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 |
|---|---|---|---|---|
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $300.17 – $300.17 | 1 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $197.30 – $197.30 | 1 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $288.52 – $288.52 | 1 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $371.05 – $371.05 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $225.23 – $225.23 | 1 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $232.97 – $232.97 | 1 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $317.94 – $317.94 | 1 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $175.29 – $175.29 | 1 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $331.84 | $544.00 | $36.14 – $505.92 | 11 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $146.48 – $146.48 | 1 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $288.58 – $288.58 | 1 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $74.25 | $121.71 | $25.56 – $121.71 | 12 |
| Single transfer toe-hand CPT 26553 | not published | not published | $2,975.28 – $6,043.99 | 4 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,806.21 | $2,961.00 | $244.44 – $2,753.73 | 11 |
| Sinus CT scan (with contrast) CPT 70487 | $1,778.15 | $2,915.00 | $194.63 – $2,710.95 | 11 |
| Sinus CT scan (without contrast) CPT 70486 | $1,389.58 | $2,278.00 | $172.35 – $2,118.54 | 11 |
| Sinus/juglr venogram s&i CPT 75860 | $499.59 | $819.00 | $137.26 – $761.67 | 11 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $652.87 – $652.87 | 1 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $1,132.30 – $1,132.30 | 1 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $983.96 – $983.96 | 1 |
| Sirolimus, oral HCPCS J7520 | $18.10 | $29.66 | $0.90 – $3.96 | 12 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,984.02 – $1,984.02 | 1 |
| Skin Biopsy CPT 11102 | not published | not published | $71.44 – $71.44 | 1 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $1,259.54 – $1,259.54 | 1 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $198.07 – $198.07 | 1 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $1,378.99 – $1,378.99 | 1 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $1,355.30 – $1,355.30 | 1 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $2,629.10 | $4,310.00 | $201.87 – $4,008.30 | 7 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $2,286.05 – $2,330.88 | 3 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,066.47 – $3,126.59 | 3 |
| Skyla, 13.5 mg HCPCS J7301 | $555.25 | $910.24 | $191.16 – $946.65 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $3,078.06 | $5,046.00 | $955.27 – $4,692.78 | 11 |
| Sleep study unattended CPT 95806 | $373.32 | $612.00 | $96.26 – $833.32 | 11 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $1,608.00 – $1,639.53 | 3 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $10.51 | $17.22 | $3.62 – $16.02 | 7 |
| Sling suprapubic suburetheral HCPCS C1771 | $5,757.03 | $9,437.75 | $129.15 – $571.95 | 11 |
| Slitting of prepuce CPT 54000 | not published | not published | $212.31 – $212.31 | 1 |
| Slitting of prepuce CPT 54001 | not published | not published | $268.13 – $268.13 | 1 |
| Slp pure tone screening CPT 92551 | $131.76 | $216.00 | $14.40 – $200.88 | 9 |
| Small bowel endoscopy CPT 44360 | not published | not published | $269.56 – $269.56 | 1 |
| Small bowel endoscopy CPT 44364 | not published | not published | $382.60 – $382.60 | 1 |
| Small bowel endoscopy CPT 44366 | not published | not published | $449.06 – $449.06 | 1 |
| Small bowel endoscopy CPT 44369 | not published | not published | $459.56 – $459.56 | 1 |
| Small bowel endoscopy CPT 44376 | not published | not published | $531.47 – $531.47 | 1 |
| Small bowel endoscopy CPT 44378 | not published | not published | $718.66 – $718.66 | 1 |
| Small bowel endoscopy CPT 44382 | not published | not published | $139.08 – $139.08 | 1 |
| Small bowel endoscopy CPT 44384 | not published | not published | $285.26 – $285.26 | 1 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $358.74 – $358.74 | 1 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $341.12 – $341.12 | 1 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $297.00 – $297.00 | 1 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $558.64 – $558.64 | 1 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $108.15 – $108.15 | 1 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $159.18 – $159.18 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $499.82 – $499.82 | 1 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | $0.01 | $0.01 | $0.01 – $0.01 | 7 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $48.80 | $80.00 | $5.22 – $74.40 | 18 |
| Smear gram stain CPT 87205 | $32.33 | $53.00 | $4.14 – $49.29 | 18 |
| Smear nasal eosinophil CPT 89190 | $32.94 | $54.00 | $5.61 – $54.00 | 18 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $82.96 | $136.00 | $5.80 – $126.48 | 18 |
| Smear wet mount CPT 87210 | $24.40 | $40.00 | $5.64 – $40.00 | 18 |
| Sock fracture or equal each HCPCS L3995 | $26.17 | $42.89 | $9.01 – $39.89 | 9 |
| Sodium 24 hour urine CPT 84300 | $45.75 | $75.00 | $4.91 – $69.75 | 18 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $0.01 | $0.01 | $0.01 – $0.01 | 12 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $0.01 | $0.02 | $0.01 – $0.02 | 12 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $0.01 | $0.02 | $0.01 – $0.02 | 7 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $3.55 | $5.82 | $1.23 – $5.42 | 12 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $55.16 | $90.42 | $18.99 – $90.42 | 12 |
| Sodium serum/plasma/whole blood CPT 84295 | $17.69 | $29.00 | $4.66 – $29.00 | 18 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1.21 | $1.98 | $0.42 – $1.85 | 7 |
| Somatropin injection HCPCS J2941 | $170.71 | $279.85 | $44.12 – $260.27 | 8 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $296.23 – $296.23 | 1 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $322.10 – $322.10 | 1 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $215.12 – $215.12 | 1 |
| Special physics consult CPT 77370 | $1,331.63 | $2,183.00 | $257.70 – $2,030.19 | 11 |
| Special radiation treatment CPT 77470 | $2,627.88 | $4,308.00 | $67.26 – $4,006.44 | 11 |
| Special teletx port plan CPT 77321 | $1,484.74 | $2,434.00 | $84.06 – $2,263.62 | 11 |
| Specific gravity body fluid CPT 84315 | $16.47 | $27.00 | $3.18 – $27.00 | 18 |
| Specimen fat stain CPT 89125 | $48.80 | $80.00 | $5.70 – $74.40 | 18 |
| Sperm washing 58323 CPT 58323 | not published | not published | $22.32 – $98.21 | 5 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $1,319.18 – $1,319.18 | 1 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $1,403.16 – $1,403.16 | 1 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $193.54 – $193.54 | 1 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $228.94 – $228.94 | 1 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $875.96 | $1,436.00 | $161.62 – $1,335.48 | 7 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $563.64 | $924.00 | $54.43 – $859.32 | 7 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $752.43 – $767.19 | 3 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $1,488.71 – $1,517.90 | 3 |
| Splicing of ureters CPT 50770 | not published | not published | $1,153.19 – $1,175.80 | 3 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $1,294.67 – $1,294.67 | 1 |
| Split blood or products CPT 86985 | $150.67 | $247.00 | $46.66 – $229.71 | 7 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | not published | not published | $241.73 – $241.73 | 1 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $2,428.19 – $2,428.19 | 1 |
| Srs cranial lesion simple CPT 61796 | not published | not published | $1,801.74 – $1,801.74 | 1 |
| Srs cran les complex addl CPT 61799 | not published | not published | $518.22 – $518.22 | 1 |
| Srs cran les simple addl CPT 61797 | not published | not published | $374.91 – $374.91 | 1 |
| Srs linear based CPT 77372 | $15,552.56 | $25,496.00 | $1,794.32 – $23,711.28 | 11 |
| Srs spinal lesion CPT 63620 | not published | not published | $1,985.84 – $1,985.84 | 1 |
| Srs spinal lesion addl CPT 63621 | not published | not published | $430.82 – $430.82 | 1 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $297.68 | $488.00 | $88.93 – $453.84 | 13 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $165.92 | $272.00 | $57.12 – $252.96 | 9 |
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.