Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm cost in Nebraska
GRAFT SFT TISS GRAFIX AMNIO PRIME 3X4CM 12SQCM-Q4133-COST PER SQ CM · HCPCS Q4133
$2,940.00
lowest in Nebraska
$3,220.00
state median
$5,950.00
highest in Nebraska
$1,132.47
national median
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| CHI Health Creighton University Medical Center - Bergan Mercy | Omaha | $2,940.00 | $30.91 – $154.53 | 13 |
| Lasting Hope Recovery Center | Omaha | $2,940.00 | $30.91 – $154.53 | 12 |
| CHI Health Immanuel | Omaha | $2,940.00 | $25.46 – $154.53 | 13 |
| CHI Health Lakeside | Omaha | $2,940.00 | $29.09 – $154.53 | 13 |
| CHI Health Midlands | Papillion | $2,940.00 | $32.73 – $154.53 | 13 |
| CHI Health Nebraska Heart | Lincoln | $3,220.00 | $144.33 – $1,713.80 | 11 |
| CHI Health St. Elizabeth | Lincoln | $3,500.00 | $60.14 – $209.16 | 11 |
| CHI Health St. Francis | Grand Island | $4,130.00 | $60.14 – $245.77 | 12 |
| CHI Health Good Samaritan | Kearney | $4,270.00 | $110.25 – $488.25 | 12 |
| CHI Health St. Mary's | Nebraska City | $5,810.00 | $447.68 – $2,006.40 | 16 |
| CHI Health Plainview | Plainview | $5,880.00 | $976.31 – $2,167.40 | 19 |
| CHI Health Schuyler | Schuyler | $5,950.00 | $342.83 – $1,812.09 | 18 |