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 |
|---|---|---|---|---|
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $449.40 | $535.00 | $81.75 – $320.46 | 19 |
| Comprehensive hearing test CPT 92557 | $157.08 | $187.00 | $114.07 – $253.24 | 19 |
| Concentration infection agents any type CPT 87015 | $96.60 | $115.00 | $6.68 – $112.70 | 19 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | $781.04 | $929.80 | $496.30 – $1,101.78 | 19 |
| Condylomata destruction 56420 CPT 56420 | $532.56 | $634.00 | $132.00 – $517.44 | 19 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $1,447.70 | $1,723.45 | $1,051.31 – $2,333.90 | 19 |
| Connect omega .5mm HCPCS L8613 | $821.90 | $978.45 | $146.54 – $325.31 | 19 |
| Connector tis 2x10mm HCPCS C9352 | $3,577.77 | $4,259.25 | $1,101.98 – $2,446.39 | 19 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $279.72 | $333.00 | $203.13 – $450.95 | 19 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $263.76 | $314.00 | $191.54 – $425.22 | 19 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $290.64 | $346.00 | $211.06 – $468.56 | 19 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $279.72 | $333.00 | $203.13 – $450.95 | 19 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $1,303.68 | $1,552.00 | $101.87 – $226.16 | 19 |
| Consult comp w/report rfrd material CPT 88325 | $564.48 | $672.00 | $409.92 – $910.03 | 19 |
| Contact layer >16<= 48 sq in HCPCS A6207 | $62.00 | $73.80 | $22.94 – $50.92 | 19 |
| Contrast baths charges CPT 97034 | $68.88 | $82.00 | $40.87 – $90.74 | 19 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $2,943.36 | $3,504.00 | $2,137.44 – $4,745.12 | 19 |
| Contrast x-ray of hip CPT 73525 | $614.88 | $732.00 | $446.52 – $991.28 | 19 |
| Contrast x-ray of knee joint CPT 73580 | $656.88 | $782.00 | $477.02 – $1,058.99 | 19 |
| Controller infinity pt dbs HCPCS C1787 | $4,611.60 | $5,490.00 | $52.73 – $117.05 | 19 |
| Control nosebleed pack+caut 30905 CPT 30905 | $840.00 | $1,000.00 | $250.00 – $916.30 | 19 |
| Control of nosebleed ant comp 30903 CPT 30903 | $588.00 | $700.00 | $175.00 – $588.00 | 19 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $374.64 | $446.00 | $111.50 – $247.53 | 19 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $875.28 | $1,042.00 | $112.50 – $441.00 | 19 |
| Contrst x-ray uppr gi tract CPT 74249 | $645.12 | $768.00 | $468.48 – $1,040.03 | 19 |
| Conv gtube to jtube CPT 44373 | $446.88 | $532.00 | $324.52 – $720.44 | 19 |
| Coombs direct CPT 86880 | $81.48 | $97.00 | $5.39 – $89.18 | 19 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $15.96 | $19.00 | $5.72 – $18.62 | 19 |
| Coombs indirect titer reference CPT 86886 | $279.72 | $333.00 | $5.18 – $309.68 | 19 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $190.68 | $227.00 | $34.25 – $134.26 | 19 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | $1,367.52 | $1,628.00 | $993.08 – $2,204.64 | 19 |
| Correction trichiasis epilation forcep 67820 CPT 67820 | $116.76 | $139.00 | $84.79 – $188.24 | 19 |
| Cortisol total am CPT 82533 | $206.64 | $246.00 | $16.30 – $41.16 | 19 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $105.64 | $125.76 | $60.70 – $134.75 | 19 |
| Co-treatment - group 15 mins, st CPT 92508 | $102.48 | $122.00 | $72.59 – $161.15 | 19 |
| Counseling smoke cess interm >10mins CPT 99407 | $25.20 | $30.00 | $17.08 – $37.92 | 19 |
| Cov-19 amp prb hgh thruput HCPCS U0003 | $154.56 | $184.00 | $112.24 – $249.18 | 19 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $13,834.80 | $16,470.00 | $31.11 – $69.07 | 19 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $115.08 | $137.00 | $41.48 – $92.09 | 19 |
| Covid-19 lab test non-cdc HCPCS U0002 | $168.00 | $200.00 | $51.31 – $196.00 | 19 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $270.48 | $322.00 | $13.03 – $53.90 | 19 |
| C-peptide CPT 84681 | $204.12 | $243.00 | $20.81 – $238.14 | 19 |
| Crbrospnl fld flw imag cistern CPT 78630 | $884.52 | $1,053.00 | $642.33 – $1,425.98 | 19 |
| C-reactive protein CPT 86140 | $126.00 | $150.00 | $5.18 – $16.66 | 19 |
| C-reactive protein high sensitivity CPT 86141 | $199.92 | $238.00 | $12.95 – $39.20 | 19 |
| Creatine kinase CPT 82550 | $142.80 | $170.00 | $6.51 – $19.60 | 19 |
| Creatine kinase isoenzymes CPT 82552 | $184.80 | $220.00 | $13.39 – $40.18 | 19 |
| Creatine kinase mb CPT 82553 | $196.56 | $234.00 | $11.55 – $34.30 | 19 |
| Creatine - sendout CPT 82540 | $749.28 | $892.00 | $4.64 – $874.16 | 19 |
| Creatinine CPT 82565 | $94.08 | $112.00 | $5.12 – $15.68 | 19 |
| Creatinine 24 hour urine CPT 82570 | $94.08 | $112.00 | $5.18 – $16.66 | 19 |
| Creatinine clearance urine CPT 82575 | $186.48 | $222.00 | $9.46 – $28.42 | 19 |
| #creutz-prot.,western blot CPT 84182 | $113.40 | $135.00 | $29.21 – $99.96 | 19 |
| Critical care 30-74 minutes CPT 99291 | $3,868.20 | $4,605.00 | $196.00 – $532.14 | 19 |
| Critical care each additional 30 minutes CPT 99292 | $889.56 | $1,059.00 | $85.50 – $335.16 | 19 |
| Crotalidae poly immune fab HCPCS J0840 | $7,520.63 | $8,953.13 | $5,461.41 – $12,124.33 | 19 |
| Cryocautery of cervix 57511 CPT 57511 | $236.88 | $282.00 | $172.02 – $381.89 | 19 |
| Cryoprecipitate each unit HCPCS P9012 | $700.56 | $834.00 | $81.13 – $180.11 | 19 |
| Cryotherapy of acne 17340 CPT 17340 | $95.76 | $114.00 | $69.54 – $154.38 | 19 |
| Crystal identification light microscopy CPT 89060 | $90.72 | $108.00 | $7.33 – $21.56 | 19 |
| Csf leakage imaging CPT 78650 | $759.36 | $904.00 | $551.44 – $1,224.20 | 19 |
| CT 3d report other modality w/workstation CPT 76377 | $708.12 | $843.00 | $398.33 – $884.30 | 19 |
| Cta abdomen without & /or w/contrast CPT 74175 | $3,447.36 | $4,104.00 | $2,503.44 – $5,557.64 | 19 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $3,540.60 | $4,215.00 | $2,571.15 – $5,707.96 | 19 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $2,763.60 | $3,290.00 | $2,006.90 – $4,455.32 | 19 |
| Cta neck without &/or w/contrast CPT 70498 | $3,221.40 | $3,835.00 | $2,339.35 – $5,193.36 | 19 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $7,659.12 | $9,118.00 | $5,561.98 – $12,347.60 | 19 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,433.08 | $4,087.00 | $2,493.07 – $5,534.62 | 19 |
| CT Angiogram of the Head CPT 70496 | $3,189.48 | $3,797.00 | $2,316.17 – $5,141.90 | 19 |
| CT angio hrt w/3d image CPT 75574 | $2,572.08 | $3,062.00 | $1,867.82 – $4,146.57 | 19 |
| CT angio pelvis CPT 72191 | $2,588.88 | $3,082.00 | $1,880.02 – $4,173.65 | 19 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,787.96 | $3,319.00 | $2,024.59 – $4,494.59 | 19 |
| CT bone density axial CPT 77078 | $404.04 | $481.00 | $293.41 – $651.38 | 19 |
| CT colonography dx CPT 74261 | $2,657.76 | $3,164.00 | $1,930.04 – $4,284.69 | 19 |
| CT colonography dx w/dye CPT 74262 | $2,079.84 | $2,476.00 | $1,510.36 – $3,353.00 | 19 |
| CT guidance for needle placement CPT 77012 | $2,242.80 | $2,670.00 | $1,611.01 – $3,576.45 | 19 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,930.32 | $2,298.00 | $1,401.78 – $3,111.96 | 19 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $2,500.68 | $2,977.00 | $1,815.97 – $4,031.46 | 19 |
| CT hrt w/3d image CPT 75572 | $2,053.80 | $2,445.00 | $1,491.45 – $3,311.02 | 19 |
| CT limited or localized follow-up study CPT 76380 | $1,324.68 | $1,577.00 | $728.95 – $1,618.27 | 19 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,948.40 | $3,510.00 | $2,141.10 – $4,753.25 | 19 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,704.80 | $3,220.00 | $1,964.20 – $4,360.53 | 19 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,281.04 | $3,906.00 | $2,382.66 – $5,289.51 | 19 |
| CT neck soft tissue w/contrast CPT 70491 | $2,794.68 | $3,327.00 | $2,029.47 – $4,505.43 | 19 |
| CT neck soft tissue without contrast CPT 70490 | $2,459.52 | $2,928.00 | $1,786.08 – $3,965.10 | 19 |
| CT neck soft tissue without & w/contrast CPT 70492 | $3,241.56 | $3,859.00 | $2,353.99 – $5,225.86 | 19 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $3,001.32 | $3,573.00 | $2,179.53 – $4,838.56 | 19 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $2,506.56 | $2,984.00 | $1,820.24 – $4,040.94 | 19 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $2,293.20 | $2,730.00 | $1,665.30 – $3,696.97 | 19 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $882.84 | $1,051.00 | $189.71 – $421.16 | 19 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $7,641.48 | $9,097.00 | $2,965.01 – $12,319.16 | 19 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $5,878.32 | $6,998.00 | $2,649.88 – $9,476.70 | 19 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $5,525.52 | $6,578.00 | $2,159.81 – $8,907.93 | 19 |
| CT thoracic spine w/contrast CPT 72129 | $2,718.24 | $3,236.00 | $1,973.96 – $4,382.20 | 19 |
| CT thoracic spine without contrast CPT 72128 | $2,564.52 | $3,053.00 | $1,862.33 – $4,134.38 | 19 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $180.60 | $215.00 | $131.15 – $291.16 | 19 |
| CT t-spine w /wo contrast CPT 72130 | $3,231.48 | $3,847.00 | $2,346.67 – $5,209.61 | 19 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,154.60 | $2,565.00 | $1,564.65 – $3,473.53 | 19 |
| CT upper extremity without contrast (both sides) CPT 73200 | $2,262.12 | $2,693.00 | $1,642.73 – $3,646.87 | 19 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,882.88 | $3,432.00 | $2,093.52 – $4,647.62 | 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.