Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm cost in Nebraska
GRAFT SFT TISS THERASKIN LG 5.1X7.6CM MESHED 39 SQ CM-Q4121-COST PER SQ CM · HCPCS Q4121
$1,271.03
lowest in Nebraska
$1,392.08
state median
$2,572.32
highest in Nebraska
$427.89
national median
| Hospital | City | Cash price | Negotiated range | Payers |
|---|---|---|---|---|
| CHI Health Creighton University Medical Center - Bergan Mercy | Omaha | $1,271.03 | $39.30 – $2,572.32 | 13 |
| Lasting Hope Recovery Center | Omaha | $1,271.03 | $49.78 – $2,572.32 | 12 |
| CHI Health Immanuel | Omaha | $1,271.03 | $39.30 – $2,572.32 | 13 |
| CHI Health Lakeside | Omaha | $1,271.03 | $39.30 – $2,572.32 | 13 |
| CHI Health Midlands | Papillion | $1,271.03 | $39.30 – $2,572.32 | 13 |
| CHI Health Nebraska Heart | Lincoln | $1,392.08 | $47.16 – $2,481.53 | 11 |
| CHI Health St. Elizabeth | Lincoln | $1,513.13 | $47.16 – $2,421.00 | 11 |
| CHI Health St. Francis | Grand Island | $1,785.49 | $47.16 – $2,844.68 | 12 |
| CHI Health Good Samaritan | Kearney | $1,846.02 | $39.30 – $2,814.42 | 12 |
| CHI Health St. Mary's | Nebraska City | $2,511.79 | $648.23 – $2,905.20 | 16 |
| CHI Health Plainview | Plainview | $2,542.05 | $1,846.02 – $4,098.15 | 19 |
| CHI Health Schuyler | Schuyler | $2,572.32 | $648.23 – $3,426.33 | 18 |