Chi Health Plainview Hospital

P O Box 489, 704 North Third St, Plainview, NE 68769 · (402) 582-4245

Critical Access HospitalsVoluntary non-profit - ChurchNorfolk, NE metro

Price file

Prices published

File dated 2026-02-28

5,546 price rows for 50 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 4 lines · metro median $22

$22

cash

$8 to $270

102 negotiated rates

$26

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 2 lines · metro median $5,878

$5,878

cash

$2,650 to $9,477

51 negotiated rates

$6,998

list

CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines · metro median $2,150

$2,150

cash

$1,335 to $3,467

51 negotiated rates

$2,560

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines · metro median $2,484

$2,484

cash

$1,804 to $4,004

51 negotiated rates

$2,957

list

Chlamydia test (DNA)

CPT 87491 · lowest of 2 lines · metro median $171

$171

cash

$35 to $199

51 negotiated rates

$203

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 8 lines · metro median $630

$630

cash

$458 to $3,185

204 negotiated rates

$750

list

Colonoscopy with biopsy

CPT 45380 · lowest of 4 lines · metro median $1,058

$1,058

cash

$768 to $4,283

102 negotiated rates

$1,259

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 4 lines · metro median $1,100

$1,100

cash

$799 to $3,089

102 negotiated rates

$1,310

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 4 lines · metro median $13

$13

cash

$8 to $190

102 negotiated rates

$15

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 4 lines · metro median $27

$27

cash

$11 to $344

102 negotiated rates

$32

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 2 lines · metro median $259

$259

cash

$188 to $417

51 negotiated rates

$308

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 8 lines · metro median $87

$87

cash

$63 to $692

204 negotiated rates

$103

list

Family psychotherapy with the patient

CPT 90847 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Family psychotherapy without the patient

CPT 90846 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 2 lines · metro median $1,495

$1,495

cash

$1,086 to $2,410

51 negotiated rates

$1,780

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines · metro median $150

$150

cash

$35 to $175

51 negotiated rates

$179

list

Group psychotherapy

CPT 90853 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 2 lines · metro median $1,188

$1,188

cash

$863 to $1,915

51 negotiated rates

$1,414

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · lowest of 4 lines · metro median $578

$578

cash

$420 to $1,398

102 negotiated rates

$688

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 6 lines · metro median $8

cash

$7 to $296

153 negotiated rates

$10

list

Liver function panel

CPT 80076 · lowest of 4 lines · metro median $21

$21

cash

$8 to $298

102 negotiated rates

$25

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines · metro median $4,453

$4,453

cash

$3,234 to $7,179

51 negotiated rates

$5,301

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 2 lines · metro median $2,932

$2,932

cash

$1,446 to $4,726

51 negotiated rates

$3,490

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 2 lines · metro median $3,919

$3,919

cash

$1,903 to $6,317

51 negotiated rates

$4,665

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines · metro median $3,979

$3,979

cash

$2,890 to $6,415

51 negotiated rates

$4,737

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 4 lines · metro median $593

$593

cash

$431 to $2,237

102 negotiated rates

$706

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 4 lines · metro median $264

$264

cash

$110 to $493

102 negotiated rates

$314

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 4 lines · metro median $395

$395

cash

$147 to $749

102 negotiated rates

$470

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 4 lines · metro median $522

$522

cash

$200 to $928

102 negotiated rates

$622

list

PSA test (prostate)

CPT 84153 · lowest of 4 lines · metro median $47

$47

cash

$18 to $217

102 negotiated rates

$56

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 4 lines · metro median $21

$21

cash

$6 to $127

102 negotiated rates

$25

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 14 lines · metro median $74

$74

cash

$54 to $2,379

357 negotiated rates

$88

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 4 lines · metro median $843

$843

cash

$612 to $1,376

102 negotiated rates

$1,003

list

Prostate biopsy

CPT 55700 · lowest of 2 lines · metro median $778

$778

cash

$565 to $1,254

51 negotiated rates

$926

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 6 lines · metro median $10

$10

cash

$4 to $89

153 negotiated rates

$12

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $291

$291

cash

$212 to $470

51 negotiated rates

$347

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 4 lines · metro median $1,194

$1,194

cash

$867 to $4,197

102 negotiated rates

$1,422

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 6 lines · metro median $183

$183

cash

$133 to $534

153 negotiated rates

$218

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 2 lines · metro median $4,495

$4,495

cash

$3,264 to $7,246

51 negotiated rates

$5,351

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · lowest of 6 lines · metro median $293

$293

cash

$213 to $1,685

153 negotiated rates

$349

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 6 lines · metro median $408

$408

cash

$296 to $2,440

153 negotiated rates

$486

list

TSH test (thyroid)

CPT 84443 · lowest of 4 lines · metro median $43

$43

cash

$17 to $172

102 negotiated rates

$51

list

Transvaginal ultrasound

CPT 76830 · lowest of 2 lines · metro median $721

$721

cash

$523 to $1,162

51 negotiated rates

$858

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $965

$965

cash

$675 to $1,556

51 negotiated rates

$1,149

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 4 lines · metro median $722

$722

cash

$524 to $3,295

102 negotiated rates

$859

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 6 lines · metro median $924

$924

cash

$275 to $3,358

153 negotiated rates

$1,100

list

Urinalysis with microscope

CPT 81001 · lowest of 6 lines · metro median $8

cash

$3 to $100

153 negotiated rates

$10

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 4 lines · metro median $84

$84

cash

$61 to $985

102 negotiated rates

$100

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.chihealth.com/content/dam/chihealthcom/documents/patients-and-visitors/financial-assistance/price-transparency-standard-charges/470757164-1861765034_alegent-creighton-health_standardcharges.json
CHI Health Plainview · parsed · json v3.0.0 · file dated 2026-02-28 · 207.4 MB · 5546 price rows read · read Nov 2026