Midwest Surgical Hospital LLC

Omaha, NE

Posts prices for 26 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.

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ProcedureCash priceGross charge× Medicare
Shoulder arthroscopy with decompression (29826) $7,889.62 $10,519.50
Knee arthroscopy with meniscectomy (29881) $4,717.88 $6,290.50 1.4×
Tonsillectomy and adenoidectomy (under age 12) (42820) $6,373.88 $8,498.50 1.0×
Epidural injection, lumbar/sacral (with imaging) (62322) $1,560.75 $2,081 1.7×
Transforaminal epidural injection, lumbar/sacral (64483) $1,523.25 $2,031 1.7×
CT head/brain without contrast (70450) $350 $881.50 3.2×
MRI brain without contrast (70551) $500 $1,823 2.0×
MRI brain with contrast (70552) $550 $2,511.50 1.5×
MRI brain without and with contrast (70553) $600 $3,756 1.7×
X-ray lower spine, 4+ views (72110) $150 $283 1.4×
MRI lumbar spine without contrast (72148) $500 $1,835 2.0×
CT pelvis with contrast (72193) $350 $1,241.50 1.9×
MRI lower-extremity joint without contrast (73721) $500 $1,980 2.0×
CT abdomen and pelvis with contrast (74177) $550 $1,108.50 1.5×
Basic metabolic panel (80048) $44.62 $59.50 5.3×
Comprehensive metabolic panel (80053) $44.62 $59.50 4.2×
Renal function panel (80069) $26.25 $35 3.0×
Hepatic function panel (80076) $53.25 $71 6.5×
Thyroid stimulating hormone (TSH) (84443) $101.62 $135.50 6.0×
CBC with automated differential (85025) $53.25 $71 6.9×
CBC, automated (85027) $51.75 $69 8.0×
Prothrombin time (PT) (85610) $24.75 $33 5.8×
Partial thromboplastin time (PTT) (85730) $40.88 $54.50 6.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $234.75 $313 8.1×
Office visit, new patient (low complexity, ~30 min) (99203) $282.75 $377 2.0×
Office visit, new patient (moderate complexity, ~45 min) (99204) $358.50 $478 2.6×

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