CMS Price Transparency Data

Hepatitis B immune globulin

Facility: CHI Health Good Samaritan

Billing Code: 90371 (HCPCS)

The BaseRate · fair price medium confidence

A fair price for this

$248

about 1.8× the $140 Medicare rate · typically $130–$652

modeled estimate · not a bill or quote

What this hospital charges insurers

$124

Below the fair price — a good deal

about $124 under the fair price · 0.9× Medicare

Medicare pays $140 Fair price $248 This hospital $124 Cash price $89 Hospital's list price $145

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

One of the lower prices — 6 of 8 other NE hospitals charge more for the same procedure.

Cheapest $109 Priciest $170

Black dot = this hospital, among the 9 NE hospitals with a price for this procedure. Full list below.

A fair price for a Hepatitis B immune globulin is about $248 (about 1.8× the $140 Medicare rate). CHI Health Good Samaritan charges insurers about $124, or about $89 in cash — below the fair price — a good deal. Located in Kearney, NE.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$28 - $139	20%
Blue Cross Blue Shieldmajor	$100 - $163	71%
Humanamajor	$124	88%
Ambetter (Centene)	$28 - $169	20%
Amerigroup	$130 - $169	93%
Medica	$104 - $276	74%
Molina	$139 - $173	99%
+ 5 smaller / regional plans	$65 - $275

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 89), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: 90371.

Insurance Before you use insurance

Call your insurance company to confirm CHI Health Good Samaritan is in-network.
Ask your insurer whether prior approval is required for HCPCS code 90371.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at CHI Health Good Samaritan

Compare: Hepatitis B immune globulin at other NE hospitals

Insurance negotiated median for the same procedure, sorted lowest first.