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 |
|---|---|---|---|---|
| Mayo opatu oxycodone definitive assay CPT 80365 | $42.09 | $69.00 | $14.49 – $64.17 | 7 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $21.96 | $36.00 | $7.56 – $47.09 | 18 |
| Mayo oxalate 24 hour urine CPT 83945 | $51.24 | $84.00 | $14.00 – $84.00 | 18 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $127.49 | $209.00 | $11.17 – $194.37 | 18 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $37.21 | $61.00 | $12.81 – $61.00 | 18 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $79.30 | $130.00 | $10.08 – $48.00 | 18 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $170.80 | $280.00 | $34.01 – $280.00 | 18 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $64.05 | $105.00 | $17.42 – $105.00 | 18 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $52.46 | $86.00 | $13.33 – $86.00 | 18 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $35.99 | $59.00 | $8.18 – $54.87 | 18 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $39.04 | $64.00 | $13.44 – $64.00 | 18 |
| Mayo proinsulin CPT 84206 | $59.17 | $97.00 | $20.37 – $97.00 | 18 |
| Mayo psaft prostate specific antigen free CPT 84154 | $68.93 | $113.00 | $17.82 – $113.00 | 18 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $780.80 | $1,280.00 | $17.83 – $1,190.40 | 18 |
| Mayo receptor assay transferrin soluble CPT 84238 | $222.04 | $364.00 | $35.43 – $364.00 | 18 |
| Mayo renin CPT 84244 | $59.17 | $97.00 | $20.37 – $97.00 | 18 |
| Mayo repu protein electrophoresis urine CPT 84166 | $64.66 | $106.00 | $17.28 – $106.00 | 18 |
| Mayo selenium CPT 84255 | $83.57 | $137.00 | $24.73 – $137.00 | 18 |
| Mayo serotonin CPT 84260 | $194.59 | $319.00 | $30.02 – $296.67 | 18 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $21.35 | $35.00 | $7.35 – $42.96 | 18 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $21.96 | $36.00 | $7.56 – $36.00 | 18 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $113.46 | $186.00 | $39.06 – $172.98 | 7 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $27.45 | $45.00 | $4.14 – $45.00 | 18 |
| Mayo tgrp testosterone free CPT 84402 | $271.45 | $445.00 | $24.68 – $413.85 | 18 |
| Mayo tgrp testosterone total CPT 84403 | $74.42 | $122.00 | $25.01 – $122.00 | 18 |
| Mayo thyroglobulin CPT 84432 | $48.19 | $79.00 | $15.57 – $79.00 | 18 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $54.90 | $90.00 | $9.86 – $90.00 | 18 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $129.93 | $213.00 | $12.01 – $198.09 | 18 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $61.00 | $100.00 | $13.72 – $93.00 | 18 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $15.86 | $26.00 | $5.46 – $30.06 | 18 |
| Mayo vasoactive intestinal peptide CPT 84586 | $62.22 | $102.00 | $21.42 – $102.00 | 18 |
| Mayo vitamin b3 (niacin) CPT 84591 | $76.25 | $125.00 | $16.53 – $125.00 | 18 |
| Mayo vitamin k CPT 84597 | $78.69 | $129.00 | $13.29 – $129.00 | 18 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $117.73 | $193.00 | $12.84 – $179.49 | 18 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $684.60 – $1,519.25 | 4 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $957.60 – $957.60 | 1 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $1,024.49 – $1,024.49 | 1 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $1,084.69 – $1,084.69 | 1 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $1,738.38 – $1,738.38 | 1 |
| Measure kidney pressure CPT 50396 | not published | not published | $218.95 – $218.95 | 1 |
| Measurement post void urine by ultrasound CPT 51798 | $204.96 | $336.00 | $21.02 – $312.48 | 7 |
| Measure ureter pressure CPT 50686 | not published | not published | $167.08 – $167.08 | 1 |
| #mec-opiates CPT 80356 | $87.23 | $143.00 | $30.03 – $132.99 | 7 |
| Medial canthopexy CPT 21280 | not published | not published | $1,125.58 – $1,125.58 | 1 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $716.92 – $716.92 | 1 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $551.10 – $551.10 | 1 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $40.17 | $65.85 | $0.49 – $44.78 | 8 |
| Melphalan oral 2 mg HCPCS J8600 | $6.58 | $10.78 | $2.27 – $10.03 | 10 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $878.40 | $1,440.00 | $100.80 – $446.40 | 12 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $3,089.88 – $3,089.88 | 1 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $3.97 | $6.51 | $0.40 – $1.89 | 12 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $2,250.19 | $3,688.83 | $25.86 – $2,841.47 | 14 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $17.44 | $28.59 | $0.05 – $0.20 | 12 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $466.64 – $466.64 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $3.85 | $6.31 | $1.33 – $5.87 | 12 |
| Metabolic Blood Panel (Basic) CPT 80048 | $111.02 | $182.00 | $8.20 – $169.26 | 18 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $148.84 | $244.00 | $10.23 – $226.92 | 18 |
| Metatarsal joint implant HCPCS L8641 | $1,373.88 | $2,252.25 | $105.00 – $465.00 | 11 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $82.35 | $135.00 | $1.27 – $6.38 | 12 |
| Methadone injection HCPCS J1230 | $13.11 | $21.49 | $4.52 – $21.49 | 12 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $0.56 | $0.92 | $0.20 – $0.92 | 12 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $1.32 | $2.16 | $0.20 – $2.01 | 12 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $2.80 | $4.59 | $0.50 – $2.37 | 12 |
| Methotrexate therapeutic drug level CPT 80204 | $63.44 | $104.00 | $21.84 – $96.72 | 14 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $117.20 | $192.12 | $1.13 – $5.55 | 9 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $12.47 | $20.44 | $4.30 – $20.44 | 12 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $158.01 | $259.03 | $2.57 – $240.89 | 7 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $0.75 | $1.23 | $0.18 – $0.78 | 12 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $10.75 | $17.61 | $1.29 – $5.70 | 7 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $0.39 | $0.64 | $0.01 – $0.01 | 12 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.02 | $0.03 | $0.01 – $0.03 | 7 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $43.52 | $71.34 | $0.36 – $14.94 | 12 |
| Microdissection manual CPT 88381 | $106.14 | $174.00 | $36.54 – $174.00 | 11 |
| Microsatellite instability CPT 81301 | $578.89 | $949.00 | $199.29 – $949.00 | 18 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | not published | not published | $371.85 – $371.85 | 1 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $1.94 | $3.17 | $0.01 – $0.01 | 12 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $0.14 | $0.22 | $0.04 – $0.16 | 7 |
| Middle cerebral artery echo CPT 76821 | $214.72 | $352.00 | $73.92 – $352.00 | 11 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $0.32 | $0.53 | $0.04 – $0.16 | 12 |
| Minocycline hydrochloride HCPCS J2265 | $120.72 | $197.90 | $2.47 – $184.05 | 9 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | $197.86 | $324.36 | $68.12 – $301.66 | 7 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $716.59 | $1,174.73 | $44.07 – $231.39 | 14 |
| Mitomycin instillation HCPCS J9281 | $708.43 | $1,161.35 | $243.89 – $1,080.06 | 14 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $4.98 | $8.17 | $1.72 – $8.49 | 14 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | not published | not published | $2,211.51 – $2,254.88 | 3 |
| Mlt osteot rlgnm imed rd hum CPT 24410 | not published | not published | $1,973.14 – $1,973.14 | 1 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | not published | not published | $155.23 – $155.23 | 1 |
| Mnl prep&insj i-artic rx dev CPT 20704 | not published | not published | $274.16 – $274.16 | 1 |
| Mnl prep&insj imed rx dev CPT 20702 | not published | not published | $260.97 – $260.97 | 1 |
| Mnpj anes sho jt fixj aprats CPT 23700 | $1,324.92 | $2,172.00 | $369.41 – $2,019.96 | 7 |
| Mnpj elbow under anes CPT 24300 | not published | not published | $848.36 – $848.36 | 1 |
| Mnpj of tmj w/anesth CPT 21073 | not published | not published | $457.88 – $457.88 | 1 |
| Mobilization of colon 44139 CPT 44139 | not published | not published | $119.69 – $216.13 | 4 |
| Modified maze/limited 33254 CPT 33254 | not published | not published | $1,190.79 – $1,214.14 | 3 |
| Modified maze/limited /w other op 33257 CPT 33257 | not published | not published | $464.14 – $1,045.72 | 4 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $488.00 | $800.00 | $168.00 – $744.00 | 7 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $6,375.27 | $10,451.25 | $1,417.50 – $6,277.50 | 11 |
| Monovisc inj per dose HCPCS J7327 | $123.84 | $203.02 | $42.64 – $203.02 | 12 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $3.79 | $6.20 | $0.17 – $0.79 | 12 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $2.55 | $4.18 | $0.34 – $1.49 | 7 |
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.