Supplies, drugs & other prices at CHI Health Plainview

Plainview, NE · every code in this section with a posted price and a Medicare benchmark.

35 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2d tte w or w/o fol w/con,fu (C8924) $1,497.72 $1,783 4.1×
Ca screen;flexi sigmoidscope (G0104) $449.40 $535 0.5×
Catheterize for urine spec (P9612) $126 $150 13.5×
Colon ca scrn not hi rsk ind (G0121) $1,307.04 $1,556 1.4×
Colorectal scrn; hi risk ind (G0105) $819.84 $976 0.8×
Covid-19 lab test non-cdc (U0002) $168 $200 3.3×
Diab manage trn per indiv (G0108) $66.36 $79 1.2×
Diab manage trn ind/group (G0109) $27.72 $33 1.7×
Direct refer hospital observ (G0379) $98.28 $117 0.2×
Drug test def 1-7 classes (G0480) $184.80 $220 1.6×
Ekg tracing for initial prev (G0404) $34.02 $40.50 1.1×
Elec stim other than wound (G0283) $86.52 $103 6.8×
Facility svs dental rehab (G0330) $1,722.84 $2,051 0.5×
Fecal blood scrn immunoassay (G0328) $63 $75 3.5×
Group mnt 2 or more 30 mins (G0271) $36.96 $44 2.2×
Hopd mntl hlt, 15-29 min (C7900) $34.44 $41 0.9×
Hopd mntl hlt, 30-60 min (C7901) $90.72 $108 0.9×
Hopd mntl hlt, grp (C7903) $35.28 $42 0.9×
Inj for sacroiliac jt anesth (G0260) $399 $475 0.5×
Mnt subs tx for change dx (G0270) $36.96 $44 1.2×
Obtaining screen pap smear (Q0091) $78.12 $93 2.6×
Oral hiv-1/hiv-2 screen (G0435) $127.68 $152 10.7×
Oth resp proc, group (G0239) $126 $150 3.2×
Oth resp proc, indiv (G0238) $94.08 $112 3.1×
Pemivibart infusion (M0224) $540.96 $644 1.2×
Perq Sacral Augmt Bilat Inj (0201T)
likely a partial charge, not the full procedure
$1,932 $2,300 0.3×
Prolonged iv inf, req pump (C8957) $405.72 $483 1.8×
Psa screening (G0103) $111.72 $133 5.8×
Scr c/v cyto,thinlayer,rescr (G0145) $134.40 $160 5.1×
Therapeutic procd strg endur (G0237) $94.08 $112 3.1×
Trauma respons w/hosp criti (G0390) $2,407.44 $2,866 1.7×
Tte w or w/o contr, cont ecg (C8930) $2,729.16 $3,249 3.4×
Tte w or w/o fol w/con,stres (C8928) $2,239.02 $2,665.50 2.8×
Tte w or wo fol wcon,doppler (C8929) $3,337.74 $3,973.50 4.1×
Unsched dialysis esrd pt hos (G0257) $789.60 $940 1.1×