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 |
|---|---|---|---|---|
| Pt evaluation low complexity patient/family CPT 97161 | $200.08 | $328.00 | $68.88 – $305.04 | 13 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $200.08 | $328.00 | $68.88 – $305.04 | 13 |
| Pt prgrm for implt neurostim HCPCS L8681 | $24,552.50 | $40,250.00 | $189.00 – $837.00 | 11 |
| Pt re-evaluation patient/family CPT 97164 | $78.08 | $128.00 | $26.88 – $128.00 | 13 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $68.93 | $113.00 | $12.29 – $105.09 | 9 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $71.98 | $118.00 | $22.00 – $118.00 | 13 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $53.68 | $88.00 | $18.48 – $88.00 | 13 |
| Pt wheelchair management each 15 minutes CPT 97542 | $48.19 | $79.00 | $16.59 – $79.00 | 13 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $1,609.55 – $1,641.11 | 3 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $970.72 – $1,786.70 | 4 |
| Pulse ox continuous overnight monitoring CPT 94762 | $295.24 | $484.00 | $42.63 – $450.12 | 7 |
| Pulse ox multiple CPT 94761 | $227.53 | $373.00 | $5.83 – $346.89 | 7 |
| Pulse ox single CPT 94760 | $85.40 | $140.00 | $3.57 – $130.20 | 7 |
| Punc of shunt for asp or inj CPT 61070 | $464.82 | $762.00 | $104.27 – $708.66 | 7 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $102.48 | $168.00 | $28.73 – $156.24 | 7 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $342.82 | $562.00 | $118.02 – $522.66 | 7 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $89.46 – $89.46 | 1 |
| Puncture spinal lumbar diagnostic CPT 62270 | $832.65 | $1,365.00 | $115.40 – $1,269.45 | 7 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $203.74 | $334.00 | $70.14 – $310.62 | 7 |
| Pvb thoracic cont infusion CPT 64463 | $734.44 | $1,204.00 | $156.07 – $1,119.72 | 7 |
| Pvb thoracic single inj site CPT 64461 | $734.44 | $1,204.00 | $148.91 – $1,119.72 | 7 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $952.77 – $1,855.88 | 4 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $917.44 – $1,793.55 | 4 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $1,011.15 – $1,030.97 | 3 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $612.49 – $1,686.49 | 4 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $6.77 | $11.09 | $2.33 – $11.09 | 12 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,536.59 | $2,519.00 | $446.84 – $2,342.67 | 11 |
| Quant diff pulm perf w/imaging CPT 78597 | $844.85 | $1,385.00 | $283.75 – $1,334.89 | 11 |
| Quest t3 uptake CPT 84479 | $62.22 | $102.00 | $6.27 – $94.86 | 18 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $246.63 | $404.31 | $84.91 – $420.48 | 10 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $296.28 | $485.69 | $102.00 – $451.70 | 10 |
| Radial keratotomy CPT 65771 | not published | not published | $1,169.64 – $1,169.64 | 1 |
| Radiation physics consult CPT 77336 | $1,032.73 | $1,693.00 | $160.53 – $1,574.49 | 11 |
| Radiation therapy dose plan CPT 77300 | $680.15 | $1,115.00 | $63.27 – $1,036.95 | 11 |
| Radiation treatment aid(s) CPT 77332 | $563.64 | $924.00 | $29.21 – $859.32 | 11 |
| Radiation treatment aid(s) CPT 77333 | $644.16 | $1,056.00 | $61.09 – $982.08 | 11 |
| Radiation treatment aid(s) CPT 77334 | $1,329.19 | $2,179.00 | $123.80 – $2,026.47 | 11 |
| Radiation treatment delivery CPT 77412 | $1,456.07 | $2,387.00 | $433.61 – $2,219.91 | 7 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $1,615.77 – $1,647.45 | 3 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $841.17 – $2,786.03 | 4 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $1,004.01 – $3,572.50 | 4 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $842.08 – $3,262.25 | 4 |
| Radical resection of elbow CPT 24149 | not published | not published | $2,214.24 – $2,214.24 | 1 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,118.19 – $2,446.10 | 4 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $1,923.64 – $1,923.64 | 1 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $2,639.43 – $2,639.43 | 1 |
| Radiesse injection HCPCS Q2026 | $1,640.97 | $2,690.10 | $564.93 – $2,501.80 | 11 |
| Radiology port images(s) CPT 77417 | $376.37 | $617.00 | $25.64 – $573.81 | 11 |
| Radiotherapy dose plan imrt CPT 77301 | $8,236.83 | $13,503.00 | $2,688.44 – $12,557.79 | 11 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $191.54 | $314.00 | $65.94 – $292.02 | 9 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,316.17 | $3,797.00 | $461.77 – $3,531.21 | 11 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,748.05 | $4,505.00 | $946.05 – $4,189.65 | 11 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,501.00 | $4,100.00 | $462.21 – $2,201.00 | 11 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,312.11 | $2,151.00 | $380.44 – $2,000.43 | 11 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $2,857.55 – $2,857.55 | 1 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $2,069.95 – $2,069.95 | 1 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $2,436.06 – $2,436.06 | 1 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $1,893.55 – $1,893.55 | 1 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $1,342.13 – $1,342.13 | 1 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $2,429.57 – $2,429.57 | 1 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $1,402.15 – $1,402.15 | 1 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,959.68 – $1,959.68 | 1 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $2,491.23 – $2,491.23 | 1 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $1,771.60 – $1,771.60 | 1 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $89.22 | $146.26 | $30.72 – $146.26 | 14 |
| Range of motion measurements CPT 95852 | $93.94 | $154.00 | $9.26 – $143.22 | 9 |
| Rapid Strep Test CPT 87880 | $34.77 | $57.00 | $11.97 – $57.00 | 18 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $2,726.80 | $4,470.16 | $225.65 – $999.31 | 12 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $1,328.19 | $2,177.36 | $187.82 – $2,024.95 | 14 |
| Rbc count only automated CPT 85041 | $13.42 | $22.00 | $2.93 – $22.00 | 18 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $89.42 – $89.42 | 1 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $4,092.50 – $4,092.50 | 1 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $1,571.64 – $3,148.78 | 4 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $1,404.25 – $2,821.06 | 4 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | not published | not published | $1,173.39 – $2,944.64 | 4 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | not published | not published | $1,216.97 – $3,074.57 | 4 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | not published | not published | $2,037.29 – $4,063.63 | 4 |
| Rcnstj mdfc lefort iii without i CPT 21154 | not published | not published | $1,823.69 – $3,665.03 | 4 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | not published | not published | $1,741.86 – $3,404.94 | 4 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | not published | not published | $2,713.68 – $5,275.35 | 4 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | not published | not published | $2,552.10 – $4,865.36 | 4 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $1,404.88 – $1,404.88 | 1 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $1,706.94 – $1,706.94 | 1 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $2,030.89 – $2,030.89 | 1 |
| Realignment of knee CPT 27457 | not published | not published | $928.50 – $1,762.28 | 4 |
| Realignment of knee CPT 27455 | not published | not published | $889.16 – $1,793.99 | 4 |
| Realignment of tendons CPT 26437 | not published | not published | $1,266.15 – $1,266.15 | 1 |
| Realignment of thigh bone CPT 27454 | not published | not published | $1,171.94 – $2,401.01 | 4 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $2,052.86 – $2,052.86 | 1 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $1,994.71 – $1,994.71 | 1 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $2,666.56 – $2,666.56 | 1 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $2,113.40 – $2,113.40 | 1 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $2,951.87 – $2,951.87 | 1 |
| Rechanneling of artery CPT 35361 | not published | not published | $1,431.10 – $1,459.16 | 3 |
| Rechanneling of artery CPT 35306 | not published | not published | $418.21 – $774.10 | 4 |
| Rechanneling of artery CPT 35311 | not published | not published | $1,532.67 – $1,562.72 | 3 |
| Rechanneling of artery CPT 35363 | not published | not published | $1,543.23 – $1,573.49 | 3 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $1,114.31 – $1,136.16 | 3 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $1,468.97 – $1,497.78 | 3 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $1,159.41 – $1,182.15 | 3 |
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.