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 |
|---|---|---|---|---|
| Tc-99m bicisate HCPCS A9557 | $4,935.84 | $5,876.00 | $3,584.36 – $7,957.28 | 19 |
| Tc-99m depreotide HCPCS A9536 | $1,377.60 | $1,640.00 | $1,000.40 – $2,220.89 | 19 |
| Tc-99m disofenin HCPCS A9510 | $166.32 | $198.00 | $120.78 – $268.14 | 19 |
| Tc-99m exametazime diag HCPCS A9521 | $4,463.76 | $5,314.00 | $3,241.54 – $7,196.22 | 19 |
| Tc-99m labeled rbc HCPCS A9560 | $441.00 | $525.00 | $169.58 – $376.47 | 19 |
| Tc-99m maa HCPCS A9540 | $530.04 | $631.00 | $384.91 – $854.51 | 19 |
| Tc-99m mebrofenin HCPCS A9537 | $99.96 | $119.00 | $72.59 – $161.15 | 19 |
| Tc-99m medronate HCPCS A9503 | $143.64 | $171.00 | $104.31 – $231.57 | 19 |
| Tc-99m mertiatide HCPCS A9562 | $948.36 | $1,129.00 | $688.69 – $1,528.90 | 19 |
| Tc-99m oxidronate HCPCS A9561 | $120.96 | $144.00 | $87.84 – $195.01 | 19 |
| Tc-99m pentetate dtpa HCPCS A9539 | $424.20 | $505.00 | $308.05 – $683.88 | 19 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $483.00 | $575.00 | $337.33 – $748.88 | 19 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $2.52 | $3.00 | $1.83 – $4.07 | 19 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $936.60 | $1,115.00 | $84.18 – $186.88 | 19 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $236.04 | $281.00 | $171.41 – $380.54 | 19 |
| Tc-99m sulfur colloid HCPCS A9541 | $496.44 | $591.00 | $204.96 – $455.02 | 19 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $119.28 | $142.00 | $86.62 – $192.30 | 19 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $233.52 | $278.00 | $46.98 – $272.44 | 19 |
| T cells absolute cd 4 count CPT 86361 | $136.92 | $163.00 | $26.78 – $159.74 | 19 |
| T cells total count CPT 86359 | $233.52 | $278.00 | $37.73 – $272.44 | 19 |
| Team conf w/pat by hc prof CPT 99366 | $301.56 | $359.00 | $63.44 – $140.84 | 19 |
| Telavancin injection HCPCS J3095 | $1,498.73 | $1,784.20 | $1,088.37 – $2,416.17 | 19 |
| Telehealth original site facility fee HCPCS Q3014 | $47.88 | $57.00 | $27.63 – $77.19 | 19 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $7,683.86 | $9,147.45 | $5,579.95 – $12,387.48 | 19 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $33,628.82 | $40,034.30 | $18,493.34 – $41,055.22 | 19 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $895.44 | $1,066.00 | $650.26 – $1,443.58 | 19 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Test for porphobilinogen CPT 84106 | $96.60 | $115.00 | $5.82 – $112.70 | 19 |
| Testicular imaging w/vasc flow CPT 78761 | $1,206.24 | $1,436.00 | $875.96 – $1,944.64 | 19 |
| Testosterone undecanoate 1mg HCPCS J3145 | $8,704.43 | $10,362.41 | $6,321.08 – $14,032.78 | 19 |
| Test stress cardiovascular tracing only CPT 93017 | $1,382.64 | $1,646.00 | $764.33 – $1,696.82 | 19 |
| Test urine for porphyrins CPT 84119 | $82.32 | $98.00 | $13.36 – $96.04 | 19 |
| Test urine urobilinogen CPT 84578 | $33.60 | $40.00 | $4.47 – $39.20 | 19 |
| Tetanus immune globulin inj HCPCS J1670 | $1,887.82 | $2,247.40 | $1,370.92 – $3,043.43 | 19 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $17,475.84 | $20,804.56 | $12,690.79 – $28,173.54 | 19 |
| Theophylline therapeutic drug level CPT 80198 | $152.04 | $181.00 | $14.14 – $39.20 | 19 |
| Therapeutic procd strg endur HCPCS G0237 | $94.08 | $112.00 | $68.32 – $151.68 | 19 |
| Therapy activity per session >= 45 minutes HCPCS G0176 | $303.24 | $361.00 | $220.21 – $488.87 | 19 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $32.76 | $39.00 | $23.79 – $52.82 | 19 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $30.24 | $36.00 | $21.96 – $48.76 | 19 |
| Ther/proph/diag inj ia CPT 96373 | $424.20 | $505.00 | $308.05 – $683.88 | 19 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,228.08 | $1,462.00 | $434.32 – $964.20 | 19 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $12,228.72 | $14,558.00 | $8,880.38 – $19,714.45 | 19 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $18,723.60 | $22,290.00 | $13,596.90 – $30,185.12 | 19 |
| Thrombin time CPT 85670 | $113.40 | $135.00 | $5.77 – $17.64 | 19 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $115.92 | $138.00 | $6.47 – $135.24 | 19 |
| Thyroglobulin antibody CPT 86800 | $154.56 | $184.00 | $15.91 – $180.32 | 19 |
| Thyroidectomy inc substrnl split/trans approch 60270 CPT 60270 | $3,117.24 | $3,711.00 | $2,263.71 – $5,025.44 | 19 |
| Thyroid imaging CPT 78013 | $576.24 | $686.00 | $418.46 – $928.99 | 19 |
| Thyroid met imaging CPT 78015 | $733.32 | $873.00 | $532.53 – $1,182.22 | 19 |
| Thyroid mets imag whole body CPT 78018 | $1,885.80 | $2,245.00 | $1,369.45 – $3,040.18 | 19 |
| Thyroid (TSH) Test CPT 84443 | $147.84 | $176.00 | $16.80 – $49.98 | 19 |
| Thyroid Ultrasound CPT 76536 | $598.92 | $713.00 | $434.93 – $965.55 | 19 |
| Thyroid uptake measurement CPT 78012 | $786.24 | $936.00 | $570.96 – $1,267.54 | 19 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $8,304.41 | $9,886.20 | $5,684.53 – $12,619.66 | 19 |
| Thyroxine binding globulin (tbg) CPT 84442 | $57.12 | $68.00 | $14.78 – $66.64 | 19 |
| Tigecycline injection HCPCS J3243 | $403.35 | $480.17 | $60.70 – $134.75 | 19 |
| Tilt table study CPT 93660 | $2,154.60 | $2,565.00 | $1,564.65 – $3,473.53 | 19 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | $917.70 | $1,092.50 | $162.87 – $361.58 | 19 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $26,678.40 | $31,760.00 | $19,373.60 – $43,009.40 | 19 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | $5,650.16 | $6,726.38 | $4,103.10 – $9,108.87 | 19 |
| Tissue culture placenta CPT 88235 | $828.24 | $986.00 | $150.30 – $966.28 | 19 |
| Tissue culture skin/biopsy CPT 88233 | $796.32 | $948.00 | $140.73 – $929.04 | 19 |
| Tissue culture tumor CPT 88239 | $845.88 | $1,007.00 | $147.52 – $986.86 | 19 |
| Tissue exam koh skin/hair/nails CPT 87220 | $96.60 | $115.00 | $4.27 – $85.26 | 19 |
| Tissue transglutaminase iga CPT 86364 | $178.08 | $212.00 | $129.32 – $287.10 | 19 |
| Tixagev and cilgav inj HCPCS M0220 | $186.48 | $222.00 | $135.42 – $300.64 | 19 |
| Tl-201 thallium diag per mci HCPCS A9505 | $57.12 | $68.00 | $41.48 – $92.09 | 19 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $1,774.66 | $2,112.69 | $60.70 – $134.75 | 19 |
| Tobramycin non-comp unit HCPCS J7682 | $56.99 | $67.84 | $20.98 – $46.56 | 19 |
| Tobramycin peak therapeutic drug level CPT 80200 | $174.72 | $208.00 | $16.13 – $203.84 | 19 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $10,764.10 | $12,814.40 | $1,563.35 – $3,470.63 | 19 |
| Tomosynthesis breast screen bilateral CPT 77063 | $113.40 | $135.00 | $82.35 – $182.82 | 19 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | $2,056.32 | $2,448.00 | $1,493.28 – $3,315.09 | 19 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $537.77 | $640.20 | $69.09 – $153.38 | 19 |
| Total Knee Replacement CPT 27447 | $2,929.92 | $3,488.00 | $2,127.68 – $4,723.45 | 19 |
| Toxoplasma antibody igg CPT 86777 | $126.84 | $151.00 | $14.39 – $147.98 | 19 |
| Toxoplasma antibody igm CPT 86778 | $126.84 | $151.00 | $14.41 – $147.98 | 19 |
| Tpmt gene com vrnts CPT 81335 | $982.80 | $1,170.00 | $174.81 – $1,146.60 | 19 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $13,008.58 | $15,486.40 | $9,446.71 – $20,971.69 | 19 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $66.36 | $79.00 | $48.19 – $106.99 | 19 |
| Transferrin CPT 84466 | $63.00 | $75.00 | $12.76 – $73.50 | 19 |
| Transfusion blood/blood component(s) CPT 36430 | $1,223.88 | $1,457.00 | $331.84 – $736.69 | 19 |
| Transparent film <= 16 sq in HCPCS A6257 | $1.29 | $1.53 | $0.56 – $1.24 | 19 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $17,570.37 | $20,917.10 | $4,753.19 – $10,552.07 | 19 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $14,655.65 | $17,447.20 | $3,801.01 – $8,438.23 | 19 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $9,058.06 | $10,783.40 | $2,349.24 – $5,215.30 | 19 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $2,407.44 | $2,866.00 | $1,748.26 – $3,881.14 | 19 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $1,008.00 | $1,200.00 | $257.72 – $572.14 | 19 |
| Treat ankle dislocation CPT 27842 | $1,175.16 | $1,399.00 | $343.25 – $1,345.54 | 19 |
| Treat clavicle dislocation 23545 CPT 23545 | $822.36 | $979.00 | $145.18 – $322.30 | 19 |
| Treat elbow dislocation CPT 24605 | $1,311.24 | $1,561.00 | $331.50 – $1,299.48 | 19 |
| Treat eyelid lesion 67850 CPT 67850 | $1,105.44 | $1,316.00 | $802.76 – $1,782.13 | 19 |
| Treat finger fracture each CPT 26742 | $879.48 | $1,047.00 | $215.94 – $479.39 | 19 |
| Treat foot dislocation CPT 28540 | $464.52 | $553.00 | $117.73 – $261.37 | 19 |
| Treat fracture of radius CPT 25505 | $1,181.88 | $1,407.00 | $300.73 – $667.63 | 19 |
| Treat fracture of ulna CPT 25535 | $1,161.72 | $1,383.00 | $218.99 – $486.16 | 19 |
| Treat hip dislocation CPT 27252 | $1,737.96 | $2,069.00 | $517.25 – $1,372.98 | 19 |
| Treat hip dislocation CPT 27257 | $1,403.64 | $1,671.00 | $245.50 – $962.36 | 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.