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 |
|---|---|---|---|---|
| Protoporphyrin rbc screen CPT 84203 | $23.52 | $28.00 | $9.74 – $27.44 | 19 |
| Prp i/hern init block >5 yr CPT 49507 | $1,333.92 | $1,588.00 | $968.68 – $2,150.47 | 19 |
| Pr removal drug delivery implant CPT 11982 | $74.76 | $89.00 | $54.29 – $120.53 | 19 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $188.16 | $224.00 | $56.00 – $165.62 | 19 |
| Pr removal intrauterine device CPT 58301 | $291.48 | $347.00 | $77.75 – $304.78 | 19 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $913.08 | $1,087.00 | $214.00 – $838.88 | 19 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $411.60 | $490.00 | $77.75 – $304.78 | 19 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $435.96 | $519.00 | $81.00 – $317.52 | 19 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $370.44 | $441.00 | $65.00 – $254.80 | 19 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $393.12 | $468.00 | $78.25 – $306.74 | 19 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,293.60 | $1,540.00 | $259.25 – $575.54 | 19 |
| Pr visit complexity e&m service serious/complex condition HCPCS G2211 | $38.64 | $46.00 | $28.06 – $62.30 | 19 |
| PSA (Prostate) Test CPT 84153 | $185.64 | $221.00 | $18.39 – $54.88 | 19 |
| Psychoeducation 45 min + HCPCS G0177 | $154.56 | $184.00 | $112.24 – $249.18 | 19 |
| Psychotherapy group therapy CPT 90853 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Psytx pt w/e&m 53+ min CPT 90838 | $291.48 | $347.00 | $211.67 – $469.91 | 19 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $101.64 | $121.00 | $44.53 – $98.86 | 19 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $139.44 | $166.00 | $13.42 – $29.80 | 19 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $139.44 | $166.00 | $60.39 – $134.07 | 19 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $2,204.16 | $2,624.00 | $38.43 – $85.32 | 19 |
| Pt application of modality traction mechanical CPT 97012 | $78.96 | $94.00 | $54.29 – $120.53 | 19 |
| Pt evaluation high complexity patient/family CPT 97163 | $178.08 | $212.00 | $61.61 – $136.78 | 19 |
| Pt evaluation low complexity patient/family CPT 97161 | $178.08 | $212.00 | $53.68 – $119.17 | 19 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $178.08 | $212.00 | $53.68 – $119.17 | 19 |
| Pt prgrm for implt neurostim HCPCS L8681 | $33,810.00 | $40,250.00 | $549.00 – $1,218.78 | 19 |
| Pt re-evaluation patient/family CPT 97164 | $99.96 | $119.00 | $54.90 – $121.88 | 19 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $51.24 | $61.00 | $34.77 – $77.19 | 19 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $139.44 | $166.00 | $45.75 – $101.57 | 19 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $99.96 | $119.00 | $54.90 – $121.88 | 19 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $149.52 | $178.00 | $43.31 – $96.15 | 19 |
| Pt wheelchair management each 15 minutes CPT 97542 | $241.08 | $287.00 | $39.04 – $86.67 | 19 |
| Pulmonary vent imaging CPT 78579 | $826.56 | $984.00 | $600.24 – $1,332.54 | 19 |
| Pulse ox continuous overnight monitoring CPT 94762 | $477.12 | $568.00 | $346.48 – $769.19 | 19 |
| Pulse ox multiple CPT 94761 | $209.16 | $249.00 | $143.96 – $319.60 | 19 |
| Pulse ox single CPT 94760 | $116.76 | $139.00 | $84.79 – $188.24 | 19 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $89.04 | $106.00 | $20.00 – $78.40 | 19 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $305.76 | $364.00 | $91.00 – $324.38 | 19 |
| Puncture spinal lumbar diagnostic CPT 62270 | $407.40 | $485.00 | $88.25 – $260.68 | 19 |
| Pvb thoracic single inj site CPT 64461 | $876.12 | $1,043.00 | $636.23 – $1,412.44 | 19 |
| Pyloroplasty 43800 CPT 43800 | $2,100.84 | $2,501.00 | $1,525.61 – $3,386.86 | 19 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Pyruvate CPT 84210 | $216.72 | $258.00 | $14.48 – $252.84 | 19 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $3,064.32 | $3,648.00 | $2,225.28 – $4,940.13 | 19 |
| Quant diff pulm perf w/imaging CPT 78597 | $305.76 | $364.00 | $222.04 – $492.93 | 19 |
| Quest t3 uptake CPT 84479 | $63.00 | $75.00 | $6.47 – $73.50 | 19 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $12,957.76 | $15,425.90 | $1,338.19 – $2,970.78 | 19 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $10,199.49 | $12,142.25 | $1,481.36 – $3,288.61 | 19 |
| Radiesse injection HCPCS Q2026 | $2,259.69 | $2,690.10 | $448.35 – $995.34 | 19 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,743.84 | $2,076.00 | $1,266.36 – $2,811.32 | 19 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,743.84 | $2,076.00 | $1,266.36 – $2,811.32 | 19 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,572.08 | $3,062.00 | $986.98 – $2,191.10 | 19 |
| Radphm lcl tumor plr sgl day CPT 78800 | $754.32 | $898.00 | $547.78 – $1,216.08 | 19 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $30,714.60 | $36,565.00 | $4,356.11 – $9,670.55 | 19 |
| Range of motion measurements CPT 95852 | $87.36 | $104.00 | $31.11 – $69.07 | 19 |
| Rapid Strep Test CPT 87880 | $165.48 | $197.00 | $16.53 – $36.70 | 19 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $18,774.68 | $22,350.80 | $3,085.81 – $6,850.48 | 19 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $100,594.04 | $119,754.80 | $19,532.21 – $43,361.50 | 19 |
| Rbc count only automated CPT 85041 | $31.92 | $38.00 | $3.02 – $37.24 | 19 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,020.60 | $1,215.00 | $741.15 – $1,645.36 | 19 |
| Rbc serum pretx incubj drugs CPT 86975 | $478.80 | $570.00 | $347.70 – $771.90 | 19 |
| Recon, cta for surg plan HCPCS G0288 | $1,433.04 | $1,706.00 | $1,040.66 – $2,310.27 | 19 |
| Reconstruct extra finger CPT 26587 | $2,398.20 | $2,855.00 | $713.75 – $1,762.04 | 19 |
| Reconstruction of nail bed CPT 11762 | $689.64 | $821.00 | $205.25 – $455.66 | 19 |
| Reconstruct lip w/local flap 40525 CPT 40525 | $3,333.12 | $3,968.00 | $2,420.48 – $5,373.47 | 19 |
| Red blood cells each unit HCPCS P9021 | $677.88 | $807.00 | $492.27 – $1,092.84 | 19 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $1,170.12 | $1,393.00 | $849.73 – $1,886.41 | 19 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $581.28 | $692.00 | $422.12 – $937.11 | 19 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $916.44 | $1,091.00 | $367.83 – $816.59 | 19 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $745.08 | $887.00 | $433.10 – $961.49 | 19 |
| Red blood cells washed each unit HCPCS P9022 | $797.16 | $949.00 | $578.89 – $1,285.14 | 19 |
| Refill/maint pump/resvr syst CPT 96522 | $394.80 | $470.00 | $286.70 – $636.48 | 19 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $990.15 | $1,178.75 | $60.70 – $134.75 | 19 |
| Rem/biv cast full arm/leg CPT 29705 | $166.32 | $198.00 | $43.50 – $170.52 | 19 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $2,666.37 | $3,174.25 | $1,586.00 – $3,520.92 | 19 |
| Rem interrog evl pm/ids CPT 93296 | $76.44 | $91.00 | $55.51 – $123.24 | 19 |
| Removal anal seton other marker 46030 CPT 46030 | $616.56 | $734.00 | $447.74 – $993.99 | 19 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,413.72 | $1,683.00 | $283.65 – $629.71 | 19 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,732.52 | $3,253.00 | $380.64 – $845.03 | 19 |
| Removal cerumen impacted (both sides) CPT 69210 | $212.52 | $253.00 | $33.00 – $125.44 | 19 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $135.24 | $161.00 | $51.24 – $113.76 | 19 |
| Removal duct glbldr calculi CPT 47544 | $2,072.28 | $2,467.00 | $1,504.87 – $3,340.82 | 19 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $446.04 | $531.00 | $132.75 – $338.10 | 19 |
| Removal foreign body foot subcutaneous right CPT 28190 | $577.08 | $687.00 | $171.75 – $562.52 | 19 |
| Removal foreign body gum 41805 CPT 41805 | $1,274.28 | $1,517.00 | $223.50 – $876.12 | 19 |
| Removal foreign body jawbone CPT 41806 | $1,274.28 | $1,517.00 | $294.75 – $1,155.42 | 19 |
| Removal foreign body mouth CPT 40805 | $679.56 | $809.00 | $202.25 – $675.22 | 19 |
| Removal implant superficial separate procedure CPT 20670 | $2,364.60 | $2,815.00 | $1,717.15 – $3,812.08 | 19 |
| Removal of anal fissure CPT 46200 | $1,128.12 | $1,343.00 | $819.23 – $1,818.70 | 19 |
| Removal of anal tags CPT 46230 | $742.56 | $884.00 | $221.00 – $667.38 | 19 |
| Removal of breast lesion CPT 19120 | $2,603.16 | $3,099.00 | $867.42 – $1,925.68 | 19 |
| Removal of foreign body CPT 27372 | $2,037.00 | $2,425.00 | $414.50 – $1,624.84 | 19 |
| Removal of gallbladder 47600 CPT 47600 | $2,418.36 | $2,879.00 | $1,756.19 – $3,898.75 | 19 |
| Removal of gallbladder 47610 CPT 47610 | $2,831.64 | $3,371.00 | $2,056.31 – $4,565.01 | 19 |
| Removal of gallbladder 47620 CPT 47620 | $3,098.76 | $3,689.00 | $2,250.29 – $4,995.65 | 19 |
| Removal of hydrocele CPT 55040 | $792.12 | $943.00 | $575.23 – $1,277.02 | 19 |
| Removal of hydroceles CPT 55041 | $1,197.84 | $1,426.00 | $869.86 – $1,931.09 | 19 |
| Removal of infusion pump CPT 36262 | $2,251.20 | $2,680.00 | $1,634.80 – $3,629.26 | 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.