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 |
|---|---|---|---|---|
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $19,729.92 | $23,488.00 | $2,865.54 – $6,361.49 | 19 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $9,463.44 | $11,266.00 | $1,374.43 – $3,051.22 | 19 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $11,259.57 | $13,404.25 | $1,635.32 – $3,630.41 | 19 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $11,229.96 | $13,369.00 | $1,630.99 – $3,620.80 | 19 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $499.80 | $595.00 | $362.95 – $805.75 | 19 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $1,282.68 | $1,527.00 | $381.75 – $1,470.00 | 19 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $837.48 | $997.00 | $608.17 – $1,350.14 | 19 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $517.44 | $616.00 | $154.00 – $550.76 | 19 |
| Romiplostim injection HCPCS J2796 | $5,008.00 | $5,961.90 | $3,636.76 – $8,073.61 | 19 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $5,520.74 | $6,572.30 | $3,818.21 – $8,476.42 | 19 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $376.32 | $448.00 | $60.70 – $134.75 | 19 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | $25,410.00 | $30,250.00 | $60.70 – $134.75 | 19 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,519.56 | $1,809.00 | $1,103.49 – $2,449.75 | 19 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $6,687.24 | $7,961.00 | $4,856.21 – $10,780.79 | 19 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $3,890.88 | $4,632.00 | $2,825.52 – $6,272.66 | 19 |
| Rpr fem hernia init blocked CPT 49553 | $1,436.40 | $1,710.00 | $1,043.10 – $2,315.69 | 19 |
| Rpr rem hernia init reduce CPT 49550 | $1,309.56 | $1,559.00 | $950.99 – $2,111.20 | 19 |
| Rsv assay w/optic CPT 87807 | $30.24 | $36.00 | $13.10 – $35.28 | 19 |
| Rubella antibody igg CPT 86762 | $148.68 | $177.00 | $14.39 – $173.46 | 19 |
| Rubeola antibody igg CPT 86765 | $99.12 | $118.00 | $12.88 – $115.64 | 19 |
| Russell viper venom diluted CPT 85613 | $194.04 | $231.00 | $9.58 – $26.46 | 19 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $10,348.64 | $12,319.80 | $7,515.08 – $16,683.48 | 19 |
| Sarscov coronavirus ag ia CPT 87426 | $88.20 | $105.00 | $35.33 – $78.43 | 19 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $333.48 | $397.00 | $70.29 – $389.06 | 19 |
| S bowel endoscope w/stent CPT 44379 | $958.44 | $1,141.00 | $696.01 – $1,545.15 | 19 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $214.20 | $255.00 | $63.75 – $249.90 | 19 |
| Sbsq psyc collab care mgmt CPT 99493 | $93.24 | $111.00 | $67.71 – $150.32 | 19 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,201.20 | $1,430.00 | $872.30 – $1,936.51 | 19 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $756.84 | $901.00 | $549.61 – $1,220.14 | 19 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,741.32 | $2,073.00 | $1,264.53 – $2,807.26 | 19 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $984.48 | $1,172.00 | $714.92 – $1,587.13 | 19 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,180.20 | $1,405.00 | $857.05 – $1,902.66 | 19 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,046.64 | $1,246.00 | $760.06 – $1,687.34 | 19 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,190.28 | $1,417.00 | $864.37 – $1,918.91 | 19 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $892.92 | $1,063.00 | $648.43 – $1,439.52 | 19 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $682.92 | $813.00 | $495.93 – $1,100.97 | 19 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,245.72 | $1,483.00 | $904.63 – $2,008.28 | 19 |
| Scope plantar fasciotomy CPT 29893 | $1,580.04 | $1,881.00 | $1,147.41 – $2,547.26 | 19 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,835.00 | $3,375.00 | $1,457.14 – $3,234.85 | 19 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $134.40 | $160.00 | $26.49 – $156.80 | 19 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $1,794.24 | $2,136.00 | $595.36 – $1,321.70 | 19 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $819.84 | $976.00 | $595.36 – $1,321.70 | 19 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $63.00 | $75.00 | $18.05 – $73.50 | 19 |
| Screening Mammogram CPT 77067 | $330.96 | $394.00 | $132.98 – $295.22 | 19 |
| Screening prostate cancer PSA HCPCS G0103 | $176.40 | $210.00 | $19.31 – $54.88 | 19 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $25,705.06 | $30,601.26 | $0.41 – $0.91 | 19 |
| Sedimentation rate erythrocyte automated CPT 85652 | $94.08 | $112.00 | $2.70 – $7.84 | 19 |
| Semen analysis presence/motility CPT 89321 | $91.56 | $109.00 | $12.05 – $106.82 | 19 |
| Semen analysis w/count CPT 89310 | $213.36 | $254.00 | $8.61 – $248.92 | 19 |
| Sertraline (zoloft) - sendout CPT 80332 | $280.56 | $334.00 | $203.74 – $452.31 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $236.04 | $281.00 | $171.41 – $380.54 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $178.92 | $213.00 | $129.93 – $288.45 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $352.80 | $420.00 | $201.30 – $446.89 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $175.56 | $209.00 | $127.49 – $283.03 | 19 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $256.20 | $305.00 | $76.25 – $236.18 | 19 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $1,039.92 | $1,238.00 | $755.18 – $1,676.50 | 19 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $1,145.76 | $1,364.00 | $832.04 – $1,847.13 | 19 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $407.40 | $485.00 | $295.85 – $656.79 | 19 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $131.04 | $156.00 | $73.81 – $163.86 | 19 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $633.36 | $754.00 | $459.94 – $1,021.07 | 19 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,670.63 | $9,131.70 | $3,101.85 – $6,886.11 | 19 |
| Shoe post-op mens m HCPCS L3260 | $126.76 | $150.90 | $92.05 – $204.35 | 19 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,617.88 | $4,307.00 | $2,627.27 – $5,832.54 | 19 |
| Shoulder MRI (with contrast) CPT 73222 | $3,180.24 | $3,786.00 | $2,309.46 – $5,127.01 | 19 |
| Shoulder MRI (without contrast) CPT 73221 | $2,917.32 | $3,473.00 | $2,118.53 – $4,703.14 | 19 |
| Shoulder X-ray CPT 73030 | $330.96 | $394.00 | $35.99 – $79.90 | 19 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $4,823.28 | $5,742.00 | $1,296.25 – $2,877.68 | 19 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $514.08 | $612.00 | $373.32 – $828.78 | 19 |
| Sickling rbc CPT 85660 | $97.44 | $116.00 | $5.51 – $113.68 | 19 |
| Sigmoidoscopy and biopsy CPT 45331 | $1,871.52 | $2,228.00 | $509.96 – $1,132.12 | 19 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $267.96 | $319.00 | $194.59 – $431.99 | 19 |
| Sigmoidoscopy for bleeding CPT 45334 | $1,219.68 | $1,452.00 | $885.72 – $1,966.30 | 19 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $714.00 | $850.00 | $518.50 – $1,151.07 | 19 |
| Sigmoidoscopy w/ablation CPT 45346 | $5,769.12 | $6,868.00 | $4,189.48 – $9,300.65 | 19 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $673.68 | $802.00 | $489.22 – $1,086.07 | 19 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $360.36 | $429.00 | $261.69 – $580.96 | 19 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $728.28 | $867.00 | $528.87 – $1,174.10 | 19 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $290.64 | $346.00 | $211.06 – $468.56 | 19 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $397.32 | $473.00 | $288.53 – $640.54 | 19 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $1,900.08 | $2,262.00 | $584.38 – $1,297.33 | 19 |
| Sig w/tndsc balloon dilation CPT 45340 | $1,132.32 | $1,348.00 | $822.28 – $1,825.47 | 19 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $511.18 | $608.54 | $192.91 – $428.24 | 19 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,963.52 | $3,528.00 | $2,152.08 – $4,777.62 | 19 |
| Sinus CT scan (with contrast) CPT 70487 | $2,516.64 | $2,996.00 | $1,827.56 – $4,057.19 | 19 |
| Sinus CT scan (without contrast) CPT 70486 | $2,352.00 | $2,800.00 | $1,708.00 – $3,791.76 | 19 |
| Sirolimus, oral HCPCS J7520 | $9,964.76 | $11,862.80 | $15.18 – $33.68 | 19 |
| Skin Biopsy CPT 11102 | $225.12 | $268.00 | $163.48 – $362.93 | 19 |
| Skyla, 13.5 mg HCPCS J7301 | $3,058.41 | $3,640.96 | $2,220.99 – $4,930.59 | 19 |
| Sleep study attended CPT 95807 | $1,636.32 | $1,948.00 | $1,188.28 – $2,637.99 | 19 |
| Sleep Study (Polysomnography) CPT 95810 | $4,494.84 | $5,351.00 | $3,264.11 – $7,246.33 | 19 |
| Sleep study unattended CPT 95806 | $484.68 | $577.00 | $351.97 – $781.38 | 19 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $81.65 | $97.20 | $7.42 – $16.46 | 19 |
| Sling suprapubic suburetheral HCPCS C1771 | $7,927.71 | $9,437.75 | $375.15 – $832.84 | 19 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | $225.12 | $268.00 | $94.55 – $209.91 | 19 |
| Slp eval non-spch gen comm dev CPT 92605 | $280.56 | $334.00 | $203.74 – $452.31 | 19 |
| Slp pure tone screening CPT 92551 | $29.40 | $35.00 | $21.35 – $47.40 | 19 |
| Slp stdy unatnd w/anal CPT 95801 | $68.88 | $82.00 | $50.02 – $111.05 | 19 |
| Slp ther svc non-spch gen CPT 92606 | $581.28 | $692.00 | $300.73 – $667.63 | 19 |
| Sm-153 lexidron ther HCPCS A9604 | $35,553.84 | $42,326.00 | $25,818.86 – $57,317.87 | 19 |
| Small bowel endoscopy CPT 44360 | $336.00 | $400.00 | $244.00 – $541.68 | 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.