CHI Health Midlands
11111 S 84th Street, Papillion, NE · Chihealth · · NPI 1215006101
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 |
|---|---|---|---|---|
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $86.84 | $206.75 | $1.43 – $84.58 | 13 |
| Dextrose 5 % IV bolus HCPCS J7070 | $86.84 | $206.75 | $2.85 – $175.74 | 13 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $141.96 | $338.00 | $21.54 – $287.30 | 21 |
| Diabetes (HbA1c) Test CPT 83036 | $81.06 | $193.00 | $9.40 – $164.05 | 21 |
| Diab manage trn ind/group HCPCS G0109 | $25.20 | $60.00 | $10.80 – $51.00 | 17 |
| Diag bronchoscope/catheter CPT 31643 | $1,824.90 | $4,345.00 | $321.30 – $3,693.25 | 9 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $604.67 – $604.67 | 1 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $176.42 – $176.42 | 1 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $233.63 – $233.63 | 1 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $238.14 | $567.00 | $77.53 – $481.95 | 8 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $42.00 | $100.00 | $18.00 – $100.00 | 9 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $28.14 | $67.00 | $12.06 – $67.00 | 9 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $96.18 | $229.00 | $41.22 – $194.65 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $252.00 | $600.00 | $108.00 – $510.00 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $128.10 | $305.00 | $54.90 – $305.00 | 11 |
| Diagnostic Mammogram (one breast) CPT 77065 | $100.38 | $239.00 | $39.06 – $217.00 | 11 |
| Diagnostic radio unlisted proc CPT 76499 | $45.36 | $108.00 | $9.72 – $45.90 | 9 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $3,521.28 | $8,384.00 | $364.14 – $7,126.40 | 9 |
| Dialysis one evaluation CPT 90945 | $1,695.12 | $4,036.00 | $147.11 – $3,430.60 | 12 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $41.79 | $99.50 | $0.06 – $84.58 | 9 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $76.76 | $182.75 | $4.63 – $84.58 | 13 |
| Dicyclomine injection HCPCS J0500 | $161.45 | $384.40 | $17.27 – $84.58 | 13 |
| Diffusing capacity CPT 94729 | $348.18 | $829.00 | $90.38 – $704.65 | 9 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $328.13 – $328.13 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $265.49 | $632.11 | $6.09 – $84.58 | 13 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $10,079.82 | $23,999.55 | $4,056.41 – $20,399.62 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $91.14 | $217.00 | $12.87 – $184.45 | 21 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $2,351.83 | $5,599.59 | $36.91 – $174.26 | 13 |
| Dilate biliary duct/ampulla CPT 47542 | $1,196.16 | $2,848.00 | $251.43 – $2,420.80 | 9 |
| Dilate esophagus CPT 43453 | not published | not published | $162.73 – $162.73 | 1 |
| Dilate esophagus 1/mult pass CPT 43450 | $378.42 | $901.00 | $150.00 – $765.85 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $7,378.56 | $17,568.00 | $491.72 – $14,932.80 | 11 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $5,903.10 | $14,055.00 | $310.09 – $11,946.75 | 11 |
| Dilate ic vasospasm init CPT 61640 | $14,759.22 | $35,141.00 | $491.72 – $29,869.85 | 11 |
| Dilate tear duct opening CPT 68801 | not published | not published | $152.65 – $152.65 | 1 |
| Dilate urethra stricture CPT 53600 | $191.94 | $457.00 | $82.26 – $388.45 | 9 |
| Dilate urethra stricture CPT 53601 | $231.00 | $550.00 | $99.00 – $467.50 | 8 |
| Dilate urethra stricture CPT 53605 | not published | not published | $119.74 – $119.74 | 1 |
| Dilate urethra stricture CPT 53621 | not published | not published | $134.84 – $134.84 | 1 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $78.46 – $78.46 | 1 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $319.81 – $319.81 | 1 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $90.34 – $90.34 | 1 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $363.01 – $363.01 | 1 |
| Dilation of salivary duct CPT 42660 | $162.12 | $386.00 | $69.48 – $328.10 | 9 |
| Dilation of urethra CPT 53661 | not published | not published | $75.98 – $75.98 | 1 |
| Dilation of urethra CPT 53665 | not published | not published | $71.17 – $71.17 | 1 |
| Dilation of vagina CPT 57400 | not published | not published | $243.05 – $243.05 | 1 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $111.99 – $111.99 | 1 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $844.62 | $2,011.00 | $163.51 – $1,709.35 | 8 |
| Dilator fascial 10fx20cm HCPCS C2627 | $408.24 | $972.00 | $7.94 – $37.49 | 12 |
| Dilat xst trc ndurlgc px CPT 50436 | $1,491.84 | $3,552.00 | $279.83 – $3,019.20 | 9 |
| Dilat xst trc new access rcs CPT 50437 | $2,509.50 | $5,975.00 | $465.02 – $5,078.75 | 9 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,121.24 | $2,669.60 | $480.53 – $2,269.16 | 15 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $41.79 | $99.50 | $0.77 – $84.58 | 13 |
| Disability dlco CPT 94727 | $254.94 | $607.00 | $62.01 – $365.50 | 9 |
| Disaccharidases CPT 82657 | $504.42 | $1,201.00 | $16.74 – $93.00 | 21 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $894.47 – $894.47 | 1 |
| Disarticulation shoulder CPT 23920 | not published | not published | $998.78 – $2,091.73 | 4 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,401.86 – $1,429.34 | 3 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $200.91 – $352.97 | 4 |
| Dise eval slp do brth flx dx CPT 42975 | $1,086.54 | $2,587.00 | $465.66 – $2,198.95 | 9 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,084.32 – $1,105.58 | 3 |
| Dissolve clot heart vessel CPT 92975 | $212.10 | $505.00 | $85.68 – $424.56 | 11 |
| Dist revas ligation hemo CPT 36838 | $3,518.34 | $8,377.00 | $1,507.86 – $7,120.45 | 9 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,338.78 – $1,365.03 | 3 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,483.48 – $1,483.48 | 1 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $229.90 – $635.99 | 4 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $669.48 | $1,594.00 | $267.85 – $1,354.90 | 11 |
| Dna antibody native/double stranded CPT 86225 | $44.94 | $107.00 | $13.31 – $107.00 | 21 |
| Dna gardnerella CPT 87510 | $40.32 | $96.00 | $17.28 – $96.00 | 21 |
| Dna probe chlamydia CPT 87490 | $79.38 | $189.00 | $22.04 – $160.65 | 21 |
| Dna probe gc CPT 87590 | $79.38 | $189.00 | $26.05 – $160.65 | 21 |
| Dna trichomonas CPT 87660 | $127.26 | $303.00 | $19.43 – $257.55 | 21 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $86.84 | $206.75 | $6.43 – $84.58 | 13 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,072.75 | $2,554.16 | $1.19 – $84.58 | 13 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $86.84 | $206.75 | $0.67 – $84.58 | 13 |
| Doppler echo complete CPT 93320 | $354.90 | $845.00 | $62.64 – $718.25 | 13 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,080.26 | $4,953.00 | $238.12 – $4,210.05 | 9 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $456.96 | $1,088.00 | $195.84 – $924.80 | 13 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $334.74 | $797.00 | $85.86 – $405.45 | 13 |
| Dornhoffer fixed part w/window HCPCS L8614 | $11,529.06 | $27,450.13 | $2,629.94 – $12,419.13 | 12 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $23,806.42 | $56,681.95 | $10,202.76 – $48,179.66 | 8 |
| Double transfer toe-hand CPT 26554 | not published | not published | $3,503.42 – $7,030.40 | 4 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $407.45 | $970.10 | $4.93 – $84.58 | 13 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $3,182.76 | $7,578.00 | $107.43 – $507.28 | 15 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $450.66 | $1,073.00 | $193.14 – $912.05 | 8 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $276.78 | $659.00 | $118.62 – $560.15 | 8 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $306.77 – $306.77 | 1 |
| Drainage external ear simple 69000 CPT 69000 | $304.92 | $726.00 | $130.68 – $617.10 | 8 |
| Drainage lymph node lesion 38300 CPT 38300 | $1,494.36 | $3,558.00 | $389.21 – $3,024.30 | 9 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $911.46 – $911.46 | 1 |
| Drainage mouth roof lesion CPT 42000 | $283.08 | $674.00 | $121.32 – $572.90 | 8 |
| Drainage of abdomen CPT 48000 | not published | not published | $816.78 – $832.79 | 3 |
| Drainage of arm bursa 23931 CPT 23931 | $959.28 | $2,284.00 | $305.99 – $1,941.40 | 8 |
| Drainage of bladder abscess CPT 51080 | $1,465.80 | $3,490.00 | $628.20 – $2,966.50 | 9 |
| Drainage of bone lesion CPT 26992 | not published | not published | $880.40 – $1,889.03 | 4 |
| Drainage of bone lesion CPT 27303 | not published | not published | $628.34 – $1,206.11 | 4 |
| Drainage of eye CPT 65800 | not published | not published | $169.51 – $169.51 | 1 |
| Drainage of eye CPT 65810 | not published | not published | $885.68 – $885.68 | 1 |
| Drainage of eye CPT 65815 | not published | not published | $908.99 – $908.99 | 1 |
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.