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 |
|---|---|---|---|---|
| Ghs spont nystagmus CPT 92541 | $69.72 | $83.00 | $50.63 – $112.40 | 19 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $2,403.24 | $2,861.00 | $1,745.21 – $3,874.37 | 19 |
| Ghs st - eval for alt comm CPT 92567 | $1,870.68 | $2,227.00 | $1,358.47 – $3,015.81 | 19 |
| Ghs strapping shoulder - 29240 CPT 29240 | $248.64 | $296.00 | $21.50 – $84.28 | 19 |
| Ghs st - re-eval for alt comm CPT 92597 | $1,069.32 | $1,273.00 | $197.03 – $437.41 | 19 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $708.12 | $843.00 | $210.75 – $467.87 | 19 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $414.96 | $494.00 | $123.50 – $397.88 | 19 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,395.24 | $1,661.00 | $218.25 – $855.54 | 19 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $751.80 | $895.00 | $223.75 – $577.22 | 19 |
| Ghs urine, porphyrins quant CPT 84120 | $260.40 | $310.00 | $14.71 – $303.80 | 19 |
| Ghs vaginal delivery only CPT 59409 | $1,775.76 | $2,114.00 | $337.33 – $748.88 | 19 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $617.40 | $735.00 | $448.35 – $995.34 | 19 |
| Ghs windowing of cast CPT 29730 | $147.00 | $175.00 | $43.75 – $146.02 | 19 |
| Gi inhouse confirmation CPT 87045 | $236.88 | $282.00 | $9.44 – $28.42 | 19 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $2,303.28 | $2,742.00 | $1,672.62 – $3,713.22 | 19 |
| Gi trc img intral colon i&r CPT 91113 | $994.56 | $1,184.00 | $722.24 – $1,603.38 | 19 |
| Glassia injection HCPCS J0257 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,075.58 | $1,280.45 | $273.96 – $608.18 | 19 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $825.89 | $983.20 | $320.53 – $711.57 | 19 |
| Glucagon plasma - sendout CPT 82943 | $194.88 | $232.00 | $14.29 – $227.36 | 19 |
| Glucose 1 hr post dose CPT 82950 | $120.96 | $144.00 | $4.75 – $13.72 | 19 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $121.80 | $145.00 | $6.05 – $142.10 | 19 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $68.88 | $82.00 | $3.28 – $7.28 | 19 |
| Glucose blood quantitative CPT 82947 | $72.24 | $86.00 | $1.95 – $8.72 | 19 |
| Glucose body fluid CPT 82945 | $116.76 | $139.00 | $3.93 – $136.22 | 19 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $400.68 | $477.00 | $12.87 – $39.20 | 19 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $117.60 | $140.00 | $3.92 – $137.20 | 19 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $8,098.66 | $9,641.26 | $5,881.17 – $13,056.20 | 19 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $221.76 | $264.00 | $18.58 – $258.72 | 19 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $228.48 | $272.00 | $18.52 – $266.56 | 19 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $12,264.09 | $14,600.10 | $3,028.11 – $6,722.39 | 19 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,998.80 | $3,570.00 | $2,177.70 – $4,834.50 | 19 |
| Graft axiofill 1000mg HCPCS J3590 | $10,251.36 | $12,204.00 | $519.69 – $1,153.70 | 19 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $805.56 | $959.00 | $234.85 – $521.37 | 19 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $36,496.21 | $43,447.86 | $176.90 – $392.72 | 19 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $5,377.05 | $6,401.25 | $420.14 – $932.71 | 19 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $29,642.55 | $35,288.75 | $85.40 – $189.59 | 19 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $5,460.00 | $6,500.00 | $608.71 – $1,351.33 | 19 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $3,265.92 | $3,888.00 | $1,054.08 – $2,340.06 | 19 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $5,880.00 | $7,000.00 | $976.31 – $2,167.40 | 19 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $2,542.05 | $3,026.25 | $1,846.02 – $4,098.15 | 19 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $39,146.74 | $46,603.26 | $2,401.88 – $5,332.17 | 19 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $7,440.05 | $8,857.20 | $507.28 – $1,126.16 | 19 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $26,042.52 | $31,003.00 | $4.85 – $10.77 | 19 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $3,059.03 | $3,641.70 | $31.94 – $70.90 | 19 |
| Granisetron hcl injection HCPCS J1626 | $255.03 | $303.60 | $60.70 – $134.75 | 19 |
| Great toe with reduction 28495 CPT 28495 | $422.52 | $503.00 | $125.75 – $437.08 | 19 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | $2,058.00 | $2,450.00 | $1,494.50 – $3,317.79 | 19 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $36.96 | $44.00 | $26.84 – $59.59 | 19 |
| Gstrst open wo constj tube CPT 43830 | $1,598.52 | $1,903.00 | $1,160.83 – $2,577.05 | 19 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,272.60 | $1,515.00 | $924.15 – $2,051.62 | 19 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,584.24 | $1,886.00 | $1,125.45 – $2,498.50 | 19 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $7,821.28 | $9,311.04 | $0.86 – $1.90 | 19 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $3,600.45 | $4,286.25 | $8.84 – $19.63 | 19 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $2,141.37 | $2,549.25 | $20.13 – $44.69 | 19 |
| Gw stiffened micro access kit HCPCS C1894 | $12,297.60 | $14,640.00 | $11.64 – $25.84 | 19 |
| Gynecomastia (males) 19300 CPT 19300 | $1,360.80 | $1,620.00 | $988.20 – $2,193.81 | 19 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $663.50 | $789.88 | $60.70 – $134.75 | 19 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $239.87 | $285.55 | $60.70 – $134.75 | 19 |
| Hand X-ray CPT 73130 | $344.40 | $410.00 | $37.82 – $83.97 | 19 |
| Haptoglobin quantitative CPT 83010 | $176.40 | $210.00 | $12.58 – $205.80 | 19 |
| Hc ea ha check monaural CPT 92594 | $284.76 | $339.00 | $206.79 – $459.08 | 19 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $514.08 | $612.00 | $373.32 – $828.78 | 19 |
| Hcg free betachain test CPT 84704 | $193.20 | $230.00 | $15.29 – $225.40 | 19 |
| Hcg qualitative CPT 84703 | $169.68 | $202.00 | $7.52 – $22.54 | 19 |
| Hcg quantitative CPT 84702 | $178.92 | $213.00 | $15.05 – $45.08 | 19 |
| Hc hearing aid chck binaurl CPT 92593 | $97.44 | $116.00 | $70.76 – $157.09 | 19 |
| Hc hearing aid chck monarl CPT 92592 | $204.12 | $243.00 | $148.23 – $329.08 | 19 |
| Hc hearing aid exam both ears CPT 92591 | $214.20 | $255.00 | $155.55 – $345.33 | 19 |
| Hc hearing aid exam one ear CPT 92590 | $142.80 | $170.00 | $103.70 – $230.22 | 19 |
| Hc nm kidney imaging with flow CPT 78701 | $1,359.12 | $1,618.00 | $986.98 – $2,191.10 | 19 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,807.28 | $3,342.00 | $2,038.62 – $4,525.74 | 19 |
| Head CT scan (with and without contrast) CPT 70470 | $3,203.76 | $3,814.00 | $1,691.22 – $5,164.92 | 19 |
| Head CT scan (with contrast) CPT 70460 | $2,623.32 | $3,123.00 | $1,905.03 – $4,229.17 | 19 |
| Head CT scan (without contrast) CPT 70450 | $2,150.40 | $2,560.00 | $1,335.18 – $3,466.76 | 19 |
| Heart image spect CPT 78494 | $600.60 | $715.00 | $436.15 – $968.26 | 19 |
| Helicobacter pylori antibody igm CPT 86677 | $94.08 | $112.00 | $16.85 – $44.10 | 19 |
| Hematocrit CPT 85014 | $53.76 | $64.00 | $2.37 – $6.86 | 19 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $45,950.06 | $54,702.45 | $33,368.50 – $74,078.06 | 19 |
| Hemoglobin CPT 85018 | $40.32 | $48.00 | $2.37 – $6.86 | 19 |
| Hemoglobin fetal qualitative CPT 83033 | $61.32 | $73.00 | $8.00 – $71.54 | 19 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $131.88 | $157.00 | $8.20 – $153.86 | 19 |
| Hemoglobin plasma CPT 83051 | $133.56 | $159.00 | $7.31 – $155.82 | 19 |
| Hemolysin acid CPT 85475 | $140.28 | $167.00 | $8.87 – $163.66 | 19 |
| Hemolysins/agglutinins auto CPT 86940 | $74.76 | $89.00 | $8.77 – $87.22 | 19 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $680.40 | $810.00 | $467.87 – $1,038.68 | 19 |
| Heparin assay CPT 85520 | $313.32 | $373.00 | $13.09 – $365.54 | 19 |
| Heparin bolus from bag HCPCS J1644 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $956.51 | $1,138.70 | $60.70 – $134.75 | 19 |
| Hepatitis a antibody igm CPT 86709 | $25.20 | $30.00 | $11.26 – $29.40 | 19 |
| Hepatitis b core antibody igm CPT 86705 | $78.12 | $93.00 | $11.77 – $91.14 | 19 |
| Hepatitis b core antibody total CPT 86704 | $161.28 | $192.00 | $12.05 – $188.16 | 19 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $3,050.80 | $3,631.90 | $229.61 – $509.73 | 19 |
| Hepatitis b surface antibody CPT 86706 | $162.96 | $194.00 | $10.74 – $32.34 | 19 |
| Hepatitis c antibody CPT 86803 | $192.36 | $229.00 | $14.27 – $43.12 | 19 |
| Hepatobiliary system imaging CPT 78226 | $2,296.56 | $2,734.00 | $1,667.74 – $3,702.39 | 19 |
| Hepb vacc 3 dose immunsup im CPT 90740 | $459.32 | $546.80 | $333.55 – $740.48 | 19 |
| Hernia Repair (Inguinal) CPT 49505 | $1,187.76 | $1,414.00 | $862.54 – $1,914.84 | 19 |
| Herpes simplex type 1 antibody igg CPT 86695 | $231.00 | $275.00 | $13.19 – $269.50 | 19 |
| Herpes simplex type 2 antibody igg CPT 86696 | $236.88 | $282.00 | $19.35 – $276.36 | 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.