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 |
|---|---|---|---|---|
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $1,187.92 | $1,947.40 | $408.96 – $1,811.09 | 7 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $3,462.82 | $5,676.75 | $142.83 – $4,795.58 | 14 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $2,318.00 | $3,800.00 | $33.87 – $3,534.00 | 14 |
| Inj, bortezomib freseniuskab HCPCS J9048 | $715.78 | $1,173.40 | $246.42 – $1,091.27 | 7 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $0.07 | $0.12 | $0.03 – $0.10 | 7 |
| Inj cefazolin (wg crit care) HCPCS J0687 | $2.00 | $3.28 | $0.32 – $1.41 | 7 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | $0.33 | $0.54 | $0.10 – $0.40 | 7 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $16.66 | $27.31 | $3.78 – $16.74 | 7 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $129.91 | $212.96 | $44.73 – $198.06 | 7 |
| Inj ceftolozane tazobactam HCPCS J0695 | $97.28 | $159.47 | $7.00 – $148.31 | 12 |
| Inj, clevidipine butyrate HCPCS C9248 | $0.97 | $1.58 | $0.34 – $1.47 | 7 |
| Inj, clindamycin (baxter) HCPCS J0737 | $0.15 | $0.24 | $0.03 – $0.13 | 7 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $242.17 | $397.00 | $75.64 – $369.21 | 7 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $708.16 | $1,160.91 | $243.80 – $1,207.35 | 14 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | $63.60 | $104.26 | $21.23 – $93.99 | 7 |
| Inj disk cerv-thor ea lev CPT 62291 | $972.95 | $1,595.00 | $272.58 – $1,483.35 | 7 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $21.22 | $34.79 | $7.31 – $32.36 | 7 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $121.93 – $121.93 | 1 |
| Inj dx for sinogram CPT 20501 | $328.18 | $538.00 | $68.86 – $500.34 | 7 |
| Inject for sacroiliac joint HCPCS G0259 | $547.78 | $898.00 | $188.58 – $835.14 | 7 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $716.14 | $1,174.00 | $157.27 – $1,091.82 | 7 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $611.22 | $1,002.00 | $127.85 – $931.86 | 7 |
| Injection, burosumab-twza 1m HCPCS J0584 | $7,758.23 | $12,718.40 | $394.60 – $7,885.38 | 14 |
| Injection, cangrelor HCPCS C9460 | $557.46 | $913.87 | $191.92 – $849.90 | 7 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $4,834.25 | $7,925.00 | $1,664.25 – $7,370.25 | 7 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $105.40 – $105.40 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | $93.83 | $153.81 | $32.31 – $144.38 | 14 |
| Injection, doxercalciferol HCPCS J1270 | $1.95 | $3.19 | $0.28 – $2.97 | 12 |
| Injection during cath supravalvular aortography CPT 93567 | $990.03 | $1,623.00 | $66.61 – $1,509.39 | 11 |
| Injection, edaravone, 1 mg HCPCS J1301 | $3.52 | $5.77 | $1.22 – $6.00 | 14 |
| Injection epidural blood patch or clot CPT 62273 | $880.84 | $1,444.00 | $215.50 – $1,342.92 | 7 |
| Injection eye drug CPT 67028 | not published | not published | $174.47 – $174.47 | 1 |
| Injection for arthrography wrist (both sides) CPT 25246 | $155.55 | $255.00 | $53.55 – $237.15 | 7 |
| Injection for bladder x-ray CPT 51600 | $503.86 | $826.00 | $81.94 – $768.18 | 7 |
| Injection for hip x-ray CPT 27095 | not published | not published | $152.50 – $152.50 | 1 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $497.76 | $816.00 | $94.19 – $758.88 | 7 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $245.83 – $245.83 | 1 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $98.09 – $98.09 | 1 |
| Injection for ureter x-ray CPT 50684 | $930.25 | $1,525.00 | $96.39 – $1,418.25 | 7 |
| Injection for ureter x-ray CPT 50690 | $1,090.07 | $1,787.00 | $132.09 – $1,661.91 | 7 |
| Injection, fulvestrant HCPCS J9395 | $108.19 | $177.35 | $7.10 – $164.94 | 14 |
| Injection, glucarpidase HCPCS C9293 | $25,116.14 | $41,174.00 | $8,646.54 – $38,291.82 | 7 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $1,375.12 | $2,254.28 | $473.40 – $2,096.49 | 7 |
| Injection into brain canal CPT 61026 | $1,393.24 | $2,284.00 | $198.98 – $2,124.12 | 7 |
| Injection into brain canal CPT 61055 | not published | not published | $217.29 – $217.29 | 1 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $348.31 – $348.31 | 1 |
| Injection into spinal artery CPT 62294 | not published | not published | $1,689.79 – $1,689.79 | 1 |
| Injection into vocal cord CPT 31513 | not published | not published | $246.73 – $246.73 | 1 |
| Injection intraop add-on CPT 48400 | not published | not published | $100.23 – $189.74 | 4 |
| Injection, isavuconazonium HCPCS J1833 | $219.75 | $360.24 | $1.02 – $335.03 | 9 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $84.48 – $84.48 | 1 |
| Injection jugular CPT 36299 | $231.19 | $379.00 | $79.59 – $352.47 | 7 |
| Injection, necitumumab, 1 mg HCPCS J9295 | $52.83 | $86.60 | $4.67 – $80.54 | 14 |
| Injection of sinus tract CPT 20500 | $622.81 | $1,021.00 | $170.60 – $949.53 | 7 |
| Injection,onabotulinumtoxina HCPCS J0585 | $788.12 | $1,292.00 | $5.42 – $600.78 | 14 |
| Injection, peramivir HCPCS J2547 | $9.66 | $15.84 | $3.33 – $14.74 | 7 |
| Injection px peyronie ds CPT 54200 | not published | not published | $166.91 – $166.91 | 1 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $624.03 | $1,023.00 | $60.25 – $951.39 | 7 |
| Injection, renflexis HCPCS Q5104 | $213.89 | $350.63 | $25.39 – $326.09 | 14 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $795.44 | $1,304.00 | $265.44 – $1,175.52 | 7 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,750.70 | $2,870.00 | $120.92 – $2,669.10 | 7 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $882.67 | $1,447.00 | $79.30 – $672.39 | 7 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,468.88 | $2,408.00 | $212.60 – $2,239.44 | 7 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $605.12 | $992.00 | $112.54 – $922.56 | 7 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,635.41 | $2,681.00 | $200.80 – $2,493.33 | 7 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,808.04 | $2,964.00 | $96.71 – $2,756.52 | 7 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,808.04 | $2,964.00 | $172.60 – $2,756.52 | 7 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,557.33 | $2,553.00 | $204.90 – $2,374.29 | 7 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,848.30 | $3,030.00 | $189.34 – $2,817.90 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $208.62 | $342.00 | $71.82 – $318.06 | 7 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $261.08 | $428.00 | $69.76 – $398.04 | 7 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $332.45 | $545.00 | $79.30 – $506.85 | 7 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $183.00 | $300.00 | $29.15 – $250.17 | 7 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $143.35 | $235.00 | $18.38 – $218.55 | 7 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $464.82 | $762.00 | $69.55 – $708.66 | 7 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $215.94 | $354.00 | $13.73 – $329.22 | 8 |
| Injection treatment of eye CPT 66020 | not published | not published | $250.43 – $250.43 | 1 |
| Injection treatment of eye CPT 66030 | not published | not published | $212.54 – $212.54 | 1 |
| Injection treatment of nerve CPT 64605 | not published | not published | $748.29 – $748.29 | 1 |
| Injection treatment of nerve CPT 64610 | not published | not published | $859.70 – $859.70 | 1 |
| Injection treatment of nerve CPT 64681 | not published | not published | $417.94 – $417.94 | 1 |
| Injection treatment of nose CPT 30200 | not published | not published | $113.32 – $113.32 | 1 |
| Inject sacroiliac joint CPT 27096 | $982.71 | $1,611.00 | $158.30 – $1,237.83 | 7 |
| Inject/treat eye socket CPT 67500 | not published | not published | $122.96 – $122.96 | 1 |
| Inject/treat eye socket CPT 67505 | not published | not published | $137.26 – $137.26 | 1 |
| Inject/treat eye socket CPT 67515 | not published | not published | $89.40 – $89.40 | 1 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | $1,718.14 | $2,816.61 | $591.49 – $2,619.45 | 7 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,557.33 | $2,553.00 | $187.64 – $2,374.29 | 7 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,848.30 | $3,030.00 | $150.49 – $2,817.90 | 7 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $99.74 | $163.50 | $7.50 – $152.06 | 7 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $183.90 | $301.47 | $17.54 – $280.37 | 14 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $6.13 | $10.04 | $2.11 – $9.34 | 7 |
| Inj for ext venography CPT 36005 | $710.65 | $1,165.00 | $86.33 – $1,083.45 | 7 |
| Inj for mammo ductogram CPT 19030 | $239.12 | $392.00 | $82.32 – $364.56 | 7 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | $7.09 | $11.62 | $2.45 – $10.81 | 7 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | $623.36 | $1,021.90 | $214.60 – $950.37 | 7 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | $1.13 | $1.85 | $0.39 – $1.73 | 7 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | $1,014.62 | $1,663.30 | $4.78 – $1,546.87 | 14 |
| Inj., guselkumab, 1 mg HCPCS J1628 | $8,574.54 | $14,056.61 | $136.50 – $645.09 | 13 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $2,970.70 | $4,870.00 | $83.18 – $4,529.10 | 11 |
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.