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 |
|---|---|---|---|---|
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $120.54 | $287.00 | $29.15 – $243.95 | 9 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $120.12 | $286.00 | $18.38 – $243.10 | 9 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $148.26 | $353.00 | $63.54 – $300.05 | 9 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $109.62 | $261.00 | $27.30 – $202.30 | 9 |
| Injection treatment of eye CPT 66020 | not published | not published | $250.43 – $250.43 | 1 |
| Injection treatment of eye CPT 66030 | not published | not published | $212.54 – $212.54 | 1 |
| Injection treatment of nerve CPT 64605 | not published | not published | $748.29 – $748.29 | 1 |
| Injection treatment of nerve CPT 64610 | not published | not published | $859.70 – $859.70 | 1 |
| Injection treatment of nerve CPT 64681 | $669.48 | $1,594.00 | $286.92 – $1,354.90 | 9 |
| Injection treatment of nose CPT 30200 | not published | not published | $113.32 – $113.32 | 1 |
| Inject sacroiliac joint CPT 27096 | $578.76 | $1,378.00 | $158.30 – $1,171.30 | 9 |
| Inject/treat eye socket CPT 67500 | not published | not published | $122.96 – $122.96 | 1 |
| Inject/treat eye socket CPT 67505 | not published | not published | $137.26 – $137.26 | 1 |
| Inject/treat eye socket CPT 67515 | not published | not published | $89.40 – $89.40 | 1 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | $33,123.30 | $78,865.00 | $14,195.70 – $67,035.25 | 8 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $640.92 | $1,526.00 | $187.64 – $1,297.10 | 9 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $686.28 | $1,634.00 | $150.49 – $1,273.30 | 9 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $343.35 | $817.50 | $7.50 – $347.44 | 8 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $6,330.79 | $15,073.30 | $17.54 – $12,812.31 | 15 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $210.70 | $501.65 | $90.30 – $426.41 | 8 |
| Inj for ext venography CPT 36005 | $447.30 | $1,065.00 | $86.33 – $751.40 | 9 |
| Inj for mammo ductogram CPT 19030 | $206.64 | $492.00 | $88.56 – $418.20 | 9 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | $172.87 | $411.58 | $74.09 – $349.85 | 8 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $200.93 | $478.40 | $20.91 – $98.73 | 8 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | $21,459.86 | $51,094.90 | $2,299.27 – $10,857.65 | 8 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | $1,397.18 | $3,326.60 | $4.78 – $2,827.61 | 15 |
| Inj., guselkumab, 1 mg HCPCS J1628 | $29,518.89 | $70,283.05 | $121.31 – $58,959.40 | 14 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $459.90 | $1,095.00 | $83.18 – $878.05 | 13 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $459.90 | $1,095.00 | $46.98 – $878.05 | 13 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | $215.59 | $513.30 | $28.89 – $389.81 | 8 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $607.01 | $1,445.24 | $2.14 – $1,228.46 | 15 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | $91,699.86 | $218,333.00 | $410.82 – $185,583.05 | 15 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $271.38 – $271.38 | 1 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $56.55 – $56.55 | 1 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $86.31 – $86.31 | 1 |
| Inj ivig privigen 500 mg HCPCS J1459 | $6,115.20 | $14,560.00 | $41.33 – $1,547.00 | 15 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | $14,308.92 | $34,068.85 | $6,132.40 – $28,958.53 | 8 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $1,337.75 | $3,185.10 | $229.33 – $1,082.95 | 8 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $74.67 | $177.78 | $17.91 – $84.58 | 13 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $161.49 | $384.50 | $58.75 – $277.40 | 8 |
| Inj, levothyroxine, hikma HCPCS J0652 | $108.51 | $258.35 | $46.51 – $219.60 | 8 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $393.92 | $937.90 | $61.74 – $310.73 | 15 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $41.79 | $99.50 | $2.87 – $84.58 | 13 |
| Inj, meropenem (b. braun) HCPCS J2184 | $86.84 | $206.75 | $37.22 – $175.74 | 8 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $373.55 | $889.39 | $2.23 – $755.99 | 10 |
| Inj, micafungin (par pharm) HCPCS J2247 | $46.10 | $109.75 | $17.91 – $84.58 | 8 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | $20,145.77 | $47,966.10 | $8,633.90 – $40,771.19 | 8 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $86.84 | $206.75 | $7.46 – $175.74 | 13 |
| Inj multihance HCPCS A9577 | $64.31 | $153.10 | $1.55 – $9.35 | 9 |
| Inj. mycophenolate mofetil HCPCS J7519 | $140.05 | $333.44 | $17.91 – $84.58 | 8 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $622.44 | $1,482.00 | $124.17 – $1,259.70 | 9 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $413.66 | $984.90 | $177.29 – $837.17 | 8 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $3,781.68 | $9,004.00 | $272.85 – $7,653.40 | 9 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,288.98 | $3,069.00 | $214.10 – $2,608.65 | 9 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | $86,692.03 | $206,409.59 | $37,153.73 – $175,448.16 | 8 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | $133.14 | $317.00 | $35.48 – $269.45 | 13 |
| Inj ogivri 10 mg HCPCS Q5114 | $3,133.75 | $7,461.30 | $47.36 – $2,265.04 | 15 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $19,950.00 | $47,500.00 | $84.35 – $40,375.00 | 15 |
| Inj, pedmark, 100 mg HCPCS J0208 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $6,269.68 | $14,927.80 | $25.52 – $12,688.63 | 15 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | $7,696.59 | $18,325.20 | $44.95 – $15,576.42 | 15 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | $95.26 | $226.80 | $40.83 – $192.78 | 8 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | $1,347.51 | $3,208.34 | $577.51 – $2,727.09 | 8 |
| Inj peritoneal venous shunt CPT 49427 | $413.70 | $985.00 | $72.32 – $837.25 | 9 |
| Inj proc ankle arthr CPT 27648 | $100.38 | $239.00 | $43.02 – $203.15 | 9 |
| Inj proc elbow arthro CPT 24220 | $176.82 | $421.00 | $75.78 – $357.85 | 9 |
| Inj proc for lymphang CPT 38790 | $129.36 | $308.00 | $55.44 – $261.80 | 8 |
| Inj proc lumbr disk ea lvl CPT 62290 | $485.10 | $1,155.00 | $207.90 – $981.75 | 9 |
| Inj proc myelogram lumbar CPT 62284 | $721.56 | $1,718.00 | $156.74 – $1,460.30 | 9 |
| Inj proc sialogram CPT 42550 | $196.14 | $467.00 | $84.06 – $396.95 | 9 |
| Inj progesterone per 50 mg HCPCS J2675 | $41.79 | $99.50 | $0.62 – $84.58 | 13 |
| Inj, releuko 1 mcg HCPCS Q5125 | $299.72 | $713.60 | $80.28 – $379.10 | 8 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $738.09 | $1,757.35 | $0.58 – $84.58 | 15 |
| Inj retro urethrocysto CPT 51610 | $338.52 | $806.00 | $121.38 – $685.10 | 9 |
| Inj scleros sol mult veins CPT 36471 | $144.06 | $343.00 | $61.74 – $291.55 | 9 |
| Inj scleros sol sgl vein CPT 36470 | $146.58 | $349.00 | $51.12 – $241.40 | 9 |
| Inj secretin synthetic human HCPCS J2850 | $1,388.10 | $3,305.00 | $29.53 – $2,809.25 | 11 |
| Inj secukinumab intrav 1mg HCPCS J3247 | $4,485.92 | $10,680.75 | $1,922.54 – $9,078.64 | 8 |
| Inj, spesolimab-sbzo, 1 mg HCPCS J1747 | $53,689.66 | $127,832.52 | $23,009.86 – $108,657.65 | 8 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | $255.36 | $608.00 | $109.44 – $516.80 | 9 |
| Inj teplizumab mzwv 5 mcg HCPCS J9381 | $22,745.80 | $54,156.65 | $9,262.20 – $43,738.16 | 8 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $32,490.36 | $77,358.00 | $285.40 – $65,754.30 | 15 |
| Inj testosterone cypionate HCPCS J1071 | $73.17 | $174.20 | $0.02 – $84.58 | 13 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | $27,967.38 | $66,589.00 | $113.39 – $56,600.65 | 15 |
| Inj, tofidence, 1 mg HCPCS Q5133 | $4,662.00 | $11,100.00 | $399.60 – $1,887.00 | 8 |
| Inj triamcinolone ace X-ray 1mg HCPCS J3304 | $1,256.85 | $2,992.50 | $15.14 – $2,543.63 | 15 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $3,768.24 | $8,972.00 | $323.03 – $1,525.41 | 8 |
| Inj, uzedy, 1 mg HCPCS J2799 | $11,729.37 | $27,927.05 | $1,005.29 – $4,747.18 | 8 |
| Inj, vancomycin hcl (xellia) HCPCS J3372 | $86.84 | $206.75 | $37.22 – $175.74 | 8 |
| Inj vasopressin (am reg) 1 u HCPCS J2599 | $41.79 | $99.50 | $17.91 – $84.58 | 8 |
| Inj w/fluor eval cv device CPT 36598 | $282.24 | $672.00 | $66.84 – $571.20 | 9 |
| Inner skull vessel surgery CPT 61702 | not published | not published | $3,053.82 – $3,113.70 | 3 |
| Ins cath ren art 1st bi CPT 36252 | $3,207.96 | $7,638.00 | $633.34 – $6,492.30 | 9 |
| Ins cath ren art 1st uni CPT 36251 | $1,899.66 | $4,523.00 | $460.72 – $3,844.55 | 9 |
| Ins cath ren art 2nd+ bi CPT 36254 | $4,164.72 | $9,916.00 | $739.35 – $8,428.60 | 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.