Alegent Health Immanuel Medical Center
Alegent Health Immanuel Medical Center in Omaha, NE publishes cash prices for 50 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Click a procedure to compare it with other hospitals nearby.
6901 N 72nd St, Omaha, NE 68112 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRST | $2,051.28 | $4,884.00 | 58% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRST | $2,051.28 | $4,884.00 | 58% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST | $673.68 | $1,604.00 | 58% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST | $673.68 | $1,604.00 | 58% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $1,051.68 | $2,504.00 | 58% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $1,051.68 | $2,504.00 | 58% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIGITAL BILATERAL | $128.10 | $305.00 | 58% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIGITAL BILATERAL | $128.10 | $305.00 | 58% |
| Diagnostic mammogram, one breast CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL | $91.14 | $217.00 | 58% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $97.02 | $231.00 | 58% |
| Diagnostic mammogram, one breast one side CPT 77065 HC MAMMO DR UNILATERAL W 3D | $100.38 | $239.00 | 58% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMOGRAM DIGITAL UNILATERL | $91.14 | $217.00 | 58% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $97.02 | $231.00 | 58% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMO DR UNILATERAL W 3D | $100.38 | $239.00 | 58% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOWER EXT WO CONT | $1,257.90 | $2,995.00 | 58% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOWER EXT WO CONT | $1,257.90 | $2,995.00 | 58% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JNT LOWER EXT W WO CONT | $1,647.66 | $3,923.00 | 58% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JNT LOWER EXT W WO CONT | $1,647.66 | $3,923.00 | 58% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST | $1,454.04 | $3,462.00 | 58% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST | $1,454.04 | $3,462.00 | 58% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST | $1,863.96 | $4,438.00 | 58% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST | $1,863.96 | $4,438.00 | 58% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR LUMBAR WO CONTRAST | $1,424.64 | $3,392.00 | 58% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR LUMBAR WO CONTRAST | $1,424.64 | $3,392.00 | 58% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC ULTRASOUND COMPLETE | $551.04 | $1,312.00 | 58% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >14 WKS | $568.68 | $1,354.00 | 58% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC ULTRASOUND COMPLETE | $551.04 | $1,312.00 | 58% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >14 WKS | $568.68 | $1,354.00 | 58% |
| Screening mammogram, both breasts CPT 77067 HC MAMMOGRAM DIGITAL SCREEN | $128.10 | $305.00 | 58% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMOGRAM DIGITAL SCREEN | $128.10 | $305.00 | 58% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR | $1,991.22 | $4,741.00 | 58% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY=> 6 YR | $1,991.22 | $4,741.00 | 58% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL | $416.64 | $992.00 | 58% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL | $416.64 | $992.00 | 58% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN | $524.58 | $1,249.00 | 58% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN | $524.58 | $1,249.00 | 58% |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $351.54 | $837.00 | 58% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $351.54 | $837.00 | 58% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $164.64 | $392.00 | 58% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $164.64 | $392.00 | 58% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $129.36 | $308.00 | 58% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $129.36 | $308.00 | 58% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFF | $91.98 | $219.00 | 58% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC W AUTO DIFF | $91.98 | $219.00 | 58% |
| Complete blood count (CBC), no differential CPT 85027 HC HEMOGRAM CBC WITHOUT DIFF | $70.56 | $168.00 | 58% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMOGRAM CBC WITHOUT DIFF | $70.56 | $168.00 | 58% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE PANEL | $204.96 | $488.00 | 58% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE PANEL | $204.96 | $488.00 | 58% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $151.62 | $361.00 | 58% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $151.62 | $361.00 | 58% |
| Liver function blood test panel CPT 80076 HC HEPATIC PROFILE | $133.56 | $318.00 | 58% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC PROFILE | $133.56 | $318.00 | 58% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $267.54 | $637.00 | 58% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $267.54 | $637.00 | 58% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $154.98 | $369.00 | 58% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $154.98 | $369.00 | 58% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA | $93.24 | $222.00 | 58% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA | $93.24 | $222.00 | 58% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $67.20 | $160.00 | 58% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $67.20 | $160.00 | 58% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC INR | $49.98 | $119.00 | 58% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PT | $55.02 | $131.00 | 58% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT PT | $57.54 | $137.00 | 58% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC INR | $49.98 | $119.00 | 58% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT | $55.02 | $131.00 | 58% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT PT | $57.54 | $137.00 | 58% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH | $112.98 | $269.00 | 58% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH | $112.98 | $269.00 | 58% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS | $58.38 | $139.00 | 58% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTOMATD W MICRO | $61.32 | $146.00 | 58% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS | $58.38 | $139.00 | 58% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTOMATD W MICRO | $61.32 | $146.00 | 58% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS DIPSTICK W MICRO | $36.12 | $86.00 | 58% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS DIPSTICK W MICRO | $36.12 | $86.00 | 58% |
| Urinalysis without microscope exam, automated CPT 81003 HC POC URINE AUTO WO MICRO | $31.50 | $75.00 | 58% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO WO MICRO | $34.02 | $81.00 | 58% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC POC URINE AUTO WO MICRO | $31.50 | $75.00 | 58% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO WO MICRO | $34.02 | $81.00 | 58% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS MANUAL | $21.42 | $51.00 | 58% |
| Urinalysis without microscope exam, manual CPT 81002 HC POCT MANUAL URINALYSIS | $24.36 | $58.00 | 58% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS MANUAL | $21.42 | $51.00 | 58% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC POCT MANUAL URINALYSIS | $24.36 | $58.00 | 58% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH NO ANGIO | $4,317.18 | $10,279.00 | 58% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH NO ANGIO | $4,317.18 | $10,279.00 | 58% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN | $1,144.08 | $2,724.00 | 58% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ ANE DRG LUM SAC W IMG GDN | $1,144.08 | $2,724.00 | 58% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX INTERLAMINAR LMBR SAC WO IMG GDN | $629.16 | $1,498.00 | 58% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN | $686.28 | $1,634.00 | 58% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX INTERLAMINAR LMBR SAC WO IMG GDN | $629.16 | $1,498.00 | 58% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ ANE DRG LUM SAC W O IMG GDN | $686.28 | $1,634.00 | 58% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG | $1,143.66 | $2,723.00 | 58% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRNSFRM LUM SNGL W IMAG | $1,143.66 | $2,723.00 | 58% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE | $1,347.36 | $3,208.00 | 58% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE | $1,347.36 | $3,208.00 | 58% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE | $1,924.86 | $4,583.00 | 58% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD BIOPSY SINGLE MULTIPLE | $1,924.86 | $4,583.00 | 58% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD DIAGNOSTIC BRUSH WASH | $643.02 | $1,531.00 | 58% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD DIAGNOSTIC BRUSH WASH | $643.02 | $1,531.00 | 58% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 HC SP PSY FAMILY THERAPY W PT 50 MIN | $202.44 | $482.00 | 58% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC SP PSY FAMILY THERAPY W PT 50 MIN | $202.44 | $482.00 | 58% |
| Family therapy without the patient, 50 minutes CPT 90846 HC SP PSY FAMILY THERAPY WO PT 50 MIN | $202.44 | $482.00 | 58% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC SP PSY FAMILY THERAPY WO PT 50 MIN | $202.44 | $482.00 | 58% |
| Group psychotherapy session CPT 90853 HC IOP GROUP THERAPY | $52.08 | $124.00 | 58% |
| Group psychotherapy session CPT 90853 HC PHP ACTIVITY THERAPY | $52.08 | $124.00 | 58% |
| Group psychotherapy session CPT 90853 HC IOP PSYCHOEDUCATION GROUP | $52.08 | $124.00 | 58% |
| Group psychotherapy session CPT 90853 HC THERAPIST GRP PSYCHOTHERAPY | $71.82 | $171.00 | 58% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $79.80 | $190.00 | 58% |
| Group psychotherapy session inpatient CPT 90853 HC IOP GROUP THERAPY | $52.08 | $124.00 | 58% |
| Group psychotherapy session inpatient CPT 90853 HC IOP PSYCHOEDUCATION GROUP | $52.08 | $124.00 | 58% |
| Group psychotherapy session inpatient CPT 90853 HC PHP ACTIVITY THERAPY | $52.08 | $124.00 | 58% |
| Group psychotherapy session inpatient CPT 90853 HC THERAPIST GRP PSYCHOTHERAPY | $71.82 | $171.00 | 58% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $79.80 | $190.00 | 58% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $221.34 | $527.00 | 58% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $221.34 | $527.00 | 58% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $291.06 | $693.00 | 58% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $291.06 | $693.00 | 58% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $325.92 | $776.00 | 58% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $325.92 | $776.00 | 58% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $56.70 | $135.00 | 58% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $56.70 | $135.00 | 58% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $56.70 | $135.00 | 58% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $56.70 | $135.00 | 58% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PATIENT 30 MINUTES | $86.10 | $205.00 | 58% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PATIENT 30 MINUTES | $86.10 | $205.00 | 58% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PATIENT 45 MINUTES | $92.40 | $220.00 | 58% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PATIENT 45 MINUTES | $92.40 | $220.00 | 58% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W PT 60 MINUTES | $109.20 | $260.00 | 58% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W PT 60 MINUTES | $109.20 | $260.00 | 58% |