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 |
|---|---|---|---|---|
| Closure of eyelid by suture CPT 67875 | not published | not published | $181.73 – $181.73 | 1 |
| Closure of salivary fistula CPT 42600 | not published | not published | $680.11 – $680.11 | 1 |
| Closure of valve CPT 33600 | not published | not published | $2,034.61 – $2,074.51 | 3 |
| Closure of valve CPT 33602 | not published | not published | $1,964.24 – $2,002.76 | 3 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $630.46 – $630.46 | 1 |
| Closure ureter/bowel fistula CPT 50930 | not published | not published | $1,071.79 – $1,092.80 | 3 |
| Closure ureter/skin fistula CPT 50920 | not published | not published | $834.41 – $1,667.65 | 4 |
| Clot factor xii hageman CPT 85280 | $89.67 | $147.00 | $18.75 – $147.00 | 18 |
| Clot factor xiii fibrin stab CPT 85290 | $155.55 | $255.00 | $15.83 – $237.15 | 18 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $541.68 | $888.00 | $186.48 – $825.84 | 7 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $306.22 | $502.00 | $105.42 – $466.86 | 7 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $369.05 | $605.00 | $127.05 – $562.65 | 7 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $466.18 – $466.18 | 1 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $462.17 – $462.17 | 1 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $776.53 | $1,273.00 | $267.33 – $1,183.89 | 7 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | $446.80 – $446.80 | 1 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $231.19 | $379.00 | $79.59 – $352.47 | 7 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $202.52 | $332.00 | $69.72 – $308.76 | 7 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $282.43 | $463.00 | $97.23 – $430.59 | 7 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $309.27 | $507.00 | $106.47 – $471.51 | 7 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $385.52 | $632.00 | $132.72 – $587.76 | 7 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,083.97 | $1,777.00 | $373.17 – $1,652.61 | 7 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $1,035.70 – $1,035.70 | 1 |
| Clsd tx fracture of radius 25500 CPT 25500 | $346.48 | $568.00 | $119.28 – $528.24 | 7 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | $243.96 – $243.96 | 1 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $286.09 | $469.00 | $98.49 – $436.17 | 7 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $322.08 | $528.00 | $110.88 – $491.04 | 7 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,162.66 | $1,906.00 | $400.26 – $1,772.58 | 7 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $195.81 | $321.00 | $67.41 – $298.53 | 7 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,815.97 | $2,977.00 | $625.17 – $2,768.61 | 7 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $507.38 – $507.38 | 1 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $317.81 | $521.00 | $109.41 – $484.53 | 7 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $223.26 | $366.00 | $76.86 – $340.38 | 7 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $177.51 | $291.00 | $61.11 – $270.63 | 7 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $332.45 | $545.00 | $114.45 – $506.85 | 7 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | not published | not published | $915.26 – $915.26 | 1 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | $432.98 – $432.98 | 1 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $267.79 | $439.00 | $92.19 – $408.27 | 7 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $523.99 | $859.00 | $180.39 – $798.87 | 7 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $965.20 – $965.20 | 1 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $371.49 | $609.00 | $127.89 – $566.37 | 7 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $371.49 | $609.00 | $127.89 – $566.37 | 7 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | not published | not published | $178.67 – $178.67 | 1 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,167.33 | $3,553.00 | $632.60 – $3,304.29 | 7 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $342.82 | $562.00 | $118.02 – $522.66 | 7 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | not published | not published | $586.05 – $586.05 | 1 |
| Clsd tx pelvic ring fx CPT 27197 | $580.11 | $951.00 | $199.71 – $884.43 | 7 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $589.05 – $589.05 | 1 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,020.53 | $1,673.00 | $351.33 – $1,555.89 | 7 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $336.72 | $552.00 | $115.92 – $513.36 | 7 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | not published | not published | $482.27 – $482.27 | 1 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,875.14 | $3,074.00 | $645.54 – $2,858.82 | 7 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | not published | not published | $474.14 – $474.14 | 1 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,789.74 | $2,934.00 | $616.14 – $2,728.62 | 7 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,832.44 | $3,004.00 | $630.84 – $2,793.72 | 7 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,051.43 | $3,363.00 | $656.88 – $2,909.04 | 7 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $654.17 – $654.17 | 1 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $146.40 | $240.00 | $50.40 – $223.20 | 7 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $319.03 | $523.00 | $109.83 – $486.39 | 7 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $242.17 | $397.00 | $83.37 – $369.21 | 7 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,668.35 | $2,735.00 | $574.35 – $2,543.55 | 7 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | not published | not published | $477.04 – $477.04 | 1 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $561.04 – $561.04 | 1 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | not published | not published | $554.67 – $554.67 | 1 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $221.43 | $363.00 | $76.23 – $337.59 | 7 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $1,013.82 – $1,013.82 | 1 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $277.55 | $455.00 | $95.55 – $423.15 | 7 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | not published | not published | $522.67 – $522.67 | 1 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $2,098.13 – $2,139.27 | 3 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,996.78 – $2,035.94 | 3 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $777.71 – $777.71 | 1 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | not published | not published | $859.45 – $859.45 | 1 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $461.99 – $1,322.71 | 4 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | not published | not published | $681.81 – $681.81 | 1 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $304.39 | $499.00 | $104.79 – $464.07 | 7 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | not published | not published | $973.27 – $973.27 | 1 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | not published | not published | $612.84 – $612.84 | 1 |
| Cltx lunate dislc w/mnpj CPT 25690 | not published | not published | $941.77 – $941.77 | 1 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | not published | not published | $1,760.68 – $1,760.68 | 1 |
| Cltx mndblr fx w/mnpj CPT 21451 | not published | not published | $1,221.40 – $1,221.40 | 1 |
| Cltx mndblr/max alv ridge fx CPT 21440 | not published | not published | $1,154.60 – $1,154.60 | 1 |
| Cltx palatal/max fx wire fix CPT 21421 | not published | not published | $1,041.29 – $1,041.29 | 1 |
| Cltx post ankle fx CPT 27767 | not published | not published | $566.12 – $566.12 | 1 |
| Cltx post ankle fx w/mnpj CPT 27768 | not published | not published | $859.03 – $859.03 | 1 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | not published | not published | $732.38 – $732.38 | 1 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $300.12 | $492.00 | $103.32 – $457.56 | 7 |
| Cltx thigh fx CPT 27267 | not published | not published | $841.95 – $841.95 | 1 |
| Cltx thigh fx w/mnpj CPT 27268 | $1,884.90 | $3,090.00 | $380.63 – $2,873.70 | 9 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $1,486.91 – $1,486.91 | 1 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $1,464.92 – $1,464.92 | 1 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $2,192.76 – $2,235.75 | 3 |
| #cmvcul-virus inoculation shell CPT 87254 | $34.16 | $56.00 | $11.76 – $56.00 | 18 |
| Cmv pcr-sendout CPT 87496 | $200.69 | $329.00 | $34.01 – $329.00 | 18 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $6,702.68 | $10,988.00 | $2.16 – $2,232.00 | 18 |
| Coagulation time activated teg CPT 85347 | $68.93 | $113.00 | $4.15 – $105.09 | 18 |
| Cocaine 4 % nasal solution HCPCS C9046 | $50.08 | $82.09 | $17.24 – $76.35 | 7 |
| Cold agglutinin titer CPT 86157 | $23.18 | $38.00 | $7.81 – $38.00 | 18 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $1,186.42 – $1,209.69 | 3 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $1,281.14 – $1,306.26 | 3 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $1,460.09 – $1,488.72 | 3 |
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.