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 |
|---|---|---|---|---|
| Enterectomy w/taper cong CPT 44127 | not published | not published | $2,185.57 – $2,228.43 | 3 |
| Enteroenterostomy fusion 44130 CPT 44130 | not published | not published | $724.36 – $738.57 | 3 |
| Enterorrhaphy 1perforation 44602 CPT 44602 | not published | not published | $629.24 – $2,538.82 | 4 |
| Enterorrhaphy multiple perforations 44603 CPT 44603 | not published | not published | $804.79 – $820.57 | 3 |
| Enterostomy/cecostomy tube open 44300 CPT 44300 | not published | not published | $537.81 – $1,530.46 | 4 |
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $3,180.54 | $5,214.00 | $1,094.94 – $4,849.02 | 7 |
| Epidrm a-grft f/n/hf/g addl CPT 15116 | $1,809.87 | $2,967.00 | $250.24 – $2,759.31 | 7 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $3,180.54 | $5,214.00 | $1,094.94 – $4,849.02 | 7 |
| Epidrm autogrft t/a/l add-on CPT 15111 | $1,460.34 | $2,394.00 | $183.29 – $2,226.42 | 7 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $778.36 | $1,276.00 | $97.97 – $1,186.68 | 7 |
| Epidural lysis mult sessions CPT 62263 | not published | not published | $620.36 – $620.36 | 1 |
| Epidural lysis on single day 62264 CPT 62264 | not published | not published | $466.35 – $466.35 | 1 |
| Epiglottidectomy CPT 31420 | not published | not published | $1,576.91 – $1,576.91 | 1 |
| Epikeratoplasty CPT 65767 | not published | not published | $1,233.96 – $2,872.28 | 4 |
| Epiphysl arrst dstl rds&ulna CPT 25455 | not published | not published | $1,375.35 – $1,375.35 | 1 |
| Epiphysl arrst dstl rds/ulna CPT 25450 | not published | not published | $1,167.14 – $1,167.14 | 1 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $0.69 | $1.12 | $0.24 – $1.12 | 12 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | not published | not published | $263.15 – $263.15 | 1 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $339.81 | $557.06 | $6.62 – $47.51 | 14 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $35.72 | $58.55 | $3.36 – $15.98 | 12 |
| Epstein barr early antigen antibody CPT 86663 | $10.98 | $18.00 | $3.78 – $29.13 | 18 |
| Epstein barr nuclear antigen antibody CPT 86664 | $28.67 | $47.00 | $9.87 – $47.00 | 18 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $66.49 | $109.00 | $17.57 – $101.37 | 18 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $1,114.98 | $1,827.83 | $15.84 – $1,699.89 | 14 |
| Ercp biliary & pancreas CPT 74330 | $1,076.65 | $1,765.00 | $131.57 – $1,641.45 | 7 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $863.58 – $863.58 | 1 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $707.05 – $707.05 | 1 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $808.48 – $808.48 | 1 |
| Ercp lithotripsy calculi CPT 43265 | not published | not published | $808.96 – $808.96 | 1 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | $680.30 – $680.30 | 1 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $703.04 – $703.04 | 1 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $667.99 – $667.99 | 1 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $899.26 – $899.26 | 1 |
| Ercp w/specimen collection CPT 43260 | not published | not published | $602.91 – $602.91 | 1 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $380.64 | $624.00 | $114.97 – $580.32 | 14 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $77.44 | $126.95 | $2.11 – $10.01 | 12 |
| ER Visit (level 1, minor) CPT 99281 | $211.06 | $346.00 | $11.72 – $321.78 | 9 |
| ER Visit (level 2) CPT 99282 | $331.84 | $544.00 | $79.28 – $505.92 | 7 |
| ER Visit (level 3) CPT 99283 | $588.04 | $964.00 | $135.01 – $896.52 | 7 |
| ER Visit (level 4) CPT 99284 | $1,009.55 | $1,655.00 | $229.78 – $1,539.15 | 7 |
| ER Visit (level 5, high severity) CPT 99285 | $1,491.45 | $2,445.00 | $333.02 – $2,273.85 | 7 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $44.92 | $73.63 | $15.47 – $73.63 | 12 |
| Escharotomy ea addl incision CPT 16036 | not published | not published | $82.22 – $149.14 | 4 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $0.27 | $0.44 | $0.10 – $0.41 | 7 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $1.01 | $1.65 | $0.08 – $0.35 | 7 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $121.23 – $201.73 | 4 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $954.09 – $972.80 | 3 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $1,059.45 – $1,080.23 | 3 |
| Esophagoplasty congenital CPT 43313 | not published | not published | $2,503.18 – $2,552.26 | 3 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $360.05 – $360.05 | 1 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $183.35 – $183.35 | 1 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $439.66 – $439.66 | 1 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $348.08 – $348.08 | 1 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $295.49 – $295.49 | 1 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $220.73 – $220.73 | 1 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $308.62 – $308.62 | 1 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $193.07 – $193.07 | 1 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $164.03 – $164.03 | 1 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $152.42 – $152.42 | 1 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $262.10 – $262.10 | 1 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $367.73 – $367.73 | 1 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $250.82 – $250.82 | 1 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $479.49 – $479.49 | 1 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $347.89 – $347.89 | 1 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $292.03 – $292.03 | 1 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $1,032.74 – $1,032.74 | 1 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $300.32 – $300.32 | 1 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $373.34 – $373.34 | 1 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $369.43 – $369.43 | 1 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $318.34 – $318.34 | 1 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $319.60 – $319.60 | 1 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $354.59 – $354.59 | 1 |
| Esophagotomy thrc rmvl fb CPT 43045 | not published | not published | $1,211.90 – $1,235.67 | 3 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $264.64 – $264.64 | 1 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $287.18 – $287.18 | 1 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $241.63 – $241.63 | 1 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $737.94 – $1,481.11 | 4 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $1,071.45 – $1,092.46 | 3 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $249.29 – $249.29 | 1 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $253.51 – $253.51 | 1 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $193.91 – $193.91 | 1 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $3,241.90 – $3,305.46 | 3 |
| Esphg thrsc moblj CPT 43288 | not published | not published | $3,395.54 – $3,462.12 | 3 |
| Esphg tot w/laps moblj CPT 43286 | not published | not published | $2,846.89 – $2,902.71 | 3 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $1,901.87 – $1,939.16 | 3 |
| Essure 58565 CPT 58565 | not published | not published | $862.32 – $862.32 | 1 |
| Establish access to aorta CPT 36160 | $464.82 | $762.00 | $160.02 – $708.66 | 7 |
| Establish access to artery CPT 36100 | not published | not published | $267.06 – $267.06 | 1 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $910.05 – $1,850.18 | 4 |
| Establish brain cavity shunt CPT 62180 | not published | not published | $1,318.68 – $1,344.53 | 3 |
| Establish brain cavity shunt CPT 62190 | not published | not published | $784.36 – $1,655.77 | 4 |
| Establish brain cavity shunt CPT 62192 | not published | not published | $870.19 – $1,767.36 | 4 |
| Establish brain cavity shunt CPT 62200 | not published | not published | $1,233.32 – $1,257.51 | 3 |
| Establish brain cavity shunt CPT 62220 | not published | not published | $921.79 – $1,732.75 | 4 |
| Established Patient Office Visit (level 1) CPT 99211 | $161.04 | $264.00 | $15.29 – $106.02 | 7 |
| Established Patient Office Visit (level 2) CPT 99212 | $203.13 | $333.00 | $60.82 – $309.69 | 7 |
| Established Patient Office Visit (level 3) CPT 99213 | $220.82 | $362.00 | $76.02 – $336.66 | 7 |
| Established Patient Office Visit (level 4) CPT 99214 | $264.13 | $433.00 | $90.93 – $402.69 | 7 |
| Established Patient Office Visit (level 5) CPT 99215 | $367.22 | $602.00 | $126.42 – $559.86 | 7 |
| Estim aid bone healg invasiv CPT 20975 | not published | not published | $319.75 – $319.75 | 1 |
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.