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 |
|---|---|---|---|---|
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $399.00 | $475.00 | $289.75 – $643.25 | 19 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,021.44 | $1,216.00 | $53.50 – $209.72 | 19 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,387.68 | $1,652.00 | $430.66 – $956.07 | 19 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $427.56 | $509.00 | $310.49 – $689.29 | 19 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $819.00 | $975.00 | $594.75 – $1,320.35 | 19 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $752.64 | $896.00 | $156.77 – $348.03 | 19 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,447.32 | $1,723.00 | $303.17 – $673.04 | 19 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,513.68 | $1,802.00 | $301.34 – $668.98 | 19 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,513.68 | $1,802.00 | $296.46 – $658.15 | 19 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $246.12 | $293.00 | $40.00 – $156.80 | 19 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $239.40 | $285.00 | $52.46 – $116.47 | 19 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $351.96 | $419.00 | $2.93 – $6.51 | 19 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $118.44 | $141.00 | $76.25 – $169.28 | 19 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $121.80 | $145.00 | $84.18 – $186.88 | 19 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $118.44 | $141.00 | $76.25 – $169.28 | 19 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $187.32 | $223.00 | $129.32 – $287.10 | 19 |
| Inject sacroiliac joint CPT 27096 | $435.12 | $518.00 | $193.37 – $429.29 | 19 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | $66,246.60 | $78,865.00 | $48,107.65 – $106,798.99 | 19 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,150.80 | $1,370.00 | $233.02 – $517.31 | 19 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,044.96 | $1,244.00 | $212.89 – $472.62 | 19 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $686.70 | $817.50 | $249.34 – $553.53 | 19 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $12,661.58 | $15,073.30 | $9,194.72 – $20,412.27 | 19 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $421.39 | $501.65 | $306.01 – $679.34 | 19 |
| Inj for ext venography CPT 36005 | $220.92 | $263.00 | $160.43 – $356.16 | 19 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | $345.73 | $411.58 | $251.07 – $557.37 | 19 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $401.86 | $478.40 | $70.86 – $157.30 | 19 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | $42,919.72 | $51,094.90 | $7,791.96 – $17,298.15 | 19 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | $2,794.35 | $3,326.60 | $2,029.23 – $4,504.89 | 19 |
| Inj., guselkumab, 1 mg HCPCS J1628 | $59,037.77 | $70,283.05 | $42,312.04 – $93,932.73 | 19 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | $431.18 | $513.30 | $279.75 – $621.04 | 19 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $1,214.01 | $1,445.24 | $881.60 – $1,957.15 | 19 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | $183,399.72 | $218,333.00 | $133,183.13 – $295,666.55 | 19 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $112.56 | $134.00 | $81.74 – $181.47 | 19 |
| Inj intralesional > 7 lsns CPT 11901 | $110.88 | $132.00 | $80.52 – $178.76 | 19 |
| Inj ivig privigen 500 mg HCPCS J1459 | $12,230.40 | $14,560.00 | $1,110.20 – $2,464.65 | 19 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | $28,617.84 | $34,068.85 | $20,782.00 – $46,136.04 | 19 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $2,675.49 | $3,185.10 | $777.18 – $1,725.32 | 19 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $149.34 | $177.78 | $60.70 – $134.75 | 19 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $322.98 | $384.50 | $199.08 – $441.95 | 19 |
| Inj, levothyroxine, hikma HCPCS J0652 | $217.02 | $258.35 | $157.60 – $349.86 | 19 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $787.84 | $937.90 | $209.20 – $464.43 | 19 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj, meropenem (b. braun) HCPCS J2184 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $747.09 | $889.39 | $542.53 – $1,204.42 | 19 |
| Inj, micafungin (par pharm) HCPCS J2247 | $92.19 | $109.75 | $60.70 – $134.75 | 19 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | $40,291.53 | $47,966.10 | $29,259.33 – $64,955.70 | 19 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Inj multihance HCPCS A9577 | $128.61 | $153.10 | $4.88 – $10.84 | 19 |
| Inj. mycophenolate mofetil HCPCS J7519 | $280.09 | $333.44 | $60.70 – $134.75 | 19 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $827.32 | $984.90 | $600.79 – $1,333.76 | 19 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | $173,384.06 | $206,409.59 | $125,909.85 – $279,519.87 | 19 |
| Inj ogivri 10 mg HCPCS Q5114 | $6,267.50 | $7,461.30 | $1,625.50 – $3,608.61 | 19 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $39,900.00 | $47,500.00 | $28,975.00 – $64,324.50 | 19 |
| Inj, pedmark, 100 mg HCPCS J0208 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $12,539.36 | $14,927.80 | $9,105.96 – $20,215.23 | 19 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | $15,393.17 | $18,325.20 | $11,178.38 – $24,815.99 | 19 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | $190.52 | $226.80 | $138.35 – $307.14 | 19 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | $2,695.01 | $3,208.34 | $1,957.09 – $4,344.74 | 19 |
| Inj progesterone per 50 mg HCPCS J2675 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj, releuko 1 mcg HCPCS Q5125 | $599.43 | $713.60 | $272.06 – $603.98 | 19 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $1,476.18 | $1,757.35 | $60.70 – $134.75 | 19 |
| Inj retro urethrocysto CPT 51610 | $173.88 | $207.00 | $126.27 – $280.32 | 19 |
| Inj scleros sol sgl vein CPT 36470 | $97.44 | $116.00 | $68.93 – $153.03 | 19 |
| Inj secretin synthetic human HCPCS J2850 | $2,776.20 | $3,305.00 | $2,016.05 – $4,475.64 | 19 |
| Inj secukinumab intrav 1mg HCPCS J3247 | $8,971.83 | $10,680.75 | $6,515.26 – $14,463.88 | 19 |
| Inj, spesolimab-sbzo, 1 mg HCPCS J1747 | $107,379.32 | $127,832.52 | $77,977.84 – $173,110.80 | 19 |
| Inj teplizumab mzwv 5 mcg HCPCS J9381 | $45,491.59 | $54,156.65 | $31,388.56 – $69,682.60 | 19 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $64,980.72 | $77,358.00 | $47,188.38 – $104,758.21 | 19 |
| Inj testosterone cypionate HCPCS J1071 | $146.33 | $174.20 | $60.70 – $134.75 | 19 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | $55,934.76 | $66,589.00 | $40,619.29 – $90,174.83 | 19 |
| Inj, tofidence, 1 mg HCPCS Q5133 | $9,324.00 | $11,100.00 | $1,354.20 – $3,006.33 | 19 |
| Inj triamcinolone ace X-ray 1mg HCPCS J3304 | $2,513.70 | $2,992.50 | $1,825.43 – $4,052.45 | 19 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $7,536.48 | $8,972.00 | $1,094.71 – $2,430.25 | 19 |
| Inj, uzedy, 1 mg HCPCS J2799 | $23,458.73 | $27,927.05 | $3,406.80 – $7,563.09 | 19 |
| Inj, vancomycin hcl (xellia) HCPCS J3372 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Inj vasopressin (am reg) 1 u HCPCS J2599 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Inj w/fluor eval cv device CPT 36598 | $189.84 | $226.00 | $137.86 – $306.05 | 19 |
| Inpatient consultation CPT 99251 | $89.04 | $106.00 | $64.66 – $143.55 | 19 |
| Insert cath pleura with image CPT 32557 | $1,632.12 | $1,943.00 | $502.03 – $1,114.51 | 19 |
| Insert cath pleura without image CPT 32556 | $1,823.64 | $2,171.00 | $478.24 – $1,061.70 | 19 |
| Insert drug delivery implant CPT 11981 | $71.40 | $85.00 | $51.85 – $115.11 | 19 |
| Insert intrauterine device iud CPT 58300 | $252.84 | $301.00 | $183.61 – $407.62 | 19 |
| Insertion catheter bladder non indwelling CPT 51701 | $219.24 | $261.00 | $31.25 – $122.50 | 19 |
| Insertion catheter bladder temporary simple CPT 51702 | $215.04 | $256.00 | $43.50 – $170.52 | 19 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $1,950.48 | $2,322.00 | $1,416.42 – $3,144.46 | 19 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $2,183.16 | $2,599.00 | $374.54 – $831.48 | 19 |
| Insertion of catheter vein CPT 36481 | $1,494.36 | $1,779.00 | $1,085.19 – $2,409.13 | 19 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,735.04 | $3,256.00 | $65.00 – $254.80 | 19 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,446.48 | $1,722.00 | $1,050.42 – $2,331.94 | 19 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $5,060.16 | $6,024.00 | $108.25 – $424.34 | 19 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $2,417.52 | $2,878.00 | $1,755.58 – $3,897.39 | 19 |
| Insert pessary/other device CPT 57160 | $126.00 | $150.00 | $91.50 – $203.13 | 19 |
| Insert tunneled cv 2cath 2sits without port/pmp 36565 CPT 36565 | $1,993.32 | $2,373.00 | $1,447.53 – $3,213.52 | 19 |
| Insert tunneled cv cath CPT 36560 | $3,020.64 | $3,596.00 | $2,193.56 – $4,869.71 | 19 |
| Insert tunneled cv cath CPT 36563 | $2,728.32 | $3,248.00 | $1,981.28 – $4,398.45 | 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.