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 |
|---|---|---|---|---|
| #fecal-sodium CPT 84302 | $78.69 | $129.00 | $4.71 – $119.97 | 18 |
| Feeding tube reposition CPT 74355 | $577.06 | $946.00 | $176.34 – $879.78 | 7 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $253.05 – $409.10 | 4 |
| Fem/popl revasc w/stent CPT 37226 | $16,960.44 | $27,804.00 | $911.74 – $25,857.72 | 7 |
| Feno poc CPT 95012 | $139.69 | $229.00 | $31.30 – $212.97 | 7 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $1.24 | $2.03 | $0.01 – $0.01 | 12 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $54.78 | $89.79 | $0.96 – $50.69 | 14 |
| Ferritin CPT 82728 | $71.98 | $118.00 | $13.21 – $118.00 | 18 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $6.57 | $10.76 | $0.28 – $10.01 | 10 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $529.48 | $868.00 | $129.89 – $807.24 | 11 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $342.21 | $561.00 | $65.79 – $521.73 | 7 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $356.01 – $356.01 | 1 |
| Fetal fibronectin CPT 82731 | $272.67 | $447.00 | $62.41 – $447.00 | 18 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $546.36 – $546.36 | 1 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $188.49 | $309.00 | $7.49 – $287.37 | 18 |
| Fetal hemoglobin rosette CPT 85461 | $105.53 | $173.00 | $9.07 – $160.89 | 18 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $73.98 – $73.98 | 1 |
| Fetal monitor w/report CPT 59050 | $97.60 | $160.00 | $33.60 – $148.80 | 9 |
| Fetal non stress test CPT 59025 | $355.02 | $582.00 | $38.05 – $243.66 | 7 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $197.93 – $197.93 | 1 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $919.70 – $919.70 | 1 |
| Fibrin degradation d dimer quantitative CPT 85379 | $187.27 | $307.00 | $9.86 – $285.51 | 18 |
| Fibrin degradation products CPT 85362 | $92.72 | $152.00 | $6.68 – $141.36 | 18 |
| Fibrinogen activity CPT 85384 | $100.04 | $164.00 | $9.41 – $152.52 | 18 |
| Fibrinolytic plasminogen CPT 85415 | $73.81 | $121.00 | $16.66 – $121.00 | 18 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $68.93 | $113.00 | $6.32 – $105.09 | 18 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $2,564.85 – $4,563.91 | 4 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $95.81 | $157.07 | $0.24 – $73.04 | 14 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $71.40 | $117.04 | $0.81 – $108.85 | 14 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $233.16 | $382.23 | $0.20 – $355.48 | 14 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $1,294.42 – $1,294.42 | 1 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $4,939.63 | $8,097.75 | $68.61 – $303.84 | 11 |
| Filter vena cava fem denali HCPCS C1880 | $3,337.74 | $5,471.70 | $24.36 – $107.88 | 11 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $687.82 – $1,541.06 | 4 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $788.12 | $1,292.00 | $168.15 – $1,201.56 | 7 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $788.12 | $1,292.00 | $96.26 – $1,201.56 | 7 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $80.43 – $80.43 | 1 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $788.12 | $1,292.00 | $94.82 – $1,201.56 | 7 |
| Fine needle asp without image guide 10021 CPT 10021 | $267.79 | $439.00 | $92.19 – $408.27 | 7 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $3,421.76 | $5,609.43 | $398.45 – $1,764.53 | 11 |
| Finger tendon transfer CPT 26497 | not published | not published | $1,705.01 – $1,705.01 | 1 |
| Finger tendon transfer CPT 26498 | not published | not published | $2,209.10 – $2,209.10 | 1 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $840.47 – $856.95 | 3 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $594.85 – $1,261.07 | 4 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $87.78 – $87.78 | 1 |
| Fixation of ankle joint CPT 27860 | not published | not published | $311.85 – $311.85 | 1 |
| Fixation of knee joint CPT 27570 | not published | not published | $290.98 – $290.98 | 1 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $1,815.39 – $1,815.39 | 1 |
| Fix g/colon tube w/device CPT 49460 | $660.02 | $1,082.00 | $93.95 – $1,006.26 | 7 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $1,267.98 – $1,267.98 | 1 |
| Fl exam g/colon tube w contrast CPT 49465 | $264.13 | $433.00 | $57.12 – $402.69 | 7 |
| Flexible Sigmoidoscopy CPT 45330 | $732.61 | $1,201.00 | $106.30 – $1,116.93 | 7 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $1,349.75 – $1,349.75 | 1 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $1,472.16 – $1,472.16 | 1 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $173.99 – $173.99 | 1 |
| Flow cytometry marker each additional CPT 88185 | $67.10 | $110.00 | $23.10 – $110.00 | 11 |
| Flow cytometry one marker technical component CPT 88184 | $273.89 | $449.00 | $94.29 – $449.00 | 11 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $0.11 | $0.18 | $0.03 – $0.10 | 12 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $75.85 | $124.33 | $21.13 – $104.64 | 14 |
| Fluidotherapy charges pt CPT 97022 | $54.90 | $90.00 | $15.04 – $90.00 | 13 |
| Fluid pressure muscle 20950 CPT 20950 | not published | not published | $165.65 – $165.65 | 1 |
| Fluorescent antibody titer dna CPT 86256 | $136.03 | $223.00 | $11.68 – $207.39 | 18 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $595.36 | $976.00 | $145.24 – $907.68 | 11 |
| Fluoroguide needle placement CPT 77002 | $991.86 | $1,626.00 | $169.20 – $1,512.18 | 11 |
| Fluoroscopy up to 1 hour CPT 76000 | $588.04 | $964.00 | $52.54 – $815.61 | 11 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $0.73 | $1.19 | $0.04 – $0.18 | 12 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $6.76 | $11.08 | $2.33 – $11.08 | 13 |
| Fna bx w/ct gdn 1st les CPT 10009 | $788.12 | $1,292.00 | $205.40 – $1,201.56 | 7 |
| Fna bx w/ct gdn ea addl CPT 10010 | $788.12 | $1,292.00 | $134.88 – $1,201.56 | 7 |
| Fna bx w/mr gdn 1st les CPT 10011 | $757.62 | $1,242.00 | $260.82 – $1,155.06 | 7 |
| Fna bx w/mr gdn ea addl CPT 10012 | $757.62 | $1,242.00 | $260.82 – $1,155.06 | 7 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | $12.83 | $21.03 | $4.42 – $19.56 | 7 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $12.03 | $19.72 | $4.15 – $18.34 | 7 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | $23.22 | $38.05 | $5.89 – $26.07 | 7 |
| Folic acid CPT 82746 | $101.87 | $167.00 | $14.25 – $167.00 | 18 |
| Follow-up angiography CPT 75898 | $924.76 | $1,516.00 | $80.28 – $1,409.88 | 7 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $1,060.48 – $1,060.48 | 1 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $557.91 | $914.60 | $5.69 – $850.58 | 10 |
| Fondaparinux sodium HCPCS J1652 | $132.59 | $217.35 | $1.29 – $42.29 | 12 |
| Foot X-ray CPT 73630 | $336.72 | $552.00 | $49.39 – $513.36 | 11 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $1,876.79 – $1,876.79 | 1 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $175.68 | $288.00 | $60.48 – $267.84 | 7 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $186.67 | $306.01 | $0.14 – $284.59 | 12 |
| Foscarnet sodium injection HCPCS J1455 | $0.95 | $1.56 | $0.33 – $1.62 | 14 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $11.28 | $18.49 | $1.20 – $10.33 | 8 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $1,086.16 – $1,086.16 | 1 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $2,222.65 – $4,221.32 | 4 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $783.42 – $798.78 | 3 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $1,727.92 – $1,761.80 | 3 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $2,227.02 – $4,255.36 | 4 |
| Free omental flap microvasc CPT 49906 | not published | not published | $1,727.92 – $1,761.80 | 3 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $1,370.35 – $1,397.22 | 3 |
| Free skin flap microvasc CPT 15757 | not published | not published | $2,229.54 – $4,237.44 | 4 |
| Frenectomy 41115 CPT 41115 | not published | not published | $278.38 – $278.38 | 1 |
| Frenotomy 40806 CPT 40806 | not published | not published | $55.78 – $55.78 | 1 |
| Frenulotomy of penis CPT 54164 | not published | not published | $371.47 – $371.47 | 1 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $129.32 | $212.00 | $44.52 – $197.16 | 7 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $134.20 | $220.00 | $0.01 – $0.01 | 7 |
| Fructosamine glycated protein CPT 82985 | $104.31 | $171.00 | $16.24 – $171.00 | 18 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $252.29 – $252.29 | 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.