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 |
|---|---|---|---|---|
| Drill hole implt ventricular cath/device 61107 CPT 61107 | not published | not published | $349.35 – $535.84 | 4 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $164.28 – $164.28 | 1 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $164.28 – $164.28 | 1 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $498.48 – $1,424.33 | 4 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $1,056.38 – $1,056.38 | 1 |
| Drng of eyelid abscess 67700 CPT 67700 | $370.27 | $607.00 | $127.47 – $564.51 | 7 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,270.63 | $2,083.00 | $350.51 – $1,937.19 | 7 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $160.10 – $160.10 | 1 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $380.71 – $380.71 | 1 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $596.93 – $596.93 | 1 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $933.03 – $933.03 | 1 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $796.05 – $796.05 | 1 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $803.21 – $803.21 | 1 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $444.07 – $444.07 | 1 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,462.78 | $2,398.00 | $318.51 – $2,230.14 | 7 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $644.57 – $657.21 | 3 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $591.89 – $1,825.97 | 4 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $528.44 – $1,343.83 | 4 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $853.74 – $870.48 | 3 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $297.97 – $297.97 | 1 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $258.66 – $258.66 | 1 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1.94 | $3.18 | $0.67 – $3.18 | 12 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $2.57 | $4.21 | $0.89 – $3.92 | 8 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $665.75 | $1,091.38 | $229.19 – $1,014.99 | 11 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $2,834.91 | $4,647.38 | $9.68 – $3,857.33 | 12 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $2,237.28 | $3,667.66 | $6.66 – $163.13 | 12 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $9,287.82 | $15,225.93 | $42.05 – $11,598.14 | 12 |
| Drug assay voriconazole CPT 80285 | $216.55 | $355.00 | $26.27 – $330.15 | 14 |
| Drug of abuse screen urine CPT 80305 | $109.80 | $180.00 | $12.21 – $167.40 | 14 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $456.89 | $749.00 | $1.68 – $17.76 | 14 |
| Drvvt confirm - quest CPT 85597 | $42.09 | $69.00 | $14.49 – $69.00 | 18 |
| Dry needling (97799) CPT 97799 | $21.35 | $35.00 | $7.35 – $36.40 | 9 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $484.66 – $484.66 | 1 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $2,115.48 | $3,468.00 | $279.49 – $3,225.24 | 7 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $384.03 – $384.03 | 1 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $324.70 – $324.70 | 1 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $377.85 – $377.85 | 1 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $513.35 – $513.35 | 1 |
| Ductogram sgl duct CPT 77053 | $506.91 | $831.00 | $69.57 – $772.83 | 11 |
| Duodenal exclusion CPT 48547 | not published | not published | $1,261.87 – $1,286.62 | 3 |
| Duplex scan bilateral study 93985 CPT 93985 | $1,319.43 | $2,163.00 | $396.82 – $2,011.59 | 10 |
| Duplex scan unilateral study 93986 CPT 93986 | $880.84 | $1,444.00 | $230.79 – $1,342.92 | 10 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $461.16 | $756.00 | $158.76 – $703.08 | 11 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,002.23 | $1,643.00 | $257.27 – $1,527.99 | 11 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $794.22 | $1,302.00 | $273.42 – $1,210.86 | 11 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $1,943.46 | $3,186.00 | $669.06 – $2,962.98 | 11 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $256.84 | $421.05 | $66.61 – $391.58 | 14 |
| Dxa bone density axl vrt fx CPT 77085 | $457.50 | $750.00 | $73.56 – $697.50 | 11 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $249.33 – $249.33 | 1 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $478.85 | $785.00 | $164.85 – $730.05 | 7 |
| Dx bronchoscope/wash 31622 CPT 31622 | $478.85 | $785.00 | $164.85 – $730.05 | 7 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $96.45 – $96.45 | 1 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $145.26 – $145.26 | 1 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $70.25 – $70.25 | 1 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $112.96 – $112.96 | 1 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $293.69 – $293.69 | 1 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $294.38 – $294.38 | 1 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $219.07 – $219.07 | 1 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $120.86 – $120.86 | 1 |
| Ear cartilage graft CPT 21235 | not published | not published | $1,085.20 – $1,085.20 | 1 |
| Ear irrigation 69209 CPT 69209 | $70.15 | $115.00 | $24.15 – $106.95 | 7 |
| Ecg 12 lead tracing only CPT 93005 | $310.49 | $509.00 | $11.55 – $434.31 | 11 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $98.82 | $162.00 | $11.00 – $150.66 | 11 |
| Ecg external < 48 hours recording CPT 93225 | $493.49 | $809.00 | $34.25 – $752.37 | 11 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $493.49 | $809.00 | $67.05 – $752.37 | 11 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $671.61 | $1,101.00 | $22.28 – $1,023.93 | 11 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $671.61 | $1,101.00 | $22.28 – $1,023.93 | 11 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,282.62 | $3,742.00 | $242.76 – $3,480.06 | 11 |
| Echocardiography doppler color flow mapping CPT 93325 | $445.91 | $731.00 | $38.47 – $679.83 | 11 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,168.55 | $3,555.00 | $746.55 – $3,306.15 | 7 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $803.98 | $1,318.00 | $139.78 – $1,225.74 | 11 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $1,396.29 | $2,289.00 | $480.69 – $2,128.77 | 7 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $270.23 | $443.00 | $34.04 – $411.99 | 11 |
| Echo stress CPT 93350 | $1,794.01 | $2,941.00 | $222.37 – $2,735.13 | 11 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,923.94 | $3,154.00 | $247.80 – $2,933.22 | 11 |
| Echo transesophageal CPT 93314 | $577.06 | $946.00 | $198.66 – $879.78 | 11 |
| Echo transthoracic CPT 93303 | $1,625.04 | $2,664.00 | $300.13 – $2,477.52 | 11 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $2,023.98 | $3,318.00 | $176.97 – $3,085.74 | 11 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | not published | not published | $220.56 – $421.51 | 4 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | not published | not published | $226.38 – $432.77 | 4 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | not published | not published | $318.94 – $610.22 | 4 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | not published | not published | $290.90 – $551.78 | 4 |
| Ecmo/ecls insj cent cannula 0-5yrs 33955 CPT 33955 | not published | not published | $819.14 – $1,453.73 | 4 |
| Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 | not published | not published | $774.87 – $1,470.53 | 4 |
| Ecmo/ecls insj prph cannula 0-5yrs opn 33953 CPT 33953 | not published | not published | $422.75 – $830.49 | 4 |
| Ecmo/ecls insj prph cannula 0-5yrs perq 33951 CPT 33951 | not published | not published | $379.05 – $743.90 | 4 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | not published | not published | $412.70 – $838.26 | 4 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | not published | not published | $369.95 – $757.16 | 4 |
| Ecmo/ecls remove cent cannula 0-5yrs 33985 CPT 33985 | not published | not published | $547.66 – $901.13 | 4 |
| Ecmo/ecls remove cent cannula 6yrs&older 33986 CPT 33986 | not published | not published | $521.06 – $921.92 | 4 |
| Ecmo/ecls remove perph cannula 0-5yrs opn 33969 CPT 33969 | not published | not published | $293.63 – $478.82 | 4 |
| Ecmo/ecls remove perph cannula 0-5yrs perq 33965 CPT 33965 | not published | not published | $228.62 – $324.28 | 4 |
| Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 | not published | not published | $287.91 – $499.30 | 4 |
| Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 | not published | not published | $260.79 – $419.45 | 4 |
| Ecmo/ecls repos cent cnula 6yrs&older 33964 CPT 33964 | not published | not published | $497.83 – $866.33 | 4 |
| Ecmo/ecls repos cent/perph cnula 0-5yrs 33963 CPT 33963 | not published | not published | $489.73 – $820.62 | 4 |
| Ecmo/ecls repos perph cnula 0-5yrs opn 33959 CPT 33959 | not published | not published | $276.70 – $411.92 | 4 |
| Ecmo/ecls repos perph cnula 0-5yrs perq 33957 CPT 33957 | not published | not published | $231.45 – $324.28 | 4 |
| Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 | not published | not published | $262.57 – $411.92 | 4 |
| Ecmo/ecls repos perph cnula 6yrs&older perq 33958 CPT 33958 | not published | not published | $225.49 – $324.28 | 4 |
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.