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 |
|---|---|---|---|---|
| Insitu hybridization manual CPT 88368 | $637.56 | $759.00 | $462.99 – $1,027.84 | 19 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $556.92 | $663.00 | $404.43 – $897.84 | 19 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $529.20 | $630.00 | $384.30 – $853.15 | 19 |
| Ins picad w subq port 5yr> CPT 36571 | $5,251.68 | $6,252.00 | $2,278.35 – $5,057.94 | 19 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | $25,005.96 | $29,769.00 | $18,159.09 – $40,313.18 | 19 |
| Insti hexaminolevulinate hcl HCPCS A9589 | $5,329.80 | $6,345.00 | $3,870.45 – $8,592.40 | 19 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $494.76 | $589.00 | $359.29 – $797.63 | 19 |
| Instill, bupivac and meloxic HCPCS C9088 | $1,177.83 | $1,402.17 | $422.95 – $938.94 | 19 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | $10,565.52 | $12,578.00 | $7,672.58 – $17,033.13 | 19 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,045.40 | $2,435.00 | $1,485.35 – $3,297.48 | 19 |
| Insulin total CPT 83525 | $134.40 | $160.00 | $11.43 – $156.80 | 19 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $8,581.74 | $10,216.35 | $5,484.14 – $12,174.79 | 19 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $208.28 | $247.95 | $151.25 – $335.78 | 19 |
| Interdiscal perq aspir dx CPT 62267 | $600.60 | $715.00 | $436.15 – $968.26 | 19 |
| Intranasal biopsy 30100 CPT 30100 | $338.52 | $403.00 | $245.83 – $545.75 | 19 |
| Intrinsic factor antibody CPT 86340 | $78.96 | $94.00 | $15.08 – $92.12 | 19 |
| Intro cath dialysis circuit CPT 36901 | $1,104.60 | $1,315.00 | $802.15 – $1,780.78 | 19 |
| Intro cath dialysis circuit w/pta CPT 36902 | $12,228.72 | $14,558.00 | $8,880.38 – $19,714.45 | 19 |
| Intubation endotracheal emergency procedure CPT 31500 | $477.96 | $569.00 | $97.75 – $217.01 | 19 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $340.12 | $404.90 | $1.22 – $2.71 | 19 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $976.50 | $1,162.50 | $1.22 – $2.71 | 19 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $149,136.63 | $177,543.60 | $27,075.46 – $60,107.53 | 19 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | $210.00 | $250.00 | $152.50 – $338.55 | 19 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | $304.92 | $363.00 | $221.43 – $491.58 | 19 |
| Ip/obs consltj new/est hi 80 CPT 99255 | $367.08 | $437.00 | $266.57 – $591.79 | 19 |
| Ip/obs consltj new/est sf 35 CPT 99252 | $136.08 | $162.00 | $98.82 – $219.39 | 19 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $137.92 | $164.18 | $60.70 – $134.75 | 19 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $11,335.80 | $13,495.00 | $8,231.95 – $18,274.93 | 19 |
| Iron CPT 83540 | $288.96 | $344.00 | $6.47 – $19.60 | 19 |
| Iron binding capacity CPT 83550 | $149.52 | $178.00 | $8.74 – $26.46 | 19 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $143.15 | $170.41 | $87.27 – $193.72 | 19 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $273.72 | $325.85 | $87.96 – $195.27 | 19 |
| Irradiation of blood product each unit reference CPT 86945 | $126.00 | $150.00 | $91.50 – $203.13 | 19 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $154.56 | $184.00 | $101.26 – $224.80 | 19 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $147.00 | $175.00 | $99.43 – $220.74 | 19 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $191.52 | $228.00 | $133.59 – $296.57 | 19 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $46.20 | $55.00 | $33.55 – $74.49 | 19 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $210.84 | $251.00 | $147.01 – $326.37 | 19 |
| Ivp w/nephrotomography CPT 74415 | $641.76 | $764.00 | $466.04 – $1,034.61 | 19 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $632.52 | $753.00 | $459.33 – $1,019.72 | 19 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $24,397.72 | $29,044.90 | $17,717.39 – $39,332.61 | 19 |
| Jejunstmy tube plcmt CPT 44372 | $556.92 | $663.00 | $404.43 – $897.84 | 19 |
| Ketogenic steroids fract CPT 83582 | $99.12 | $118.00 | $15.47 – $115.64 | 19 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $154.56 | $184.00 | $8.17 – $180.32 | 19 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Kidney function study CPT 78725 | $543.48 | $647.00 | $394.67 – $876.17 | 19 |
| Kidney imaging morphology CPT 78700 | $605.64 | $721.00 | $439.81 – $976.38 | 19 |
| Kidney imag w/bld flow multi CPT 78709 | $2,368.80 | $2,820.00 | $1,720.20 – $3,818.85 | 19 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,891.68 | $2,252.00 | $1,373.72 – $3,049.66 | 19 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $827.40 | $985.00 | $600.85 – $1,333.89 | 19 |
| Kit case 4.2mm spinejack HCPCS C1062 | $7,084.67 | $8,434.13 | $110.65 – $245.63 | 19 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | $21.21 | $25.25 | $15.41 – $34.20 | 19 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $8,883.00 | $10,575.00 | $5,676.66 – $12,602.19 | 19 |
| Kit lead specify 5-6-5 HCPCS C1778 | $57,106.98 | $67,984.50 | $23.67 – $52.55 | 19 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $913.10 | $1,087.02 | $181.17 – $402.20 | 19 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $1,956.15 | $2,328.75 | $1,395.38 – $3,097.74 | 19 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $5,987.52 | $7,128.00 | $4,348.08 – $9,652.74 | 19 |
| Knee MRI (with and without contrast) CPT 73723 | $3,634.68 | $4,327.00 | $2,639.47 – $5,859.63 | 19 |
| Knee MRI (with contrast) CPT 73722 | $3,195.36 | $3,804.00 | $2,320.44 – $5,151.38 | 19 |
| Knee MRI (without contrast) CPT 73721 | $2,931.60 | $3,490.00 | $1,445.67 – $4,726.16 | 19 |
| Knee X-ray CPT 73564 | $454.44 | $541.00 | $50.63 – $112.40 | 19 |
| Kras gene variants exon 2 CPT 81275 | $1,445.64 | $1,721.00 | $193.25 – $1,686.58 | 19 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $64.68 | $77.00 | $19.25 – $75.46 | 19 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | $57.12 | $68.00 | $17.00 – $66.64 | 19 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $89.13 | $106.10 | $60.70 – $134.75 | 19 |
| Lab pathology consultation CPT 80500 | $44.52 | $53.00 | $32.33 – $71.78 | 19 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $380.61 | $453.10 | $60.70 – $134.75 | 19 |
| Lactate dehydrogenase (ldh) CPT 83615 | $117.60 | $140.00 | $6.04 – $18.62 | 19 |
| Lactated ringers intravenous solution HCPCS J7120 | $173.67 | $206.75 | $14.83 – $279.99 | 19 |
| Lactic acid CPT 83605 | $137.76 | $164.00 | $11.57 – $26.46 | 19 |
| Lactoferrin fecal qualitative CPT 83630 | $98.28 | $117.00 | $19.70 – $114.66 | 19 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $38,430.00 | $45,750.00 | $8,812.80 – $19,564.40 | 19 |
| Laparo cholecystectomy/explr CPT 47564 | $2,525.04 | $3,006.00 | $1,833.66 – $4,070.73 | 19 |
| Laparo cholecystectomy/graph CPT 47563 | $1,627.08 | $1,937.00 | $1,181.57 – $2,623.09 | 19 |
| Laparo cholecystoenterostomy CPT 47570 | $1,753.92 | $2,088.00 | $1,273.68 – $2,827.57 | 19 |
| Laparo drng lymphocele 49323 CPT 49323 | $1,444.80 | $1,720.00 | $1,049.20 – $2,329.23 | 19 |
| Laparo partial colectomy 44204 CPT 44204 | $3,485.16 | $4,149.00 | $2,530.89 – $5,618.58 | 19 |
| Laparoscopy aspiration CPT 49322 | $853.44 | $1,016.00 | $619.76 – $1,375.87 | 19 |
| Laparoscopy biopsy CPT 49321 | $785.40 | $935.00 | $570.35 – $1,266.18 | 19 |
| Laparoscopy splenectomy CPT 38120 | $2,384.76 | $2,839.00 | $1,731.79 – $3,844.58 | 19 |
| Laparotomy; inject/aspirate liver cyst 47015 CPT 47015 | $2,636.76 | $3,139.00 | $1,914.79 – $4,250.84 | 19 |
| Laparo-vag hyst incl t/o CPT 58552 | $2,280.60 | $2,715.00 | $1,656.15 – $3,676.66 | 19 |
| Lap colectomy part w/ileum 44205 CPT 44205 | $3,034.92 | $3,613.00 | $2,203.93 – $4,892.73 | 19 |
| Lap enterectomy 44202 CPT 44202 | $3,131.52 | $3,728.00 | $2,274.08 – $5,048.46 | 19 |
| Lap enterolysis CPT 44180 | $2,078.16 | $2,474.00 | $1,509.14 – $3,350.30 | 19 |
| Lap inc hernia repair 49654 CPT 49654 | $1,909.32 | $2,273.00 | $1,386.53 – $3,078.10 | 19 |
| Lap inc hernia repair recurr 49656 CPT 49656 | $2,072.28 | $2,467.00 | $1,504.87 – $3,340.82 | 19 |
| Lap ing hernia repair init CPT 49650 | $984.48 | $1,172.00 | $714.92 – $1,587.13 | 19 |
| Lap ing hernia repair recur CPT 49651 | $1,284.36 | $1,529.00 | $932.69 – $2,070.58 | 19 |
| Lap insert tunnel ip cath CPT 49324 | $876.12 | $1,043.00 | $636.23 – $1,412.44 | 19 |
| Lap part colectomy w/stoma 44206 CPT 44206 | $3,951.36 | $4,704.00 | $2,869.44 – $6,370.16 | 19 |
| Lap resect s/intestine addl 44203 CPT 44203 | $537.60 | $640.00 | $390.40 – $866.69 | 19 |
| Lap w/omentopexy add-on 49326 CPT 49326 | $420.00 | $500.00 | $305.00 – $677.10 | 19 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $651.84 | $776.00 | $194.00 – $701.68 | 19 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $801.36 | $954.00 | $175.50 – $687.96 | 19 |
| Laryngoscopy w/fb removal CPT 31530 | $1,101.24 | $1,311.00 | $136.75 – $536.06 | 19 |
| Lateral canthopexy CPT 21282 | $2,019.36 | $2,404.00 | $276.00 – $1,081.92 | 19 |
| Lavage cannulation maxillary sinus CPT 31000 | $435.96 | $519.00 | $129.75 – $320.46 | 19 |
| Lb with mastopexy 15839 CPT 15839 | $2,971.92 | $3,538.00 | $2,158.18 – $4,791.16 | 19 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $5,670.00 | $6,750.00 | $347.70 – $771.90 | 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.