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 |
|---|---|---|---|---|
| Culture aerobic additional method definitive id each CPT 87077 | $66.36 | $79.00 | $8.08 – $24.50 | 19 |
| Culture afb any source CPT 87116 | $306.60 | $365.00 | $10.80 – $217.56 | 19 |
| Culture anaerobic additional method definitive id each CPT 87076 | $203.28 | $242.00 | $8.08 – $24.50 | 19 |
| Culture anaerobic except blood CPT 87075 | $206.64 | $246.00 | $9.47 – $28.42 | 19 |
| Culture bacteria anaerobic CPT 87073 | $323.40 | $385.00 | $9.66 – $377.30 | 19 |
| Culture bact stool aero addl path ea CPT 87046 | $147.84 | $176.00 | $9.44 – $28.42 | 19 |
| Culture body fluid CPT 87070 | $221.76 | $264.00 | $8.62 – $26.46 | 19 |
| Culture fungi definitive id mold CPT 87107 | $157.92 | $188.00 | $10.32 – $184.24 | 19 |
| Culture fungi definitive id yeast CPT 87106 | $141.12 | $168.00 | $10.32 – $164.64 | 19 |
| Culture fungi other (except blood) CPT 87102 | $316.68 | $377.00 | $8.41 – $369.46 | 19 |
| Culture fungi skin/hair/nail CPT 87101 | $120.12 | $143.00 | $7.71 – $140.14 | 19 |
| Culture mycoplasma any source CPT 87109 | $138.60 | $165.00 | $15.39 – $161.70 | 19 |
| Culture quantitative aerobic other source CPT 87071 | $76.44 | $91.00 | $9.89 – $89.18 | 19 |
| Culture screening strep group a CPT 87081 | $119.28 | $142.00 | $6.63 – $20.58 | 19 |
| Culture typing immunologic CPT 87147 | $197.40 | $235.00 | $5.18 – $16.66 | 19 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $181.44 | $216.00 | $35.09 – $211.68 | 19 |
| Culture urine each isolate CPT 87088 | $105.84 | $126.00 | $8.09 – $24.50 | 19 |
| Cutter lead HCPCS C1773 | $7,224.84 | $8,601.00 | $35.42 – $78.62 | 19 |
| Cv stress test i&r only 93018 CPT 93018 | $52.08 | $62.00 | $37.82 – $83.97 | 19 |
| Cv stress test/supervision only 93016 CPT 93016 | $52.08 | $62.00 | $37.82 – $83.97 | 19 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Cyclic citrullinated peptide antibody CPT 86200 | $126.00 | $150.00 | $12.95 – $39.20 | 19 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $1,465.51 | $1,744.65 | $150.22 – $333.48 | 19 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $2,301.60 | $2,740.00 | $2.14 – $4.74 | 19 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $268.05 | $319.10 | $194.66 – $432.13 | 19 |
| Cyclosporine 2 hour CPT 80158 | $243.60 | $290.00 | $18.05 – $284.20 | 19 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $413.59 | $492.36 | $2.14 – $4.74 | 19 |
| Cyclosporine oral 100 mg HCPCS J7502 | $2,421.05 | $2,882.20 | $3.75 – $8.32 | 19 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $22,335.77 | $26,590.20 | $774.70 – $1,719.84 | 19 |
| Cystatin c CPT 82610 | $114.24 | $136.00 | $18.52 – $79.38 | 19 |
| Cystine urine quantitative CPT 82131 | $298.20 | $355.00 | $22.98 – $347.90 | 19 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $411.60 | $490.00 | $298.90 – $663.56 | 19 |
| Cystoscopy and biopsy CPT 52007 | $992.04 | $1,181.00 | $720.41 – $1,599.32 | 19 |
| Cystoscopy and treatment CPT 52214 | $1,929.48 | $2,297.00 | $1,401.17 – $3,110.60 | 19 |
| Cystoscopy and treatment CPT 52277 | $747.60 | $890.00 | $542.90 – $1,205.24 | 19 |
| Cystoscopy and treatment CPT 52310 | $992.04 | $1,181.00 | $720.41 – $1,599.32 | 19 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,191.12 | $1,418.00 | $172.50 – $676.20 | 19 |
| Cystoscopy & ureter catheter CPT 52005 | $2,456.16 | $2,924.00 | $217.75 – $853.58 | 19 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $992.04 | $1,181.00 | $720.41 – $1,599.32 | 19 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $240.03 | $285.75 | $60.70 – $134.75 | 19 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $232.68 | $277.00 | $14.39 – $65.66 | 19 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $152.88 | $182.00 | $16.85 – $178.36 | 19 |
| Cytopath fl nongyn filter CPT 88106 | $170.52 | $203.00 | $123.83 – $274.91 | 19 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $272.16 | $324.00 | $197.64 – $438.77 | 19 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $148.68 | $177.00 | $26.61 – $65.66 | 19 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $128.52 | $153.00 | $20.26 – $46.06 | 19 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $165.48 | $197.00 | $120.17 – $266.78 | 19 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $146.16 | $174.00 | $106.14 – $235.64 | 19 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $118.44 | $141.00 | $86.01 – $190.95 | 19 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $121.80 | $145.00 | $88.45 – $196.36 | 19 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $358.68 | $427.00 | $260.47 – $578.25 | 19 |
| Cytopath smear other source CPT 88160 | $94.08 | $112.00 | $68.32 – $151.68 | 19 |
| Cytopath smear other source CPT 88162 | $56.28 | $67.00 | $40.87 – $90.74 | 19 |
| Cytopath smear oth prep screen & interp CPT 88161 | $2,122.68 | $2,527.00 | $71.37 – $158.45 | 19 |
| Cytopath tbs c/v manual CPT 88164 | $75.60 | $90.00 | $18.19 – $40.38 | 19 |
| Cytotoxic antibody screening CPT 86808 | $1,445.64 | $1,721.00 | $29.68 – $1,686.58 | 19 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $83.58 | $99.50 | $60.70 – $134.75 | 19 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $2,691.24 | $3,203.85 | $1,954.35 – $4,338.66 | 19 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $6,492.49 | $7,729.15 | $4,714.79 – $10,466.82 | 19 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $123.02 | $146.45 | $60.70 – $134.75 | 19 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $44,179.83 | $52,595.03 | $32,082.97 – $71,224.19 | 19 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $15,664.87 | $18,648.65 | $549.58 – $1,220.06 | 19 |
| Dark field exam spec collj CPT 87164 | $205.80 | $245.00 | $10.74 – $240.10 | 19 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $347.03 | $413.12 | $252.01 – $559.45 | 19 |
| Dch glucoscan CPT 82948 | $42.00 | $50.00 | $5.04 – $49.00 | 19 |
| Dch pulmonary stress test CPT 94621 | $466.20 | $555.00 | $338.55 – $751.59 | 19 |
| Dch validity tests CPT 81002 | $75.60 | $90.00 | $3.48 – $7.84 | 19 |
| Deamidated gliadin antibody iga CPT 86258 | $194.88 | $232.00 | $141.52 – $314.18 | 19 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $658.56 | $784.00 | $41.25 – $161.70 | 19 |
| Debridement (>20 cm) charge pt CPT 97598 | $201.60 | $240.00 | $31.75 – $124.46 | 19 |
| Debridement bone <= 20 sq cm CPT 11044 | $2,453.64 | $2,921.00 | $215.00 – $842.80 | 19 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $312.48 | $372.00 | $122.61 – $272.20 | 19 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $967.68 | $1,152.00 | $201.30 – $446.89 | 19 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,870.68 | $2,227.00 | $91.50 – $358.68 | 19 |
| Debride nail1-5 11720 CPT 11720 | $100.80 | $120.00 | $22.75 – $89.18 | 19 |
| Debride nail6 or more 11721 CPT 11721 | $583.80 | $695.00 | $73.20 – $162.51 | 19 |
| Debride skin bone at fx site CPT 11012 | $1,570.80 | $1,870.00 | $450.00 – $1,764.00 | 19 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $312.48 | $372.00 | $68.93 – $153.03 | 19 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | $320.88 | $382.00 | $134.20 – $297.93 | 19 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,064.28 | $1,267.00 | $316.75 – $703.19 | 19 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $582.12 | $693.00 | $422.73 – $938.47 | 19 |
| Decalcification CPT 88311 | $105.00 | $125.00 | $59.17 – $131.36 | 19 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $2,304.80 | $2,743.80 | $97.64 – $216.74 | 19 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $758.52 | $903.00 | $550.83 – $1,222.85 | 19 |
| Deep muscle biopsy 20205 CPT 20205 | $710.64 | $846.00 | $516.06 – $1,145.66 | 19 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $202.23 | $240.75 | $60.70 – $134.75 | 19 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $5,854.89 | $6,970.10 | $1,264.41 – $2,806.99 | 19 |
| Delivery of placenta 59414 CPT 59414 | $635.88 | $757.00 | $58.75 – $230.30 | 19 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $142.80 | $170.00 | $103.70 – $230.22 | 19 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $13,980.42 | $16,643.35 | $5,519.32 – $12,252.87 | 19 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $693.00 | $825.00 | $150.67 – $334.49 | 19 |
| Depo-estradiol cypionate inj HCPCS J1000 | $856.93 | $1,020.15 | $622.30 – $1,381.49 | 19 |
| Dermagraft HCPCS Q4106 | $3,175.20 | $3,780.00 | $1,612.69 – $3,580.17 | 19 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $3,155.67 | $3,756.75 | $60.70 – $134.75 | 19 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $158.76 | $189.00 | $47.25 – $121.52 | 19 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $174.72 | $208.00 | $126.88 – $281.68 | 19 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $804.72 | $958.00 | $155.55 – $345.33 | 19 |
| Destruction 2-14 lesions 17003 CPT 17003 | $72.24 | $86.00 | $52.46 – $116.47 | 19 |
| Destruction benign lesions < 14 lesions CPT 17110 | $161.28 | $192.00 | $117.12 – $260.01 | 19 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $2,331.00 | $2,775.00 | $1,692.75 – $3,757.91 | 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.