Fomepizole 1 gram/ml intravenous solution at CHI Health Good Samaritan
10 East 31st Street, Kearney, NE · Chihealth · · NPI 1336184019
$557.91
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$914.60
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$5.69 with BCBS - NE vs $850.58 with MultiPlan PHCS — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| BCBS - NE | Commercial|BluePrint | $5.69 | ↓ -99% |
| Medica | Medicare|All Plans | $5.71 | ↓ -99% |
| BCBS - NE | Medicare|All Plans | $5.71 | ↓ -99% |
| PACE | Medicare|All Plans | $5.71 | ↓ -99% |
| Humana | Medicare|All Plans | $5.71 | ↓ -99% |
| United | Medicare|All Plans | $5.83 | ↓ -99% |
| Centene | Medicare|All Plans | $5.88 | ↓ -99% |
| Amerigroup | Medicare|All Plans | $6.00 | ↓ -99% |
| Great Plains | Medicare|All Plans | $6.00 | ↓ -99% |
| BCBS - NE | Commercial|All Other Plans | $7.59 | ↓ -99% |
| AMPS | Commercial|All Plans | $12.68 | ↓ -98% |
| Amerigroup | Medicaid|All Plans | $15.49 | ↓ -97% |
| Centene | Medicaid|IA Total Care | $15.49 | ↓ -97% |
| IAMolina | Medicaid|All Plans | $15.80 | ↓ -97% |
| Medica | Commercial|CHI Health | $30.84 | ↓ -94% |
| Medica | Commercial|ACO | $31.50 | ↓ -94% |
| Medica | Commercial|All Other Plans | $32.30 | ↓ -94% |
| United | Medicaid|Community Plan | $192.07 | ↓ -66% |
| Centene | Medicaid|NE Total Care | $193.99 | ↓ -65% |
| Creighton University Employees | Commercial|All Plans | $448.16 | ↓ -20% |
| ELAP | Commercial|All Plans | $530.47 | ↓ -5% |
| United | Commercial|All Plans | $695.10 | ↑ +25% |
| Medica | Commercial|Open Access | $713.39 | ↑ +28% |
| Midlands Choice | Commercial|Premier | $713.39 | ↑ +28% |
| Midlands Choice | Commercial|Standard | $841.44 | ↑ +51% |
| MultiPlan PHCS | Commercial|All Plans | $850.58 | ↑ +52% |
Visitor-reported prices
Comments
Fomepizole 1 gram/ml intravenous solution at other Nebraska hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Health Midlands | Papillion | $2,880.99 | $5.69 – $1,589.04 |
| CHI Health Schuyler | Schuyler | $5,830.58 | $400.44 – $2,116.60 |
| CHI Health Immanuel | Omaha | $2,880.99 | $5.69 – $1,589.04 |
| CHI Health Nebraska Heart | Lincoln | $420.72 | $6.83 – $749.98 |
| CHI Health St. Mary's | Nebraska City | $759.12 | $195.91 – $878.02 |
| Lasting Hope Recovery Center | Omaha | $2,880.99 | $7.21 – $1,589.04 |
| CHI Health St. Francis | Grand Island | $539.62 | $6.83 – $859.73 |
| CHI Health Creighton University Medical Center - Bergan Mercy | Omaha | $2,880.99 | $5.69 – $1,589.04 |