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 |
|---|---|---|---|---|
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $71.40 | $170.00 | $12.84 – $158.00 | 11 |
| Ghs sphenopalatine ganglion block CPT 64505 | $268.80 | $640.00 | $107.64 – $508.30 | 9 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $78.12 | $186.00 | $33.48 – $158.10 | 11 |
| Ghs strapping shoulder - 29240 CPT 29240 | $189.42 | $451.00 | $34.80 – $383.35 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | $139.44 | $332.00 | $59.76 – $282.20 | 11 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $54.18 | $129.00 | $23.22 – $109.65 | 9 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $328.44 | $782.00 | $140.76 – $664.70 | 8 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $178.50 | $425.00 | $76.50 – $361.25 | 8 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,033.20 | $2,460.00 | $442.80 – $2,091.00 | 8 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $283.08 | $674.00 | $121.32 – $572.90 | 8 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $444.07 – $444.07 | 1 |
| Ghs urine, porphyrins quant CPT 84120 | $165.06 | $393.00 | $14.25 – $334.05 | 21 |
| Ghs vaginal delivery only CPT 59409 | $2,731.68 | $6,504.00 | $585.72 – $4,227.60 | 9 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,713.20 | $6,460.00 | $1,162.80 – $5,491.00 | 9 |
| Ghs windowing of cast CPT 29730 | $96.60 | $230.00 | $41.40 – $195.50 | 9 |
| Gi inhouse confirmation CPT 87045 | $111.72 | $266.00 | $9.15 – $226.10 | 21 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $575.36 – $575.36 | 1 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,646.40 | $3,920.00 | $246.96 – $1,166.20 | 9 |
| Gi trc img intral colon i&r CPT 91113 | $585.06 | $1,393.00 | $250.74 – $1,184.05 | 9 |
| Gi trc img intral esophagus CPT 91111 | $866.88 | $2,064.00 | $371.52 – $1,754.40 | 9 |
| Glassia injection HCPCS J0257 | $41.79 | $99.50 | $4.58 – $84.58 | 15 |
| Glaucoma surgery CPT 66150 | not published | not published | $1,673.81 – $1,673.81 | 1 |
| Glaucoma surgery CPT 66155 | not published | not published | $1,672.48 – $1,672.48 | 1 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,879.46 – $1,879.46 | 1 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,084.61 – $2,084.61 | 1 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $537.79 | $1,280.45 | $80.84 – $407.11 | 15 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $412.95 | $983.20 | $94.59 – $446.64 | 8 |
| Glucagon plasma - sendout CPT 82943 | $101.64 | $242.00 | $13.85 – $205.70 | 21 |
| Glucose 1 hr post dose CPT 82950 | $55.44 | $132.00 | $4.60 – $112.20 | 21 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $71.40 | $170.00 | $5.87 – $144.50 | 21 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $35.28 | $84.00 | $3.18 – $71.40 | 21 |
| Glucose blood quantitative CPT 82947 | $36.96 | $88.00 | $0.54 – $6.66 | 21 |
| Glucose body fluid CPT 82945 | $53.34 | $127.00 | $3.80 – $107.95 | 21 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $43.26 | $103.00 | $18.54 – $87.55 | 9 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $261.24 | $622.00 | $12.47 – $528.70 | 21 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $73.92 | $176.00 | $3.79 – $149.60 | 21 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,049.33 | $9,641.26 | $9.65 – $8,195.08 | 15 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $112.56 | $268.00 | $18.00 – $227.80 | 21 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $124.32 | $296.00 | $17.94 – $251.60 | 21 |
| Goniotomy CPT 65820 | not published | not published | $1,568.72 – $1,568.72 | 1 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $6,132.05 | $14,600.10 | $893.54 – $4,219.49 | 13 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $56.66 | $134.90 | $14.76 – $69.70 | 13 |
| Graft axiofill 1000mg HCPCS J3590 | $5,125.68 | $12,204.00 | $153.35 – $724.15 | 8 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $402.78 | $959.00 | $69.30 – $327.25 | 12 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,733.51 – $1,733.51 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $18,248.11 | $43,447.86 | $24.46 – $115.48 | 13 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $887.04 | $2,112.00 | $380.16 – $1,795.20 | 13 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $2,688.53 | $6,401.25 | $123.98 – $585.44 | 12 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $14,821.28 | $35,288.75 | $25.20 – $119.00 | 12 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $2,730.00 | $6,500.00 | $10.80 – $329.31 | 13 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,632.96 | $3,888.00 | $19.44 – $91.80 | 13 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $887.95 – $905.36 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $2,940.00 | $7,000.00 | $32.73 – $154.53 | 13 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $1,271.03 | $3,026.25 | $39.30 – $2,572.32 | 13 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $19,573.37 | $46,603.26 | $708.75 – $3,346.88 | 12 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $3,720.03 | $8,857.20 | $46.13 – $217.82 | 13 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $13,021.26 | $31,003.00 | $5.40 – $25.50 | 12 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $1,529.52 | $3,641.70 | $9.43 – $44.50 | 12 |
| Granisetron hcl injection HCPCS J1626 | $127.52 | $303.60 | $0.25 – $84.58 | 13 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,000.43 – $6,084.83 | 4 |
| Great toe with reduction 28495 CPT 28495 | $412.86 | $983.00 | $176.94 – $835.55 | 8 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $942.44 – $942.44 | 1 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $959.30 – $959.30 | 1 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $272.96 – $272.96 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $898.07 – $898.07 | 1 |
| Group mnt 2 or more 30 mins HCPCS G0271 | $26.46 | $63.00 | $11.34 – $53.55 | 16 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,134.98 – $1,157.24 | 3 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $961.48 – $2,324.22 | 4 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,178.16 – $1,201.26 | 3 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,295.60 – $1,321.01 | 3 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $969.11 – $988.11 | 3 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,285.54 – $1,285.54 | 1 |
| G-tube reposition CPT 43761 | $608.58 | $1,449.00 | $191.14 – $1,161.95 | 9 |
| Gu dilat ureter/urethra s&i CPT 74485 | $699.72 | $1,666.00 | $152.80 – $1,348.95 | 13 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,219.26 | $2,903.00 | $252.97 – $2,467.55 | 9 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $3,910.64 | $9,311.04 | $0.26 – $1.19 | 12 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $7,045.50 | $16,775.00 | $2.61 – $12.32 | 12 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,070.69 | $2,549.25 | $5.94 – $28.05 | 12 |
| Guid loc target vol rad tx CPT 77387 | $678.72 | $1,616.00 | $192.53 – $1,209.55 | 9 |
| Gum graft CPT 41870 | not published | not published | $568.39 – $568.39 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $8,330.28 | $19,834.00 | $0.01 – $0.01 | 12 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $802.18 – $802.18 | 1 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $145.55 – $145.55 | 1 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $471.62 – $471.62 | 1 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $645.39 – $645.39 | 1 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $331.75 | $789.88 | $5.54 – $84.58 | 13 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $119.94 | $285.55 | $0.98 – $84.58 | 13 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,588.61 – $1,588.61 | 1 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $1,302.88 – $1,302.88 | 1 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $1,427.94 – $1,427.94 | 1 |
| Hand X-ray CPT 73130 | $223.02 | $531.00 | $54.43 – $451.35 | 13 |
| Haptoglobin quantitative CPT 83010 | $91.14 | $217.00 | $12.19 – $184.45 | 21 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $161.36 – $161.36 | 1 |
| Harvest auto stem cells CPT 38206 | $1,563.66 | $3,723.00 | $158.19 – $3,164.55 | 9 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $230.81 – $230.81 | 1 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $785.88 – $785.88 | 1 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $599.66 – $599.66 | 1 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $89.42 – $89.42 | 1 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $555.30 – $555.30 | 1 |
| Hast w/i&r phys/qhp CPT 94452 | $161.28 | $384.00 | $68.94 – $326.40 | 9 |
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.