Does Children's Nebraska have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Children's Nebraska. In a medical emergency, call 911.

Where is Children's Nebraska?

8200 Dodge St, Omaha, NE 68114, in Douglas County, Nebraska.

What is the phone number of Children's Nebraska?

(402) 955-5400, as listed by Medicare (CMS).

What is the Medicare star rating of Children's Nebraska?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Children's Nebraska — Phone, Address, ER & Ratings

Quick answers

Does Children's Nebraska have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Children's Nebraska. In a medical emergency, call 911.
Where is Children's Nebraska?: 8200 Dodge St, Omaha, NE 68114, in Douglas County, Nebraska.
What is the phone number of Children's Nebraska?: (402) 955-5400, as listed by Medicare (CMS).
What is the Medicare star rating of Children's Nebraska?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^{[6][8][11][15]}

Conditions treated^[8][14][15]

Allergic reactions or hives
Animal, snake or human bites
Blue or purple lips, skin or fingernails
Chest or stomach pain or pressure
Fever in infants under 2 months
Head, spinal cord or eye injuries
Seizures
Severe bleeding or burns
Shortness of breath or trouble breathing
Uncontrolled pain
Anxiety
ADHD
Depression
Obsessive compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)/trauma
Suicidal thoughts and behaviors
Anorexia nervosa
Avoidant/restrictive food intake disorder (ARFID)
Binge eating syndrome
Bulimia nervosa
Orthorexia
Other specific feeding and eating disorder (OSFED)

Treatments^{[8][9][12][13][14]}

Radiology, imaging and lab services
Respiratory therapy
Individual therapy
Family therapy
Group therapy
Medication management and psychiatric care
Psychiatric assessment and medication consultation
Nutrition therapy
Neuropsychology evaluations
Parent-Child Interaction Therapy (PCIT)
Psychological evaluation
Telehealth (virtual visits)
Crisis stabilization
Care coordination
Infusion therapy
Immunizations

Programs and centers^{[8][10][11][12][13][15]}

Behavioral Health Crisis Assessment
Behavioral Health Inpatient
Eating Disorders Partial Hospitalization
Mental Health Partial Hospitalization
Critical care transport
Project Austin
PATCH program (Patient Assistance Team at Children's Nebraska)
Breastfeeding support
Car seat fittings

Emergency care (hospital website)^[4][5][8]

Emergency room	Yes
Open 24/7	Yes
Trauma designation	Level I

Visiting and practical information

Interpreters and languages	On-site interpreters, or phone/video remote interpreting; sign language; no cost; request when scheduling^[7]

Recognition^[4][8]

U.S. News & World Report Best Children's Hospital 2026
Level I pediatric trauma center, American College of Surgeons (ACS) verified

Doctors and clinicians (6)

6 doctors and other clinicians list Children's Nebraska as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (6)

Angela T. Yetman, MDPediatric Medicine
Helen B. Lovell, MDPediatric Medicine
Jared D. Baxter, MDEmergency Medicine
Jonathan W. Cramer, MDPediatric Medicine
Matthew W. Sorensen, MDPediatric Medicine
Vincent J. Gonzalez, MDPediatric Medicine

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

The Nebraska Methodist Hospital0.1 mi · Omaha, NE · Acute Care Hospital
CHI Health Bergan Mercy1.7 mi · Omaha, NE · Acute Care Hospital
Omaha VA Medical Center (VA Nebraska Western Iowa Healthcare System)3.7 mi · Omaha, NE · Federal/VA Acute Care Hospital
Nebraska Orthopaedic Hospital5.1 mi · Omaha, NE · Acute Care Hospital
CHI Health Lakeside7.2 mi · Omaha, NE · Acute Care Hospital

Find the closest emergency room to where you are →

Other hospitals near Omaha

Midwest Surgical Hospital LLC0.4 mi · Omaha, NE · Acute Care Hospital
Select Specialty Hospital - Omaha (Central Campus)1.5 mi · Omaha, NE · Long-Term Acute Care Hospital
Douglas County Community Mental Health Center3.7 mi · Omaha, NE · Psychiatric Hospital

All hospitals in Omaha · Hospitals in Douglas County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Emerald Nursing & Rehabilitation Mercy1.7 mi · Omaha, NE · 1 of 5 stars
Maple Crest Health Center2.2 mi · Omaha, NE · 2 of 5 stars
Old Mill Rehabilitation2.8 mi · Omaha, NE · 3 of 5 stars

All nursing homes in the state →

Hospice providers

Care Initiatives Hospice-Omaha0.5 mi · Omaha, NE
Gentiva I0.5 mi · Omaha, NE · 3 of 5 stars
CHI Health at Home - Omaha1.8 mi · Omaha, NE · 3 of 5 stars

All hospice providers in the state →

Home health agencies

Accentcare Home Health of Nebraska0.5 mi · Omaha, NE · 4 of 5 stars
Amedisys Home Health of the Midlands0.5 mi · Omaha, NE · 4.5 of 5 stars
Children's Home Healthcare1.8 mi · Omaha, NE

All home health agencies in the state →

Dialysis facilities

Children's Nebraska0.5 mi · Omaha, NE
FMC - Nebraska Home Dialysis1.8 mi · Omaha, NE · 2 of 5 stars
DCI - Spring Street2.6 mi · Omaha, NE · 1 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Midwest Endoscopy Services, LLC0.5 mi · Omaha, NE
MPC Colonoscopy Center0.5 mi · Omaha, NE
Omaha Ambulatory Surgery Center0.5 mi · Omaha, NE

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

OneWorld Hillside School Based Health Center1.1 mi · Omaha, NE · Community health center
OneWorld Northwest2.6 mi · Omaha, NE · Community health center
Charles Drew Health Center, Inc. Teen & Young Adult Health Center at Benson2.7 mi · Omaha, NE · Community health center

Clinics and urgent care

American Current Care of Nebraska P.C.3.7 mi · Omaha, NE · Urgent care center
VWB LLC4.2 mi · Omaha, NE · Urgent care center
Midwest Minor Medical PC5.4 mi · Omaha, NE · Urgent care center

Pharmacies

Children's Hospital & Medical Center0.5 mi · Omaha, NE · Community/retail pharmacy
Hy-Vee Inc0.5 mi · Omaha, NE · Community/retail pharmacy
Nebraska Methodist Hospital0.5 mi · Omaha, NE · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

An Angel's Touch0.5 mi · Omaha, NE
An Angel's Touch0.5 mi · Omaha, NE
Astoria Senior Living0.5 mi · Omaha, NE
Legato Living at Indian Hills0.5 mi · Omaha, NE

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Children's Nebraska reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

Not reported to Medicare: the patient survey, infections caught in the hospital, complications and deaths, readmissions, emergency room times and sepsis care. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Omaha Best hospitals in Omaha

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 81 common services exactly as Children's Nebraska lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 81 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prof Exam Level 3 New Pat 99203	$306	Not listed in the file	$23.41 – $248.95
New patient office visit (about 30–44 minutes): 10 of 97 insurance plan rates Aetna — All Products - Facility: $170.35 Aetna — All Products - Non -Facility: $222.90 Ambetter — All Products - Facility: $141.68 Ambetter — All Products - Non -Facility: $194.07 Avera — All Products - Facility: $121.75 Avera — All Products - Non-Facility: $166.78 Blue Cross Blue Shield — All Products_Facility: $179.74 Blue Cross Blue Shield — All Products_Non_Facility: $243.43 Blue Cross Blue Shield — BluePrint - Facility: $174.35 Blue Cross Blue Shield — BluePrint - Non-Facility: $236.13
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Exam Level 3 New Pat 99203	$422	Not listed in the file	$130.82 – $371.36
New patient office visit (about 30–44 minutes): 10 of 15 insurance plan rates Aetna — All Products: $371.36 Ambetter — All Products: $295.40 Avera Health Plan — All Products: $358.70 Blue Cross Blue Shield — All Products: $337.60 Blue Cross Blue Shield — BluePrint: $334.22 Blue Cross Blue Shield — Select Blue: $303.84 Centivo — All Products: $358.70 Midlands Choice — All Products: $371.36 Midlands Choice CHI — All Products: $295.40 Midlands Choice Elevate — All Products: $337.60
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prof Exam Level 4 New Pat 99204	$459	Not listed in the file	$47.49 – $373.93
New patient office visit (about 45–59 minutes): 10 of 97 insurance plan rates Aetna — All Products - Facility: $252.46 Aetna — All Products - Non -Facility: $318.79 Ambetter — All Products - Facility: $231.49 Ambetter — All Products - Non -Facility: $291.86 Avera — All Products - Facility: $198.94 Avera — All Products - Non-Facility: $250.82 Blue Cross Blue Shield — All Products_Facility: $291.45 Blue Cross Blue Shield — All Products_Non_Facility: $363.82 Blue Cross Blue Shield — BluePrint - Facility: $282.71 Blue Cross Blue Shield — BluePrint - Non-Facility: $352.91
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Exam Level 4 New Pat 99204	$448	Not listed in the file	$138.88 – $394.24
New patient office visit (about 45–59 minutes): 10 of 15 insurance plan rates Aetna — All Products: $394.24 Ambetter — All Products: $313.60 Avera Health Plan — All Products: $380.80 Blue Cross Blue Shield — All Products: $358.40 Blue Cross Blue Shield — BluePrint: $354.82 Blue Cross Blue Shield — Select Blue: $322.56 Centivo — All Products: $380.80 Midlands Choice — All Products: $394.24 Midlands Choice CHI — All Products: $313.60 Midlands Choice Elevate — All Products: $358.40
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prof Exam Level 5 New Pat 99205	$569	Not listed in the file	$54.74 – $493.05
New patient office visit (about 60–74 minutes): 10 of 97 insurance plan rates Aetna — All Products - Facility: $335.50 Aetna — All Products - Non -Facility: $407.86 Ambetter — All Products - Facility: $314.34 Ambetter — All Products - Non -Facility: $384.96 Avera — All Products - Facility: $270.14 Avera — All Products - Non-Facility: $330.83 Blue Cross Blue Shield — All Products_Facility: $395.65 Blue Cross Blue Shield — All Products_Non_Facility: $480.36 Blue Cross Blue Shield — BluePrint - Facility: $383.78 Blue Cross Blue Shield — BluePrint - Non-Facility: $465.95
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Exam Level 5 New Pat 99205	$626	Not listed in the file	$194.06 – $550.88
New patient office visit (about 60–74 minutes): 10 of 15 insurance plan rates Aetna — All Products: $550.88 Ambetter — All Products: $438.20 Avera Health Plan — All Products: $532.10 Blue Cross Blue Shield — All Products: $500.80 Blue Cross Blue Shield — BluePrint: $495.79 Blue Cross Blue Shield — Select Blue: $450.72 Centivo — All Products: $532.10 Midlands Choice — All Products: $550.88 Midlands Choice CHI — All Products: $438.20 Midlands Choice Elevate — All Products: $500.80
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prof Exam Level 3 Est Pat 99213	$205	Not listed in the file	$21.52 – $204.65
Established patient office visit (about 20–29 minutes): 10 of 101 insurance plan rates Aetna — All Products - Facility: $84.32 Aetna — All Products - Non -Facility: $123.09 Ambetter — All Products - Facility: $115.08 Ambetter — All Products - Non -Facility: $159.51 Avera — All Products - Facility: $98.90 Avera — All Products - Non-Facility: $137.08 Blue Cross Blue Shield — All Products_Facility: $145.03 Blue Cross Blue Shield — All Products_Non_Facility: $197.89 Blue Cross Blue Shield — BluePrint - Facility: $140.68 Blue Cross Blue Shield — BluePrint - Non-Facility: $191.95
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Exam Level 3 Est Pat 99213	$422	Not listed in the file	$130.82 – $371.36
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates Aetna — All Products: $371.36 Ambetter — All Products: $295.40 Avera Health Plan — All Products: $358.70 Blue Cross Blue Shield — All Products: $337.60 Blue Cross Blue Shield — BluePrint: $334.22 Blue Cross Blue Shield — Select Blue: $303.84 Centivo — All Products: $358.70 Midlands Choice — All Products: $371.36 Midlands Choice CHI — All Products: $295.40 Midlands Choice Elevate — All Products: $337.60
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Prof Exam Level 4 Est Pat 99214	$309	Not listed in the file	$24.11 – $287.93
Established patient office visit (about 30–39 minutes): 10 of 97 insurance plan rates Aetna — All Products - Facility: $138.57 Aetna — All Products - Non -Facility: $192.83 Ambetter — All Products - Facility: $169.34 Ambetter — All Products - Non -Facility: $224.58 Avera — All Products - Facility: $145.53 Avera — All Products - Non-Facility: $193 Blue Cross Blue Shield — All Products_Facility: $214.60 Blue Cross Blue Shield — All Products_Non_Facility: $280.47 Blue Cross Blue Shield — BluePrint - Facility: $208.16 Blue Cross Blue Shield — BluePrint - Non-Facility: $272.06
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Exam Level 4 Est Pat 99214	$448	Not listed in the file	$138.88 – $394.24
Established patient office visit (about 30–39 minutes): 10 of 15 insurance plan rates Aetna — All Products: $394.24 Ambetter — All Products: $313.60 Avera Health Plan — All Products: $380.80 Blue Cross Blue Shield — All Products: $358.40 Blue Cross Blue Shield — BluePrint: $354.82 Blue Cross Blue Shield — Select Blue: $322.56 Centivo — All Products: $380.80 Midlands Choice — All Products: $394.24 Midlands Choice CHI — All Products: $313.60 Midlands Choice Elevate — All Products: $358.40
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	Not listed in the file	Not listed in the file	$102.04 – $105.61
Preventive checkup, new patient, age 18–39: rates for 4 insurance plans Iowa Medicaid — Managed Medicaid: $102.04 Iowa Medicaid — Total Care: $105.10 Molina (Iowa) — Managed Medicaid: $105.61 Wellpoint — Managed Medicaid: $102.04
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	Not listed in the file	Not listed in the file	$122.89 – $127.19
Preventive checkup, new patient, age 40–64: rates for 4 insurance plans Iowa Medicaid — Managed Medicaid: $122.89 Iowa Medicaid — Total Care: $126.58 Molina (Iowa) — Managed Medicaid: $127.19 Wellpoint — Managed Medicaid: $122.89
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Med Exam Limited Service	$361	Not listed in the file	$50.25 – $156.05
Emergency room visit (moderate): 10 of 73 insurance plan rates Aetna — All Products - Facility: $146.40 Aetna — All Products - Non -Facility: $146.40 Ambetter — All Products - Facility: $122.32 Ambetter — All Products - Non -Facility: $122.32 Avera — All Products - Facility: $105.12 Avera — All Products - Non-Facility: $105.12 Blue Cross Blue Shield — All Products_Non_Facility: $156.05 Blue Cross Blue Shield — BluePrint - Non-Facility: $151.37 Blue Cross Blue Shield — Select Blue - Non-Facility: $148.25 Centivo — All Products - Facility: $124.23
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Limited Service	$819	Not listed in the file	$253.89 – $720.72
Emergency room visit (moderate): 10 of 19 insurance plan rates Aetna — All Products: $720.72 Ambetter — All Products: $557.78 Avera Health Plan — All Products: $696.15 Blue Cross Blue Shield — All Products: $655.20 Blue Cross Blue Shield — BluePrint: $648.65 Blue Cross Blue Shield — Select Blue: $589.68 Centivo — All Products: $696.15 Iowa Medicaid — Managed Medicaid: $339.09 Iowa Medicaid — Total Care: $349.26 Midlands Choice — All Products: $720.72
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Med Exam Intermediate Srv	$496	Not listed in the file	$77.37 – $264.55
Emergency room visit (moderately high): 10 of 73 insurance plan rates Aetna — All Products - Facility: $228.84 Aetna — All Products - Non -Facility: $228.84 Ambetter — All Products - Facility: $208.11 Ambetter — All Products - Non -Facility: $208.11 Avera — All Products - Facility: $178.84 Avera — All Products - Non-Facility: $178.84 Blue Cross Blue Shield — All Products_Non_Facility: $264.30 Blue Cross Blue Shield — BluePrint - Non-Facility: $256.37 Blue Cross Blue Shield — Select Blue - Non-Facility: $251.09 Centivo — All Products - Facility: $211.36
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Intermediate Scv	$999	Not listed in the file	$309.69 – $879.12
Emergency room visit (moderately high): 10 of 19 insurance plan rates Aetna — All Products: $879.12 Ambetter — All Products: $852.60 Avera Health Plan — All Products: $849.15 Blue Cross Blue Shield — All Products: $799.20 Blue Cross Blue Shield — BluePrint: $791.21 Blue Cross Blue Shield — Select Blue: $719.28 Centivo — All Products: $849.15 Iowa Medicaid — Managed Medicaid: $521.47 Iowa Medicaid — Total Care: $537.12 Midlands Choice — All Products: $879.12
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: Med Exam Extended Srvc	$741	Not listed in the file	$121.64 – $383.34
Emergency room visit (high): 10 of 73 insurance plan rates Aetna — All Products - Facility: $356.68 Aetna — All Products - Non -Facility: $356.68 Ambetter — All Products - Facility: $301.54 Ambetter — All Products - Non -Facility: $301.54 Avera — All Products - Facility: $259.13 Avera — All Products - Non-Facility: $259.13 Blue Cross Blue Shield — All Products_Non_Facility: $383.34 Blue Cross Blue Shield — BluePrint - Non-Facility: $371.84 Blue Cross Blue Shield — Select Blue - Non-Facility: $364.17 Centivo — All Products - Facility: $306.25
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Facility Extended Srvc	$1,111	Not listed in the file	$344.41 – $977.68
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — All Products: $977.68 Ambetter — All Products: $1,111 Avera Health Plan — All Products: $944.35 Blue Cross Blue Shield — All Products: $888.80 Blue Cross Blue Shield — BluePrint: $879.91 Blue Cross Blue Shield — Select Blue: $799.92 Centivo — All Products: $944.35 Iowa Medicaid — Managed Medicaid: $750.83 Iowa Medicaid — Total Care: $773.35 Midlands Choice — All Products: $977.68
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Non Qualifying Trauma Activation Level 1	$8,529	Not listed in the file	$2,643.99 – $7,505.52
Emergency room visit (high): 10 of 19 insurance plan rates Aetna — All Products: $7,505.52 Ambetter — All Products: $1,216.86 Avera Health Plan — All Products: $7,249.65 Blue Cross Blue Shield — All Products: $6,823.20 Blue Cross Blue Shield — BluePrint: $6,754.97 Blue Cross Blue Shield — Select Blue: $6,140.88 Centivo — All Products: $7,249.65 Iowa Medicaid — Managed Medicaid: $750.83 Iowa Medicaid — Total Care: $773.35 Midlands Choice — All Products: $7,505.52

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Metabolic/Kidney Panel	$320	Not listed in the file	$99.20 – $281.60
Basic metabolic panel (blood test): 10 of 23 insurance plan rates Aetna — All Products: $281.60 Ambetter — All Products: $8.46 Avera Health Plan — All Products: $272 Blue Cross Blue Shield — All Products: $146.26 Blue Cross Blue Shield — BluePrint: $144.80 Blue Cross Blue Shield — Select Blue: $131.63 Centivo — All Products: $272 Iowa Medicaid — Managed Medicaid: $8.04 Iowa Medicaid — Total Care: $8.28 Midlands Choice — All Products: $281.60
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Comprehen Metabolic Panel	$437	Not listed in the file	$135.47 – $384.56
Comprehensive metabolic panel (blood test): 10 of 23 insurance plan rates Aetna — All Products: $384.56 Ambetter — All Products: $10.56 Avera Health Plan — All Products: $371.45 Blue Cross Blue Shield — All Products: $206 Blue Cross Blue Shield — BluePrint: $203.94 Blue Cross Blue Shield — Select Blue: $185.40 Centivo — All Products: $371.45 Iowa Medicaid — Managed Medicaid: $10.03 Iowa Medicaid — Total Care: $10.33 Midlands Choice — All Products: $384.56
Obstetric blood test panel CPT 80055 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OBSTETRIC PANEL	Not listed in the file	Not listed in the file	$95.62
Obstetric blood test panel: rates for 5 insurance plans Ambetter — All Products: $95.62 Iowa Medicaid — Managed Medicaid: $45.42 Iowa Medicaid — Total Care: $46.78 Molina (Iowa) — Managed Medicaid: $47.01 Wellpoint — Managed Medicaid: $45.42
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Lipid Profile	$75	Not listed in the file	$23.25 – $66
Cholesterol panel (lipid panel): 10 of 23 insurance plan rates Aetna — All Products: $66 Ambetter — All Products: $13.39 Avera Health Plan — All Products: $63.75 Blue Cross Blue Shield — All Products: $145.59 Blue Cross Blue Shield — BluePrint: $144.13 Blue Cross Blue Shield — Select Blue: $131.03 Centivo — All Products: $63.75 Iowa Medicaid — Managed Medicaid: $12.72 Iowa Medicaid — Total Care: $13.10 Midlands Choice — All Products: $66
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Renal Panel	$371	Not listed in the file	$115.01 – $326.48
Kidney function panel: 10 of 23 insurance plan rates Aetna — All Products: $326.48 Ambetter — All Products: $8.68 Avera Health Plan — All Products: $315.35 Blue Cross Blue Shield — All Products: $296.80 Blue Cross Blue Shield — BluePrint: $293.83 Blue Cross Blue Shield — Select Blue: $267.12 Centivo — All Products: $315.35 Iowa Medicaid — Managed Medicaid: $8.25 Iowa Medicaid — Total Care: $8.50 Midlands Choice — All Products: $326.48
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hepatic Function Panel	$296	Not listed in the file	$91.76 – $260.48
Liver function panel: 10 of 23 insurance plan rates Aetna — All Products: $260.48 Ambetter — All Products: $8.17 Avera Health Plan — All Products: $251.60 Blue Cross Blue Shield — All Products: $236.80 Blue Cross Blue Shield — BluePrint: $234.43 Blue Cross Blue Shield — Select Blue: $213.12 Centivo — All Products: $251.60 Iowa Medicaid — Managed Medicaid: $7.76 Iowa Medicaid — Total Care: $7.99 Midlands Choice — All Products: $260.48
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urinalysis W/Micro	$123	Not listed in the file	$38.13 – $108.24
Urine test (automated, with microscope): 10 of 23 insurance plan rates Aetna — All Products: $108.24 Ambetter — All Products: $3.17 Avera Health Plan — All Products: $104.55 Blue Cross Blue Shield — All Products: $61.80 Blue Cross Blue Shield — BluePrint: $61.18 Blue Cross Blue Shield — Select Blue: $55.62 Centivo — All Products: $104.55 Iowa Medicaid — Managed Medicaid: $3.01 Iowa Medicaid — Total Care: $3.10 Midlands Choice — All Products: $108.24
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Ketones Urine	$60	Not listed in the file	$18.60 – $52.80
Urine test (manual, without microscope): 10 of 23 insurance plan rates Aetna — All Products: $52.80 Ambetter — All Products: $3.48 Avera Health Plan — All Products: $51 Blue Cross Blue Shield — All Products: $48 Blue Cross Blue Shield — BluePrint: $47.52 Blue Cross Blue Shield — Select Blue: $43.20 Centivo — All Products: $51 Iowa Medicaid — Managed Medicaid: $3.31 Iowa Medicaid — Total Care: $3.41 Midlands Choice — All Products: $52.80
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Blood Urine	$66	Not listed in the file	$20.46 – $58.08
Urine test (manual, without microscope): 10 of 23 insurance plan rates Aetna — All Products: $58.08 Ambetter — All Products: $3.48 Avera Health Plan — All Products: $56.10 Blue Cross Blue Shield — All Products: $52.80 Blue Cross Blue Shield — BluePrint: $52.27 Blue Cross Blue Shield — Select Blue: $47.52 Centivo — All Products: $56.10 Iowa Medicaid — Managed Medicaid: $3.31 Iowa Medicaid — Total Care: $3.41 Midlands Choice — All Products: $58.08
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Urogram	$64	Not listed in the file	$19.84 – $56.32
Urine test (automated, without microscope): 10 of 23 insurance plan rates Aetna — All Products: $56.32 Ambetter — All Products: $2.25 Avera Health Plan — All Products: $54.40 Blue Cross Blue Shield — All Products: $51.20 Blue Cross Blue Shield — BluePrint: $50.69 Blue Cross Blue Shield — Select Blue: $46.08 Centivo — All Products: $54.40 Iowa Medicaid — Managed Medicaid: $2.14 Iowa Medicaid — Total Care: $2.20 Midlands Choice — All Products: $56.32
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psa Tot	$263	Not listed in the file	$81.53 – $231.44
PSA (prostate specific antigen) blood test: 10 of 23 insurance plan rates Aetna — All Products: $231.44 Ambetter — All Products: $18.39 Avera Health Plan — All Products: $223.55 Blue Cross Blue Shield — All Products: $210.40 Blue Cross Blue Shield — BluePrint: $208.30 Blue Cross Blue Shield — Select Blue: $189.36 Centivo — All Products: $223.55 Iowa Medicaid — Managed Medicaid: $17.47 Iowa Medicaid — Total Care: $17.99 Midlands Choice — All Products: $231.44
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh 3rd Generation	$148	Not listed in the file	$45.88 – $130.24
Thyroid stimulating hormone (TSH) test: 10 of 23 insurance plan rates Aetna — All Products: $130.24 Ambetter — All Products: $16.80 Avera Health Plan — All Products: $125.80 Blue Cross Blue Shield — All Products: $87.55 Blue Cross Blue Shield — BluePrint: $86.67 Blue Cross Blue Shield — Select Blue: $78.80 Centivo — All Products: $125.80 Iowa Medicaid — Managed Medicaid: $15.96 Iowa Medicaid — Total Care: $16.44 Midlands Choice — All Products: $130.24
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tsh (V5600)	$190	Not listed in the file	$58.90 – $167.20
Thyroid stimulating hormone (TSH) test: 10 of 23 insurance plan rates Aetna — All Products: $167.20 Ambetter — All Products: $16.80 Avera Health Plan — All Products: $161.50 Blue Cross Blue Shield — All Products: $87.55 Blue Cross Blue Shield — BluePrint: $86.67 Blue Cross Blue Shield — Select Blue: $78.80 Centivo — All Products: $161.50 Iowa Medicaid — Managed Medicaid: $15.96 Iowa Medicaid — Total Care: $16.44 Midlands Choice — All Products: $167.20
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TSH	$342	Not listed in the file	$106.02 – $300.96
Thyroid stimulating hormone (TSH) test: 10 of 23 insurance plan rates Aetna — All Products: $300.96 Ambetter — All Products: $16.80 Avera Health Plan — All Products: $290.70 Blue Cross Blue Shield — All Products: $87.55 Blue Cross Blue Shield — BluePrint: $86.67 Blue Cross Blue Shield — Select Blue: $78.80 Centivo — All Products: $290.70 Iowa Medicaid — Managed Medicaid: $15.96 Iowa Medicaid — Total Care: $16.44 Midlands Choice — All Products: $300.96
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Cbc Auto Diff	$193	Not listed in the file	$59.83 – $169.84
Complete blood count (CBC) with differential: 10 of 23 insurance plan rates Aetna — All Products: $169.84 Ambetter — All Products: $7.77 Avera Health Plan — All Products: $164.05 Blue Cross Blue Shield — All Products: $72.10 Blue Cross Blue Shield — BluePrint: $71.38 Blue Cross Blue Shield — Select Blue: $64.89 Centivo — All Products: $164.05 Iowa Medicaid — Managed Medicaid: $7.38 Iowa Medicaid — Total Care: $7.60 Midlands Choice — All Products: $169.84
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hemogram	$138	Not listed in the file	$42.78 – $121.44
Complete blood count (CBC), automated: 10 of 23 insurance plan rates Aetna — All Products: $121.44 Ambetter — All Products: $6.47 Avera Health Plan — All Products: $117.30 Blue Cross Blue Shield — All Products: $82.40 Blue Cross Blue Shield — BluePrint: $81.58 Blue Cross Blue Shield — Select Blue: $74.16 Centivo — All Products: $117.30 Iowa Medicaid — Managed Medicaid: $6.15 Iowa Medicaid — Total Care: $6.33 Midlands Choice — All Products: $121.44
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT	$134	Not listed in the file	$41.54 – $117.92
Blood clotting time test (prothrombin time, PT): 10 of 23 insurance plan rates Aetna — All Products: $117.92 Ambetter — All Products: $4.29 Avera Health Plan — All Products: $113.90 Blue Cross Blue Shield — All Products: $107.20 Blue Cross Blue Shield — BluePrint: $106.13 Blue Cross Blue Shield — Select Blue: $96.48 Centivo — All Products: $113.90 Iowa Medicaid — Managed Medicaid: $4.08 Iowa Medicaid — Total Care: $4.20 Midlands Choice — All Products: $117.92
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Protime	$128	Not listed in the file	$39.68 – $112.64
Blood clotting time test (prothrombin time, PT): 10 of 23 insurance plan rates Aetna — All Products: $112.64 Ambetter — All Products: $4.29 Avera Health Plan — All Products: $108.80 Blue Cross Blue Shield — All Products: $102.40 Blue Cross Blue Shield — BluePrint: $101.38 Blue Cross Blue Shield — Select Blue: $92.16 Centivo — All Products: $108.80 Iowa Medicaid — Managed Medicaid: $4.08 Iowa Medicaid — Total Care: $4.20 Midlands Choice — All Products: $112.64
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tc Prothrombin Time	$32	Not listed in the file	$9.92 – $28.16
Blood clotting time test (prothrombin time, PT): 10 of 23 insurance plan rates Aetna — All Products: $28.16 Ambetter — All Products: $4.29 Avera Health Plan — All Products: $27.20 Blue Cross Blue Shield — All Products: $25.60 Blue Cross Blue Shield — BluePrint: $25.34 Blue Cross Blue Shield — Select Blue: $23.04 Centivo — All Products: $27.20 Iowa Medicaid — Managed Medicaid: $4.08 Iowa Medicaid — Total Care: $4.20 Midlands Choice — All Products: $28.16
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Aptt Lupus	$155	Not listed in the file	$48.05 – $136.40
Blood clotting test (partial thromboplastin time, PTT): 10 of 23 insurance plan rates Aetna — All Products: $136.40 Ambetter — All Products: $6.01 Avera Health Plan — All Products: $131.75 Blue Cross Blue Shield — All Products: $124 Blue Cross Blue Shield — BluePrint: $122.76 Blue Cross Blue Shield — Select Blue: $111.60 Centivo — All Products: $131.75 Iowa Medicaid — Managed Medicaid: $5.71 Iowa Medicaid — Total Care: $5.88 Midlands Choice — All Products: $136.40
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Partial Thrombopalstin	$317	Not listed in the file	$98.27 – $278.96
Blood clotting test (partial thromboplastin time, PTT): 10 of 23 insurance plan rates Aetna — All Products: $278.96 Ambetter — All Products: $6.01 Avera Health Plan — All Products: $269.45 Blue Cross Blue Shield — All Products: $253.60 Blue Cross Blue Shield — BluePrint: $251.06 Blue Cross Blue Shield — Select Blue: $228.24 Centivo — All Products: $269.45 Iowa Medicaid — Managed Medicaid: $5.71 Iowa Medicaid — Total Care: $5.88 Midlands Choice — All Products: $278.96
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PTT	$175	Not listed in the file	$54.25 – $154
Blood clotting test (partial thromboplastin time, PTT): 10 of 23 insurance plan rates Aetna — All Products: $154 Ambetter — All Products: $6.01 Avera Health Plan — All Products: $148.75 Blue Cross Blue Shield — All Products: $140 Blue Cross Blue Shield — BluePrint: $138.60 Blue Cross Blue Shield — Select Blue: $126 Centivo — All Products: $148.75 Iowa Medicaid — Managed Medicaid: $5.71 Iowa Medicaid — Total Care: $5.88 Midlands Choice — All Products: $154

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Head WO Contrast	$3,165	Not listed in the file	$981.15 – $2,785.20
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates Aetna — All Products: $2,785.20 Ambetter — All Products: $213.62 Avera Health Plan — All Products: $2,690.25 Blue Cross Blue Shield — All Products: $2,532 Blue Cross Blue Shield — BluePrint: $2,506.68 Blue Cross Blue Shield — Select Blue: $2,278.80 Centivo — All Products: $2,690.25 Iowa Medicaid — Managed Medicaid: $130.23 Iowa Medicaid — Total Care: $134.14 Midlands Choice — All Products: $2,785.20
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Brain Brain Stem W and WO Contrast	$7,152	Not listed in the file	$2,217.12 – $6,293.76
MRI of the brain, before and after contrast: 10 of 23 insurance plan rates Aetna — All Products: $6,293.76 Ambetter — All Products: $712.86 Avera Health Plan — All Products: $6,079.20 Blue Cross Blue Shield — All Products: $5,721.60 Blue Cross Blue Shield — BluePrint: $5,664.38 Blue Cross Blue Shield — Select Blue: $5,149.44 Centivo — All Products: $6,079.20 Iowa Medicaid — Managed Medicaid: $437.36 Iowa Medicaid — Total Care: $450.48 Midlands Choice — All Products: $6,293.76
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Exam Chest 2 Views	$660	Not listed in the file	$204.60 – $580.80
Chest X-ray, 2 views: 10 of 23 insurance plan rates Aetna — All Products: $580.80 Ambetter — All Products: $177.82 Avera Health Plan — All Products: $561 Blue Cross Blue Shield — All Products: $200 Blue Cross Blue Shield — BluePrint: $198 Blue Cross Blue Shield — Select Blue: $180 Centivo — All Products: $561 Iowa Medicaid — Managed Medicaid: $107.82 Iowa Medicaid — Total Care: $111.06 Midlands Choice — All Products: $580.80
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Xr Spine Lumb Oblq Min 4v	$992	Not listed in the file	$307.52 – $872.96
X-ray of the lower spine, at least 4 views: 10 of 23 insurance plan rates Aetna — All Products: $872.96 Ambetter — All Products: $213.62 Avera Health Plan — All Products: $843.20 Blue Cross Blue Shield — All Products: $793.60 Blue Cross Blue Shield — BluePrint: $785.66 Blue Cross Blue Shield — Select Blue: $714.24 Centivo — All Products: $843.20 Iowa Medicaid — Managed Medicaid: $130.23 Iowa Medicaid — Total Care: $134.14 Midlands Choice — All Products: $872.96
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Lumbar WO Con	$5,364	Not listed in the file	$1,662.84 – $4,720.32
MRI of the lower back (lumbar spine), without contrast: 10 of 23 insurance plan rates Aetna — All Products: $4,720.32 Ambetter — All Products: $487.54 Avera Health Plan — All Products: $4,559.40 Blue Cross Blue Shield — All Products: $4,291.20 Blue Cross Blue Shield — BluePrint: $4,248.29 Blue Cross Blue Shield — Select Blue: $3,862.08 Centivo — All Products: $4,559.40 Iowa Medicaid — Managed Medicaid: $296.02 Iowa Medicaid — Total Care: $304.90 Midlands Choice — All Products: $4,720.32
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Pelvis W Contrast	$4,334	Not listed in the file	$1,343.54 – $3,813.92
CT scan of the pelvis, with contrast: 10 of 23 insurance plan rates Aetna — All Products: $3,813.92 Ambetter — All Products: $358.40 Avera Health Plan — All Products: $3,683.90 Blue Cross Blue Shield — All Products: $3,467.20 Blue Cross Blue Shield — BluePrint: $3,432.53 Blue Cross Blue Shield — Select Blue: $3,120.48 Centivo — All Products: $3,683.90 Iowa Medicaid — Managed Medicaid: $218.01 Iowa Medicaid — Total Care: $224.55 Midlands Choice — All Products: $3,813.92
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI Any Jt Lower Extrem WO Con	$4,312	Not listed in the file	$1,336.72 – $3,794.56
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates Aetna — All Products: $3,794.56 Ambetter — All Products: $487.54 Avera Health Plan — All Products: $3,665.20 Blue Cross Blue Shield — All Products: $3,449.60 Blue Cross Blue Shield — BluePrint: $3,415.10 Blue Cross Blue Shield — Select Blue: $3,104.64 Centivo — All Products: $3,665.20 Iowa Medicaid — Managed Medicaid: $296.02 Iowa Medicaid — Total Care: $304.90 Midlands Choice — All Products: $3,794.56
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: MRI Any Jt Lower Extrem WO Con	$4,312	Not listed in the file	$1,336.72 – $3,794.56
MRI of a leg joint (such as the knee), without contrast: 10 of 19 insurance plan rates Aetna — All Products: $3,794.56 Ambetter — All Products: $3,018.40 Avera Health Plan — All Products: $3,665.20 Blue Cross Blue Shield — All Products: $3,449.60 Blue Cross Blue Shield — BluePrint: $3,415.10 Blue Cross Blue Shield — Select Blue: $3,104.64 Centivo — All Products: $3,665.20 Midlands Choice — All Products: $3,794.56 Midlands Choice CHI — All Products: $3,018.40 Midlands Choice Elevate — All Products: $3,449.60
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT Abdomen & Pelvis W Contrast	$6,433	Not listed in the file	$1,994.23 – $5,661.04
CT scan of the abdomen and pelvis, with contrast: 10 of 23 insurance plan rates Aetna — All Products: $5,661.04 Ambetter — All Products: $712.86 Avera Health Plan — All Products: $5,468.05 Blue Cross Blue Shield — All Products: $5,146.40 Blue Cross Blue Shield — BluePrint: $5,094.94 Blue Cross Blue Shield — Select Blue: $4,631.76 Centivo — All Products: $5,468.05 Iowa Medicaid — Managed Medicaid: $437.36 Iowa Medicaid — Total Care: $450.48 Midlands Choice — All Products: $5,661.04
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Abdomen Complete	$1,565	Not listed in the file	$485.15 – $1,377.20
Ultrasound of the abdomen, complete: 10 of 23 insurance plan rates Aetna — All Products: $1,377.20 Ambetter — All Products: $213.62 Avera Health Plan — All Products: $1,330.25 Blue Cross Blue Shield — All Products: $1,252 Blue Cross Blue Shield — BluePrint: $1,239.48 Blue Cross Blue Shield — Select Blue: $1,126.80 Centivo — All Products: $1,330.25 Iowa Medicaid — Managed Medicaid: $130.23 Iowa Medicaid — Total Care: $134.14 Midlands Choice — All Products: $1,377.20
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Preg Uter Fetal & Mat 2-3 Trimest	$1,039	Not listed in the file	$322.09 – $914.32
Pregnancy ultrasound (after the first trimester): 10 of 23 insurance plan rates Aetna — All Products: $914.32 Ambetter — All Products: $213.62 Avera Health Plan — All Products: $883.15 Blue Cross Blue Shield — All Products: $831.20 Blue Cross Blue Shield — BluePrint: $822.89 Blue Cross Blue Shield — Select Blue: $748.08 Centivo — All Products: $883.15 Iowa Medicaid — Managed Medicaid: $130.23 Iowa Medicaid — Total Care: $134.14 Midlands Choice — All Products: $914.32
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US Echography Transvaginal	$934	Not listed in the file	$289.54 – $821.92
Transvaginal ultrasound: 10 of 23 insurance plan rates Aetna — All Products: $821.92 Ambetter — All Products: $213.62 Avera Health Plan — All Products: $793.90 Blue Cross Blue Shield — All Products: $747.20 Blue Cross Blue Shield — BluePrint: $739.73 Blue Cross Blue Shield — Select Blue: $672.48 Centivo — All Products: $793.90 Iowa Medicaid — Managed Medicaid: $130.23 Iowa Medicaid — Total Care: $134.14 Midlands Choice — All Products: $821.92
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	Not listed in the file	Not listed in the file	$164.52 – $336.22
Diagnostic mammogram, one breast: rates for 6 insurance plans Aetna — All Products: $164.52 Ambetter — All Products: $336.22 Iowa Medicaid — Managed Medicaid: $111.25 Iowa Medicaid — Total Care: $114.59 Molina (Iowa) — Managed Medicaid: $115.14 Wellpoint — Managed Medicaid: $111.25
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	Not listed in the file	Not listed in the file	$207.95 – $426.16
Diagnostic mammogram, both breasts: rates for 6 insurance plans Aetna — All Products: $207.95 Ambetter — All Products: $426.16 Iowa Medicaid — Managed Medicaid: $140.82 Iowa Medicaid — Total Care: $145.04 Molina (Iowa) — Managed Medicaid: $145.75 Wellpoint — Managed Medicaid: $140.82
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCR MAMMO BI INCL CAD	Not listed in the file	Not listed in the file	$169.06 – $344.68
Screening mammogram, both breasts: rates for 6 insurance plans Aetna — All Products: $169.06 Ambetter — All Products: $344.68 Iowa Medicaid — Managed Medicaid: $113.76 Iowa Medicaid — Total Care: $117.17 Molina (Iowa) — Managed Medicaid: $117.74 Wellpoint — Managed Medicaid: $113.76

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	Not listed in the file	Not listed in the file	$25.65 – $26.55
Electrocardiogram (ECG/EKG) with reading: rates for 4 insurance plans Iowa Medicaid — Managed Medicaid: $25.65 Iowa Medicaid — Total Care: $26.42 Molina (Iowa) — Managed Medicaid: $26.55 Wellpoint — Managed Medicaid: $25.65
Left heart catheterization (diagnostic) CPT 93452 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Left Hrt Cath W/Ventrclgrphy	$21,777	Not listed in the file	$6,750.87 – $19,163.76
Left heart catheterization (diagnostic): 10 of 23 insurance plan rates Aetna — All Products: $19,163.76 Ambetter — All Products: $6,624.30 Avera Health Plan — All Products: $18,510.45 Blue Cross Blue Shield — All Products: $17,421.60 Blue Cross Blue Shield — BluePrint: $17,247.38 Blue Cross Blue Shield — Select Blue: $15,679.44 Centivo — All Products: $18,510.45 Iowa Medicaid — Managed Medicaid: $3,938.95 Iowa Medicaid — Total Care: $4,057.12 Midlands Choice — All Products: $19,163.76
Heart rhythm study (electrophysiology evaluation) CPT 93619 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Compre Electrophysiologic W/O Arrhyt Induction	$18,596	Not listed in the file	$5,764.76 – $16,364.48
Heart rhythm study (electrophysiology evaluation): 10 of 23 insurance plan rates Aetna — All Products: $16,364.48 Ambetter — All Products: $15,937.20 Avera Health Plan — All Products: $15,806.60 Blue Cross Blue Shield — All Products: $14,876.80 Blue Cross Blue Shield — BluePrint: $14,728.03 Blue Cross Blue Shield — Select Blue: $13,389.12 Centivo — All Products: $15,806.60 Iowa Medicaid — Managed Medicaid: $9,292.70 Iowa Medicaid — Total Care: $9,571.48 Midlands Choice — All Products: $16,364.48
Heart rhythm study with ablation for atrial fibrillation CPT 93656 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tx Atrial Fib Pulm Vein Isol	$67,257	Not listed in the file	$20,849.67 – $59,186.16
Heart rhythm study with ablation for atrial fibrillation: 10 of 23 insurance plan rates Aetna — All Products: $59,186.16 Ambetter — All Products: $53,407.98 Avera Health Plan — All Products: $57,168.45 Blue Cross Blue Shield — All Products: $53,805.60 Blue Cross Blue Shield — BluePrint: $53,267.54 Blue Cross Blue Shield — Select Blue: $48,425.04 Centivo — All Products: $57,168.45 Iowa Medicaid — Managed Medicaid: $30,043.26 Iowa Medicaid — Total Care: $30,944.55 Midlands Choice — All Products: $59,186.16
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Sleep Staging 4+ Attend > 6 Yrs	$6,509	Not listed in the file	$2,017.79 – $5,727.92
Sleep study (overnight, in a sleep lab): 10 of 23 insurance plan rates Aetna — All Products: $5,727.92 Ambetter — All Products: $1,754.68 Avera Health Plan — All Products: $5,532.65 Blue Cross Blue Shield — All Products: $5,207.20 Blue Cross Blue Shield — BluePrint: $5,155.13 Blue Cross Blue Shield — Select Blue: $4,686.48 Centivo — All Products: $5,532.65 Iowa Medicaid — Managed Medicaid: $1,245.94 Iowa Medicaid — Total Care: $1,283.32 Midlands Choice — All Products: $5,727.92
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: Sleep Stag 4+ Attend > 6 Yrs <6hr	$3,744	Not listed in the file	$1,160.64 – $3,294.72
Sleep study (overnight, in a sleep lab): 10 of 19 insurance plan rates Aetna — All Products: $3,294.72 Ambetter — All Products: $2,620.80 Avera Health Plan — All Products: $3,182.40 Blue Cross Blue Shield — All Products: $2,995.20 Blue Cross Blue Shield — BluePrint: $2,965.25 Blue Cross Blue Shield — Select Blue: $2,695.68 Centivo — All Products: $3,182.40 Midlands Choice — All Products: $3,294.72 Midlands Choice CHI — All Products: $2,620.80 Midlands Choice Elevate — All Products: $2,995.20

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	Not listed in the file	Not listed in the file	$37.06 – $74.62
Physical therapy: therapeutic exercise (each 15 minutes): rates for 6 insurance plans Aetna — All Products: $37.06 Ambetter — All Products: $74.62 Iowa Medicaid — Managed Medicaid: $24.88 Iowa Medicaid — Total Care: $25.63 Molina (Iowa) — Managed Medicaid: $25.75 Wellpoint — Managed Medicaid: $24.88
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Ther Ex 15 Min	$199	Not listed in the file	$61.69 – $175.12
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — All Products: $175.12 Ambetter — All Products: $139.30 Avera Health Plan — All Products: $169.15 Blue Cross Blue Shield — All Products: $159.20 Blue Cross Blue Shield — BluePrint: $157.61 Blue Cross Blue Shield — Select Blue: $143.28 Centivo — All Products: $169.15 Midlands Choice — All Products: $175.12 Midlands Choice CHI — All Products: $139.30 Midlands Choice Elevate — All Products: $159.20
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GO In the file: Ot Ther Ex 15 Min	$186	Not listed in the file	$57.66 – $163.68
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates Aetna — All Products: $163.68 Ambetter — All Products: $130.20 Avera Health Plan — All Products: $158.10 Blue Cross Blue Shield — All Products: $148.80 Blue Cross Blue Shield — BluePrint: $147.31 Blue Cross Blue Shield — Select Blue: $133.92 Centivo — All Products: $158.10 Midlands Choice — All Products: $163.68 Midlands Choice CHI — All Products: $130.20 Midlands Choice Elevate — All Products: $148.80
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	Not listed in the file	Not listed in the file	$126.19 – $252.86
Physical therapy evaluation (low complexity): rates for 6 insurance plans Aetna — All Products: $126.19 Ambetter — All Products: $252.86 Iowa Medicaid — Managed Medicaid: $73.33 Iowa Medicaid — Total Care: $75.53 Molina (Iowa) — Managed Medicaid: $75.90 Wellpoint — Managed Medicaid: $73.33
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval Low Complex	$359	Not listed in the file	$111.29 – $315.92
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — All Products: $315.92 Ambetter — All Products: $251.30 Avera Health Plan — All Products: $305.15 Blue Cross Blue Shield — All Products: $287.20 Blue Cross Blue Shield — BluePrint: $284.33 Blue Cross Blue Shield — Select Blue: $258.48 Centivo — All Products: $305.15 Midlands Choice — All Products: $315.92 Midlands Choice CHI — All Products: $251.30 Midlands Choice Elevate — All Products: $287.20
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval Low Complex +	$686	Not listed in the file	$212.66 – $603.68
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates Aetna — All Products: $603.68 Ambetter — All Products: $480.20 Avera Health Plan — All Products: $583.10 Blue Cross Blue Shield — All Products: $548.80 Blue Cross Blue Shield — BluePrint: $543.31 Blue Cross Blue Shield — Select Blue: $493.92 Centivo — All Products: $583.10 Midlands Choice — All Products: $603.68 Midlands Choice CHI — All Products: $480.20 Midlands Choice Elevate — All Products: $548.80
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	Not listed in the file	Not listed in the file	$126.19 – $252.86
Physical therapy evaluation (moderate complexity): rates for 6 insurance plans Aetna — All Products: $126.19 Ambetter — All Products: $252.86 Iowa Medicaid — Managed Medicaid: $73.33 Iowa Medicaid — Total Care: $75.53 Molina (Iowa) — Managed Medicaid: $75.90 Wellpoint — Managed Medicaid: $73.33
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval Mod Complex	$359	Not listed in the file	$111.29 – $315.92
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — All Products: $315.92 Ambetter — All Products: $251.30 Avera Health Plan — All Products: $305.15 Blue Cross Blue Shield — All Products: $287.20 Blue Cross Blue Shield — BluePrint: $284.33 Blue Cross Blue Shield — Select Blue: $258.48 Centivo — All Products: $305.15 Midlands Choice — All Products: $315.92 Midlands Choice CHI — All Products: $251.30 Midlands Choice Elevate — All Products: $287.20
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval Mod Complex +	$686	Not listed in the file	$212.66 – $603.68
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates Aetna — All Products: $603.68 Ambetter — All Products: $480.20 Avera Health Plan — All Products: $583.10 Blue Cross Blue Shield — All Products: $548.80 Blue Cross Blue Shield — BluePrint: $543.31 Blue Cross Blue Shield — Select Blue: $493.92 Centivo — All Products: $583.10 Midlands Choice — All Products: $603.68 Midlands Choice CHI — All Products: $480.20 Midlands Choice Elevate — All Products: $548.80
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	Not listed in the file	Not listed in the file	$126.19 – $252.86
Physical therapy evaluation (high complexity): rates for 6 insurance plans Aetna — All Products: $126.19 Ambetter — All Products: $252.86 Iowa Medicaid — Managed Medicaid: $73.33 Iowa Medicaid — Total Care: $75.53 Molina (Iowa) — Managed Medicaid: $75.90 Wellpoint — Managed Medicaid: $73.33
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval High Complex	$359	Not listed in the file	$111.29 – $315.92
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — All Products: $315.92 Ambetter — All Products: $251.30 Avera Health Plan — All Products: $305.15 Blue Cross Blue Shield — All Products: $287.20 Blue Cross Blue Shield — BluePrint: $284.33 Blue Cross Blue Shield — Select Blue: $258.48 Centivo — All Products: $305.15 Midlands Choice — All Products: $315.92 Midlands Choice CHI — All Products: $251.30 Midlands Choice Elevate — All Products: $287.20
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: Pt Eval High Complex +	$713	Not listed in the file	$221.03 – $627.44
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates Aetna — All Products: $627.44 Ambetter — All Products: $499.10 Avera Health Plan — All Products: $606.05 Blue Cross Blue Shield — All Products: $570.40 Blue Cross Blue Shield — BluePrint: $564.70 Blue Cross Blue Shield — Select Blue: $513.36 Centivo — All Products: $606.05 Midlands Choice — All Products: $627.44 Midlands Choice CHI — All Products: $499.10 Midlands Choice Elevate — All Products: $570.40
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 30 Minutes	$221	Not listed in the file	$68.51 – $194.48
Psychotherapy, 30 minutes: 10 of 23 insurance plan rates Aetna — All Products: $194.48 Ambetter — All Products: $221 Avera Health Plan — All Products: $187.85 Blue Cross Blue Shield — All Products: $176.80 Blue Cross Blue Shield — BluePrint: $175.03 Blue Cross Blue Shield — Select Blue: $159.12 Centivo — All Products: $187.85 Iowa Medicaid — Managed Medicaid: $196.77 Iowa Medicaid — Total Care: $202.67 Midlands Choice — All Products: $194.48
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 45 Minutes	$308	Not listed in the file	$95.48 – $271.04
Psychotherapy, 45 minutes: 10 of 23 insurance plan rates Aetna — All Products: $271.04 Ambetter — All Products: $308 Avera Health Plan — All Products: $261.80 Blue Cross Blue Shield — All Products: $246.40 Blue Cross Blue Shield — BluePrint: $243.94 Blue Cross Blue Shield — Select Blue: $221.76 Centivo — All Products: $261.80 Iowa Medicaid — Managed Medicaid: $196.77 Iowa Medicaid — Total Care: $202.67 Midlands Choice — All Products: $271.04
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Psychotherapy W/Patient 60 Minutes	$386	Not listed in the file	$119.66 – $339.68
Psychotherapy, 60 minutes: 10 of 23 insurance plan rates Aetna — All Products: $339.68 Ambetter — All Products: $362.68 Avera Health Plan — All Products: $328.10 Blue Cross Blue Shield — All Products: $308.80 Blue Cross Blue Shield — BluePrint: $305.71 Blue Cross Blue Shield — Select Blue: $277.92 Centivo — All Products: $328.10 Iowa Medicaid — Managed Medicaid: $196.77 Iowa Medicaid — Total Care: $202.67 Midlands Choice — All Products: $339.68
Family psychotherapy, without the patient CPT 90846 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Psychotherapy W/O Patient Present 50 Mins	$255	Not listed in the file	$79.05 – $224.40
Family psychotherapy, without the patient: 10 of 23 insurance plan rates Aetna — All Products: $224.40 Ambetter — All Products: $255 Avera Health Plan — All Products: $216.75 Blue Cross Blue Shield — All Products: $204 Blue Cross Blue Shield — BluePrint: $201.96 Blue Cross Blue Shield — Select Blue: $183.60 Centivo — All Products: $216.75 Iowa Medicaid — Managed Medicaid: $196.77 Iowa Medicaid — Total Care: $202.67 Midlands Choice — All Products: $224.40
Family psychotherapy, with the patient CPT 90847 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Family Psychotherapy W/Patient Present 50 Mins	$297	Not listed in the file	$92.07 – $261.36
Family psychotherapy, with the patient: 10 of 23 insurance plan rates Aetna — All Products: $261.36 Ambetter — All Products: $297 Avera Health Plan — All Products: $252.45 Blue Cross Blue Shield — All Products: $237.60 Blue Cross Blue Shield — BluePrint: $235.22 Blue Cross Blue Shield — Select Blue: $213.84 Centivo — All Products: $252.45 Iowa Medicaid — Managed Medicaid: $196.77 Iowa Medicaid — Total Care: $202.67 Midlands Choice — All Products: $261.36
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: GROUP PSYCHOTHERAPY	Not listed in the file	Not listed in the file	$207.58
Group psychotherapy: rates for 5 insurance plans Ambetter — All Products: $207.58 Iowa Medicaid — Managed Medicaid: $113.28 Iowa Medicaid — Total Care: $116.68 Molina (Iowa) — Managed Medicaid: $117.25 Wellpoint — Managed Medicaid: $113.28

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF BREAST LESION	Not listed in the file	Not listed in the file	$8,000.48
Removal of breast growth (open surgery): rates for 5 insurance plans Ambetter — All Products: $8,000.48 Iowa Medicaid — Managed Medicaid: $4,689.50 Iowa Medicaid — Total Care: $4,830.18 Molina (Iowa) — Managed Medicaid: $4,853.63 Wellpoint — Managed Medicaid: $4,689.50
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL HIP ARTHROPLASTY	Not listed in the file	Not listed in the file	$26,233.52
Total hip replacement: rates for 5 insurance plans Ambetter — All Products: $26,233.52 Iowa Medicaid — Managed Medicaid: $15,757.23 Iowa Medicaid — Total Care: $16,229.95 Molina (Iowa) — Managed Medicaid: $16,308.74 Wellpoint — Managed Medicaid: $15,757.23
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total hip arthroplasty	Not listed in the file	Not listed in the file	$19,245.25 – $20,592.42
Total hip replacement: rates for 4 insurance plans Molina (Nebraska) — Managed Medicaid: $20,592.42 Nebraska Medicaid — Community Plan - All Products: $19,245.25 Nebraska Medicaid — Managed Medicaid Community Plan: $19,245.25 Nebraska Medicaid — Total Care: $19,822.61
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TOTAL KNEE ARTHROPLASTY	Not listed in the file	Not listed in the file	$26,233.52
Total knee replacement: rates for 5 insurance plans Ambetter — All Products: $26,233.52 Iowa Medicaid — Managed Medicaid: $15,757.23 Iowa Medicaid — Total Care: $16,229.95 Molina (Iowa) — Managed Medicaid: $16,308.74 Wellpoint — Managed Medicaid: $15,757.23
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Total knee arthroplasty	Not listed in the file	Not listed in the file	$19,245.25 – $20,592.42
Total knee replacement: rates for 4 insurance plans Molina (Nebraska) — Managed Medicaid: $20,592.42 Nebraska Medicaid — Community Plan - All Products: $19,245.25 Nebraska Medicaid — Managed Medicaid Community Plan: $19,245.25 Nebraska Medicaid — Total Care: $19,822.61
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ARTHRS KNE SRG MNISECTMY M/L	Not listed in the file	Not listed in the file	$6,685.74
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 5 insurance plans Ambetter — All Products: $6,685.74 Iowa Medicaid — Managed Medicaid: $3,973.48 Iowa Medicaid — Total Care: $4,092.69 Molina (Iowa) — Managed Medicaid: $4,112.55 Wellpoint — Managed Medicaid: $3,973.48
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVE TONSILS AND ADENOIDS	Not listed in the file	Not listed in the file	$12,096.10
Removal of tonsils and adenoids (under age 12): rates for 5 insurance plans Ambetter — All Products: $12,096.10 Iowa Medicaid — Managed Medicaid: $7,244.56 Iowa Medicaid — Total Care: $7,461.89 Molina (Iowa) — Managed Medicaid: $7,498.12 Wellpoint — Managed Medicaid: $7,244.56
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	Not listed in the file	Not listed in the file	$1,853.26
Upper GI endoscopy (diagnostic): rates for 5 insurance plans Ambetter — All Products: $1,853.26 Iowa Medicaid — Managed Medicaid: $1,148.17 Iowa Medicaid — Total Care: $1,182.62 Molina (Iowa) — Managed Medicaid: $1,188.36 Wellpoint — Managed Medicaid: $1,148.17
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD BIOPSY SINGLE/MULTIPLE	Not listed in the file	Not listed in the file	$1,853.26
Upper GI endoscopy with biopsy: rates for 5 insurance plans Ambetter — All Products: $1,853.26 Iowa Medicaid — Managed Medicaid: $1,148.17 Iowa Medicaid — Total Care: $1,182.62 Molina (Iowa) — Managed Medicaid: $1,188.36 Wellpoint — Managed Medicaid: $1,148.17
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC COLONOSCOPY	Not listed in the file	Not listed in the file	$1,900.20
Colonoscopy (diagnostic): rates for 5 insurance plans Ambetter — All Products: $1,900.20 Iowa Medicaid — Managed Medicaid: $1,116.52 Iowa Medicaid — Total Care: $1,150.01 Molina (Iowa) — Managed Medicaid: $1,155.59 Wellpoint — Managed Medicaid: $1,116.52
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY AND BIOPSY	Not listed in the file	Not listed in the file	$2,445.12
Colonoscopy with biopsy: rates for 5 insurance plans Ambetter — All Products: $2,445.12 Iowa Medicaid — Managed Medicaid: $1,443.95 Iowa Medicaid — Total Care: $1,487.27 Molina (Iowa) — Managed Medicaid: $1,494.49 Wellpoint — Managed Medicaid: $1,443.95
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/LESION REMOVAL	Not listed in the file	Not listed in the file	$2,445.12
Colonoscopy with removal of polyps (snare): rates for 5 insurance plans Ambetter — All Products: $2,445.12 Iowa Medicaid — Managed Medicaid: $1,443.95 Iowa Medicaid — Total Care: $1,487.27 Molina (Iowa) — Managed Medicaid: $1,494.49 Wellpoint — Managed Medicaid: $1,443.95
Ultrasound of the lower bowel by endoscope CPT 45391 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLONOSCOPY W/ENDOSCOPE US	Not listed in the file	Not listed in the file	$2,445.12
Ultrasound of the lower bowel by endoscope: rates for 5 insurance plans Ambetter — All Products: $2,445.12 Iowa Medicaid — Managed Medicaid: $1,443.95 Iowa Medicaid — Total Care: $1,487.27 Molina (Iowa) — Managed Medicaid: $1,494.49 Wellpoint — Managed Medicaid: $1,443.95
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Colon ca scrn not hi rsk ind	Not listed in the file	Not listed in the file	$1,900.20
Screening colonoscopy (not high risk): rates for 9 insurance plans Ambetter — All Products: $1,900.20 Iowa Medicaid — Managed Medicaid: $1,116.52 Iowa Medicaid — Total Care: $1,150.01 Molina (Iowa) — Managed Medicaid: $1,155.59 Molina (Nebraska) — Managed Medicaid: $2,139.04 Nebraska Medicaid — Community Plan - All Products: $1,999.10 Nebraska Medicaid — Managed Medicaid Community Plan: $1,999.10 Nebraska Medicaid — Total Care: $2,059.07 Wellpoint — Managed Medicaid: $1,116.52
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPAROSCOPIC CHOLECYSTECTOMY	Not listed in the file	Not listed in the file	$12,352.94
Gallbladder removal by laparoscope: rates for 5 insurance plans Ambetter — All Products: $12,352.94 Iowa Medicaid — Managed Medicaid: $7,145 Iowa Medicaid — Total Care: $7,359.35 Molina (Iowa) — Managed Medicaid: $7,395.07 Wellpoint — Managed Medicaid: $7,145
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PRP I/HERN INIT REDUC >5 YR	Not listed in the file	Not listed in the file	$7,315.90
Groin (inguinal) hernia repair, age 5 or older: rates for 5 insurance plans Ambetter — All Products: $7,315.90 Iowa Medicaid — Managed Medicaid: $4,321.83 Iowa Medicaid — Total Care: $4,451.49 Molina (Iowa) — Managed Medicaid: $4,473.09 Wellpoint — Managed Medicaid: $4,321.83
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE	Not listed in the file	Not listed in the file	$2,508.68 – $2,596.49
Prostate biopsy: rates for 4 insurance plans Iowa Medicaid — Managed Medicaid: $2,508.68 Iowa Medicaid — Total Care: $2,583.94 Molina (Iowa) — Managed Medicaid: $2,596.49 Wellpoint — Managed Medicaid: $2,508.68
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LAPS SURG PRST8ECT RPBIC RAD	Not listed in the file	Not listed in the file	$21,720.14
Prostate removal by laparoscope (radical prostatectomy): rates for 5 insurance plans Ambetter — All Products: $21,720.14 Iowa Medicaid — Managed Medicaid: $12,750.01 Iowa Medicaid — Total Care: $13,132.51 Molina (Iowa) — Managed Medicaid: $13,196.26 Wellpoint — Managed Medicaid: $12,750.01
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HYSTEROSCOPY BIOPSY	Not listed in the file	Not listed in the file	$6,614.48
Hysteroscopy with biopsy of the uterus lining: rates for 5 insurance plans Ambetter — All Products: $6,614.48 Iowa Medicaid — Managed Medicaid: $3,893.78 Iowa Medicaid — Total Care: $4,010.59 Molina (Iowa) — Managed Medicaid: $4,030.06 Wellpoint — Managed Medicaid: $3,893.78
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Hysteroscopy biopsy	Not listed in the file	Not listed in the file	$4,714.50 – $5,044.52
Hysteroscopy with biopsy of the uterus lining: rates for 4 insurance plans Molina (Nebraska) — Managed Medicaid: $5,044.52 Nebraska Medicaid — Community Plan - All Products: $4,714.50 Nebraska Medicaid — Managed Medicaid Community Plan: $4,714.50 Nebraska Medicaid — Total Care: $4,855.94
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	Not listed in the file	Not listed in the file	$1,442.34
Spinal injection, lower back (epidural), with imaging guidance: rates for 5 insurance plans Ambetter — All Products: $1,442.34 Iowa Medicaid — Managed Medicaid: $848.09 Iowa Medicaid — Total Care: $873.53 Molina (Iowa) — Managed Medicaid: $877.77 Wellpoint — Managed Medicaid: $848.09
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Tc Inj Foramen L/S 1 Level	$2,639	Not listed in the file	$818.09 – $2,322.32
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates Aetna — All Products: $2,322.32 Ambetter — All Products: $1,807.26 Avera Health Plan — All Products: $2,243.15 Blue Cross Blue Shield — All Products: $2,111.20 Blue Cross Blue Shield — BluePrint: $2,090.09 Blue Cross Blue Shield — Select Blue: $1,900.08 Centivo — All Products: $2,243.15 Iowa Medicaid — Managed Medicaid: $1,090.29 Iowa Medicaid — Total Care: $1,122.99 Midlands Choice — All Products: $2,322.32
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Inj Foramen L/S 1 Level	$2,639	Not listed in the file	$818.09 – $2,322.32
Nerve root injection, lower back, with imaging guidance: 10 of 23 insurance plan rates Aetna — All Products: $2,322.32 Ambetter — All Products: $1,807.26 Avera Health Plan — All Products: $2,243.15 Blue Cross Blue Shield — All Products: $2,111.20 Blue Cross Blue Shield — BluePrint: $2,090.09 Blue Cross Blue Shield — Select Blue: $1,900.08 Centivo — All Products: $2,243.15 Iowa Medicaid — Managed Medicaid: $1,090.29 Iowa Medicaid — Total Care: $1,122.99 Midlands Choice — All Products: $2,322.32
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	Not listed in the file	Not listed in the file	$3,990.04
Carpal tunnel release: rates for 5 insurance plans Ambetter — All Products: $3,990.04 Iowa Medicaid — Managed Medicaid: $2,391.45 Iowa Medicaid — Total Care: $2,463.19 Molina (Iowa) — Managed Medicaid: $2,475.15 Wellpoint — Managed Medicaid: $2,391.45
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: Carpal tunnel surgery	Not listed in the file	Not listed in the file	$2,731.24 – $2,922.43
Carpal tunnel release: rates for 4 insurance plans Molina (Nebraska) — Managed Medicaid: $2,922.43 Nebraska Medicaid — Community Plan - All Products: $2,731.24 Nebraska Medicaid — Managed Medicaid Community Plan: $2,731.24 Nebraska Medicaid — Total Care: $2,813.18
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	Not listed in the file	Not listed in the file	$1,123.82
Laser treatment of clouding after cataract surgery: rates for 5 insurance plans Ambetter — All Products: $1,123.82 Iowa Medicaid — Managed Medicaid: $671.84 Iowa Medicaid — Total Care: $692 Molina (Iowa) — Managed Medicaid: $695.36 Wellpoint — Managed Medicaid: $671.84
Cataract removal with lens implant CPT 66984 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: XCAPSL CTRC RMVL W/O ECP	Not listed in the file	Not listed in the file	$4,715.62
Cataract removal with lens implant: rates for 5 insurance plans Ambetter — All Products: $4,715.62 Iowa Medicaid — Managed Medicaid: $2,793.07 Iowa Medicaid — Total Care: $2,876.87 Molina (Iowa) — Managed Medicaid: $2,890.83 Wellpoint — Managed Medicaid: $2,793.07

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$73,587.77 – $76,163.38
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 18 insurance plan rates Iowa Medicaid — Managed Medicaid: $73,587.77 Iowa Medicaid — Total Care: $75,795.42 Molina (Iowa) — Managed Medicaid: $76,163.38 Wellpoint — Managed Medicaid: $73,587.77 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Ambetter — All Products: 70% (a percentage in the contract, not a dollar amount) Avera Health Plan — All Products: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All Products: 80% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — BluePrint: 79.2% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Select Blue: 72% (a percentage in the contract, not a dollar amount)
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	Not listed in the file	Not listed in the file	$29,773.88 – $30,815.98
Spinal fusion (not neck), without major complications: rates for 4 insurance plans Iowa Medicaid — Managed Medicaid: $29,773.88 Iowa Medicaid — Total Care: $30,667.10 Molina (Iowa) — Managed Medicaid: $30,815.98 Wellpoint — Managed Medicaid: $29,773.88
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Major joint replacement or reattachment of lower extremity w/o MCC	Not listed in the file	Not listed in the file	$16,769.22 – $17,356.15
Hip or knee replacement (major joint of the leg), without major complications: 10 of 18 insurance plan rates Iowa Medicaid — Managed Medicaid: $16,769.22 Iowa Medicaid — Total Care: $17,272.30 Molina (Iowa) — Managed Medicaid: $17,356.15 Wellpoint — Managed Medicaid: $16,769.22 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Ambetter — All Products: 70% (a percentage in the contract, not a dollar amount) Avera Health Plan — All Products: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All Products: 80% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — BluePrint: 79.2% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Select Blue: 72% (a percentage in the contract, not a dollar amount)
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$16,486.78 – $17,063.82
Neck (cervical) spinal fusion, without complications: 10 of 18 insurance plan rates Iowa Medicaid — Managed Medicaid: $16,486.78 Iowa Medicaid — Total Care: $16,981.39 Molina (Iowa) — Managed Medicaid: $17,063.82 Wellpoint — Managed Medicaid: $16,486.78 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Ambetter — All Products: 70% (a percentage in the contract, not a dollar amount) Avera Health Plan — All Products: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All Products: 80% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — BluePrint: 79.2% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Select Blue: 72% (a percentage in the contract, not a dollar amount)
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$7,084.72 – $7,332.68
Uterus and ovary surgery (not for cancer), without complications: 10 of 18 insurance plan rates Iowa Medicaid — Managed Medicaid: $7,084.72 Iowa Medicaid — Total Care: $7,297.26 Molina (Iowa) — Managed Medicaid: $7,332.68 Wellpoint — Managed Medicaid: $7,084.72 Aetna — All Products: 88% (a percentage in the contract, not a dollar amount) Ambetter — All Products: 70% (a percentage in the contract, not a dollar amount) Avera Health Plan — All Products: 85% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — All Products: 80% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — BluePrint: 79.2% (a percentage in the contract, not a dollar amount) Blue Cross Blue Shield — Select Blue: 72% (a percentage in the contract, not a dollar amount)

Source: Children's Nebraska’s standard charges file (childrensnebraska.pt.panaceainc.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 31, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Children's Hospital
Address	8200 Dodge St, Omaha, NE 68114
County	Douglas County
State	Nebraska
Phone	(402) 955‑5400
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	283301
Name in Medicare records	CHILDREN'S NEBRASKA
Profile level	Medicare data + hospital website
Official website	childrensnebraska.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Children's Nebraska — childrensnebraska.org
Emergency Department — childrensnebraska.org
Services & Specialties — childrensnebraska.org
Interpreter Services | Children's Nebraska — childrensnebraska.org
Emergency Medicine | Children's Nebraska — childrensnebraska.org
Pharmacy | Children's Nebraska — childrensnebraska.org
Support Services | Children's Nebraska — childrensnebraska.org
Behavioral Health | Children's Nebraska — childrensnebraska.org
Behavioral Health Crisis Assessment | Children's Nebraska — childrensnebraska.org
Behavioral Health Inpatient | Children's Nebraska — childrensnebraska.org
Behavioral Health Outpatient | Children's Nebraska — childrensnebraska.org
Eating Disorders Partial Hospitalization | Children's Nebraska — childrensnebraska.org

Children's Nebraska

Summary

Profile from official sources

At a glance