Visits & medical services prices at CHI Health Good Samaritan
Kearney, NE · every code in this section with a posted price and a Medicare benchmark.
202 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $44.53 | $73 | 1.1× |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$147.62–$204.96 | $242–$336 | varies |
| Analyze neurostim no prog (95970) | $118.95 | $195 | 0.9× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $49.41 | $81 | 3.4× |
| Application on-body injector (96377) | $165.31 | $271 | 3.4× |
| Behavior id support assmt by 1 tech ea 15 min (97152) | $206.18 | $338 | 2.0× |
| Behavral qualit analys voice (92524) | $297.68 | $488 | 2.7× |
| Biofeedback training any modality (90901) | $122 | $200 | 3.0× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $563.64 | $924 | 1.5× |
| Car seat/bed test 60 min (94780) | $220.21 | $361 | 5.7× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,164.49 | $1,909 | 5.2× |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$817.40–$888.16 | $1,340–$1,456 | varies |
| Cardioversion (92960) | $1,811.70 | $2,970 | 2.6× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) | $19,623.70 | $32,170 | 5.8× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) | $15,698.96 | $25,736 | 4.7× |
| Cbt 1st hour (94644) | $283.04 | $464 | 2.0× |
| Chemo Anti-Neopl Sq/Im (96401) | $153.11 | $251 | 2.0× |
| Chemo Hormon Antineopl Sq/Im (96402) | $157.38 | $258 | 2.1× |
| Chemo IV infusion addl hr (96415) | $161.04 | $264 | 2.2× |
| Chemo IV push addl drug (96411) | $278.16 | $456 | 3.7× |
| Chemother Prolong Infuse W/Pump (96416) | $667.95 | $1,095 | 1.9× |
| Chemotherapy Into Cns (96450) | $831.43 | $1,363 | 2.4× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) range across 2 matching MRF lines |
$408.09–$427 | $669–$700 | varies |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $1,094.95 | $1,795 | 3.2× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $439.20 | $720 | 1.3× |
| Chest Wall Manipulation (94668) | $218.99 | $359 | 1.6× |
| Color/duplex Doppler, complete (93975) | $932.69 | $1,529 | 3.8× |
| Color/duplex Doppler, limited (93976) | $550.22 | $902 | 5.1× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $57.95 | $95 | 1.8× |
| Continuous Pulse Ox (94762) | $295.24 | $484 | 2.2× |
| Coronary Art/Grft Angio S&I (93455) | $10,335.23 | $16,943 | 3.1× |
| Coronary Artery Angio S&I (93454) | $11,879.75 | $19,475 | 3.5× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $733.83 | $1,203 | 3.2× |
| Cpt initial (94667) | $214.72 | $352 | 1.6× |
| Critical care first hour (99291) | $1,715.93 | $2,813 | 2.0× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 4 matching MRF lines |
$279.99–$350.14 | $459–$574 | varies |
| Dialysis One Evaluation (90945) | $2,342.40 | $3,840 | 5.4× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $522.16 | $856 | 2.1× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $410.53 | $673 | 3.8× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,053.47 | $1,727 | 4.3× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $927.20 | $1,520 | 8.5× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,265.75 | $2,075 | 5.1× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,216.34 | $1,994 | 11.2× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) | $1,319.43 | $2,163 | 5.3× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) | $880.84 | $1,444 | 8.1× |
| Duplex Scan Hemodialysis Access (93990) | $461.16 | $756 | 4.2× |
| Duplex up extrem art bilat (93930) | $794.22 | $1,302 | 3.2× |
| Duplex up extrem art unilat/ltd (93931) | $397.11 | $651 | 3.7× |
| Echo Congenital Complete (93303) | $1,625.04 | $2,664 | 2.9× |
| Echo Heart Xthoracic,Limited (93308) | $803.98 | $1,318 | 3.2× |
| Echo transesophageal (93312) | $1,923.94 | $3,154 | 3.4× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) range across 2 matching MRF lines |
$1,503.04–$1,616.50 | $2,464–$2,650 | varies |
| Eeg 41-60 Minutes (95812) | $1,140.09 | $1,869 | 5.1× |
| EEG awake and asleep (95819) | $921.71 | $1,511 | 4.1× |
| EEG awake drowsy (95816) | $857.05 | $1,405 | 3.8× |
| EEG extended monitoring 61-119 minutes (95813) | $1,276.73 | $2,093 | 5.7× |
| Eeg Sleep Only (95822) | $791.78 | $1,298 | 3.5× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) | $964.41 | $1,581 | 4.3× |
| EEG wo vid ea 12-26hr unmntr (95708) | $2,094.13 | $3,433 | 5.4× |
| EKG signal averaged (93278) | $331.84 | $544 | 5.4× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) | $90.28 | $148 | 0.9× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) | $35.38 | $58 | 0.9× |
| Electrical Stimulation Ea 15 Min (97032) | $56.12 | $92 | 3.8× |
| Electrocardiogram Tracing (93005) range across 2 matching MRF lines |
$284.87–$310.49 | $467–$509 | varies |
| Electrophysiology Evaluation (93642) | $2,442.44 | $4,004 | 1.9× |
| Emergency Dept Visit Level 2 (99282) | $331.84 | $544 | 2.1× |
| Emergency Dept Visit Level 3 (99283) | $588.04 | $964 | 2.1× |
| Emergency Dept Visit Level 4 (99284) | $1,009.55 | $1,655 | 2.3× |
| Er level 1 (99281) | $211.06 | $346 | 2.4× |
| Er level v (99285) | $1,491.45 | $2,445 | 2.4× |
| Evaluate pt use of inhaler (94664) | $146.40 | $240 | 0.6× |
| Evaluate Speech Production (92522) | $180.56 | $296 | 1.6× |
| Evaluate Swallowing Function (92610) | $222.04 | $364 | 2.6× |
| Evaluation of speech fluency (92521) | $123.22 | $202 | 0.9× |
| Evoked Auditory Test,Limited (92587) | $150.67 | $247 | 0.7× |
| Exercise test for bronchospasm (94617) | $370.27 | $607 | 2.7× |
| External ECG rec>48hr<7d recording (93242) | $671.61 | $1,101 | 17.3× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $1,162.05 | $1,905 | 8.4× |
| External ECG rec>7d<15d recording (93246) | $671.61 | $1,101 | 17.3× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $1,162.05 | $1,905 | 8.4× |
| External Ecg Scanning Analysis Report (93226) | $493.49 | $809 | 8.1× |
| Extracranial Bilat Study (93880) | $1,160.22 | $1,902 | 4.7× |
| Extracranial Uni/Ltd Study (93882) | $336.72 | $552 | 3.1× |
| Gi tract imaging intraluminal colon i&r (91113) | $1,726.91 | $2,831 | 1.8× |
| Group Therapeutic Procedures (97150) | $72.59 | $119 | 4.0× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) | $20,722.31 | $33,971 | 6.2× |
| Holter monitor recording (93225) | $493.49 | $809 | 3.6× |
| Icd Device Interrogate (93289) | $64.66 | $106 | 1.7× |
| Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) | $66.49 | $109 | 1.7× |
| Immunization administration (90471) range across 5 matching MRF lines |
$11.59–$111.63 | $19–$183 | varies |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) | $313.54 | $514 | 0.8× |
| Insert/Place Heart Catheter (93503) range across 2 matching MRF lines |
$1,808.65–$1,917.23 | $2,965–$3,143 | varies |
| Intracranial Complete Study (93886) | $616.10 | $1,010 | 2.5× |
| Iontophoresis 15 min (97033) | $70.76 | $116 | 3.7× |
| Irrig Drug Delivery Device (96523) | $153.11 | $251 | 2.5× |
| IV infusion hydration each additional hour (96361) | $129.93 | $213 | 2.7× |
| IV infusion hydration initial 31 min-1 hour (96360) | $470.31 | $771 | 2.1× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $154.94 | $254 | 2.1× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $117.73 | $193 | 2.4× |
| IV push initial (96374) | $464.82 | $762 | 2.1× |
| L Hrt Art/Grft Angio (93459) | $16,954.95 | $27,795 | 5.0× |
| Liver Elastography W/O Imag W/I&R (91200) | $286.70 | $470 | 2.1× |
| Low frequency non-thermal us (97610) | $265.35 | $435 | 1.3× |
| Lung Function Test (Mbc/Mvv) (94200) | $220.21 | $361 | 3.6× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $1,002.23 | $1,643 | 4.5× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $43.31 | $71 | 1.4× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $53.68 | $88 | 1.5× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) | $56.73 | $93 | 3.3× |
| Methacholine challenge (94070) | $1,240.13 | $2,033 | 3.2× |
| Motion Fluoroscopy/Swallow (92611) | $395.28 | $648 | 4.3× |
| Multiple Sleep Latency Test (95805) | $3,075.01 | $5,041 | 3.4× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) range across 2 matching MRF lines |
$311.10–$373.93 | $510–$613 | varies |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) | $373.93 | $613 | 0.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) range across 2 matching MRF lines |
$226.31–$327.57 | $371–$537 | varies |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) range across 3 matching MRF lines |
$222.04–$376.98 | $364–$618 | varies |
| Nerve Conduction Studies 1-2 Studies (95907) | $533.75 | $875 | 2.4× |
| Nerve Conduction Studies 11-12 Studies (95912) | $533.75 | $875 | 1.4× |
| Nerve conduction studies 13 or more studies (95913) | $533.75 | $875 | 1.4× |
| Nerve Conduction Studies 3-4 Studies (95908) | $533.75 | $875 | 2.4× |
| Nerve conduction studies 5-6 studies (95909) | $533.75 | $875 | 2.4× |
| Nerve conduction studies 7-8 studies (95910) | $533.75 | $875 | 1.4× |
| Nerve Conduction Studies 9-10 Studies (95911) | $533.75 | $875 | 1.4× |
| Neuromuscular Reeducation (97112) | $64.66 | $106 | 2.0× |
| Newborn resuscitation (99465) | $745.42 | $1,222 | 1.1× |
| Nitric oxide expired gas determination (95012) | $139.69 | $229 | 3.6× |
| Oral Function Therapy (92526) | $222.04 | $364 | 2.6× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $56.12 | $92 | 1.1× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $61 | $100 | 1.3× |
| Ot eval high complexity (97167) | $225.70 | $370 | 2.2× |
| Ot Eval Low Complex (97165) | $225.70 | $370 | 2.2× |
| Ot Eval Moderate Complexity (97166) | $225.70 | $370 | 2.2× |
| Ot manual therapy 15 min (97140) | $69.54 | $114 | 2.5× |
| Ot Prosthetic Training, Each 15 Min (97761) | $65.88 | $108 | 1.6× |
| Ot Re-Eval Est Plan Care (97168) | $78.69 | $129 | 1.1× |
| Ot rom hand (95852) | $93.94 | $154 | 4.4× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $320.25 | $525 | 2.4× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) | $304.39 | $499 | 2.3× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) | $154.33 | $253 | 0.7× |
| Peripheral arterial disease rehab per session (93668) range across 2 matching MRF lines |
$121.39–$253.15 | $199–$415 | varies |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) | $3,341.58 | $5,478 | 0.6× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) | $9,690.46 | $15,886 | 0.8× |
| Phlebotomy therapeutic (99195) | $247.05 | $405 | 1.8× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $188.49 | $309 | 3.1× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $188.49 | $309 | 3.1× |
| Plethysmography (94726) | $655.14 | $1,074 | 1.7× |
| Pm device eval in person (93288) | $42.70 | $70 | 1.1× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $3,486.15 | $5,715 | 3.9× |
| Prq Card Angio/Athrect 1 Art (92924) | $20,383.76 | $33,416 | 1.7× |
| Prq Card Stent W/Angio 1 Vsl (92928) | $16,707.90 | $27,390 | 1.4× |
| Prq Card Stent/Ath/Angio (92933) | $19,214.39 | $31,499 | 1.0× |
| Prq Revasc Byp Graft 1 Vsl (92937) | $11,862.67 | $19,447 | 1.0× |
| Psychiatric diagnostic evaluation (90791) | $185.44 | $304 | 1.0× |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) | $142.13 | $233 | 3.8× |
| Pt Eval High Complex (97163) | $200.08 | $328 | 2.0× |
| Pt eval low complex 20 min (97161) | $200.08 | $328 | 2.0× |
| Pt Eval Mod Complex (97162) | $200.08 | $328 | 2.0× |
| Pt gait training 15 min (97116) | $71.98 | $118 | 2.5× |
| Pt mechanical traction (97012) | $121.39 | $199 | 8.5× |
| Pt Re-Eval Est Plan Care (97164) | $78.08 | $128 | 1.2× |
| Pulm function test by gas (94727) | $294.63 | $483 | 1.3× |
| Pulmonary service/procedure (94799) range across 2 matching MRF lines |
$22.57–$193.37 | $37–$317 | varies |
| Pulmonary Stress Testing (94618) | $444.69 | $729 | 3.2× |
| R Hrt Art/Grft Angio (93457) | $12,716.06 | $20,846 | 3.8× |
| R hrt coronary artery angio (93456) | $15,698.96 | $25,736 | 4.7× |
| R&L Hrt Cath W/Ventriclgrphy (93453) | $12,633.71 | $20,711 | 3.8× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) | $525.82 | $862 | 1.5× |
| Refill/Maint Portable Pump (96521) | $508.74 | $834 | 2.3× |
| Remote 30 Day Ecg Rev/Report (93270) | $328.79 | $539 | 8.5× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) | $98.82 | $162 | 1.6× |
| Right Heart Cath (93451) | $8,257.57 | $13,537 | 2.5× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $136.64 | $224 | 0.7× |
| Self Care Mngment Training (97535) | $88.45 | $145 | 2.7× |
| Sleep study unattended (95806) | $373.32 | $612 | 1.7× |
| Speech sound lang comprehen (92523) | $269.62 | $442 | 1.2× |
| Spirometry (94010) | $258.03 | $423 | 1.2× |
| Standardized Cognitive Performance Testing (96125) | $165.92 | $272 | 1.6× |
| Stress Tte Only (93350) | $1,794.01 | $2,941 | 3.2× |
| Subcutaneous Infusion Each Additional Hour (96370) | $84.79 | $139 | 1.7× |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) | $333.06 | $546 | 1.5× |
| Subq Infusion Additional Pump Infusion Site (96371) | $89.06 | $146 | 1.2× |
| Surfactant Admin Thru Tube (94610) | $117.73 | $193 | 0.5× |
| Temp transcutaneous pacing (92953) | $533.75 | $875 | 0.8× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $86.01 | $141 | 3.8× |
| Ther Ivntj Ea Addl 15 Min (97130) | $86.01 | $141 | 4.1× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $53.68 | $88 | 1.8× |
| Ther/Proph/Diag Inj Sc/Im (96372) | $215.94 | $354 | 2.9× |
| Ther/Proph/Diag Iv Inf Init (96365) | $612.44 | $1,004 | 2.8× |
| Therapeutic Activities (97530) | $89.06 | $146 | 2.5× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $322.69 | $529 | 3.0× |
| Tte w/doppler, complete (93306) | $2,282.62 | $3,742 | 4.0× |
| Tte W/O Doppler Complete (93307) | $2,023.98 | $3,318 | 8.2× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $252.54 | $414 | 3.3× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) | $42.70 | $70 | 1.8× |
| Tx/Pro/Dx Inj New Drug Addon (96375) range across 3 matching MRF lines |
$164.09–$183 | $269–$300 | varies |
| Unlisted cardiovascular service/procedure (93799) range across 4 matching MRF lines |
$348.92–$11,982.84 | $572–$19,644 | varies |
| Upr/L Xtremity Art 2 Levels (93922) | $479.46 | $786 | 3.5× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $944.89 | $1,549 | 4.2× |
| Vent Mgmt Inpat Init Day (94002) | $1,224.88 | $2,008 | 1.9× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $914.39 | $1,499 | 1.4× |
| Vital capacity, total (94150) | $63.44 | $104 | 0.5× |
| Wheelchair Mgmt Ea 15 Min (97542) | $48.19 | $79 | 1.6× |
| Whirlpool Therapy (97022) | $54.90 | $90 | 3.5× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.