPT 40806 | $467.88 | $557.00 | $339.77 – $754.29 | 19 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $134.40 | $160.00 | $97.60 – $216.68 | 19 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $149.52 | $178.00 | $108.58 – $241.05 | 19 |
| Fresh frozen plasma thawing ea un CPT 86927 | $37.80 | $45.00 | $27.45 – $60.94 | 19 |
| Fructosamine glycated protein CPT 82985 | $152.04 | $181.00 | $16.76 – $177.38 | 19 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $4,882.08 | $5,812.00 | $646.25 – $2,533.30 | 19 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $162.12 | $193.00 | $117.73 – $261.37 | 19 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $153.09 | $182.25 | $60.70 – $134.75 | 19 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $187.37 | $223.05 | $6.71 – $14.90 | 19 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $318.85 | $379.58 | $60.70 – $134.75 | 19 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $545.29 | $649.15 | $14.64 – $32.51 | 19 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $198.24 | $236.00 | $21.07 – $231.28 | 19 |
| Galactose transferase test CPT 82776 | $34.44 | $41.00 | $11.74 – $40.18 | 19 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $1,495.20 | $1,780.00 | $1,085.80 – $2,410.48 | 19 |
| Gamma globulin 1 cc inj HCPCS J1460 | $1,850.02 | $2,202.40 | $1,343.47 – $2,982.50 | 19 |
| Gammaglobulin iga CPT 82784 | $161.28 | $192.00 | $9.30 – $90.16 | 19 |
| Gammaglobulin ige CPT 82785 | $120.12 | $143.00 | $16.46 – $140.14 | 19 |
| Gamma glutamyltransferase CPT 82977 | $80.64 | $96.00 | $7.20 – $21.56 | 19 |
| Gamunex-c/gammaked HCPCS J1561 | $13,087.20 | $15,580.00 | $60.70 – $134.75 | 19 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $192.07 | $228.65 | $93.46 – $207.47 | 19 |
| Gastroduodenostomy CPT 43810 | $2,292.36 | $2,729.00 | $1,664.69 – $3,695.62 | 19 |
| Gastroesophageal reflux study CPT 78262 | $1,069.32 | $1,273.00 | $776.53 – $1,723.90 | 19 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | $3,031.56 | $3,609.00 | $2,201.49 – $4,887.31 | 19 |
| Gastrojejunostomy w/vagotomy CPT 43825 | $2,955.12 | $3,518.00 | $2,145.98 – $4,764.08 | 19 |
| Gastro/jejuno tube, std HCPCS B4087 | $333.98 | $397.59 | $21.45 – $47.61 | 19 |
| Gated heart multiple CPT 78473 | $1,669.92 | $1,988.00 | $1,212.68 – $2,692.15 | 19 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $435.71 | $518.70 | $60.70 – $134.75 | 19 |
| General health panel CPT 80050 | $679.56 | $809.00 | $56.12 – $124.59 | 19 |
| Generator barostim neo2 2014 HCPCS C1767 | $74,415.86 | $88,590.30 | $438.30 – $973.02 | 19 |
| Generator emblem MRI sicd subq HCPCS C1722 | $63,025.20 | $75,030.00 | $5,871.25 – $13,034.18 | 19 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Gentamicin peak therapeutic drug level CPT 80170 | $184.80 | $220.00 | $16.38 – $215.60 | 19 |
| Ghs abscess perianal iandd CPT 46050 | $567.00 | $675.00 | $168.25 – $659.54 | 19 |
| Ghs abscess postoperative iandd complex CPT 10180 | $940.80 | $1,120.00 | $182.50 – $715.40 | 19 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $115.92 | $138.00 | $9.81 – $135.24 | 19 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $186.48 | $222.00 | $17.11 – $217.56 | 19 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $157.92 | $188.00 | $114.68 – $254.59 | 19 |
| Ghs antibodies (torch) igm CPT 86694 | $139.44 | $166.00 | $14.39 – $43.12 | 19 |
| Ghs bladder cath - complex-foley CPT 51703 | $379.68 | $452.00 | $106.25 – $416.50 | 19 |
| Ghs bleeding time (ivy) CPT 85002 | $185.64 | $221.00 | $4.82 – $216.58 | 19 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,808.52 | $2,153.00 | $137.00 – $537.04 | 19 |
| Ghs change cysto/gastrost CPT 43762 | $554.40 | $660.00 | $165.00 – $366.30 | 19 |
| Ghs chemo >8 hrs CPT 96416 | $209.16 | $249.00 | $137.25 – $304.70 | 19 |
| Ghs chemo IV push, ea addtl CPT 96411 | $320.04 | $381.00 | $209.84 – $465.85 | 19 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $147.84 | $176.00 | $35.09 – $172.48 | 19 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $670.32 | $798.00 | $145.79 – $323.66 | 19 |
| Ghs closed reduction ankle dislocation CPT 27840 | $889.56 | $1,059.00 | $240.34 – $533.56 | 19 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,102.92 | $1,313.00 | $300.73 – $667.63 | 19 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $1,045.80 | $1,245.00 | $311.25 – $690.98 | 19 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,246.56 | $1,484.00 | $371.00 – $823.62 | 19 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $1,839.60 | $2,190.00 | $547.50 – $1,690.50 | 19 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $784.56 | $934.00 | $233.50 – $709.52 | 19 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $1,199.52 | $1,428.00 | $189.10 – $419.81 | 19 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $792.96 | $944.00 | $145.79 – $323.66 | 19 |
| Ghs community re-entry 15 minutes CPT 97537 | $1,585.92 | $1,888.00 | $59.17 – $131.36 | 19 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $409.92 | $488.00 | $27.50 – $107.80 | 19 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $288.96 | $344.00 | $20.50 – $80.36 | 19 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $299.88 | $357.00 | $41.75 – $163.66 | 19 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $409.92 | $488.00 | $47.75 – $187.18 | 19 |
| Ghs cricothyroidotomy CPT 31605 | $1,395.24 | $1,661.00 | $546.56 – $1,213.37 | 19 |
| Ghs cutdown placement age 1 and over CPT 36425 | $556.92 | $663.00 | $68.32 – $151.68 | 19 |
| Ghs cutdown placement under 1 yr CPT 36420 | $556.92 | $663.00 | $31.50 – $123.48 | 19 |
| Ghs dislocation elbow closed treatment CPT 24600 | $874.44 | $1,041.00 | $189.71 – $421.16 | 19 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $617.40 | $735.00 | $72.00 – $282.24 | 19 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $141.96 | $169.00 | $42.25 – $146.02 | 19 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $874.44 | $1,041.00 | $635.01 – $1,409.73 | 19 |
| Ghs elect torsion swing CPT 92546 | $192.36 | $229.00 | $139.69 – $310.12 | 19 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | $1,558.20 | $1,855.00 | $1,131.55 – $2,512.05 | 19 |
| Ghs excision ingrown nail CPT 11765 | $395.64 | $471.00 | $117.75 – $378.28 | 19 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $655.20 | $780.00 | $195.00 – $432.90 | 19 |
| Ghs fb removal foot - deep - left CPT 28192 | $1,090.32 | $1,298.00 | $324.50 – $720.39 | 19 |
| Ghs fb removal from muscle - complicated CPT 20525 | $1,669.08 | $1,987.00 | $327.50 – $1,283.80 | 19 |
| Ghs fb removal - incisional CPT 10121 | $980.28 | $1,167.00 | $185.75 – $728.14 | 19 |
| Ghs fb removal - non-incisional CPT 20520 | $514.08 | $612.00 | $153.00 – $520.38 | 19 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $76.44 | $91.00 | $6.98 – $89.18 | 19 |
| Ghs fish cytogen CPT 88271 | $178.92 | $213.00 | $21.42 – $208.74 | 19 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $354.48 | $422.00 | $51.19 – $413.56 | 19 |
| Ghs gastric intub aspiration lavage CPT 43753 | $191.52 | $228.00 | $14.75 – $57.82 | 19 |
| Ghs hcv amplificaiton CPT 87521 | $406.56 | $484.00 | $35.09 – $474.32 | 19 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $1,255.80 | $1,495.00 | $15.49 – $1,465.10 | 19 |
| Ghs hgb stability-thal CPT 83068 | $153.72 | $183.00 | $9.47 – $179.34 | 19 |
| Ghs histoplasma antigen CPT 87385 | $236.04 | $281.00 | $13.25 – $275.38 | 19 |
| Ghs HIV antibody CPT 86703 | $135.24 | $161.00 | $13.65 – $30.44 | 19 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | $1,908.48 | $2,272.00 | $106.14 – $2,226.56 | 19 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $2,322.60 | $2,765.00 | $147.75 – $579.18 | 19 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,805.16 | $2,149.00 | $947.33 – $2,103.08 | 19 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $824.88 | $982.00 | $599.02 – $1,329.83 | 19 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $608.16 | $724.00 | $168.36 – $373.76 | 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.