Hospital

Nemaha County Hospital

Nemaha County Hospital in Auburn, NE publishes cash prices for 255 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Nebraska median for 223 of 254 procedures and below it for 31. By typical cash price it ranks #41 of 53 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

2022 13th Street, Auburn, Ne 68305 Collected Sep 29, 2026 Source price file (402) 274-4366

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281324 · CMS hospital register NPI 1891736237

The price file shows no self-pay discount

For 716 of the 716 prices listed here, the cash price in Nemaha County Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Nemaha County Hospital in Auburn, NE:

Apr 30, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE 3VW-R	$375.00	$375.00	$202.50–$360.00	14% above	—
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE 3VW-L	$375.00	$375.00	$202.50–$360.00	14% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE 3VW-L	$375.00	$375.00	$202.50–$360.00	—	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE 3VW-R	$375.00	$375.00	$202.50–$360.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE/ARM INDEX	$587.00	$587.00	$316.98–$563.52	24% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ARTERIAL GRAFT SCAN/ABI	$587.00	$587.00	$316.98–$563.52	24% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE/ARM INDEX	$587.00	$587.00	$316.98–$563.52	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ARTERIAL GRAFT SCAN/ABI	$587.00	$587.00	$316.98–$563.52	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$740.00	$740.00	$399.60–$710.40	20% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS	$740.00	$740.00	$399.60–$710.40	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE TOTAL	$1,993.00	$1,993.00	$1,076.22–$1,913.28	15% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE TOTAL	$1,993.00	$1,993.00	$1,076.22–$1,913.28	—	—
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE UNILATERAL	$623.00	$623.00	$336.42–$598.08	28% above	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE UNILATERAL	$623.00	$623.00	$336.42–$598.08	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED UNILATERAL	$462.00	$462.00	$249.48–$443.52	20% above	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED UNILATERAL	$462.00	$462.00	$249.48–$443.52	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CTA CHEST W/ & W/O CONT	$3,736.00	$3,736.00	$2,017.44–$3,586.56	13% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CTA CHEST W/ CONTRA	$3,736.00	$3,736.00	$2,017.44–$3,586.56	13% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CTA CHEST W/ CONTRA	$3,736.00	$3,736.00	$2,017.44–$3,586.56	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CTA CHEST W/ & W/O CONT	$3,736.00	$3,736.00	$2,017.44–$3,586.56	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING	$150.00	$150.00	$81.00–$144.00	11% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING	$150.00	$150.00	$81.00–$144.00	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O CONT	$4,200.00	$4,200.00	$2,268.00–$4,032.00	22% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS W/O CONT	$4,200.00	$4,200.00	$2,268.00–$4,032.00	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W CONT	$5,129.00	$5,129.00	$2,769.66–$4,923.84	24% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W CONT	$5,129.00	$5,129.00	$2,769.66–$4,923.84	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W&W/O CONT	$5,917.00	$5,917.00	$3,195.18–$5,680.32	19% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W&W/O CONT	$5,917.00	$5,917.00	$3,195.18–$5,680.32	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONT	$2,853.00	$2,853.00	$1,540.62–$2,738.88	10% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONT	$2,853.00	$2,853.00	$1,540.62–$2,738.88	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$2,697.00	$2,697.00	$1,456.38–$2,589.12	22% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONT	$2,697.00	$2,697.00	$1,456.38–$2,589.12	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILOFACE W/O C	$2,062.00	$2,062.00	$1,113.48–$1,979.52	13% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT LIMITED SINUS	$2,062.00	$2,062.00	$1,113.48–$1,979.52	13% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILOFACE W/O C	$2,062.00	$2,062.00	$1,113.48–$1,979.52	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT LIMITED SINUS	$2,062.00	$2,062.00	$1,113.48–$1,979.52	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONT	$2,244.00	$2,244.00	$1,211.76–$2,154.24	17% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONT	$2,244.00	$2,244.00	$1,211.76–$2,154.24	—	—
CT scan of the head with contrast CPT 70460 CT HEAD W/ CONT	$2,544.00	$2,544.00	$1,373.76–$2,442.24	21% above	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ CONT	$2,544.00	$2,544.00	$1,373.76–$2,442.24	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD W&W/O CONT	$2,933.00	$2,933.00	$1,583.82–$2,815.68	17% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W&W/O CONT	$2,933.00	$2,933.00	$1,583.82–$2,815.68	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/O CONT	$2,700.00	$2,700.00	$1,458.00–$2,592.00	21% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/O CONT	$2,700.00	$2,700.00	$1,458.00–$2,592.00	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE LS BENDING 2-3 VIEWS	$2,670.00	$2,670.00	$1,441.80–$2,563.20	16% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE W/O CONT	$2,670.00	$2,670.00	$1,441.80–$2,563.20	16% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C SPINE W/O CONT	$2,670.00	$2,670.00	$1,441.80–$2,563.20	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE LS BENDING 2-3 VIEWS	$2,670.00	$2,670.00	$1,441.80–$2,563.20	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CONTR	$2,956.00	$2,956.00	$1,596.24–$2,837.76	19% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTR	$2,956.00	$2,956.00	$1,596.24–$2,837.76	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DOP-BIL	$1,596.00	$1,596.00	$861.84–$1,532.16	1% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DOP-BIL	$1,596.00	$1,596.00	$861.84–$1,532.16	—	—
Chest X-ray, 2 views CPT 71046 XR CHEST (2VIEW)	$395.00	$395.00	$213.30–$379.20	37% above	—
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST (2VIEW)	$395.00	$395.00	$213.30–$379.20	—	—
Chest X-ray, single view CPT 71045 XR CHEST (1VIEW)	$317.00	$317.00	$171.18–$304.32	32% above	—
Chest X-ray, single view inpatient CPT 71045 XR CHEST (1VIEW)	$317.00	$317.00	$171.18–$304.32	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$890.00	$890.00	$480.60–$854.40	12% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$890.00	$890.00	$480.60–$854.40	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEX BONE DENSITY AX	$534.00	$534.00	$288.36–$512.64	31% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEX BONE DENSITY AX	$534.00	$534.00	$288.36–$512.64	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT LIMITED CHEST W/O	$2,545.00	$2,545.00	$1,374.30–$2,443.20	17% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONT	$2,545.00	$2,545.00	$1,374.30–$2,443.20	17% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT LIMITED CHEST W/O	$2,545.00	$2,545.00	$1,374.30–$2,443.20	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONT	$2,545.00	$2,545.00	$1,374.30–$2,443.20	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRA	$2,817.00	$2,817.00	$1,521.18–$2,704.32	12% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRA	$2,817.00	$2,817.00	$1,521.18–$2,704.32	—	—
Diagnostic mammogram, both breasts CPT 77066 MM BIL-DIAGNOSTIC(W/CAD)	$466.00	$466.00	$251.64–$447.36	1% above	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MM BIL-DIAGNOSTIC(W/CAD)	$466.00	$466.00	$251.64–$447.36	—	—
Diagnostic mammogram, one breast CPT 77065 MM UNI-DIAGNOSTIC(W/CAD)	$415.00	$415.00	$224.10–$398.40	31% above	—
Diagnostic mammogram, one breast inpatient CPT 77065 MM UNI-DIAGNOSTIC(W/CAD)	$415.00	$415.00	$224.10–$398.40	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ARTERIAL DOP-LO BI	$1,304.00	$1,304.00	$704.16–$1,251.84	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ARTERIAL DOP-LO BI	$1,304.00	$1,304.00	$704.16–$1,251.84	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DOP-BIL	$1,533.00	$1,533.00	$827.82–$1,471.68	6% above	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DOP-BIL	$1,533.00	$1,533.00	$827.82–$1,471.68	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W/ COLOR DOPPLER	$2,574.00	$2,574.00	$1,389.96–$2,471.04	19% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W/ COLOR DOPPLER	$2,574.00	$2,574.00	$1,389.96–$2,471.04	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY IMAGING W/O GBEF	$2,157.00	$2,157.00	$1,164.78–$2,070.72	41% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY IMAGING W/O GBEF	$2,157.00	$2,157.00	$1,164.78–$2,070.72	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RT HOME SLEEP STUDY	$572.00	$572.00	$308.88–$549.12	18% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RT SLEEP STUDY/SPLIT N	$4,820.00	$4,820.00	$2,602.80–$4,627.20	23% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RT SLEEP STUDY/SPLIT N	$4,820.00	$4,820.00	$2,602.80–$4,627.20	—	—
Knee X-ray, 3 views both sides CPT 73562 XR KNEE 3VW BI	$685.00	$685.00	$369.90–$657.60	—	—
Knee X-ray, 3 views CPT 73562 XR KNEE 3VW R	$403.00	$403.00	$217.62–$386.88	7% above	—
Knee X-ray, 3 views CPT 73562 XR KNEE 3VW L	$403.00	$403.00	$217.62–$386.88	7% above	—
Knee X-ray, 3 views inpatient both sides CPT 73562 XR KNEE 3VW BI	$685.00	$685.00	$369.90–$657.60	—	—
Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3VW R	$403.00	$403.00	$217.62–$386.88	—	—
Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3VW L	$403.00	$403.00	$217.62–$386.88	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMIT	$757.00	$757.00	$408.78–$726.72	35% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMIT	$757.00	$757.00	$408.78–$726.72	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CANCER SCREENING	$500.00	$500.00	$270.00–$480.00	19% below	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG CANCER SCREENING	$500.00	$500.00	$270.00–$480.00	—	—
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR LO EXT JNT-BI WO	$2,990.00	$2,990.00	$1,614.60–$2,870.40	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LO EXT JNT W/O-R	$2,788.00	$2,788.00	$1,505.52–$2,676.48	8% above	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LO EXT JNT W/O-L	$2,788.00	$2,788.00	$1,505.52–$2,676.48	8% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR LO EXT JNT-BI WO	$2,990.00	$2,990.00	$1,614.60–$2,870.40	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LO EXT JNT W/O-R	$2,788.00	$2,788.00	$1,505.52–$2,676.48	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LO EXT JNT W/O-L	$2,788.00	$2,788.00	$1,505.52–$2,676.48	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LO EXT JNT-R W&W/O CONT	$3,745.00	$3,745.00	$2,022.30–$3,595.20	11% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LO EXT JNT-L W&W/O CONT	$3,745.00	$3,745.00	$2,022.30–$3,595.20	11% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LO EXT JNT-R W&W/O CONT	$3,745.00	$3,745.00	$2,022.30–$3,595.20	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LO EXT JNT-L W&W/O CONT	$3,745.00	$3,745.00	$2,022.30–$3,595.20	—	—
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN W/O CONTRAST	$3,648.00	$3,648.00	$1,969.92–$3,502.08	21% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN W/O CONTRAST	$3,648.00	$3,648.00	$1,969.92–$3,502.08	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W&WO CONTRAST	$4,633.00	$4,633.00	$2,501.82–$4,447.68	21% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W&WO CONTRAST	$4,633.00	$4,633.00	$2,501.82–$4,447.68	—	—
MRI of the brain, no contrast dye CPT 70551 MR BRAIN W/O CONT	$3,852.00	$3,852.00	$2,080.08–$3,697.92	17% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN W/O CONT	$3,852.00	$3,852.00	$2,080.08–$3,697.92	—	—
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W&W/O CONT	$4,379.00	$4,379.00	$2,364.66–$4,203.84	11% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W&W/O CONT	$4,379.00	$4,379.00	$2,364.66–$4,203.84	—	—
MRI of the lower back, no contrast dye CPT 72148 MR L SPINE W/O CONT	$3,686.00	$3,686.00	$1,990.44–$3,538.56	15% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPINE W/O CONT	$3,686.00	$3,686.00	$1,990.44–$3,538.56	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPINE W&W/O CON	$4,597.00	$4,597.00	$2,482.38–$4,413.12	17% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L SPINE W&W/O CON	$4,597.00	$4,597.00	$2,482.38–$4,413.12	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPINE W/O CONT	$3,836.00	$3,836.00	$2,071.44–$3,682.56	13% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T SPINE W/O CONT	$3,836.00	$3,836.00	$2,071.44–$3,682.56	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPINE W&W/O CON	$4,694.00	$4,694.00	$2,534.76–$4,506.24	18% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C SPINE W&W/O CON	$4,694.00	$4,694.00	$2,534.76–$4,506.24	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPINE W/O CONT	$3,724.00	$3,724.00	$2,010.96–$3,575.04	12% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C SPINE W/O CONT	$3,724.00	$3,724.00	$2,010.96–$3,575.04	—	—
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W/WO CONTRAST	$4,348.00	$4,348.00	$2,347.92–$4,174.08	21% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W/WO CONTRAST	$4,348.00	$4,348.00	$2,347.92–$4,174.08	—	—
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O	$3,350.00	$3,350.00	$1,809.00–$3,216.00	14% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O	$3,350.00	$3,350.00	$1,809.00–$3,216.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR UP EXT JNT-BI	$4,699.00	$4,699.00	$2,537.46–$4,511.04	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT JNT-L	$2,764.00	$2,764.00	$1,492.56–$2,653.44	11% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT JNT-R	$2,764.00	$2,764.00	$1,492.56–$2,653.44	11% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR UP EXT JNT-BI	$4,699.00	$4,699.00	$2,537.46–$4,511.04	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT JNT-R	$2,764.00	$2,764.00	$1,492.56–$2,653.44	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT JNT-L	$2,764.00	$2,764.00	$1,492.56–$2,653.44	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NMMYOPERFMULTI	$4,874.00	$4,874.00	$2,631.96–$4,679.04	15% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NMMYOPERFMULTI	$4,874.00	$4,874.00	$2,631.96–$4,679.04	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 CT PET/CT SKULL BASE-MID THIGH SUBSEQUEN	$7,076.00	$7,076.00	$3,821.04–$6,792.96	31% above	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 CT PET/CT SKULL BASE-MID THIGH INITIAL	$7,076.00	$7,076.00	$3,821.04–$6,792.96	31% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 CT PET/CT SKULL BASE-MID THIGH INITIAL	$7,076.00	$7,076.00	$3,821.04–$6,792.96	—	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 CT PET/CT SKULL BASE-MID THIGH SUBSEQUEN	$7,076.00	$7,076.00	$3,821.04–$6,792.96	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$558.00	$558.00	$301.32–$535.68	37% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$558.00	$558.00	$301.32–$535.68	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONPREG	$861.00	$861.00	$464.94–$826.56	9% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONPREG	$861.00	$861.00	$464.94–$826.56	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PELVIS COM OB > 14WKS	$893.00	$893.00	$482.22–$857.28	28% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PELVIS COM OB > 14WKS	$893.00	$893.00	$482.22–$857.28	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 US PREG UTERUS RT W/IMAGE 1ST TRIMESTER	$773.00	$773.00	$417.42–$742.08	25% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 US PREG UTERUS RT W/IMAGE 1ST TRIMESTER	$773.00	$773.00	$417.42–$742.08	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PELVIS LIM OB	$503.00	$503.00	$271.62–$482.88	28% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PELVIS LIM OB	$503.00	$503.00	$271.62–$482.88	—	—
Screening mammogram, both breasts CPT 77067 MM BIL-SCREEN(W/CAD)	$423.00	$423.00	$228.42–$406.08	65% above	—
Screening mammogram, both breasts CPT 77067 MM UNI-SCREEN(W/CAD)	$423.00	$423.00	$228.42–$406.08	65% above	—
Screening mammogram, both breasts inpatient CPT 77067 MM BIL-SCREEN(W/CAD)	$423.00	$423.00	$228.42–$406.08	—	—
Screening mammogram, both breasts inpatient CPT 77067 MM UNI-SCREEN(W/CAD)	$423.00	$423.00	$228.42–$406.08	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-L	$387.00	$387.00	$208.98–$371.52	13% above	—
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-R	$387.00	$387.00	$208.98–$371.52	13% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-R	$387.00	$387.00	$208.98–$371.52	—	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-L	$387.00	$387.00	$208.98–$371.52	—	—
Sleep study in a lab (polysomnography) CPT 95810 RT FULL SLEEP STUDY	$4,564.00	$4,564.00	$2,464.56–$4,381.44	23% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 RT FULL SLEEP STUDY	$4,564.00	$4,564.00	$2,464.56–$4,381.44	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$733.00	$733.00	$395.82–$703.68	16% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$733.00	$733.00	$395.82–$703.68	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS REALTIME TRANSVAG	$681.00	$681.00	$367.74–$653.76	34% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS REALTIME TRANSVAG	$681.00	$681.00	$367.74–$653.76	—	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN	$984.00	$984.00	$531.36–$944.64	17% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN	$984.00	$984.00	$531.36–$944.64	—	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/CONTENT	$752.00	$752.00	$406.08–$721.92	15% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/CONTENT	$752.00	$752.00	$406.08–$721.92	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISS OF HD&NK	$680.00	$680.00	$367.20–$652.80	14% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISS OF HD&NK	$680.00	$680.00	$367.20–$652.80	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS MAPPING	$1,233.00	$1,233.00	$665.82–$1,183.68	19% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DOP-LTD	$1,233.00	$1,233.00	$665.82–$1,183.68	19% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DOP-LTD	$1,233.00	$1,233.00	$665.82–$1,183.68	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS MAPPING	$1,233.00	$1,233.00	$665.82–$1,183.68	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST 3VW-R	$352.00	$352.00	$190.08–$337.92	7% above	—
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST 3 VW-L	$352.00	$352.00	$190.08–$337.92	7% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST 3 VW-L	$352.00	$352.00	$190.08–$337.92	—	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST 3VW-R	$352.00	$352.00	$190.08–$337.92	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI 2-3 VW LT WITH PELVIS IF REQU	$375.00	$375.00	$202.50–$360.00	28% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI2-3VW RT WITH PELVIS IF REQUES	$375.00	$375.00	$202.50–$360.00	28% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNI 2-3 VW LT WITH PELVIS IF REQU	$375.00	$375.00	$202.50–$360.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNI2-3VW RT WITH PELVIS IF REQUES	$375.00	$375.00	$202.50–$360.00	—	—
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$340.00	$340.00	$183.60–$326.40	24% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$340.00	$340.00	$183.60–$326.40	—	—
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 1VW-R	$301.00	$301.00	$162.54–$288.96	17% above	—
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 1VW-L	$301.00	$301.00	$162.54–$288.96	17% above	—
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2VW-R	$301.00	$301.00	$162.54–$288.96	17% above	—
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2VW-L	$301.00	$301.00	$162.54–$288.96	17% above	—
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 1VW-R	$301.00	$301.00	$162.54–$288.96	—	—
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2VW-L	$301.00	$301.00	$162.54–$288.96	—	—
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 1VW-L	$301.00	$301.00	$162.54–$288.96	—	—
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2VW-R	$301.00	$301.00	$162.54–$288.96	—	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S)MIN 2 VIEWS RT	$261.00	$261.00	$140.94–$250.56	13% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S)MIN 2 VIEWS LT	$261.00	$261.00	$140.94–$250.56	13% above	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S)MIN 2 VIEWS LT	$261.00	$261.00	$140.94–$250.56	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S)MIN 2 VIEWS RT	$261.00	$261.00	$140.94–$250.56	—	—
X-ray of the foot, 2 views CPT 73620 XR FOOT 2VW-L	$286.00	$286.00	$154.44–$274.56	31% above	—
X-ray of the foot, 2 views CPT 73620 XR FOOT 2VW-R	$286.00	$286.00	$154.44–$274.56	31% above	—
X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2VW-L	$286.00	$286.00	$154.44–$274.56	—	—
X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2VW-R	$286.00	$286.00	$154.44–$274.56	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT 3VW-R	$381.00	$381.00	$205.74–$365.76	17% above	—
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT 3 VW-L	$381.00	$381.00	$205.74–$365.76	17% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT 3VW-R	$381.00	$381.00	$205.74–$365.76	—	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT 3 VW-L	$381.00	$381.00	$205.74–$365.76	—	—
X-ray of the hand, 3 or more views CPT 73130 XR HAND 3 VW-L	$367.00	$367.00	$198.18–$352.32	7% above	—
X-ray of the hand, 3 or more views CPT 73130 XR HAND 3VW-R	$367.00	$367.00	$198.18–$352.32	7% above	—
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND 3VW-R	$367.00	$367.00	$198.18–$352.32	—	—
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND 3 VW-L	$367.00	$367.00	$198.18–$352.32	—	—
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE 1 OR 2VW-BI	$602.00	$602.00	$325.08–$577.92	—	—
X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 1 OR 2VW-L	$354.00	$354.00	$191.16–$339.84	10% above	—
X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE 1 OR 2VW-R	$354.00	$354.00	$191.16–$339.84	10% above	—
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE 1 OR 2VW-BI	$602.00	$602.00	$325.08–$577.92	—	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 1 OR 2VW-R	$354.00	$354.00	$191.16–$339.84	—	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 1 OR 2VW-L	$354.00	$354.00	$191.16–$339.84	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LS AP/LAT 2-3 VW	$504.00	$504.00	$272.16–$483.84	19% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LS AP/LAT 2-3 VW	$504.00	$504.00	$272.16–$483.84	—	—
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LS MIN 4 VIEWS	$611.00	$611.00	$329.94–$586.56	25% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LS MIN 4 VIEWS	$611.00	$611.00	$329.94–$586.56	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE T / 2 VIEW	$415.00	$415.00	$224.10–$398.40	35% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE T / 2 VIEW	$415.00	$415.00	$224.10–$398.40	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLET	$371.00	$371.00	$200.34–$356.16	27% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLET	$371.00	$371.00	$200.34–$356.16	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 3 VIEWS OR LESS	$406.00	$406.00	$219.24–$389.76	27% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 3 VIEWS OR LESS	$406.00	$406.00	$219.24–$389.76	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP	$373.00	$373.00	$201.42–$358.08	32% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP	$373.00	$373.00	$201.42–$358.08	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM-COCCYX 2VIEW	$363.00	$363.00	$196.02–$348.48	28% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM-COCCYX 2VIEW	$363.00	$363.00	$196.02–$348.48	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT/ALT	$82.00	$82.00	$44.28–$78.72	35% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT/ALT	$82.00	$82.00	$44.28–$78.72	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT/AST	$81.00	$81.00	$43.74–$77.76	42% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT/AST	$81.00	$81.00	$43.74–$77.76	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE #794	$379.00	$379.00	$204.66–$363.84	19% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE #794	$379.00	$379.00	$204.66–$363.84	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WHEAT IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER, ImmunCAP #1459	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~MILK (COW) IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~EGG WHITE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~SCALLOP IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WEED, SHEEP SORREL IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WEED, NETTLE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~ANIMAL, DOG DANDER IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, WHITE MULBERTY TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~FUNGI/MOLD M. RACEMOSUS IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~ANIMAL, MOUSE EPITHELIUM IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~INSECT, COCROACH GERMAN IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WEED, COMMON/SHORT RAGWEED IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~FUNGI/MOLD P. NOTATUM IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, WHITE ASH TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~GRASS, BERMUDA GRASS IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~MITES, D FARINAE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~MITES, D PTERONYSSINUS IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~FUNGI/MOLD A. FUNIGATUS IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, OAK TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~FUNGI/MOLD, A. ALTERNATA IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~FUNGI/MOLD, HORMODENDRUM IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~GRASS, TIMOTHY GRASS IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WEED, RUSSIAN THISTLE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, COTTONWOOD TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE MOUNTAIN CEDAR TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~ANIMAL, CAT DANDER IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, BOX ELDER/MAPLE TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~TREE, ELM TREE IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~CLAIM IG	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~WALNUT (JUGLANS SPP) IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~CORN IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~PEANUT IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~CODFISH IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~SHRIMP IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ~SOYBEAN IGE	$51.00	$51.00	$27.54–$48.96	1% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~MITES, D PTERONYSSINUS IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~EGG WHITE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~GRASS, TIMOTHY GRASS IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WEED, SHEEP SORREL IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~CORN IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WEED, NETTLE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WEED, RUSSIAN THISTLE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~ANIMAL, DOG DANDER IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WHEAT IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, WHITE MULBERTY TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, COTTONWOOD TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~FUNGI/MOLD M. RACEMOSUS IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~ANIMAL, MOUSE EPITHELIUM IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE MOUNTAIN CEDAR TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~INSECT, COCROACH GERMAN IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~SCALLOP IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, OAK TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WEED, COMMON/SHORT RAGWEED IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~CLAIM IG	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~FUNGI/MOLD A. FUNIGATUS IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~ANIMAL, CAT DANDER IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~FUNGI/MOLD P. NOTATUM IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, WHITE ASH TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, BOX ELDER/MAPLE TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~GRASS, BERMUDA GRASS IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~SHRIMP IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~MITES, D FARINAE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~TREE, ELM TREE IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~CODFISH IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~WALNUT (JUGLANS SPP) IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER, ImmunCAP #1459	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~FUNGI/MOLD, HORMODENDRUM IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~FUNGI/MOLD, A. ALTERNATA IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~SOYBEAN IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~MILK (COW) IGE	$51.00	$51.00	$27.54–$48.96	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ~PEANUT IGE	$51.00	$51.00	$27.54–$48.96	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE IgG #9290	$185.00	$185.00	$99.90–$177.60	63% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE IgG #9290	$185.00	$185.00	$99.90–$177.60	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, IGG BY ELISA WITH REFLEX #10004	$142.00	$142.00	$76.68–$136.32	73% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, IgG SCREEN (w/REFLEX IFA TITER)	$142.00	$142.00	$76.68–$136.32	73% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY #556	$142.00	$142.00	$76.68–$136.32	73% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY #556	$142.00	$142.00	$76.68–$136.32	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA, IGG BY ELISA WITH REFLEX #10004	$142.00	$142.00	$76.68–$136.32	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA, IgG SCREEN (w/REFLEX IFA TITER)	$142.00	$142.00	$76.68–$136.32	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP2 (NCH)	$307.00	$307.00	$165.78–$294.72	38% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP (NT-PROBNP)#9330	$307.00	$307.00	$165.78–$294.72	38% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP2 (NCH)	$307.00	$307.00	$165.78–$294.72	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO-BNP (NT-PROBNP)#9330	$307.00	$307.00	$165.78–$294.72	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$157.00	$157.00	$84.78–$150.72	10% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$157.00	$157.00	$84.78–$150.72	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 ~CYTOPATH CELL BLOCK	$409.00	$409.00	$220.86–$392.64	107% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 ~SURGICAL PATH IV TECH 88305 (#3101)	$409.00	$409.00	$220.86–$392.64	107% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 ~CYTOPATH CELL BLOCK	$409.00	$409.00	$220.86–$392.64	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 ~SURGICAL PATH IV TECH 88305 (#3101)	$409.00	$409.00	$220.86–$392.64	—	—
Blood culture for bacteria CPT 87040 BLOOD CULT NCH #2	$292.00	$292.00	$157.68–$280.32	62% above	—
Blood culture for bacteria CPT 87040 BLOOD CULT NCH #1	$292.00	$292.00	$157.68–$280.32	62% above	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULT NCH #1	$292.00	$292.00	$157.68–$280.32	—	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULT NCH #2	$292.00	$292.00	$157.68–$280.32	—	—
Blood glucose (sugar) test CPT 82947 GLUCOSE	$69.00	$69.00	$37.26–$66.24	31% above	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$69.00	$69.00	$37.26–$66.24	—	—
Blood lead test CPT 83655 LEAD, WHOLE BLOOD #2816	$90.00	$90.00	$48.60–$86.40	39% above	—
Blood lead test inpatient CPT 83655 LEAD, WHOLE BLOOD #2816	$90.00	$90.00	$48.60–$86.40	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL SERUM	$142.00	$142.00	$76.68–$136.32	16% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL SERUM	$142.00	$142.00	$76.68–$136.32	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ~ARC BLOOD TYPE-ABO	$80.00	$80.00	$43.20–$76.80	36% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 NCH BLOOD TYPE-ABO	$80.00	$80.00	$43.20–$76.80	36% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 NCH BLOOD TYPE-ABO	$80.00	$80.00	$43.20–$76.80	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ~ARC BLOOD TYPE-ABO	$80.00	$80.00	$43.20–$76.80	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (NCH)	$120.00	$120.00	$64.80–$115.20	17% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (NCH)	$120.00	$120.00	$64.80–$115.20	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE DNA #8187 (CONFIRMATION)	$234.00	$234.00	$126.36–$224.64	36% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 STOOL - CLOS DIF AG & TOXIN	$234.00	$234.00	$126.36–$224.64	36% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 STOOL - CLOS DIF AG & TOXIN	$234.00	$234.00	$126.36–$224.64	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE DNA #8187 (CONFIRMATION)	$234.00	$234.00	$126.36–$224.64	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 #512	$245.00	$245.00	$132.30–$235.20	36% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 #512	$245.00	$245.00	$132.30–$235.20	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 #1820	$231.00	$231.00	$124.74–$221.76	57% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 #1820	$231.00	$231.00	$124.74–$221.76	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 (NCH)	$189.00	$189.00	$102.06–$181.44	43% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 (NCH)	$189.00	$189.00	$102.06–$181.44	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ~CHLAMYDIA GEN PROBE	$164.00	$164.00	$88.56–$157.44	40% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC/TRICH PANEL #2000	$164.00	$164.00	$88.56–$157.44	40% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC PCR/URINE #2182	$164.00	$164.00	$88.56–$157.44	40% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC/TRICH PANEL #2000	$164.00	$164.00	$88.56–$157.44	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC PCR/URINE #2182	$164.00	$164.00	$88.56–$157.44	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ~CHLAMYDIA GEN PROBE	$164.00	$164.00	$88.56–$157.44	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$143.00	$143.00	$77.22–$137.28	18% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$143.00	$143.00	$77.22–$137.28	—	—
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO-DIFF	$115.00	$115.00	$62.10–$110.40	25% above	—
Complete blood count (CBC) with differential CPT 85025 HEMAGRAM W/AUTO DIFF	$115.00	$115.00	$62.10–$110.40	25% above	—
Complete blood count (CBC) with differential CPT 85025 ~UNMC CBC (CHARGE ONLY)	$115.00	$115.00	$62.10–$110.40	25% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO-DIFF	$115.00	$115.00	$62.10–$110.40	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 ~UNMC CBC (CHARGE ONLY)	$115.00	$115.00	$62.10–$110.40	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 HEMAGRAM W/AUTO DIFF	$115.00	$115.00	$62.10–$110.40	—	—
Complete blood count (CBC), no differential CPT 85027 HEMAGRAM	$89.00	$89.00	$48.06–$85.44	21% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 HEMAGRAM	$89.00	$89.00	$48.06–$85.44	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$186.00	$186.00	$100.44–$178.56	12% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$186.00	$186.00	$100.44–$178.56	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$189.00	$189.00	$102.06–$181.44	24% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$189.00	$189.00	$102.06–$181.44	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEAS, #920	$230.00	$230.00	$124.20–$220.80	62% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEAS, #920	$230.00	$230.00	$124.20–$220.80	—	—
Estradiol blood test CPT 82670 ESTRADIOL ADULT #925	$204.00	$204.00	$110.16–$195.84	49% above	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL ADULT #925	$204.00	$204.00	$110.16–$195.84	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH (FOLLICLE STIMULATING HORMONE) #928	$161.00	$161.00	$86.94–$154.56	41% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (FOLLICLE STIMULATING HORMONE) #928	$161.00	$161.00	$86.94–$154.56	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL #9391	$530.00	$530.00	$286.20–$508.80	36% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL #9391	$530.00	$530.00	$286.20–$508.80	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN (NCH)	$145.00	$145.00	$78.30–$139.20	35% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (NCH)	$145.00	$145.00	$78.30–$139.20	—	—
Folate (folic acid) blood test CPT 82746 FOLATE (NCH)	$158.00	$158.00	$85.32–$151.68	46% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (NCH)	$158.00	$158.00	$85.32–$151.68	—	—
Free T3 thyroid hormone test CPT 84481 T-3, FREE #1366	$226.00	$226.00	$122.04–$216.96	39% above	—
Free T3 thyroid hormone test CPT 84481 FREE T3 (NCH)	$226.00	$226.00	$122.04–$216.96	39% above	—
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 (NCH)	$226.00	$226.00	$122.04–$216.96	—	—
Free T3 thyroid hormone test inpatient CPT 84481 T-3, FREE #1366	$226.00	$226.00	$122.04–$216.96	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 (NCH)	$123.00	$123.00	$66.42–$118.08	37% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 (NCH)	$123.00	$123.00	$66.42–$118.08	—	—
Free testosterone test CPT 84402 TESTOSTERONE FREE BY DIALYSIS & MS ARUP	$195.00	$195.00	$105.30–$187.20	54% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE BY DIALYSIS & MS ARUP	$195.00	$195.00	$105.30–$187.20	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, OB 1 HR GTT	$72.00	$72.00	$38.88–$69.12	30% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, OB 1 HR GTT	$72.00	$72.00	$38.88–$69.12	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR	$187.00	$187.00	$100.98–$179.52	36% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2 HR	$187.00	$187.00	$100.98–$179.52	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PCR, SWAB #1990	$158.00	$158.00	$85.32–$151.68	34% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ~GC PCR	$158.00	$158.00	$85.32–$151.68	34% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC PCR, SWAB #1990	$158.00	$158.00	$85.32–$151.68	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ~GC PCR	$158.00	$158.00	$85.32–$151.68	—	—
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN, FECAL #2095	$261.00	$261.00	$140.94–$250.56	60% above	—
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN, FECAL #2095	$261.00	$261.00	$140.94–$250.56	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTITATIVE PCR #7258	$471.00	$471.00	$254.34–$452.16	8% below	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTITATIVE PCR #7258	$471.00	$471.00	$254.34–$452.16	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV RAPID #4680	$112.00	$112.00	$60.48–$107.52	53% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV RAPID #4680	$112.00	$112.00	$60.48–$107.52	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 ANTIBODY #680	$133.00	$133.00	$71.82–$127.68	61% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 ANTIBODY #680	$133.00	$133.00	$71.82–$127.68	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, HIGH RISK SCREEN #7613	$174.00	$174.00	$93.96–$167.04	51% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, HIGH RISK SCREEN W/ 16/18 #7614	$174.00	$174.00	$93.96–$167.04	51% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, HIGH RISK SCREEN #7613	$174.00	$174.00	$93.96–$167.04	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, HIGH RISK SCREEN W/ 16/18 #7614	$174.00	$174.00	$93.96–$167.04	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C (NCH)	$94.00	$94.00	$50.76–$90.24	16% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1c (#350)	$94.00	$94.00	$50.76–$90.24	16% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1c (#350)	$94.00	$94.00	$50.76–$90.24	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C (NCH)	$94.00	$94.00	$50.76–$90.24	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY #568	$178.00	$178.00	$96.12–$170.88	95% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY #568	$178.00	$178.00	$96.12–$170.88	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG #565	$119.00	$119.00	$64.26–$114.24	27% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG #565	$119.00	$119.00	$64.26–$114.24	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB IGG #945	$134.00	$134.00	$72.36–$128.64	46% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB IGG #945	$134.00	$134.00	$72.36–$128.64	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL LOAD BY PCR #7650	$573.00	$573.00	$309.42–$550.08	70% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL LOAD BY PCR #7650	$573.00	$573.00	$309.42–$550.08	—	—
Herpes blood test, HSV-1 antibody CPT 86695 ~HERPES SIMPLEX VIRUS 1 Igg	$129.00	$129.00	$69.66–$123.84	29% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ~HERPES SIMPLEX VIRUS 1 Igg	$129.00	$129.00	$69.66–$123.84	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS (HSV) 2 IgG #8214	$120.00	$120.00	$64.80–$115.20	12% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS (HSV) 2 IgG #8214	$120.00	$120.00	$64.80–$115.20	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HS (HIGH SENSITIVE) #1545	$139.00	$139.00	$75.06–$133.44	45% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HS (HIGH SENSITIVE) #1545	$139.00	$139.00	$75.06–$133.44	—	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL #1524	$262.00	$262.00	$141.48–$251.52	63% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL #1524	$262.00	$262.00	$141.48–$251.52	—	—
Insulin blood test CPT 83525 INSULIN (FASTING) #9144	$140.00	$140.00	$75.60–$134.40	28% above	—
Insulin blood test CPT 83525 INSULIN 120 MINUTES #9148	$140.00	$140.00	$75.60–$134.40	28% above	—
Insulin blood test CPT 83525 INSULIN 60 MINUTES #9146	$140.00	$140.00	$75.60–$134.40	28% above	—
Insulin blood test inpatient CPT 83525 INSULIN 120 MINUTES #9148	$140.00	$140.00	$75.60–$134.40	—	—
Insulin blood test inpatient CPT 83525 INSULIN 60 MINUTES #9146	$140.00	$140.00	$75.60–$134.40	—	—
Insulin blood test inpatient CPT 83525 INSULIN (FASTING) #9144	$140.00	$140.00	$75.60–$134.40	—	—
Iron blood test (serum iron) CPT 83540 IRON (NCH)	$82.00	$82.00	$44.28–$78.72	30% above	—
Iron blood test (serum iron) CPT 83540 IRON TOTAL #149	$82.00	$82.00	$44.28–$78.72	30% above	—
Iron blood test (serum iron) inpatient CPT 83540 IRON (NCH)	$82.00	$82.00	$44.28–$78.72	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL #149	$82.00	$82.00	$44.28–$78.72	—	—
Iron-binding capacity (TIBC) test CPT 83550 ~TIBC	$330.00	$330.00	$178.20–$316.80	319% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 ~TIBC	$330.00	$330.00	$178.20–$316.80	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$180.00	$180.00	$97.20–$172.80	21% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$180.00	$180.00	$97.20–$172.80	—	—
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORMONE) #84	$139.00	$139.00	$75.06–$133.44	12% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LH (LUTEINIZING HORMONE) #84	$139.00	$139.00	$75.06–$133.44	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$140.00	$140.00	$75.60–$134.40	40% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$140.00	$140.00	$75.60–$134.40	—	—
Liver function blood test panel CPT 80076 HEPATIC FUNC PANEL	$157.00	$157.00	$84.78–$150.72	18% above	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNC PANEL	$157.00	$157.00	$84.78–$150.72	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB W/REFLEX #426	$211.00	$211.00	$113.94–$202.56	55% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB W/REFLEX #426	$211.00	$211.00	$113.94–$202.56	—	—
Magnesium blood test CPT 83735 MAGNESIUM	$102.00	$102.00	$55.08–$97.92	41% above	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$102.00	$102.00	$55.08–$97.92	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO-TEST	$92.00	$92.00	$49.68–$88.32	41% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO-TEST	$92.00	$92.00	$49.68–$88.32	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 ~PSA FREE	$150.00	$150.00	$81.00–$144.00	10% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ~PSA FREE	$150.00	$150.00	$81.00–$144.00	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL, #544	$150.00	$150.00	$81.00–$144.00	38% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL (NCH)	$150.00	$150.00	$81.00–$144.00	38% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL (NCH)	$150.00	$150.00	$81.00–$144.00	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL, #544	$150.00	$150.00	$81.00–$144.00	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR, THIN PREP LIQ BASED #3516	$142.00	$142.00	$76.68–$136.32	109% above	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR, TP W/ HPV REFLEX #3616	$142.00	$142.00	$76.68–$136.32	109% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR, TP W/ HPV REFLEX #3616	$142.00	$142.00	$76.68–$136.32	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR, THIN PREP LIQ BASED #3516	$142.00	$142.00	$76.68–$136.32	—	—
Parathyroid hormone (PTH) blood test CPT 83970 ~PTH, INTACT	$315.00	$315.00	$170.10–$302.40	49% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT w/o TOTAL CALCIUM #1342	$315.00	$315.00	$170.10–$302.40	49% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ~PTH, INTACT	$315.00	$315.00	$170.10–$302.40	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT w/o TOTAL CALCIUM #1342	$315.00	$315.00	$170.10–$302.40	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 ~PTT-LA SCREEN (PTT-D)	$110.00	$110.00	$59.40–$105.60	39% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$110.00	$110.00	$59.40–$105.60	39% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$110.00	$110.00	$59.40–$105.60	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ~PTT-LA SCREEN (PTT-D)	$110.00	$110.00	$59.40–$105.60	—	—
Progesterone blood test CPT 84144 PROGESTERONE #325	$180.00	$180.00	$97.20–$172.80	56% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE #325	$180.00	$180.00	$97.20–$172.80	—	—
Prolactin blood test CPT 84146 PROLACTIN #1316	$214.00	$214.00	$115.56–$205.44	72% above	—
Prolactin blood test inpatient CPT 84146 PROLACTIN #1316	$214.00	$214.00	$115.56–$205.44	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR	$72.00	$72.00	$38.88–$69.12	41% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 INR-POC	$72.00	$72.00	$38.88–$69.12	41% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR-POC	$72.00	$72.00	$38.88–$69.12	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR	$72.00	$72.00	$38.88–$69.12	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR #570	$84.00	$84.00	$45.36–$80.64	54% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR #570	$84.00	$84.00	$45.36–$80.64	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG #873	$129.00	$129.00	$69.66–$123.84	68% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG #873	$129.00	$129.00	$69.66–$123.84	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE (ESR)	$63.00	$63.00	$34.02–$60.48	17% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AFHC	$63.00	$63.00	$34.02–$60.48	17% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE (ESR)	$63.00	$63.00	$34.02–$60.48	—	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AFHC	$63.00	$63.00	$34.02–$60.48	—	—
Stool ova and parasites exam CPT 87177 ~OVA-PARA DIRECT SMEARS	$114.00	$114.00	$61.56–$109.44	35% above	—
Stool ova and parasites exam inpatient CPT 87177 ~OVA-PARA DIRECT SMEARS	$114.00	$114.00	$61.56–$109.44	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD, FECAL SCREENING	$46.00	$46.00	$24.84–$44.16	66% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECAL SCREENING	$46.00	$46.00	$24.84–$44.16	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD #9711	$281.00	$281.00	$151.74–$269.76	37% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD #9711	$281.00	$281.00	$151.74–$269.76	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL (NCH)	$188.00	$188.00	$101.52–$180.48	59% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE (AFHC)	$188.00	$188.00	$101.52–$180.48	59% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL #318	$188.00	$188.00	$101.52–$180.48	59% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL #318	$188.00	$188.00	$101.52–$180.48	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE (AFHC)	$188.00	$188.00	$101.52–$180.48	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL (NCH)	$188.00	$188.00	$101.52–$180.48	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB #7163	$144.00	$144.00	$77.76–$138.24	44% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB #7163	$144.00	$144.00	$77.76–$138.24	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GEN, ULTRASENSITIVE #195	$134.00	$134.00	$72.36–$128.64	19% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION (NCH)	$164.00	$164.00	$88.56–$157.44	45% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GEN, ULTRASENSITIVE #195	$134.00	$134.00	$72.36–$128.64	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION (NCH)	$164.00	$164.00	$88.56–$157.44	—	—
Trichomonas test (NAAT) CPT 87661 ~TRICHAMONAS	$111.00	$111.00	$59.94–$106.56	17% above	—
Trichomonas test (NAAT) inpatient CPT 87661 ~TRICHAMONAS	$111.00	$111.00	$59.94–$106.56	—	—
Uric acid blood test CPT 84550 URIC ACID	$72.00	$72.00	$38.88–$69.12	36% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$72.00	$72.00	$38.88–$69.12	—	—
Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO	$67.00	$67.00	$36.18–$64.32	16% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/MICRO	$67.00	$67.00	$36.18–$64.32	—	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO	$51.00	$51.00	$27.54–$48.96	50% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO	$51.00	$51.00	$27.54–$48.96	—	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE, #603	$103.00	$103.00	$55.62–$98.88	43% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE, #603	$103.00	$103.00	$55.62–$98.88	—	—
Urine pregnancy test, read by color change CPT 81025 HCG QUAL URINE	$100.00	$100.00	$54.00–$96.00	55% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL URINE	$100.00	$100.00	$54.00–$96.00	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 (NCH)	$165.00	$165.00	$89.10–$158.40	42% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (NCH)	$165.00	$165.00	$89.10–$158.40	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY #9277	$199.00	$199.00	$107.46–$191.04	28% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, TOTAL (NCH)	$199.00	$199.00	$107.46–$191.04	28% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY (SCREENING) #9277	$199.00	$199.00	$107.46–$191.04	28% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY #9277	$199.00	$199.00	$107.46–$191.04	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY (SCREENING) #9277	$199.00	$199.00	$107.46–$191.04	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, TOTAL (NCH)	$199.00	$199.00	$107.46–$191.04	—	—
Zinc blood test CPT 84630 ZINC SERUM #807	$122.00	$122.00	$65.88–$117.12	68% above	—
Zinc blood test inpatient CPT 84630 ZINC SERUM #807	$122.00	$122.00	$65.88–$117.12	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE (NCH)	$157.00	$157.00	$84.78–$150.72	39% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT SERUM #1981	$157.00	$157.00	$84.78–$150.72	39% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG BETA QUANTITATIVE (NCH)	$157.00	$157.00	$84.78–$150.72	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT SERUM #1981	$157.00	$157.00	$84.78–$150.72	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$618.00	$618.00	$333.72–$593.28	42% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE	$618.00	$618.00	$333.72–$593.28	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$465.00	$465.00	$251.10–$446.40	23% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FRACTURE	$465.00	$465.00	$251.10–$446.40	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,820.00	$1,820.00	$982.80–$1,747.20	27% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,820.00	$1,820.00	$982.80–$1,747.20	—	—
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$2,442.00	$2,442.00	$1,318.68–$2,344.32	44% above	—
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$2,442.00	$2,442.00	$1,318.68–$2,344.32	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$309.00	$309.00	$166.86–$296.64	15% below	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$309.00	$309.00	$166.86–$296.64	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA	$791.00	$791.00	$427.14–$759.36	59% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA	$791.00	$791.00	$427.14–$759.36	—	—
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/POLYPECTOMY	$3,074.00	$3,074.00	$1,659.96–$2,951.04	110% above	—
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/POLYPECTOMY	$3,074.00	$3,074.00	$1,659.96–$2,951.04	—	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX OR FORCEP POLYPECTOMY	$2,761.00	$2,761.00	$1,490.94–$2,650.56	50% above	—
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BX OR FORCEP POLYPECTOMY	$2,761.00	$2,761.00	$1,490.94–$2,650.56	—	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREEN-NOT HIGH RISK	$2,184.00	$2,184.00	$1,179.36–$2,096.64	50% above	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREEN-HIGH RISK	$2,184.00	$2,184.00	$1,179.36–$2,096.64	50% above	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREEN-HIGH RISK	$2,184.00	$2,184.00	$1,179.36–$2,096.64	—	—
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREEN-NOT HIGH RISK	$2,184.00	$2,184.00	$1,179.36–$2,096.64	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,350.00	$1,350.00	$729.00–$1,296.00	147% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,350.00	$1,350.00	$729.00–$1,296.00	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY W/ TUBE INSERTION	$414.00	$414.00	$223.56–$397.44	12% below	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY W/ TUBE INSERTION	$414.00	$414.00	$223.56–$397.44	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED CERUMEN-IRRIGATION/LAVAG	$80.00	$80.00	$43.20–$76.80	72% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED CERUMEN-IRRIGATION/LAVAG	$80.00	$80.00	$43.20–$76.80	—	—
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$55.00	$55.00	$29.70–$52.80	38% below	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$55.00	$55.00	$29.70–$52.80	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$103.00	$103.00	$55.62–$98.88	51% below	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$103.00	$103.00	$55.62–$98.88	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$333.00	$333.00	$179.82–$319.68	70% below	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$333.00	$333.00	$179.82–$319.68	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,595.00	$1,595.00	$861.30–$1,531.20	18% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,595.00	$1,595.00	$861.30–$1,531.20	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,573.00	$1,573.00	$849.42–$1,510.08	202% above	—
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,573.00	$1,573.00	$849.42–$1,510.08	—	—
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$638.00	$638.00	$344.52–$612.48	53% below	—
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$638.00	$638.00	$344.52–$612.48	—	—
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$337.00	$337.00	$181.98–$323.52	45% below	—
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$337.00	$337.00	$181.98–$323.52	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$86.00	$86.00	$46.44–$82.56	56% below	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$86.00	$86.00	$46.44–$82.56	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABCESS	$359.00	$359.00	$193.86–$344.64	24% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABCESS	$359.00	$359.00	$193.86–$344.64	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$66.00	$66.00	$35.64–$63.36	58% below	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$66.00	$66.00	$35.64–$63.36	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INTRAARTICULAR MAJOR JOINT INJECTION	$50.00	$50.00	$27.00–$48.00	74% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$75.00	$75.00	$40.50–$72.00	61% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INTRAARTICULAR MAJOR JOINT INJECTION	$50.00	$50.00	$27.00–$48.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$75.00	$75.00	$40.50–$72.00	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT	$103.00	$103.00	$55.62–$98.88	56% below	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DLVR IMPLANT	$103.00	$103.00	$55.62–$98.88	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$63.00	$63.00	$34.02–$60.48	66% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$63.00	$63.00	$34.02–$60.48	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$61.00	$61.00	$32.94–$58.56	57% below	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$61.00	$61.00	$32.94–$58.56	—	—
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER	$1,207.00	$1,207.00	$651.78–$1,158.72	41% above	—
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER	$1,207.00	$1,207.00	$651.78–$1,158.72	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,297.00	$1,297.00	$700.38–$1,245.12	13% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,297.00	$1,297.00	$700.38–$1,245.12	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S1	$1,364.00	$1,364.00	$736.56–$1,309.44	7% below	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S1	$1,364.00	$1,364.00	$736.56–$1,309.44	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$281.00	$281.00	$151.74–$269.76	6% below	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$281.00	$281.00	$151.74–$269.76	—	—
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$94.00	$94.00	$50.76–$90.24	61% below	—
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$94.00	$94.00	$50.76–$90.24	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$179.00	$179.00	$96.66–$171.84	47% below	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$179.00	$179.00	$96.66–$171.84	—	—
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$108.00	$108.00	$58.32–$103.68	45% below	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST	$108.00	$108.00	$58.32–$103.68	—	—
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$70.00	$70.00	$37.80–$67.20	54% below	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$70.00	$70.00	$37.80–$67.20	—	—
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$101.00	$101.00	$54.54–$96.96	45% below	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$101.00	$101.00	$54.54–$96.96	—	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$80.00	$80.00	$43.20–$76.80	69% below	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$80.00	$80.00	$43.20–$76.80	—	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15	$260.00	$260.00	$140.40–$249.60	34% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <W/15	$260.00	$260.00	$140.40–$249.60	—	—
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$608.00	$608.00	$328.32–$583.68	58% below	—
Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH	$608.00	$608.00	$328.32–$583.68	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$63.00	$63.00	$34.02–$60.48	55% below	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$63.00	$63.00	$34.02–$60.48	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 ENDO W/BX	$2,658.00	$2,658.00	$1,435.32–$2,551.68	38% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDO W/BX	$2,658.00	$2,658.00	$1,435.32–$2,551.68	—	—
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ	$423.00	$423.00	$228.42–$406.08	58% below	—
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPR GI SCOPE W/SUBMUC INJ	$423.00	$423.00	$228.42–$406.08	—	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDO W/ SNARE POLYPECTOMY	$2,730.00	$2,730.00	$1,474.20–$2,620.80	114% above	—
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDO W/ SNARE POLYPECTOMY	$2,730.00	$2,730.00	$1,474.20–$2,620.80	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY	$2,566.00	$2,566.00	$1,385.64–$2,463.36	142% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY	$2,566.00	$2,566.00	$1,385.64–$2,463.36	—	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$2,261.00	$2,261.00	$1,220.94–$2,170.56	110% above	—
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$2,261.00	$2,261.00	$1,220.94–$2,170.56	—	—
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1014	$124.00	$124.00	$66.96–$119.04	35% below	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1014	$124.00	$124.00	$66.96–$119.04	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$198.00	$198.00	$106.92–$190.08	32% below	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$198.00	$198.00	$106.92–$190.08	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 1-4 HRS	$700.00	$700.00	$378.00–$672.00	5% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 5-8 HRS	$870.00	$870.00	$469.80–$835.20	18% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 8+ HRS	$1,040.00	$1,040.00	$561.60–$998.40	41% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 1-4 HRS	$700.00	$700.00	$378.00–$672.00	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 5-8 HRS	$870.00	$870.00	$469.80–$835.20	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 8+ HRS	$1,040.00	$1,040.00	$561.60–$998.40	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-1	$310.00	$310.00	$167.40–$297.60	178% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-2	$620.00	$620.00	$334.80–$595.20	457% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-3	$930.00	$930.00	$502.20–$892.80	735% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-4	$1,240.00	$1,240.00	$669.60–$1,190.40	1014% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-5	$1,550.00	$1,550.00	$837.00–$1,488.00	1292% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL/MDI TX-6 OR MORE	$1,860.00	$1,860.00	$1,004.40–$1,785.60	1570% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-1	$310.00	$310.00	$167.40–$297.60	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-2	$620.00	$620.00	$334.80–$595.20	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-3	$930.00	$930.00	$502.20–$892.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-4	$1,240.00	$1,240.00	$669.60–$1,190.40	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-5	$1,550.00	$1,550.00	$837.00–$1,488.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL/MDI TX-6 OR MORE	$1,860.00	$1,860.00	$1,004.40–$1,785.60	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION/1ST HR/1ST DRUG	$450.00	$450.00	$243.00–$432.00	18% below	—
Critical care, first 30 to 74 minutes CPT 99291 ER-CRITICAL CARE	$2,000.00	$2,000.00	$1,080.00–$1,920.00	82% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE	$370.00	$370.00	$199.80–$355.20	45% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE	$370.00	$370.00	$199.80–$355.20	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TREATMENT ROOM-AMA	$224.00	$224.00	$120.96–$215.04	47% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT -1	$224.00	$224.00	$120.96–$215.04	47% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT -2	$390.00	$390.00	$210.60–$374.40	74% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT -3	$590.00	$590.00	$318.60–$566.40	74% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT -4	$930.00	$930.00	$502.20–$892.80	70% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT -5	$1,420.00	$1,420.00	$766.80–$1,363.20	67% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TESTING	$1,338.00	$1,338.00	$722.52–$1,284.48	22% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TESTING	$1,338.00	$1,338.00	$722.52–$1,284.48	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION/HYDRATION/1ST HR W/MODIFIER	$430.00	$430.00	$232.20–$412.80	13% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION/HYDRATION/1ST HR	$430.00	$430.00	$232.20–$412.80	13% above	—
IV infusion of a medicine, first hour CPT 96365 NON-CHEMO IV INFUSION/1ST HR	$440.00	$440.00	$237.60–$422.40	15% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION/SQ OR IM	$192.00	$192.00	$103.68–$184.32	92% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION/SQ OR IM-W/MOD	$192.00	$192.00	$103.68–$184.32	92% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION/SQ OR IM-WITH MOD	$192.00	$192.00	$103.68–$184.32	92% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT NEURO-MUSC RE-ED/15 MIN *	$115.00	$115.00	$62.10–$110.40	23% above	—
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED/15 MIN	$115.00	$115.00	$62.10–$110.40	23% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-ED/15 MIN	$115.00	$115.00	$62.10–$110.40	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEURO-MUSC RE-ED/15 MIN *	$115.00	$115.00	$62.10–$110.40	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT-INITIAL ASSESSMENT(INDIVIDUAL)	$120.00	$120.00	$64.80–$115.20	138% above	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL - LOW *	$208.00	$208.00	$112.32–$199.68	25% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL - LOW *	$208.00	$208.00	$112.32–$199.68	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL - HIGH	$285.00	$285.00	$153.90–$273.60	31% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL - HIGH	$285.00	$285.00	$153.90–$273.60	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL - LOW	$184.00	$184.00	$99.36–$176.64	14% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL - LOW	$184.00	$184.00	$99.36–$176.64	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL - MODERATE	$221.00	$221.00	$119.34–$212.16	20% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL - MODERATE	$221.00	$221.00	$119.34–$212.16	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY/15 MIN	$95.00	$95.00	$51.30–$91.20	1% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY/15 MIN *	$95.00	$95.00	$51.30–$91.20	1% below	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY/15 MIN *	$95.00	$95.00	$51.30–$91.20	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY/15 MIN	$95.00	$95.00	$51.30–$91.20	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE I/15 MIN	$100.00	$100.00	$54.00–$96.00	5% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EXERCISE/15 MIN *	$100.00	$100.00	$54.00–$96.00	5% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER EXERCISE/15 MIN *	$100.00	$100.00	$54.00–$96.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE I/15 MIN	$100.00	$100.00	$54.00–$96.00	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT SMOKE/TOBACCO COUNS<10MIN	$45.00	$45.00	$24.30–$43.20	52% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT SMOKE/TOBACCO COUNS<10MIN	$45.00	$45.00	$24.30–$43.20	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP TREATMENT ROOM FACILITY FEE	$93.00	$93.00	$50.22–$89.28	8% above	—
Speech and language evaluation CPT 92523 ST SOUND PRODUCTION WITH LANG COMP	$449.00	$449.00	$242.46–$431.04	42% above	—
Speech and language evaluation inpatient CPT 92523 ST SOUND PRODUCTION WITH LANG COMP	$449.00	$449.00	$242.46–$431.04	—	—
Speech therapy session, individual CPT 92507 ST TREATMENT OF SPEECH	$337.00	$337.00	$181.98–$323.52	36% above	—
Speech therapy session, individual inpatient CPT 92507 ST TREATMENT OF SPEECH	$337.00	$337.00	$181.98–$323.52	—	—
Spirometry (breathing test) CPT 94010 RT SPIROMETRY/PRE ONLY	$356.00	$356.00	$192.24–$341.76	28% above	—
Spirometry (breathing test) inpatient CPT 94010 RT SPIROMETRY/PRE ONLY	$356.00	$356.00	$192.24–$341.76	—	—
Spirometry before and after a bronchodilator CPT 94060 RT SPIROMETRY/PRE&POST	$794.00	$794.00	$428.76–$762.24	36% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 RT SPIROMETRY/PRE&POST	$794.00	$794.00	$428.76–$762.24	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THER ACTIVITIES/15 MIN *	$120.00	$120.00	$64.80–$115.20	30% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPUTIC ACTIVITI/15 MIN	$120.00	$120.00	$64.80–$115.20	30% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THER ACTIVITIES/15 MIN *	$120.00	$120.00	$64.80–$115.20	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPUTIC ACTIVITI/15 MIN	$120.00	$120.00	$64.80–$115.20	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$215.00	$215.00	$116.10–$206.40	12% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$215.00	$215.00	$116.10–$206.40	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Nebraska	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza (AFLURIA) vaccine:0.5mL	$93.65	$93.65	$50.57–$89.90	218% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza (AFLURIA) vaccine:0.5mL	$93.65	$93.65	$50.57–$89.90	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza HD 65+ (FLUZONE) vaccine	$258.35	$258.35	$139.51–$248.02	204% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza HD 65+ (FLUZONE) vaccine	$258.35	$258.35	$139.51–$248.02	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal (PREVNAR 20) vaccine:0.5mL	$794.45	$794.45	$429.00–$762.67	73% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal (PREVNAR 20) vaccine:0.5mL	$794.45	$794.45	$429.00–$762.67	—	—
Rabies vaccine, one dose CPT 90675 rabies vaccine injection: 2.5iu/mL	$1,266.85	$1,266.85	$684.10–$1,216.18	130% above	—
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine injection: 2.5iu/mL	$1,266.85	$1,266.85	$684.10–$1,216.18	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diptheria toxoids vaccine:0.5mL	$165.70	$165.70	$89.48–$159.07	217% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diptheria toxoids vaccine:0.5mL	$165.70	$165.70	$89.48–$159.07	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap (BOOSTRIX) vaccine injection:0.5mL	$194.10	$194.10	$104.81–$186.34	174% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap (BOOSTRIX) vaccine injection:0.5mL	$194.10	$194.10	$104.81–$186.34	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-PNEUMONIA	$79.00	$79.00	$42.66–$75.84	104% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-TETANUS	$79.00	$79.00	$42.66–$75.84	104% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-RABIES	$79.00	$79.00	$42.66–$75.84	104% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-HEP B	$79.00	$79.00	$42.66–$75.84	104% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION-FLU	$79.00	$79.00	$42.66–$75.84	104% above	—

Source file: https://nemahacountyhospital.com/wp-content/uploads/2026/06/470471042_nemaha-county-hospital_standardcharges.csv