CHI Health Good Samaritan
10 East 31st Street, Kearney, NE · Chihealth · · NPI 1336184019
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $404.71 – $404.71 | 1 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $94.75 – $94.75 | 1 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $75.87 – $75.87 | 1 |
| Chemodenerv musc migraine 64615 CPT 64615 | not published | not published | $217.31 – $217.31 | 1 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | not published | not published | $195.53 – $195.53 | 1 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $205.30 – $205.30 | 1 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $209.69 – $209.69 | 1 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $240.66 – $240.66 | 1 |
| Chest 2 vws w oblique CPT 71048 | $469.09 | $769.00 | $58.84 – $715.17 | 7 |
| Chest apical lordotic proj CPT 71047 | $269.62 | $442.00 | $55.06 – $411.06 | 7 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,584.57 | $4,237.00 | $269.66 – $3,940.41 | 11 |
| Chest CT scan (with contrast) CPT 71260 | $2,241.14 | $3,674.00 | $219.85 – $3,416.82 | 11 |
| Chest CT scan (without contrast) CPT 71250 | $1,189.50 | $1,950.00 | $161.64 – $1,813.50 | 11 |
| Chest X-ray CPT 71046 | $303.17 | $497.00 | $43.72 – $462.21 | 7 |
| Chest X-ray (single view) CPT 71045 | $303.17 | $497.00 | $32.36 – $462.21 | 7 |
| Chg pr pul rehab for copd patients CPT 94626 | $188.49 | $309.00 | $64.89 – $287.37 | 7 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $654.53 | $1,073.00 | $145.24 – $997.89 | 7 |
| Chlamydia culture CPT 87110 | $114.07 | $187.00 | $18.99 – $187.00 | 18 |
| Chlamydia type CPT 87140 | $35.38 | $58.00 | $5.40 – $58.00 | 18 |
| Chloramphenicol sodium injec HCPCS J0720 | $22.15 | $36.32 | $7.63 – $33.78 | 8 |
| Chloride CPT 82435 | $32.94 | $54.00 | $4.46 – $53.05 | 18 |
| Chloride 24 hour urine CPT 82436 | $59.17 | $97.00 | $5.57 – $90.21 | 18 |
| Chloroprocaine hcl injection HCPCS J2401 | $0.60 | $0.98 | $0.20 – $0.87 | 7 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $55.69 | $91.28 | $19.17 – $91.28 | 12 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $15.32 | $25.11 | $5.28 – $25.11 | 12 |
| Cholangiogram percutaneous compl CPT 47532 | $2,681.56 | $4,396.00 | $391.61 – $4,088.28 | 7 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $551.44 | $904.00 | $43.72 – $840.72 | 7 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $983.57 – $1,002.85 | 3 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $722.39 – $736.56 | 3 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $802.51 – $818.24 | 3 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $2,414.38 | $3,958.00 | $624.67 – $3,680.94 | 7 |
| Cholesterol CPT 82465 | $45.14 | $74.00 | $4.21 – $68.82 | 18 |
| Cholesterol (Lipid) Test CPT 80061 | $98.82 | $162.00 | $1.26 – $13.32 | 18 |
| Cholinesterase CPT 82480 | $50.02 | $82.00 | $7.63 – $82.00 | 18 |
| Chorion biopsy CPT 59015 | not published | not published | $232.95 – $232.95 | 1 |
| Chromatography CPT 83021 | $73.20 | $120.00 | $17.50 – $120.00 | 18 |
| Chromosome analysis 15-20 cell count CPT 88262 | $766.16 | $1,256.00 | $121.60 – $1,256.00 | 18 |
| Chromosome analysis 5 CPT 88261 | $328.79 | $539.00 | $113.19 – $586.83 | 18 |
| Chromosome count additional CPT 88285 | $93.33 | $153.00 | $26.07 – $153.00 | 18 |
| Chromosome karyotype study CPT 88280 | $125.05 | $205.00 | $32.44 – $205.00 | 18 |
| Chylomicron screen, bf - sendout CPT 82664 | $143.96 | $236.00 | $49.56 – $236.00 | 18 |
| Cidofovir injection HCPCS J0740 | $87.54 | $143.50 | $30.14 – $149.24 | 14 |
| Cilastatin sodium injection HCPCS J0743 | $18.22 | $29.87 | $1.20 – $5.69 | 12 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $746.45 – $746.45 | 1 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $0.02 | $0.03 | $0.01 – $0.02 | 12 |
| Circum 28 days or older CPT 54161 | not published | not published | $375.38 – $375.38 | 1 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $276.30 – $276.30 | 1 |
| Circumcision (newborn) CPT 54150 | not published | not published | $180.43 – $180.43 | 1 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $278.96 | $457.30 | $0.13 – $0.60 | 12 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $8.79 | $14.40 | $3.03 – $14.98 | 14 |
| C-laminoplasty w/graft/plate CPT 63051 | not published | not published | $1,492.97 – $1,522.25 | 3 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $19,558.13 | $32,062.50 | $288.75 – $1,278.75 | 11 |
| Clamp neck artery CPT 61703 | not published | not published | $1,098.63 – $1,120.17 | 3 |
| Claviculectomy partial CPT 23120 | not published | not published | $1,113.53 – $1,113.53 | 1 |
| Claviculectomy total CPT 23125 | not published | not published | $1,334.61 – $1,334.61 | 1 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $260.48 – $260.48 | 1 |
| Clearance of airways CPT 31720 | $263.52 | $432.00 | $90.72 – $401.76 | 7 |
| Clearance of airways CPT 31725 | not published | not published | $107.66 – $150.15 | 4 |
| Clearance of tear duct CPT 68530 | not published | not published | $483.27 – $483.27 | 1 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $0.93 | $1.51 | $0.02 – $0.07 | 7 |
| Clip ligating vesolock lg HCPCS C1760 | $613.97 | $1,006.50 | $12.48 – $55.25 | 11 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $2,185.28 – $2,185.28 | 1 |
| Cl mult vsd w/rem pul band CPT 33677 | not published | not published | $2,028.61 – $2,068.38 | 3 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $6.73 | $11.03 | $0.34 – $1.58 | 12 |
| Close bladder-uterus fistula CPT 51920 | not published | not published | $683.98 – $1,447.38 | 4 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $1,471.15 – $1,499.99 | 3 |
| Close chest after drainage CPT 32810 | not published | not published | $832.87 – $1,619.25 | 4 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | not published | not published | $738.95 – $738.95 | 1 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | not published | not published | $761.04 – $761.04 | 1 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | not published | not published | $704.14 – $1,350.85 | 4 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $779.73 – $779.73 | 1 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $1,354.20 | $2,220.00 | $466.20 – $2,064.60 | 7 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $300.12 | $492.00 | $103.32 – $457.56 | 7 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $249.49 | $409.00 | $85.89 – $380.37 | 7 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $300.12 | $492.00 | $103.32 – $457.56 | 7 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $1,219.34 – $1,219.34 | 1 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $323.80 – $323.80 | 1 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $624.16 – $624.16 | 1 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,176.69 | $1,929.00 | $405.09 – $1,793.97 | 7 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $573.76 – $573.76 | 1 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $200.53 – $200.53 | 1 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | $410.51 – $410.51 | 1 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $1,448.85 – $1,448.85 | 1 |
| Close kidney-skin fistula CPT 50520 | not published | not published | $995.60 – $1,015.12 | 3 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $292.80 | $480.00 | $100.80 – $446.40 | 7 |
| Close mastoid fistula CPT 69700 | not published | not published | $1,264.60 – $1,264.60 | 1 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $771.95 – $1,223.92 | 4 |
| Close mult vsd CPT 33675 | not published | not published | $1,895.95 – $1,933.12 | 3 |
| Close mult vsd w/resection CPT 33676 | not published | not published | $1,951.68 – $1,989.95 | 3 |
| Close nephrovisceral fistula CPT 50525 | not published | not published | $1,273.17 – $1,298.14 | 3 |
| Close nephrovisceral fistula CPT 50526 | not published | not published | $1,270.37 – $1,295.28 | 3 |
| Close tear duct opening CPT 68760 | not published | not published | $278.54 – $278.54 | 1 |
| Close tear duct opening CPT 68761 | not published | not published | $224.74 – $224.74 | 1 |
| Close tear system fistula CPT 68770 | not published | not published | $1,193.81 – $1,193.81 | 1 |
| Clos txnose fx without stablz 21315 CPT 21315 | $1,381.65 | $2,265.00 | $111.59 – $2,106.45 | 7 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $609.67 – $1,583.57 | 4 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $1,225.10 – $1,249.12 | 3 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $786.49 – $1,854.95 | 4 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $802.34 – $818.07 | 3 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $780.80 | $1,280.00 | $268.80 – $1,190.40 | 7 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.