CHI Health Schuyler
104 West 17th Street, Schuyler, NE · Chihealth · · NPI 1568547032
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 |
|---|---|---|---|---|
| Lead capillary CPT 83655 | $147.90 | $174.00 | $7.93 – $36.26 | 18 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $4,977.60 | $5,856.00 | $32.91 – $173.91 | 18 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $11,510.70 | $13,542.00 | $604.48 – $3,195.07 | 18 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $2,117.35 | $2,491.00 | $533.58 – $2,820.32 | 18 |
| Leishmania antibody CPT 86717 | $168.30 | $198.00 | $12.25 – $194.04 | 18 |
| Lens, intraocular (new tech) HCPCS C1780 | $1,007.25 | $1,185.00 | $32.13 – $169.83 | 18 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $420.75 | $495.00 | $7.29 – $38.50 | 18 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $2,114.38 | $2,487.50 | $13.93 – $73.60 | 18 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $742.34 | $873.33 | $18.21 – $96.24 | 18 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $335.03 | $394.15 | $21.32 – $112.66 | 18 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $4,129.73 | $4,858.50 | $96.98 – $512.61 | 18 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $21,003.16 | $24,709.60 | $1,764.26 – $9,325.37 | 18 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | $5,302.35 | $6,238.05 | $1,336.20 – $7,062.73 | 18 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $223.16 | $262.53 | $21.32 – $112.66 | 18 |
| Levetiracetam therapeutic drug level CPT 80177 | $178.50 | $210.00 | $13.25 – $205.80 | 18 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $175.74 | $206.75 | $44.29 – $234.09 | 18 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $311.23 | $366.15 | $66.82 – $353.19 | 18 |
| Liberta rc ipg HCPCS C1820 | $58,206.81 | $68,478.60 | $289.17 – $1,528.47 | 18 |
| Lidocaine injection HCPCS J2001 | $84.58 | $99.50 | $21.32 – $112.66 | 18 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $84.58 | $99.50 | $21.32 – $112.66 | 18 |
| Lidocaine therapeutic drug level CPT 80176 | $157.25 | $185.00 | $14.69 – $181.30 | 18 |
| Lift heel adj small gl60404sm HCPCS L3332 | $20.00 | $23.52 | $5.04 – $26.63 | 18 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $742.05 | $873.00 | $187.00 – $988.42 | 18 |
| Liletta, 52 mg HCPCS J7297 | $2,027.46 | $2,385.24 | $510.92 – $2,700.57 | 18 |
| Lincomycin injection HCPCS J2010 | $660.75 | $777.35 | $166.51 – $880.12 | 18 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $311.10 | $366.00 | $21.32 – $112.66 | 18 |
| Lipase CPT 83690 | $180.20 | $212.00 | $4.50 – $20.58 | 18 |
| Lipoprotein blood quant CPT 83704 | $449.65 | $529.00 | $34.19 – $518.42 | 18 |
| Lipoprotein direct measurement hdl CPT 83718 | $168.30 | $198.00 | $5.36 – $24.50 | 18 |
| Lipoprotein direct measurement ldl CPT 83721 | $188.70 | $222.00 | $6.22 – $28.42 | 18 |
| Lip surgery procedure CPT 40799 | $107.95 | $127.00 | $27.21 – $143.79 | 18 |
| Lithium therapeutic drug level CPT 80178 | $152.15 | $179.00 | $4.50 – $20.58 | 18 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | $2,778.65 | $3,269.00 | $700.22 – $3,701.17 | 18 |
| Liver Function Test CPT 80076 | $258.40 | $304.00 | $5.36 – $24.50 | 18 |
| Liver imaging CPT 78201 | $446.25 | $525.00 | $112.46 – $594.41 | 18 |
| Liver/spleen imag static only CPT 78215 | $888.25 | $1,045.00 | $223.84 – $1,183.15 | 18 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $600.10 | $706.00 | $151.23 – $799.34 | 18 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $84.58 | $99.50 | $21.32 – $112.66 | 18 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,153.50 | $3,710.00 | $794.69 – $4,200.47 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,864.50 | $3,370.00 | $721.86 – $3,815.52 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,670.70 | $3,142.00 | $673.02 – $3,557.38 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,401.30 | $5,178.00 | $1,109.13 – $5,862.54 | 18 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,965.25 | $4,665.00 | $999.25 – $5,281.72 | 18 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,965.25 | $4,665.00 | $999.25 – $5,281.72 | 18 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $429.25 | $505.00 | $16.07 – $84.92 | 18 |
| Lso flex no ri stays pre ots HCPCS L0628 | $526.55 | $619.47 | $21.93 – $115.89 | 18 |
| L/s ratio fetal lung CPT 83661 | $528.70 | $622.00 | $21.99 – $609.56 | 18 |
| Lung Function Test (Spirometry) CPT 94010 | $365.50 | $430.00 | $92.11 – $486.85 | 18 |
| Lung perfusion imaging CPT 78580 | $1,042.95 | $1,227.00 | $262.83 – $1,389.21 | 18 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $29,317.86 | $34,491.60 | $7,388.11 – $39,051.39 | 18 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $50,405.94 | $59,301.10 | $4,234.12 – $22,380.32 | 18 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $201,875.00 | $237,500.00 | $50,872.50 – $268,897.50 | 18 |
| Lymphatics/lymph node imaging CPT 78195 | $1,430.55 | $1,683.00 | $360.50 – $1,905.50 | 18 |
| Macroscopic exam arthropod CPT 87168 | $63.75 | $75.00 | $4.27 – $73.50 | 18 |
| Macroscopic exam parasite CPT 87169 | $67.15 | $79.00 | $4.31 – $77.42 | 18 |
| Magnesium CPT 83735 | $98.60 | $116.00 | $4.50 – $20.58 | 18 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $175.74 | $206.75 | $21.32 – $112.66 | 18 |
| Mammosite ced HCPCS C1728 | $8,555.25 | $10,065.00 | $35.45 – $187.36 | 18 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $74.80 | $88.00 | $18.85 – $99.64 | 18 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $127.50 | $150.00 | $32.13 – $169.83 | 18 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $84.58 | $99.50 | $21.32 – $112.66 | 18 |
| Manual diff wbc count b-coat CPT 85009 | $103.70 | $122.00 | $5.07 – $119.56 | 18 |
| Marker biop eviva buckle ss HCPCS A4648 | $5,355.00 | $6,300.00 | $0.21 – $1.08 | 18 |
| Mastectomy partial CPT 19301 | $3,759.55 | $4,423.00 | $381.92 – $2,018.72 | 18 |
| Mast mod rad CPT 19307 | $2,708.10 | $3,186.00 | $682.45 – $3,607.19 | 18 |
| Mastoids complete CPT 70130 | $363.80 | $428.00 | $91.68 – $484.59 | 18 |
| Mast radical CPT 19305 | $2,633.30 | $3,098.00 | $663.60 – $3,507.56 | 18 |
| Mast rad urban type CPT 19306 | $2,805.00 | $3,300.00 | $706.86 – $3,736.26 | 18 |
| Mast simple complete CPT 19303 | $2,193.00 | $2,580.00 | $552.64 – $2,921.08 | 18 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $8,154.90 | $9,594.00 | $163.44 – $863.87 | 18 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $261.80 | $308.00 | $14.46 – $301.84 | 18 |
| Mayo aathr protein s free CPT 85306 | $485.35 | $571.00 | $15.32 – $559.58 | 18 |
| Mayo activated protein c resistance assay CPT 85307 | $79.05 | $93.00 | $15.32 – $91.14 | 18 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $255.85 | $301.00 | $11.79 – $62.28 | 18 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $127.50 | $150.00 | $9.64 – $44.10 | 18 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $221.85 | $261.00 | $55.91 – $295.51 | 18 |
| Mayo alpha 1 antitrypsin CPT 82103 | $120.70 | $142.00 | $13.44 – $139.16 | 18 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $153.85 | $181.00 | $15.08 – $177.38 | 18 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $185.30 | $218.00 | $46.70 – $246.82 | 18 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $16.15 | $19.00 | $4.07 – $21.52 | 18 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $899.30 | $1,058.00 | $91.66 – $1,036.84 | 18 |
| Mayo androstenedione CPT 82157 | $246.50 | $290.00 | $29.28 – $284.20 | 18 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $172.55 | $203.00 | $14.60 – $198.94 | 18 |
| Mayo antithrombin iii antigen CPT 85301 | $234.60 | $276.00 | $10.81 – $270.48 | 18 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $137.70 | $162.00 | $15.05 – $158.76 | 18 |
| Mayo avwpr vw factor activity CPT 85397 | $281.35 | $331.00 | $30.86 – $324.38 | 18 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $210.80 | $248.00 | $53.13 – $280.79 | 18 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $85.00 | $100.00 | $10.18 – $98.00 | 18 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $167.45 | $197.00 | $12.90 – $193.06 | 18 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $150.45 | $177.00 | $13.19 – $173.46 | 18 |
| Mayo brcmg brucella antibody igm CPT 86622 | $105.40 | $124.00 | $8.93 – $121.52 | 18 |
| Mayo c1 esterase inhibitor CPT 83883 | $161.50 | $190.00 | $13.60 – $186.20 | 18 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $216.75 | $255.00 | $54.63 – $288.72 | 18 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $141.95 | $167.00 | $16.87 – $163.66 | 18 |
| Mayo ceruloplasmin CPT 82390 | $123.25 | $145.00 | $10.74 – $142.10 | 18 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $234.60 | $276.00 | $14.12 – $84.28 | 18 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $198.90 | $234.00 | $8.57 – $39.20 | 18 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $95.20 | $112.00 | $11.82 – $109.76 | 18 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $106.25 | $125.00 | $4.07 – $28.15 | 18 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $707.20 | $832.00 | $116.49 – $815.36 | 18 |
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.