Saint Francis Medical Center
Saint Francis Medical Center in Grand Island, NE publishes cash prices for 42 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Click a procedure to compare it with other hospitals nearby.
2620 West Faidley Avenue, Grand Island, NE 68803 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRST | $3,558.88 | $6,032.00 | 41% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRST | $3,558.88 | $6,032.00 | 41% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST | $1,564.09 | $2,651.00 | 41% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST | $1,564.09 | $2,651.00 | 41% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $1,794.19 | $3,041.00 | 41% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $1,794.19 | $3,041.00 | 41% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGMRAM DIGMITAL BILATERAL | $210.63 | $357.00 | 41% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $292.05 | $495.00 | 41% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGMRAM DIGMITAL BILATERAL | $210.63 | $357.00 | 41% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $292.05 | $495.00 | 41% |
| Diagnostic mammogram, one breast CPT 77065 HC MAMMOGMRAM DIGMITAL UNILATERL | $205.32 | $348.00 | 41% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $263.14 | $446.00 | 41% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMOGMRAM DIGMITAL UNILATERL | $205.32 | $348.00 | 41% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $263.14 | $446.00 | 41% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOWER EXT WO CONT | $2,575.94 | $4,366.00 | 41% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOWER EXT WO CONT | $2,575.94 | $4,366.00 | 41% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JNT LOWER EXT W WO CONT | $3,372.44 | $5,716.00 | 41% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JNT LOWER EXT W WO CONT | $3,372.44 | $5,716.00 | 41% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST | $2,312.21 | $3,919.00 | 41% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST | $2,312.21 | $3,919.00 | 41% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST | $3,256.80 | $5,520.00 | 41% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST | $3,256.80 | $5,520.00 | 41% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR LUMBAR WO CONTRAST | $2,413.10 | $4,090.00 | 41% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR LUMBAR WO CONTRAST | $2,413.10 | $4,090.00 | 41% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC ULTRASOUND COMPLETE | $849.60 | $1,440.00 | 41% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC ULTRASOUND COMPLETE | $849.60 | $1,440.00 | 41% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $274.94 | $466.00 | 41% |
| Screening mammogram, both breasts CPT 77067 HC MAMMOGMRAM DIGMITAL SCREEN | $197.65 | $335.00 | 41% |
| Screening mammogram, both breasts one side CPT 77067 HC MAMMOGM DR UNILAT SCREEN M52 | $191.16 | $324.00 | 41% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $274.94 | $466.00 | 41% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMOGMRAM DIGMITAL SCREEN | $197.65 | $335.00 | 41% |
| Screening mammogram, both breasts inpatient one side CPT 77067 HC MAMMOGM DR UNILAT SCREEN M52 | $191.16 | $324.00 | 41% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGMRAPHY=> 6 YR | $3,156.50 | $5,350.00 | 41% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGMRAPHY=> 6 YR | $3,156.50 | $5,350.00 | 41% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGMINAL | $643.10 | $1,090.00 | 41% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGMINAL | $643.10 | $1,090.00 | 41% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN | $792.37 | $1,343.00 | 41% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN | $792.37 | $1,343.00 | 41% |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $559.32 | $948.00 | 41% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $559.32 | $948.00 | 41% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $108.56 | $184.00 | 41% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $108.56 | $184.00 | 41% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $84.96 | $144.00 | 41% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $84.96 | $144.00 | 41% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFF | $75.52 | $128.00 | 41% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC W AUTO DIFF | $75.52 | $128.00 | 41% |
| Complete blood count (CBC), no differential CPT 85027 HC HEMOGMRAM CBC WITHOUT DIFF | $79.06 | $134.00 | 41% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMOGMRAM CBC WITHOUT DIFF | $79.06 | $134.00 | 41% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE PANEL | $138.06 | $234.00 | 41% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE PANEL | $138.06 | $234.00 | 41% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $106.20 | $180.00 | 41% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $106.20 | $180.00 | 41% |
| Liver function blood test panel CPT 80076 HC HEPATIC PROFILE | $105.61 | $179.00 | 41% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC PROFILE | $105.61 | $179.00 | 41% |
| Obstetric blood test panel CPT 80055 HC RHC OBSTETRIC PANEL | $125.67 | $213.00 | 41% |
| Obstetric blood test panel inpatient CPT 80055 HC RHC OBSTETRIC PANEL | $125.67 | $213.00 | 41% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $58.41 | $99.00 | 41% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $58.41 | $99.00 | 41% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA | $92.04 | $156.00 | 41% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA | $92.04 | $156.00 | 41% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $65.49 | $111.00 | 41% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $65.49 | $111.00 | 41% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PT | $43.66 | $74.00 | 41% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT | $43.66 | $74.00 | 41% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH | $93.22 | $158.00 | 41% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH | $93.22 | $158.00 | 41% |
| Urinalysis with microscope exam, automated CPT 81001 HC RHC COMPL UA W MICRO | $22.42 | $38.00 | 41% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS | $50.15 | $85.00 | 41% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC RHC COMPL UA W MICRO | $22.42 | $38.00 | 41% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS | $50.15 | $85.00 | 41% |
| Urinalysis without microscope exam, automated CPT 81003 HC RHC UA WO MICRO AUTO | $24.78 | $42.00 | 41% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO WO MICRO | $30.68 | $52.00 | 41% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC RHC UA WO MICRO AUTO | $24.78 | $42.00 | 41% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO WO MICRO | $30.68 | $52.00 | 41% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALY NON AUTO WO SCOPE | $21.83 | $37.00 | 41% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALY NON AUTO WO SCOPE | $21.83 | $37.00 | 41% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH NO ANGMIO | $10,781.66 | $18,274.00 | 41% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH NO ANGMIO | $10,781.66 | $18,274.00 | 41% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ ANE DRGM LUM SAC W IMGM GMDN | $880.87 | $1,493.00 | 41% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ ANE DRGM LUM SAC W IMGM GMDN | $880.87 | $1,493.00 | 41% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ ANE DRGM LUM SAC W O IMGM GMDN | $880.87 | $1,493.00 | 41% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ ANE DRGM LUM SAC W O IMGM GMDN | $880.87 | $1,493.00 | 41% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRNSFRM LUM SNGML W IMAGM | $1,420.72 | $2,408.00 | 41% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRNSFRM LUM SNGML W IMAGM | $1,420.72 | $2,408.00 | 41% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE | $1,256.70 | $2,130.00 | 41% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE | $1,256.70 | $2,130.00 | 41% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGMD BIOPSY SINGMLE MULTIPLE | $483.80 | $820.00 | 41% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGMD BIOPSY SINGMLE MULTIPLE | $483.80 | $820.00 | 41% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $318.01 | $539.00 | 41% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $318.01 | $539.00 | 41% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $549.88 | $932.00 | 41% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $549.88 | $932.00 | 41% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $680.86 | $1,154.00 | 41% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $680.86 | $1,154.00 | 41% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $80.83 | $137.00 | 41% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $80.83 | $137.00 | 41% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $80.83 | $137.00 | 41% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $80.83 | $137.00 | 41% |