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 |
|---|---|---|---|---|
| Alginate drsg wound filler HCPCS A6199 | $25.11 | $41.15 | $8.65 – $38.27 | 7 |
| Alkaline phosphatase CPT 84075 | $20.13 | $33.00 | $5.02 – $33.00 | 18 |
| Allergen egg white ige CPT 86003 | $21.35 | $35.00 | $5.06 – $35.00 | 18 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $2,380.41 – $2,380.41 | 1 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $3,156.75 | $5,175.00 | $67.08 – $527.73 | 12 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $5,270.40 | $8,640.00 | $0.01 – $0.04 | 11 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $8,413.42 | $13,792.49 | $173.51 – $768.37 | 11 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $1,235.25 | $2,025.00 | $26.21 – $1,883.25 | 12 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $6,787.11 | $11,126.40 | $78.61 – $930.00 | 12 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $5,764.50 | $9,450.00 | $166.95 – $739.35 | 11 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $1,777.39 | $2,913.75 | $207.59 – $2,709.79 | 12 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $0.41 | $0.66 | $0.11 – $0.52 | 14 |
| Alpha-fetoprotein tumor marker CPT 82105 | $75.03 | $123.00 | $16.25 – $123.00 | 18 |
| Alprostadil for injection HCPCS J0270 | $73.41 | $120.33 | $0.57 – $111.91 | 8 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $5,180.34 | $8,492.35 | $37.53 – $178.69 | 14 |
| Alt/sgpt CPT 84460 | $29.89 | $49.00 | $5.14 – $49.00 | 18 |
| Aluminum - quest CPT 82108 | $84.79 | $139.00 | $24.69 – $139.00 | 18 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $466.28 – $466.28 | 1 |
| Amantadine (symmetrel)-sendout CPT 80375 | $106.75 | $175.00 | $36.75 – $162.75 | 7 |
| Amifostine HCPCS J0207 | $609.91 | $999.84 | $209.97 – $1,039.84 | 10 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $1.00 | $1.64 | $0.34 – $1.48 | 12 |
| Aminolevulinic acid delta CPT 82135 | $139.08 | $228.00 | $15.94 – $212.04 | 18 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $0.79 | $1.29 | $0.05 – $0.22 | 12 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $0.20 | $0.32 | $0.05 – $0.21 | 7 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $1.71 | $2.80 | $0.20 – $1.09 | 12 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $331.73 | $543.82 | $114.21 – $505.76 | 7 |
| Ammonia CPT 82140 | $99.43 | $163.00 | $14.12 – $151.59 | 18 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $580.72 | $952.00 | $143.79 – $885.36 | 7 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $315.69 – $315.69 | 1 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $2,246.63 | $3,683.00 | $773.43 – $3,425.19 | 7 |
| Amphetamine confirm urine -sendout CPT 80324 | $56.12 | $92.00 | $19.32 – $85.56 | 7 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $21.18 | $34.71 | $7.29 – $34.71 | 12 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $177.31 | $290.67 | $18.37 – $270.33 | 14 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $11.80 | $19.33 | $0.01 – $0.01 | 12 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $8.90 | $14.59 | $0.59 – $2.77 | 12 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $799.49 – $799.49 | 1 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $715.06 – $1,297.72 | 4 |
| Amputate hand at wrist CPT 25922 | not published | not published | $1,219.89 – $1,219.89 | 1 |
| Amputate hand at wrist CPT 25920 | not published | not published | $592.07 – $1,374.01 | 4 |
| Amputate leg at thigh CPT 27591 | not published | not published | $906.52 – $1,796.45 | 4 |
| Amputate leg at thigh CPT 27592 | not published | not published | $699.34 – $1,217.75 | 4 |
| Amputate lower leg at knee CPT 27598 | not published | not published | $748.81 – $1,263.26 | 4 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $1,440.12 – $1,440.12 | 1 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $813.41 – $1,417.06 | 4 |
| Amputate upper arm & implant CPT 24931 | not published | not published | $818.07 – $1,735.59 | 4 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $1,076.44 – $1,076.44 | 1 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $1,160.59 – $1,160.59 | 1 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $1,288.60 – $1,288.60 | 1 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $1,131.31 – $1,131.31 | 1 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $1,505.01 – $1,505.01 | 1 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $930.07 – $930.07 | 1 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $1,060.54 – $1,060.54 | 1 |
| Amputation follow-up surgery CPT 24930 | not published | not published | $712.84 – $1,448.98 | 4 |
| Amputation follow-up surgery CPT 25924 | not published | not published | $591.84 – $1,342.30 | 4 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $780.30 – $1,625.86 | 4 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $640.71 – $1,186.67 | 4 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $1,173.59 – $1,173.59 | 1 |
| Amputation of foot at ankle CPT 27888 | not published | not published | $698.55 – $1,029.95 | 4 |
| Amputation of forearm CPT 25900 | not published | not published | $667.63 – $1,351.27 | 4 |
| Amputation of forearm CPT 25905 | not published | not published | $689.30 – $1,318.97 | 4 |
| Amputation of forearm CPT 25915 | not published | not published | $1,169.62 – $2,166.74 | 4 |
| Amputation of hand CPT 25927 | not published | not published | $636.65 – $1,623.85 | 4 |
| Amputation of leg at hip CPT 27290 | not published | not published | $1,593.55 – $3,004.79 | 4 |
| Amputation of leg at hip CPT 27295 | not published | not published | $1,225.74 – $2,330.87 | 4 |
| Amputation of lower leg CPT 27882 | not published | not published | $654.03 – $1,072.05 | 4 |
| Amputation of lower leg CPT 27881 | not published | not published | $859.85 – $1,535.42 | 4 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $562.04 – $1,009.76 | 4 |
| Amputation of upper arm CPT 24900 | not published | not published | $659.34 – $1,384.76 | 4 |
| Amputation of upper arm CPT 24920 | not published | not published | $653.69 – $1,375.23 | 4 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $1,340.41 – $1,340.41 | 1 |
| Amputation toe interphalangeal joint CPT 28825 | $1,294.42 | $2,122.00 | $328.61 – $1,973.46 | 7 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $336.95 – $336.95 | 1 |
| Amylase CPT 82150 | $65.27 | $107.00 | $6.28 – $99.51 | 18 |
| Ana ds-dna CPT 86226 | $14.03 | $23.00 | $4.83 – $26.88 | 18 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $235.46 | $386.00 | $24.78 – $109.74 | 7 |
| Anal/urinary muscle study CPT 51784 | $381.86 | $626.00 | $52.54 – $582.18 | 7 |
| Anal/urinary muscle study CPT 51785 | not published | not published | $652.62 – $652.62 | 1 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | $90.28 | $148.00 | $31.08 – $137.64 | 7 |
| Analysis gene f2 20210g>a variant CPT 81240 | $198.25 | $325.00 | $63.66 – $325.00 | 18 |
| Analysis gene f5 leiden variant CPT 81241 | $198.25 | $325.00 | $68.25 – $325.00 | 18 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $35.38 | $58.00 | $12.18 – $53.94 | 7 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $61.00 | $100.00 | $21.00 – $93.00 | 7 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | not published | not published | $1,213.36 – $1,237.15 | 3 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | not published | not published | $1,264.84 – $1,289.64 | 3 |
| Anast cavopulm sec sup v/c CPT 33768 | not published | not published | $730.21 – $1,693.93 | 4 |
| Anastomosis/artery-aorta CPT 33606 | not published | not published | $2,165.92 – $2,208.39 | 3 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | not published | not published | $893.50 – $1,878.93 | 4 |
| Anca screen with reflex to titer -quest CPT 86021 | $147.62 | $242.00 | $14.59 – $225.06 | 18 |
| An cholangiogram percutaneous compl CPT 47531 | $3,212.26 | $5,266.00 | $131.84 – $4,897.38 | 7 |
| An fluoro guide for cvp CPT 77001 | $941.84 | $1,544.00 | $152.80 – $1,435.92 | 11 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $887.55 | $1,455.00 | $266.13 – $1,353.15 | 7 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $7,355.99 | $12,059.00 | $782.00 – $11,214.87 | 7 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $12,620.90 | $20,690.00 | $705.71 – $19,241.70 | 7 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $3,857.03 | $6,323.00 | $353.35 – $5,880.39 | 7 |
| Angioscopy CPT 35400 | not published | not published | $173.00 – $257.69 | 4 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $33.50 | $54.91 | $0.06 – $0.27 | 7 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $6,384.26 | $10,466.00 | $952.90 – $9,733.38 | 7 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $1,188.28 | $1,948.00 | $309.75 – $1,811.64 | 7 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $8,237.44 | $13,504.00 | $624.12 – $12,558.72 | 7 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $1,108.98 | $1,818.00 | $261.98 – $1,690.74 | 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.