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 |
|---|---|---|---|---|
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $605.12 | $992.00 | $114.43 – $922.56 | 7 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $596.58 | $978.00 | $98.60 – $909.54 | 7 |
| Ghs peritonsillar abscess i andd CPT 42700 | $317.81 | $521.00 | $109.41 – $484.53 | 7 |
| Ghs phenylketonurid CPT 84030 | $30.50 | $50.00 | $5.33 – $50.00 | 18 |
| Ghs picc line insert < 5 CPT 36568 | $1,122.40 | $1,840.00 | $171.76 – $1,711.20 | 7 |
| Ghs plngl fx pm cl CPT 26725 | $560.59 | $919.00 | $192.99 – $854.67 | 7 |
| Ghs ppd (tb intradermal) CPT 86580 | $64.82 | $106.25 | $12.39 – $59.00 | 11 |
| Ghs protoporphyrins fract CPT 84202 | $82.96 | $136.00 | $13.90 – $126.48 | 18 |
| Ghs pr without cont pulse ox CPT 94625 | $188.49 | $309.00 | $64.89 – $287.37 | 7 |
| Ghs refill of implantable pump CPT 95990 | $525.82 | $862.00 | $168.78 – $801.66 | 7 |
| Ghs removal intranasal foreign body CPT 30300 | $217.77 | $357.00 | $74.97 – $332.01 | 7 |
| Ghs removal pharyngeal foreign body CPT 42809 | $460.55 | $755.00 | $158.55 – $702.15 | 7 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,834.88 | $3,008.00 | $631.68 – $2,797.44 | 7 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $2,954.23 | $4,843.00 | $940.55 – $4,503.99 | 7 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $61.00 | $100.00 | $13.47 – $100.00 | 18 |
| Ghs sensitivity (per antimicro) CPT 87184 | $35.99 | $59.00 | $7.25 – $59.00 | 18 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $390.40 | $640.00 | $134.40 – $595.20 | 7 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $450.18 | $738.00 | $154.98 – $686.34 | 7 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $412.36 | $676.00 | $141.96 – $628.68 | 7 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $470.31 | $771.00 | $161.91 – $717.03 | 7 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $382.47 | $627.00 | $131.67 – $583.11 | 7 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $367.83 | $603.00 | $126.63 – $560.79 | 7 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $419.68 | $688.00 | $144.48 – $639.84 | 7 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $437.98 | $718.00 | $150.78 – $667.74 | 7 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $531.31 | $871.00 | $182.91 – $810.03 | 7 |
| Ghs sphenopalatine ganglion block CPT 64505 | $711.87 | $1,167.00 | $192.05 – $1,085.31 | 7 |
| Ghs strapping shoulder - 29240 CPT 29240 | $334.89 | $549.00 | $34.80 – $510.57 | 7 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $84.79 | $139.00 | $26.61 – $129.27 | 7 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $333.06 | $546.00 | $114.66 – $507.78 | 7 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $441.64 | $724.00 | $152.04 – $673.32 | 7 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $265.71 – $265.71 | 1 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $586.70 – $586.70 | 1 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $211.67 | $347.00 | $72.87 – $322.71 | 7 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $444.07 – $444.07 | 1 |
| Ghs urine, porphyrins quant CPT 84120 | $51.24 | $84.00 | $14.25 – $84.00 | 18 |
| Ghs vaginal delivery only CPT 59409 | $1,530.49 | $2,509.00 | $526.89 – $2,333.37 | 7 |
| Ghs windowing of cast CPT 29730 | not published | not published | $83.29 – $83.29 | 1 |
| Gi inhouse confirmation CPT 87045 | $82.96 | $136.00 | $9.15 – $126.48 | 18 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $575.36 – $575.36 | 1 |
| Gi trc img intral colon i&r CPT 91113 | $1,726.91 | $2,831.00 | $594.51 – $2,632.83 | 7 |
| Glassia injection HCPCS J0257 | $0.38 | $0.62 | $0.14 – $0.65 | 14 |
| Glaucoma surgery CPT 66150 | not published | not published | $1,673.81 – $1,673.81 | 1 |
| Glaucoma surgery CPT 66155 | not published | not published | $1,672.48 – $1,672.48 | 1 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,879.46 – $1,879.46 | 1 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,084.61 – $2,084.61 | 1 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $156.22 | $256.09 | $19.72 – $97.61 | 14 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $119.96 | $196.64 | $23.70 – $104.95 | 7 |
| Glucagon plasma - sendout CPT 82943 | $42.09 | $69.00 | $13.85 – $69.00 | 18 |
| Glucose 1 hr post dose CPT 82950 | $39.04 | $64.00 | $4.60 – $59.52 | 18 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $39.65 | $65.00 | $3.18 – $60.45 | 18 |
| Glucose blood quantitative CPT 82947 | $25.01 | $41.00 | $3.80 – $41.00 | 18 |
| Glucose body fluid CPT 82945 | $43.31 | $71.00 | $3.80 – $66.03 | 18 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $61.61 | $101.00 | $12.47 – $101.00 | 18 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $14.64 | $24.00 | $3.79 – $24.00 | 18 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $294.06 | $482.07 | $9.65 – $448.33 | 14 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $87.23 | $143.00 | $18.00 – $143.00 | 18 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $57.95 | $95.00 | $17.94 – $95.00 | 18 |
| Goniotomy CPT 65820 | not published | not published | $1,568.72 – $1,568.72 | 1 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,781.22 | $2,920.02 | $208.50 – $992.82 | 12 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $82.29 | $134.90 | $17.22 – $111.97 | 12 |
| Graft axiofill 1000mg HCPCS J3590 | $1,189.50 | $1,950.00 | $1.34 – $5.94 | 7 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $584.99 | $959.00 | $19.15 – $84.81 | 11 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,733.51 – $1,733.51 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $26,503.20 | $43,447.86 | $26.41 – $377.83 | 12 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $3,904.77 | $6,401.25 | $144.64 – $640.54 | 11 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $21,526.14 | $35,288.75 | $47.19 – $208.98 | 11 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $3,965.00 | $6,500.00 | $37.49 – $928.03 | 12 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $2,371.68 | $3,888.00 | $22.68 – $100.44 | 12 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $887.95 – $905.36 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $4,270.00 | $7,000.00 | $110.25 – $488.25 | 12 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $1,846.02 | $3,026.25 | $39.30 – $2,814.42 | 12 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $28,427.99 | $46,603.26 | $826.88 – $3,891.87 | 11 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $5,402.90 | $8,857.20 | $82.64 – $477.09 | 12 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $18,911.83 | $31,003.00 | $7.55 – $33.41 | 11 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,221.44 | $3,641.70 | $11.00 – $48.69 | 11 |
| Granisetron hcl injection HCPCS J1626 | $9.26 | $15.18 | $0.25 – $1.74 | 12 |
| Great toe-hand transfer CPT 26551 | not published | not published | $3,000.43 – $6,084.83 | 4 |
| Great toe with reduction 28495 CPT 28495 | $288.53 | $473.00 | $99.33 – $439.89 | 7 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $942.44 – $942.44 | 1 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $959.30 – $959.30 | 1 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $272.96 – $272.96 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $898.07 – $898.07 | 1 |
| Group health education CPT 99078 | $14.64 | $24.00 | $5.04 – $22.32 | 7 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $1,134.98 – $1,157.24 | 3 |
| Gstr rstcv oth/thn v-band CPT 43843 | not published | not published | $961.48 – $2,324.22 | 4 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,178.16 – $1,201.26 | 3 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,295.60 – $1,321.01 | 3 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $969.11 – $988.11 | 3 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $1,285.54 – $1,285.54 | 1 |
| G-tube reposition CPT 43761 | $461.16 | $756.00 | $158.76 – $703.08 | 7 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,399.95 | $2,295.00 | $152.80 – $2,134.35 | 11 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,758.42 | $4,522.00 | $252.97 – $4,205.46 | 7 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $5,679.74 | $9,311.04 | $0.30 – $1.31 | 11 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $2,614.62 | $4,286.25 | $3.05 – $13.48 | 11 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,555.05 | $2,549.25 | $17.64 – $78.12 | 11 |
| Guid loc target vol rad tx CPT 77387 | $713.09 | $1,169.00 | $192.53 – $1,087.17 | 7 |
| Gum graft CPT 41870 | not published | not published | $568.39 – $568.39 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $8,930.40 | $14,640.00 | $0.02 – $0.08 | 11 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $802.18 – $802.18 | 1 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $145.55 – $145.55 | 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.