Children's Nebraska
8200 Dodge St, Omaha, NE 68114 · 133 Priced Procedures
Typical commercial prices here are +67% above the fair benchmark (1.67×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
Children's Nebraska prices shoppable and inpatient services (1.7× to 1.2× Medicare, divergence 0.71×) in alignment with regional hospital peers (1.67× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.14× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (49.7% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
- Commercial insurance median sits at 1.34× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.74×) jump +30% above the median procedure ratio (Q50 1.34×)
- Unnegotiated chargemaster list prices average 12.9× Medicare (19¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Children's Nebraska
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 133 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Total hip replacement CPT Code: 27130 | $18,451 | unverified |
| Total knee replacement CPT Code: 27447 | $18,451 | unverified |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $17,063 | 0.9× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $12,816 | 0.7× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $7,395 | 1.2× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $5,421 | 0.7× |
| Bunion correction surgery CPT Code: 28296 | $5,399 | unverified |
| Breast lump removal CPT Code: 19120 | $4,854 | unverified |
| Inguinal hernia repair CPT Code: 49505 | $4,473 | 1.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,113 | 1.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,891 | 1.1× |
| Trauma team activation HCPCS Code: G0390 | $1,677 | 1.2× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,503 | 1.5× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,494 | 1.2× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,188 | 1.2× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,156 | 1.2× |
| Behavioral health counseling (per session) HCPCS Code: H0008 | $1,128 | 4.4× |
| Behavioral health counseling (group) HCPCS Code: H0009 | $1,128 | 4.2× |
| Behavioral health day treatment HCPCS Code: H0010 | $1,128 | 3.3× |
| Behavioral health residential care HCPCS Code: H0011 | $1,128 | 3.1× |
| Injection procedure for pain management HCPCS Code: G0260 | $937 | 1.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $798 | 1.6× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $817 | 1.4× |
| Residential mental health treatment HCPCS Code: H2036 | $772 | 1.9× |
| Psychological testing by technician CPT Code: 96138 | $709 | 1.8× |
Audit a Bill or Quote at Children's Nebraska (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $22,004
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (49.7% of gross = $22,004).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Children's Nebraska's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)
Your bill ($44,282) is $30,869 above the denoised Fair BaseRate ($13,413) and 3.4× the $13,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (49.7% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Children's Nebraska. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-08-11·administrative_or_closure
Met Requirements
Recorded - 2024-10-17·administrative_or_closure
Closure Notice
Recorded - 2024-09-10·cap_corrective_action
CAP Request
Recorded - 2024-03-20·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Children's Nebraska.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.