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 |
|---|---|---|---|---|
| Small bowel endoscopy CPT 44364 | $477.96 | $569.00 | $347.09 – $770.54 | 19 |
| Small bowel endoscopy CPT 44366 | $561.96 | $669.00 | $408.09 – $905.96 | 19 |
| Small bowel endoscopy CPT 44369 | $575.40 | $685.00 | $417.85 – $927.63 | 19 |
| Small bowel endoscopy CPT 44376 | $666.12 | $793.00 | $483.73 – $1,073.89 | 19 |
| Small bowel endoscopy CPT 44378 | $902.16 | $1,074.00 | $655.14 – $1,454.42 | 19 |
| Small bowel endoscopy CPT 44382 | $734.16 | $874.00 | $533.14 – $1,183.58 | 19 |
| Small bowel endoscopy CPT 44384 | $360.36 | $429.00 | $261.69 – $580.96 | 19 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $448.56 | $534.00 | $325.74 – $723.15 | 19 |
| Small bowel endoscopy 44365 CPT 44365 | $425.88 | $507.00 | $309.27 – $686.58 | 19 |
| Small bowel endoscopy/biopsy CPT 44361 | $371.28 | $442.00 | $269.62 – $598.56 | 19 |
| Small bowel endoscopy/biopsy CPT 44377 | $700.56 | $834.00 | $508.74 – $1,129.41 | 19 |
| Small bowel endoscopy br/wa CPT 44380 | $474.60 | $565.00 | $344.65 – $765.13 | 19 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $624.12 | $743.00 | $453.23 – $1,006.18 | 19 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $164.64 | $196.00 | $5.39 – $192.08 | 19 |
| Smear gram stain CPT 87205 | $97.44 | $116.00 | $4.27 – $13.72 | 19 |
| Smear nasal eosinophil CPT 89190 | $78.12 | $93.00 | $5.79 – $91.14 | 19 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $213.36 | $254.00 | $5.99 – $248.92 | 19 |
| Smear wet mount CPT 87210 | $119.28 | $142.00 | $5.82 – $13.72 | 19 |
| Sock fracture or equal each HCPCS L3995 | $36.03 | $42.89 | $26.17 – $58.09 | 19 |
| Sodium 24 hour urine CPT 84300 | $82.32 | $98.00 | $5.06 – $96.04 | 19 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $173.67 | $206.75 | $126.12 – $279.99 | 19 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $173.67 | $206.75 | $3.45 – $7.66 | 19 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $122.17 | $145.43 | $60.70 – $134.75 | 19 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $759.49 | $904.15 | $551.54 – $1,224.40 | 19 |
| Sodium serum/plasma/whole blood CPT 84295 | $101.64 | $121.00 | $4.81 – $14.70 | 19 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $415.80 | $495.00 | $301.95 – $670.33 | 19 |
| Somatropin injection HCPCS J2941 | $1,175.37 | $1,399.25 | $853.55 – $1,894.87 | 19 |
| Specific gravity body fluid CPT 84315 | $37.80 | $45.00 | $3.28 – $44.10 | 19 |
| Specimen fat stain CPT 89125 | $47.04 | $56.00 | $5.88 – $35.28 | 19 |
| Speech audiometry complete CPT 92556 | $57.12 | $68.00 | $41.48 – $92.09 | 19 |
| Speech evaluation complex CPT 70371 | $471.24 | $561.00 | $342.21 – $759.71 | 19 |
| Speech recep thresh CPT 92555 | $57.12 | $68.00 | $41.48 – $92.09 | 19 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $874.44 | $1,041.00 | $635.01 – $1,409.73 | 19 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $627.48 | $747.00 | $455.67 – $1,011.59 | 19 |
| Splenectomy total open 38100 CPT 38100 | $2,595.60 | $3,090.00 | $1,884.90 – $4,184.48 | 19 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $85.98 | $102.35 | $62.44 – $138.61 | 19 |
| Splint finger 4 prong foam sm HCPCS A4570 | $110.30 | $131.30 | $44.11 – $97.91 | 19 |
| Split blood or products CPT 86985 | $120.12 | $143.00 | $87.23 – $193.66 | 19 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $1,011.36 | $1,204.00 | $196.42 – $436.06 | 19 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $1,011.36 | $1,204.00 | $103.09 – $228.86 | 19 |
| Stem cells total count CPT 86367 | $874.44 | $1,041.00 | $77.78 – $1,020.18 | 19 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $25,898.46 | $30,831.50 | $17.99 – $39.93 | 19 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $4,963.14 | $5,908.50 | $24.17 – $53.66 | 19 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $25,919.11 | $30,856.08 | $9.03 – $20.03 | 19 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $827.40 | $985.00 | $600.85 – $1,333.89 | 19 |
| Sternal debridement CPT 21627 | $1,240.68 | $1,477.00 | $900.97 – $2,000.16 | 19 |
| St evaluate speech sound production CPT 92522 | $1,011.36 | $1,204.00 | $196.42 – $436.06 | 19 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $499.80 | $595.00 | $200.69 – $445.54 | 19 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $1,011.36 | $1,204.00 | $284.26 – $631.06 | 19 |
| St evaluation swallow function CPT 92610 | $502.32 | $598.00 | $172.02 – $381.89 | 19 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | $85.05 | $101.25 | $36.67 – $81.39 | 19 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $252.84 | $301.00 | $19.50 – $76.44 | 19 |
| Strapping of chest CPT 29200 | $276.36 | $329.00 | $23.75 – $93.10 | 19 |
| Strapping of elbow or wrist 29260 CPT 29260 | $362.04 | $431.00 | $21.00 – $82.32 | 19 |
| Strapping of hand or finger CPT 29280 | $202.44 | $241.00 | $20.75 – $81.34 | 19 |
| Strapping of hip CPT 29520 | $345.24 | $411.00 | $25.00 – $98.00 | 19 |
| Strapping of knee CPT 29530 | $252.84 | $301.00 | $21.50 – $84.28 | 19 |
| Strapping of toes 29550 CPT 29550 | $252.84 | $301.00 | $13.50 – $52.92 | 19 |
| Strep a ag ia CPT 87430 | $139.44 | $166.00 | $16.81 – $93.10 | 19 |
| Strep b dna amp probe CPT 87653 | $92.40 | $110.00 | $35.09 – $107.80 | 19 |
| Stress test pulmonary CPT 94618 | $155.40 | $185.00 | $100.04 – $222.09 | 19 |
| Stress tte complete CPT 93351 | $2,650.20 | $3,155.00 | $1,924.55 – $4,272.51 | 19 |
| St treatment speech individual CPT 92507 | $1,304.52 | $1,553.00 | $190.32 – $422.52 | 19 |
| St treatment swallow dysfunction/oral CPT 92526 | $1,285.20 | $1,530.00 | $195.20 – $433.35 | 19 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $173.67 | $206.75 | $60.70 – $134.75 | 19 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $29,430.92 | $35,036.80 | $799.10 – $1,774.01 | 19 |
| Sulfonylurea screen qn-sendout CPT 80377 | $404.88 | $482.00 | $294.02 – $652.73 | 19 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $639.29 | $761.05 | $60.70 – $134.75 | 19 |
| Support clav 29.6-40.5in med HCPCS L3650 | $28.06 | $33.40 | $11.75 – $26.09 | 19 |
| Surg dx exam anorectal CPT 45990 | $241.92 | $288.00 | $175.68 – $390.01 | 19 |
| Surgical pathology level 1 gross examination only CPT 88300 | $135.24 | $161.00 | $98.21 – $218.03 | 19 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $155.40 | $185.00 | $85.88 – $250.53 | 19 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $232.68 | $277.00 | $168.97 – $375.12 | 19 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $337.68 | $402.00 | $195.70 – $544.39 | 19 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $438.48 | $522.00 | $318.42 – $706.90 | 19 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $583.80 | $695.00 | $423.95 – $941.17 | 19 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $1,331.40 | $1,585.00 | $966.85 – $2,146.41 | 19 |
| Susceptibility agar dilution per agent CPT 87181 | $70.56 | $84.00 | $4.75 – $82.32 | 19 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $70.56 | $84.00 | $4.75 – $14.70 | 19 |
| Susceptibility mic per plate CPT 87186 | $174.72 | $208.00 | $8.65 – $26.46 | 19 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $2,384.76 | $2,839.00 | $1,731.79 – $3,844.58 | 19 |
| Synvisc or synvisc-one HCPCS J7325 | $1,728.60 | $2,057.85 | $418.43 – $928.92 | 19 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $57.12 | $68.00 | $4.40 – $13.72 | 19 |
| System cardiomems hosp electronics HCPCS C2624 | $34,927.20 | $41,580.00 | $22,417.50 – $49,766.85 | 19 |
| System pacing micra av HCPCS C1786 | $34,587.00 | $41,175.00 | $1,990.13 – $4,418.08 | 19 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $16,140.60 | $19,215.00 | $2.22 – $4.92 | 19 |
| System sealant biosentry tract HCPCS C2613 | $879.56 | $1,047.09 | $638.73 – $1,417.97 | 19 |
| T3 (triiodothyronine) free CPT 84481 | $223.44 | $266.00 | $16.94 – $37.61 | 19 |
| T3 (triiodothyronine) total CPT 84480 | $96.60 | $115.00 | $14.18 – $31.48 | 19 |
| T4 (thyroxine) free CPT 84439 | $140.28 | $167.00 | $9.02 – $26.46 | 19 |
| T4 (thyroxine) total CPT 84436 | $119.28 | $142.00 | $6.87 – $20.58 | 19 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $353.48 | $420.80 | $2.46 – $5.46 | 19 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $979.65 | $1,166.25 | $711.42 – $1,579.34 | 19 |
| Tacrolimus therapeutic drug level CPT 80197 | $364.56 | $434.00 | $13.73 – $41.16 | 19 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $5,349.25 | $6,368.15 | $3,884.58 – $8,623.75 | 19 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $43,490.25 | $51,774.10 | $2,368.67 – $5,258.43 | 19 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1,701.68 | $2,025.80 | $235.34 – $522.44 | 19 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $403.20 | $480.00 | $61.98 – $470.40 | 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.