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 |
|---|---|---|---|---|
| X-ray bone survey complete CPT 77075 | $893.65 | $1,465.00 | $138.52 – $1,362.45 | 11 |
| X-ray bone survey infant CPT 77076 | $348.31 | $571.00 | $119.91 – $531.03 | 11 |
| X-ray cervical spine 2-3 views CPT 72040 | $355.63 | $583.00 | $54.43 – $542.19 | 11 |
| X-ray cervical spine 4-5 views CPT 72050 | $485.56 | $796.00 | $77.13 – $740.28 | 11 |
| X-ray cervical spine >= 6 views CPT 72052 | $665.51 | $1,091.00 | $91.01 – $1,014.63 | 11 |
| X-ray clavicle complete (both sides) CPT 73000 | $290.36 | $476.00 | $46.24 – $442.68 | 11 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $900.36 | $1,476.00 | $198.20 – $1,372.68 | 11 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,154.73 | $1,893.00 | $303.09 – $1,760.49 | 11 |
| X-ray elbow 2 views (both sides) CPT 73070 | $276.94 | $454.00 | $39.94 – $422.22 | 11 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $352.58 | $578.00 | $46.24 – $537.54 | 11 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $630.74 | $1,034.00 | $130.73 – $961.62 | 11 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $230.58 | $378.00 | $79.38 – $351.54 | 7 |
| X-ray exam entire spi 6/> vw CPT 72084 | $233.63 | $383.00 | $80.43 – $356.19 | 7 |
| X-ray exam of arm infant CPT 73092 | $203.74 | $334.00 | $44.98 – $310.62 | 11 |
| X-ray exam of eye sockets CPT 70200 | $418.46 | $686.00 | $65.16 – $637.98 | 11 |
| X-ray exam of femur 1 CPT 73551 | $133.59 | $219.00 | $39.94 – $203.67 | 7 |
| X-ray exam of sinuses CPT 70210 | $264.74 | $434.00 | $44.98 – $403.62 | 11 |
| X-ray exam of teeth CPT 70310 | $117.12 | $192.00 | $40.32 – $192.00 | 11 |
| X-ray exam si joints CPT 72200 | $258.64 | $424.00 | $47.50 – $394.32 | 11 |
| X-ray exam thorac spine4/>vw CPT 72074 | $331.84 | $544.00 | $62.01 – $505.92 | 11 |
| X-ray facial bones complete > 3 views CPT 70150 | $410.53 | $673.00 | $65.79 – $625.89 | 11 |
| X-ray femur >=2 views (both sides) CPT 73552 | $278.16 | $456.00 | $50.65 – $424.08 | 7 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $222.04 | $364.00 | $59.47 – $338.52 | 11 |
| X-ray foot 2 views (both sides) CPT 73620 | $203.13 | $333.00 | $39.94 – $309.69 | 11 |
| X-ray forearm 2 views (both sides) CPT 73090 | $264.74 | $434.00 | $40.57 – $403.62 | 11 |
| X-ray hand 2 views (both sides) CPT 73120 | $297.68 | $488.00 | $44.35 – $453.84 | 11 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $174.46 | $286.00 | $39.31 – $265.98 | 11 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $197.64 | $324.00 | $68.04 – $301.32 | 7 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $455.67 | $747.00 | $57.58 – $694.71 | 7 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $459.94 | $754.00 | $75.24 – $701.22 | 7 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $399.55 | $655.00 | $88.49 – $609.15 | 7 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $132.37 | $217.00 | $44.98 – $201.81 | 7 |
| X-ray humerus >= 2 views left CPT 73060 | $284.87 | $467.00 | $45.61 – $434.31 | 11 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $364.17 | $597.00 | $49.39 – $555.21 | 11 |
| X-ray knee 3 views (both sides) CPT 73562 | $387.35 | $635.00 | $60.10 – $590.55 | 11 |
| X-ray knee ap standing bilateral CPT 73565 | $195.81 | $321.00 | $60.10 – $298.53 | 11 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $142.74 | $234.00 | $44.98 – $217.62 | 11 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $527.04 | $864.00 | $56.32 – $803.52 | 11 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $536.19 | $879.00 | $74.61 – $817.47 | 11 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $573.40 | $940.00 | $88.49 – $874.20 | 11 |
| X-ray mandible complete > 4 views CPT 70110 | $395.89 | $649.00 | $60.10 – $603.57 | 11 |
| X-ray mandible ltd <4 views CPT 70100 | $190.32 | $312.00 | $56.95 – $290.16 | 11 |
| X-ray nasal bones complete > 3 views CPT 70160 | $292.80 | $480.00 | $55.69 – $446.40 | 11 |
| X-ray neck soft tissue CPT 70360 | $268.40 | $440.00 | $42.46 – $409.20 | 11 |
| X-ray nose to rectum for foreign body child CPT 76010 | $235.46 | $386.00 | $39.31 – $358.98 | 11 |
| X-ray pelvis 1-2 views CPT 72170 | $281.82 | $462.00 | $36.77 – $429.66 | 11 |
| X-ray pelvis complete > 3 views CPT 72190 | $315.37 | $517.00 | $56.95 – $480.81 | 11 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $762.50 | $1,250.00 | $101.72 – $1,162.50 | 7 |
| X-ray ribs 2 views left CPT 71100 | $267.18 | $438.00 | $49.39 – $407.34 | 11 |
| X-ray ribs 3 views bilateral CPT 71110 | $412.97 | $677.00 | $56.95 – $629.61 | 11 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $366.00 | $600.00 | $55.69 – $558.00 | 11 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $480.07 | $787.00 | $70.20 – $731.91 | 11 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $435.54 | $714.00 | $53.80 – $664.02 | 11 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $261.08 | $428.00 | $45.61 – $398.04 | 11 |
| X-ray scapula complete (both sides) CPT 73010 | $353.19 | $579.00 | $28.58 – $538.47 | 11 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $218.38 | $358.00 | $26.69 – $332.94 | 11 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $358.07 | $587.00 | $51.28 – $545.91 | 11 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,055.30 | $1,730.00 | $66.42 – $1,608.90 | 11 |
| X-ray skull < 4 views CPT 70250 | $311.71 | $511.00 | $51.91 – $475.23 | 11 |
| X-ray skull > 4 views complete CPT 70260 | $442.25 | $725.00 | $58.84 – $674.25 | 11 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $661.85 | $1,085.00 | $158.49 – $1,009.05 | 11 |
| X-ray small intestine follow-through study CPT 74248 | $490.44 | $804.00 | $93.53 – $747.72 | 7 |
| X-ray spine single view CPT 72020 | $283.04 | $464.00 | $31.10 – $431.52 | 11 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $220.21 | $361.00 | $58.21 – $335.73 | 11 |
| X-ray sternum > 2 views CPT 71120 | $121.39 | $199.00 | $41.79 – $185.07 | 11 |
| X-ray surgical specimen CPT 76098 | $386.74 | $634.00 | $51.91 – $589.62 | 11 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $498.37 | $817.00 | $171.57 – $780.79 | 11 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $217.77 | $357.00 | $74.97 – $332.01 | 11 |
| X-ray thoracic spine 2 views CPT 72070 | $277.55 | $455.00 | $43.72 – $423.15 | 11 |
| X-ray thoracic spine 3 views CPT 72072 | $416.63 | $683.00 | $54.43 – $635.19 | 11 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $265.96 | $436.00 | $46.24 – $405.48 | 11 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $261.08 | $428.00 | $56.95 – $398.04 | 7 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $606.95 | $995.00 | $104.24 – $925.35 | 7 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $301.95 | $495.00 | $44.98 – $460.35 | 11 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $247.05 | $405.00 | $43.09 – $376.65 | 11 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $708.21 | $1,161.00 | $183.08 – $1,079.73 | 11 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $649.04 | $1,064.00 | $160.38 – $989.52 | 11 |
| X-ray upper gi&small intest CPT 74245 | $940.01 | $1,541.00 | $323.61 – $1,433.13 | 7 |
| X-ray wrist 2 views (both sides) CPT 73100 | $216.55 | $355.00 | $48.76 – $330.15 | 11 |
| Xyntha inj HCPCS J7185 | $0.70 | $1.14 | $0.18 – $3.42 | 18 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $47,601.35 | $78,035.00 | $16,387.35 – $72,572.55 | 7 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $0.82 | $1.34 | $0.29 – $1.34 | 12 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $23.37 | $38.31 | $6.86 – $35.63 | 12 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $20.90 | $34.27 | $0.05 – $0.23 | 12 |
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.