Supplies, drugs & other prices at CHI Health St. Francis

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

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

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $34.22 $58 1.0×
2d tee w or w/o fol w/con,in (C8925) $3,527.02 $5,978 4.3×
2d tte w or w/o fol w/con,fu (C8924) $1,487.39 $2,521 4.1×
Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) $5,440.39 $9,221 2.7×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T) $5,440.39 $9,221 0.6×
Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) $5,440.39 $9,221 2.7×
Adm tocilizu covid-19 1st (M0249) $284.38 $482 0.6×
Adm tocilizu covid-19 2nd (M0250) $284.38 $482 0.6×
Catheterize for urine spec (P9612) $122.13 $207 13.1×
Covid-19 lab test non-cdc (U0002) $97.35 $165 1.9×
Ephys eval ccm-d ld 1st impl (0930T) $200.56 $339.92 0.2×
Ephys eval ccm-d ld separate (0931T) $200.56 $339.92 0.2×
Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) $8,059.99 $13,661 0.7×
Histotripsy mal hepatocellular tiss w/img gdn (0686T)
unusually low: confirm this is the full procedure
$8,336.70 $14,130 0.5×
Insertion perm ccm-d system pulse generator only (0916T) $18,540.56 $31,424.67 0.8×
Insj Perm Ccm-D Sys 1 Transvns Lead Only (0917T) $6,835.96 $11,586.37 0.8×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $6,835.96 $11,586.37 0.8×
Insj perm ccm-d sys pg&dual transvns eltrds/lds (0915T) $26,482.87 $44,886.21 0.8×
Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) $32,399.85 $54,915 1.0×
Insj/Rplc Car Modulj Sys Ventr Electrode Only (0411T) $8,244.66 $13,974 1.0×
Insj/Rplc Cardiac Modulj Sys Atr Electrode Only (0410T) $8,244.66 $13,974 1.0×
Insj/Rplc Cardiac Modulj Sys Pls Generator Only (0409T) $23,048.35 $39,065 1.0×
Interro Device Evaluation Cardiac Modulj System (0418T) $35.40 $60 0.9×
Interrog dev eval impl ccm-d system in person (0927T) $6.16 $10.44 0.2×
Mri w/cont, breast, bi (C8906) $2,844.39 $4,821 7.9×
Mri w/cont, breast, uni (C8903) $2,203.06 $3,734 12.1×
Mri w/o fol w/cont, breast, (C8908) $2,844.39 $4,821 7.9×
Mri w/o fol w/cont, brst, un (C8905) $2,454.40 $4,160 6.8×
N-invs det hrt fail aug echo (0932T) $49.56 $83.99 0.2×
Pemivibart infusion (M0224) $425.39 $721 0.9×
Perc d-e cor revasc chro sin (C9607) $10,411.14 $17,646 0.5×
Perc d-e cor revasc t cabg s (C9604) $15,072.73 $25,547 1.3×
Perc d-e cor stent ather s (C9602) $17,248.06 $29,234 0.9×
Perc drug-el cor stent sing (C9600) $16,160.10 $27,390 1.3×
Perq Sacral Augmt Bilat Inj (0201T) $8,778.61 $14,879 1.2×
Perq Sacral Augmt Unilat Inj (0200T) $6,313.59 $10,701 0.8×
Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T)
unusually low: confirm this is the full procedure
$4,709.46 $7,982.13 0.4×
Prgrmg Device Evaluation Cardiac Modulj System (0417T) $35.40 $60 0.9×
Programming device eval impl ccm-d sys in person (0926T) $6.16 $10.44 0.2×
Prolonged iv inf, req pump (C8957) $394.12 $668 1.8×
Quan CT tiss charac i&r w/cncrnt CT exam (0722T) $1,249.03 $2,117 1.9×
Quan CT tiss charac w/o CT (0721T) $1,249.03 $2,117 1.9×
Reloc Skin Pocket Cardiac Modulj Pulse Generator (0416T) $1,742.86 $2,954 0.8×
Relocation skin pocket implanted ccm-d pg (0925T) $1,510.95 $2,560.92 0.7×
Removal Cardiac Modulj Sys Pls Generator Only (0412T) $3,384.24 $5,736 0.9×
Removal Cardiac Modulj Sys Transvenous Electrode (0413T) $3,384.24 $5,736 0.9×
Removal perm ccm-d system pulse generator only (0919T) $3,006.07 $5,095.02 0.8×
Repos Cardiac Modulj Transvenous Electrode (0415T) $584.69 $991 0.9×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $510.69 $865.56 0.8×
Revasc intra lithotrip-ather (C9766) $21,697.25 $36,775 1.1×
Revasc intra lithotrip-stent (C9765) $22,849.52 $38,728 1.2×
Revasc intravasc lithotripsy (C9764) $12,922.18 $21,902 1.1×
Revasc lith-sten-ath tib/per (C9775) $21,323.78 $36,142 1.1×
Revasc lithotr-ather tib/per (C9774) $20,401.02 $34,578 1.1×
Revasc lithotr-stent tib/per (C9773) $28,838.61 $48,879 1.5×
Revasc lithotrip tibi/perone (C9772) $16,198.45 $27,455 1.4×
Revasc lithotrip-stent-ather (C9767) $23,841.90 $40,410 1.3×
Rmvl & Rpl Cardiac Modulj Sys Pls Generator Only (0414T) $23,048.35 $39,065 1.0×
Rmvl Perm Ccm-D Sys 1 Transvns Dfb Lead Only (0921T) $3,006.07 $5,095.02 0.8×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $3,006.07 $5,095.02 0.8×
Rmvl Perm Ccm-D Sys Dual Transvns Leads Only (0922T) $3,006.07 $5,095.02 0.8×
Rmvl&Rplcmt Permanent Ccm-D Pulse Generator Only (0923T) $18,540.56 $31,424.67 0.8×
Tcat Implt Wrls L Atr Prs Snr L-T L Atr Prs Mntr (0933T) $531.36 $900.61 0.2×
Trluml peripheral atherectomy iliac artery ea (0238T) $18,096.48 $30,672 1.0×
Tte w or w/o contr, cont ecg (C8930) $1,970.01 $3,339 2.4×
Tte w or w/o fol w/con,stres (C8928) $2,024.29 $3,431 2.5×
Tte w or wo fol wcon,doppler (C8929) $2,229.61 $3,779 2.7×