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 |
|---|---|---|---|---|
| Ligate/strip short leg vein CPT 37718 | not published | not published | $698.59 – $698.59 | 1 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $699.28 – $699.28 | 1 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $375.69 – $375.69 | 1 |
| Ligation common iliac vein CPT 37660 | not published | not published | $608.63 – $620.57 | 3 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $439.55 – $439.55 | 1 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $1,390.39 – $1,390.39 | 1 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $1,300.38 – $1,300.38 | 1 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $1,336.13 – $1,336.13 | 1 |
| Ligation major artery chest CPT 37616 | not published | not published | $924.05 – $942.17 | 3 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $332.22 – $713.35 | 4 |
| Ligation major artery neck CPT 37615 | not published | not published | $953.82 – $953.82 | 1 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $1,147.48 – $1,147.48 | 1 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $875.99 – $2,383.92 | 4 |
| Ligation of femoral vein CPT 37650 | not published | not published | $814.55 – $814.55 | 1 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $3,093.38 – $3,093.38 | 1 |
| Ligation of neck artery CPT 37606 | not published | not published | $1,306.77 – $1,306.77 | 1 |
| Ligation of salivary duct CPT 42665 | not published | not published | $415.99 – $415.99 | 1 |
| Ligation of shunt CPT 49428 | not published | not published | $141.85 – $782.86 | 4 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,656.19 – $1,656.19 | 1 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $459.50 – $459.50 | 1 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $670.47 – $670.47 | 1 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $1,030.64 – $1,030.64 | 1 |
| Liletta, 52 mg HCPCS J7297 | $363.75 | $596.31 | $125.23 – $620.17 | 9 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $391.44 – $391.44 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $0.07 | $0.10 | $0.03 – $0.10 | 12 |
| Lipase CPT 83690 | $79.91 | $131.00 | $6.68 – $121.83 | 18 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $665.34 – $665.34 | 1 |
| Lipoprotein blood quant CPT 83704 | $145.18 | $238.00 | $33.13 – $238.00 | 18 |
| Lipoprotein direct measurement hdl CPT 83718 | $65.27 | $107.00 | $7.94 – $99.51 | 18 |
| Lipoprotein direct measurement ldl CPT 83721 | $31.72 | $52.00 | $10.18 – $52.00 | 18 |
| Lithium therapeutic drug level CPT 80178 | $81.13 | $133.00 | $6.41 – $123.69 | 18 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,845.23 | $7,943.00 | $1,668.03 – $7,386.99 | 7 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $612.71 – $624.73 | 3 |
| Liver elastography 91200 CPT 91200 | $286.70 | $470.00 | $38.05 – $437.10 | 7 |
| Liver Function Test CPT 80076 | $131.76 | $216.00 | $7.92 – $200.88 | 18 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $657.51 – $670.40 | 3 |
| Liver imaging CPT 78201 | $631.35 | $1,035.00 | $217.35 – $1,035.00 | 11 |
| Liver/spleen imag static only CPT 78215 | $727.12 | $1,192.00 | $250.32 – $1,192.00 | 11 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $892.48 – $892.48 | 1 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $1.54 | $2.51 | $0.01 – $0.01 | 12 |
| Low back disk surgery CPT 63030 | not published | not published | $1,660.20 – $1,660.20 | 1 |
| Low cost skin substitute app HCPCS C5271 | $559.37 | $917.00 | $192.57 – $852.81 | 7 |
| Low cost skin substitute app HCPCS C5275 | $559.37 | $917.00 | $192.57 – $852.81 | 7 |
| Low cost skin substitute app HCPCS C5272 | $161.65 | $265.00 | $55.65 – $246.45 | 7 |
| Low cost skin substitute app HCPCS C5276 | $170.19 | $279.00 | $58.59 – $259.47 | 7 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,027.64 | $3,324.00 | $270.92 – $3,091.32 | 11 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,939.80 | $3,180.00 | $219.22 – $2,957.40 | 11 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,747.65 | $2,865.00 | $161.64 – $2,664.45 | 11 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,345.45 | $3,845.00 | $416.79 – $3,575.85 | 11 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,919.46 | $4,786.00 | $366.98 – $4,450.98 | 11 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,821.46 | $2,986.00 | $239.40 – $2,776.98 | 11 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $428.83 | $703.00 | $55.06 – $653.79 | 11 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,508.81 – $1,508.81 | 1 |
| Low frequency non-thermal Ultrasound CPT 97610 | $265.35 | $435.00 | $31.76 – $404.55 | 7 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $1,377.89 – $1,377.89 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $1,581.93 – $1,581.93 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $1,561.10 – $1,561.10 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,699.17 – $1,699.17 | 1 |
| Lso flex no ri stays pre ots HCPCS L0628 | $377.88 | $619.47 | $70.45 – $576.11 | 9 |
| Lumbar diskogram s&i CPT 72295 | $2,162.45 | $3,545.00 | $136.42 – $3,296.85 | 11 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,863.62 – $2,863.62 | 1 |
| Lung function test (mbc/mvv) CPT 94200 | $220.21 | $361.00 | $22.91 – $335.73 | 7 |
| Lung Function Test (Spirometry) CPT 94010 | $258.03 | $423.00 | $36.14 – $393.39 | 7 |
| Lung perfusion imaging CPT 78580 | $1,237.69 | $2,029.00 | $343.85 – $1,886.97 | 11 |
| Lung transplant double CPT 32853 | not published | not published | $4,061.77 – $4,141.42 | 3 |
| Lung transplant single CPT 32851 | not published | not published | $2,905.63 – $2,962.61 | 3 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,151.44 – $3,213.24 | 3 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,301.31 – $4,385.65 | 3 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,367.10 – $1,393.90 | 3 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $4,207.98 | $6,898.32 | $164.98 – $6,415.44 | 14 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $7,234.74 | $11,860.22 | $34.54 – $3,676.69 | 14 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $28,975.00 | $47,500.00 | $267.46 – $44,175.00 | 9 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $59.64 – $59.64 | 1 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $618.60 – $1,321.49 | 4 |
| Lymphatics/lymph node imaging CPT 78195 | $1,537.81 | $2,521.00 | $506.33 – $2,387.69 | 11 |
| Lymph vessel x-ray trunk CPT 75805 | $977.22 | $1,602.00 | $336.42 – $1,489.86 | 7 |
| Lymph vessel x-ray trunk CPT 75807 | $883.89 | $1,449.00 | $304.29 – $1,347.57 | 7 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $287.85 – $287.85 | 1 |
| Lysis of labial adhesions CPT 56441 | $4,273.66 | $7,006.00 | $295.03 – $6,515.58 | 7 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $381.68 – $381.68 | 1 |
| Macroscopic exam parasite CPT 87169 | $51.85 | $85.00 | $4.17 – $79.05 | 18 |
| Magnesium CPT 83735 | $57.95 | $95.00 | $6.50 – $88.35 | 18 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $1.97 | $3.23 | $0.01 – $0.02 | 12 |
| Male sling procedure CPT 53440 | not published | not published | $1,426.30 – $1,426.30 | 1 |
| Mammosite ced HCPCS C1728 | $6,139.65 | $10,065.00 | $34.76 – $153.90 | 11 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $1,649.06 – $1,681.40 | 3 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $690.82 – $690.82 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $834.29 – $834.29 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $218.99 | $359.00 | $60.91 – $333.87 | 7 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $214.72 | $352.00 | $38.84 – $327.36 | 7 |
| Manipulation of hip joint CPT 27275 | not published | not published | $348.43 – $348.43 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $239.93 – $239.93 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $148.09 – $148.09 | 1 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $0.07 | $0.12 | $0.03 – $0.12 | 12 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $247.30 – $247.30 | 1 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,843.00 | $6,300.00 | $0.34 – $1.50 | 11 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $600.22 – $611.99 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $1,206.60 – $1,206.60 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $2,152.50 – $2,152.50 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $1,349.25 – $1,349.25 | 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.