CHI Health Immanuel
6901 N 72nd St, Omaha, NE · Chihealth · · NPI 1912085184
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 |
|---|---|---|---|---|
| Low cost skin substitute app HCPCS C5273 | $1,219.26 | $2,903.00 | $406.42 – $2,467.55 | 9 |
| Low cost skin substitute app HCPCS C5275 | $363.72 | $866.00 | $121.24 – $736.10 | 9 |
| Low cost skin substitute app HCPCS C5277 | $363.72 | $866.00 | $121.24 – $736.10 | 9 |
| Low cost skin substitute app HCPCS C5272 | $349.44 | $832.00 | $116.48 – $707.20 | 9 |
| Low cost skin substitute app HCPCS C5274 | $1,178.94 | $2,807.00 | $392.98 – $2,385.95 | 9 |
| Low cost skin substitute app HCPCS C5276 | $349.44 | $832.00 | $116.48 – $707.20 | 9 |
| Low cost skin substitute app HCPCS C5278 | $349.44 | $832.00 | $116.48 – $707.20 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,150.38 | $2,739.00 | $270.92 – $2,328.15 | 13 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,094.10 | $2,605.00 | $219.22 – $2,214.25 | 13 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $935.34 | $2,227.00 | $161.64 – $1,892.95 | 13 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,966.02 | $4,681.00 | $416.79 – $3,978.85 | 13 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,695.54 | $4,037.00 | $366.98 – $3,431.45 | 13 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,424.64 | $3,392.00 | $239.40 – $2,883.20 | 13 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $311.22 | $741.00 | $55.06 – $629.85 | 13 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,508.81 – $1,508.81 | 1 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $1,377.89 – $1,377.89 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $1,581.93 – $1,581.93 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $1,561.10 – $1,561.10 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,699.17 – $1,699.17 | 1 |
| Lso flex no ri stays pre ots HCPCS L0628 | $260.18 | $619.47 | $70.45 – $526.55 | 10 |
| L/s ratio fetal lung CPT 83661 | $341.88 | $814.00 | $21.31 – $691.90 | 21 |
| Lumbar diskogram s&i CPT 72295 | $2,306.22 | $5,491.00 | $136.42 – $4,667.35 | 13 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,863.62 – $2,863.62 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $173.46 | $413.00 | $36.14 – $351.05 | 9 |
| Lung perfusion imaging CPT 78580 | $614.04 | $1,462.00 | $204.68 – $1,242.70 | 13 |
| Lung transplant double CPT 32853 | not published | not published | $4,061.77 – $4,141.42 | 3 |
| Lung transplant single CPT 32851 | not published | not published | $2,905.63 – $2,962.61 | 3 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,151.44 – $3,213.24 | 3 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,301.31 – $4,385.65 | 3 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,367.10 – $1,393.90 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $14,486.48 | $34,491.60 | $164.98 – $29,317.86 | 15 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $24,906.47 | $59,301.10 | $34.54 – $16,802.04 | 15 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $99,750.00 | $237,500.00 | $108.70 – $659.93 | 10 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $59.64 – $59.64 | 1 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $618.60 – $1,321.49 | 4 |
| Lymphatics/lymph node imaging CPT 78195 | $956.34 | $2,277.00 | $318.78 – $1,935.45 | 13 |
| Lymph vessel x-ray trunk CPT 75807 | $2,097.90 | $4,995.00 | $377.87 – $4,245.75 | 9 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $287.85 – $287.85 | 1 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $295.03 – $295.03 | 1 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $381.68 – $381.68 | 1 |
| Macroscopic exam arthropod CPT 87168 | $41.58 | $99.00 | $4.14 – $84.15 | 21 |
| Macroscopic exam parasite CPT 87169 | $41.58 | $99.00 | $4.17 – $84.15 | 21 |
| Magnesium CPT 83735 | $63.00 | $150.00 | $6.50 – $127.50 | 21 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $86.84 | $206.75 | $0.43 – $84.58 | 13 |
| Male sling procedure CPT 53440 | not published | not published | $1,426.30 – $1,426.30 | 1 |
| Mammosite ced HCPCS C1728 | $4,227.30 | $10,065.00 | $23.17 – $140.66 | 12 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $1,649.06 – $1,681.40 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $690.82 – $690.82 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $834.29 – $834.29 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $64.68 | $154.00 | $21.56 – $130.90 | 9 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $126.84 | $302.00 | $38.84 – $256.70 | 9 |
| Manipulation of hip joint CPT 27275 | not published | not published | $348.43 – $348.43 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $239.93 – $239.93 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $148.09 – $148.09 | 1 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $41.79 | $99.50 | $2.45 – $84.58 | 13 |
| Manual diff wbc count b-coat CPT 85009 | $56.28 | $134.00 | $4.92 – $113.90 | 21 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $201.18 | $479.00 | $67.06 – $407.15 | 9 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $247.30 – $247.30 | 1 |
| Map tachycard site(s) CPT 93609 | $4,082.82 | $9,721.00 | $187.89 – $7,795.35 | 9 |
| Marker biop eviva buckle ss HCPCS A4648 | $2,646.00 | $6,300.00 | $0.14 – $0.81 | 12 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $600.22 – $611.99 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $1,206.60 – $1,206.60 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $2,152.50 – $2,152.50 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $1,349.25 – $1,349.25 | 1 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $1,791.01 – $1,791.01 | 1 |
| Mastoid surgery revision CPT 69603 | not published | not published | $2,431.51 – $2,431.51 | 1 |
| Mastopexy CPT 19316 | not published | not published | $1,475.90 – $1,475.90 | 1 |
| Mast radical CPT 19305 | not published | not published | $883.25 – $900.57 | 3 |
| Mast rad urban type CPT 19306 | not published | not published | $917.53 – $935.52 | 3 |
| Mast simple complete CPT 19303 | not published | not published | $1,747.75 – $1,747.75 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $4,029.48 | $9,594.00 | $16.12 – $648.55 | 13 |
| Maxillofacial fixation CPT 21100 | not published | not published | $683.99 – $683.99 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $66.36 | $158.00 | $14.01 – $134.30 | 21 |
| Mayo aathr protein s free CPT 85306 | $128.10 | $305.00 | $14.84 – $259.25 | 21 |
| Mayo activated protein c resistance assay CPT 85307 | $49.98 | $119.00 | $14.84 – $102.50 | 21 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $160.44 | $382.00 | $9.10 – $58.18 | 9 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $94.50 | $225.00 | $14.32 – $191.25 | 21 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $138.18 | $329.00 | $46.06 – $279.65 | 9 |
| Mayo alpha 1 antitrypsin CPT 82103 | $65.52 | $156.00 | $13.03 – $132.60 | 21 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $102.90 | $245.00 | $14.62 – $208.25 | 21 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $108.78 | $259.00 | $36.26 – $220.15 | 9 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $10.08 | $24.00 | $3.36 – $24.00 | 9 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $519.54 | $1,237.00 | $88.82 – $1,051.45 | 21 |
| Mayo androstenedione CPT 82157 | $114.66 | $273.00 | $28.38 – $232.05 | 21 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $73.08 | $174.00 | $14.15 – $147.90 | 21 |
| Mayo antithrombin iii antigen CPT 85301 | $204.54 | $487.00 | $10.48 – $413.95 | 21 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $119.70 | $285.00 | $14.59 – $242.25 | 21 |
| Mayo avwpr vw factor activity CPT 85397 | $163.38 | $389.00 | $29.91 – $330.65 | 21 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $107.94 | $257.00 | $35.98 – $218.45 | 9 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $47.04 | $112.00 | $9.86 – $95.20 | 21 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $164.22 | $391.00 | $12.51 – $332.35 | 21 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $80.22 | $191.00 | $12.78 – $162.35 | 21 |
| Mayo brcmg brucella antibody igm CPT 86622 | $44.10 | $105.00 | $8.65 – $89.25 | 21 |
| Mayo c1 esterase inhibitor CPT 83883 | $160.86 | $383.00 | $6.38 – $325.55 | 21 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $125.58 | $299.00 | $41.86 – $254.15 | 9 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $39.06 | $93.00 | $4.48 – $37.45 | 21 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $64.26 | $153.00 | $21.42 – $130.05 | 20 |
| Mayo ceruloplasmin CPT 82390 | $50.82 | $121.00 | $10.40 – $102.85 | 21 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $110.88 | $264.00 | $6.38 – $81.60 | 21 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $186.06 | $443.00 | $12.48 – $376.55 | 21 |
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.