| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Chi Health St. Francis | 2116 W Faidley Ave, Grand Island | A9517 | $49 [source] | 4 years ago |
| Chi Health St. Elizabeth | 555 S. 70Th St., Lincoln | A9517 | $63 [source] | 4 years ago |
| Chi Health Lakeside | 17201 Wright St, Omaha | A9517 | $71 [source] | 4 years ago |
| Chi Health Midlands | 11111 S 84Th St, Papillion | A9517 | $71 [source] | 4 years ago |
| Chi Health Creighton University Medical Center - Bergan Mercy | 7500 Mercy Rd, Omaha | A9517 | $71 [source] | 4 years ago |
| Chi Health Immanuel | 7101 Newport Ave, Omaha | A9517 | $71 [source] | 4 years ago |
| Chi Health Good Samaritan | 10 E 31St St, Kearney | A9517 | $411 [source] | 4 years ago |