CHI Health Good Samaritan

Kearney, NE

Posts prices for 41 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.

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ProcedureCash priceGross charge× Medicare
Epidural injection, lumbar/sacral (with imaging) (62322) $1,848.30 $3,030 2.0×
Transforaminal epidural injection, lumbar/sacral (64483) $1,468.88 $2,408 1.6×
CT head/brain without contrast (70450) $1,584.78 $2,598 14.6×
MRI brain without contrast (70551) $2,357.04 $3,864 9.5×
MRI brain with contrast (70552) $2,727.31 $4,471 7.5×
MRI brain without and with contrast (70553) $2,996.93 $4,913 8.3×
X-ray lower spine, 4+ views (72110) $536.19 $879 4.9×
MRI lumbar spine without contrast (72148) $1,821.46 $2,986 7.4×
CT pelvis with contrast (72193) $1,825.73 $2,993 10.0×
MRI lower-extremity joint without contrast (73721) $1,751.92 $2,872 7.1×
CT abdomen and pelvis with contrast (74177) $3,605.71 $5,911 10.0×
Ultrasound, abdomen complete (76700) $810.69 $1,329 7.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $864.37 $1,417 8.0×
Ultrasound, transvaginal (76830) $651.48 $1,068 6.0×
Mammography, one breast (diagnostic) (77065) $218.99 $359 2.5×
Mammography, both breasts (diagnostic) (77066) $274.50 $450 2.5×
Mammography, screening (bilateral) (77067) $241.56 $396 2.6×
Basic metabolic panel (80048) $111.02 $182 13.1×
Comprehensive metabolic panel (80053) $148.84 $244 14.1×
Obstetric panel (80055) $110.41 $181 2.3×
Lipid panel (80061) $51.24 $84 3.8×
Renal function panel (80069) $127.49 $209 14.7×
Hepatic function panel (80076) $131.76 $216 16.1×
Urinalysis, non-automated, with microscopy (81000) $39.04 $64 9.7×
Urinalysis, non-automated, without microscopy (81002) $47.58 $78 13.7×
PSA, total (84153) $79.30 $130 4.3×
Thyroid stimulating hormone (TSH) (84443) $97.60 $160 5.8×
CBC with automated differential (85025) $85.40 $140 11.0×
CBC, automated (85027) $60.39 $99 9.3×
Prothrombin time (PT) (85610) $51.24 $84 11.9×
Partial thromboplastin time (PTT) (85730) $63.44 $104 10.6×
Psychotherapy, 45 minutes (90834) $134.81 $221 0.7×
Psychotherapy, 60 minutes (90837) $196.42 $322 1.1×
Family psychotherapy, with patient (50 min) (90847) $154.94 $254 0.8×
Group psychotherapy (90853) $95.77 $157 0.9×
Left heart catheterization (93452) $12,551.36 $20,576 3.7×
Sleep study (attended polysomnography) (95810) $3,078.06 $5,046 3.5×
Physical therapy, therapeutic exercise (per 15 min) (97110) $83.57 $137 2.9×
Office visit, new patient (low complexity, ~30 min) (99203) $325.74 $534 2.4×
Office visit, new patient (moderate complexity, ~45 min) (99204) $391.62 $642 2.8×
Office visit, new patient (high complexity, ~60 min) (99205) $401.38 $658 2.9×

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