Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC INSJ/RPLC CAR MODULJ PLS GN
Kearney, NE
See all hospitals reporting CPT 0409T →Price type
Good Samaritan Hospital’s median price of $21.6k is 4% below the median hospital's median price ($22.5k), higher than 37% of the 1,319 hospitals reporting CPT 0409T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Medica commercial|aco fee schedule · outpatient | $679.88 | $679.88 | $679.88 – $679.88 |
| 2 | UnitedHealthcare medicaid|community plan fee schedule · outpatient | $8,778 | $8,778 | $8,778 – $8,778 |
| 3 | Blue Cross Blue Shield medicare|all plans case rate · outpatient | $21,252 | $21,252 | $21,252 – $21,252 |
| 4 | Humana medicare|all plans case rate · outpatient | $21,252 | $21,252 | $21,252 – $21,252 |
| 5 | Medica medicare|all plans case rate · outpatient | $21,252 | $21,252 | $21,252 – $21,252 |
| 6 | UnitedHealthcare medicare|all plans case rate · outpatient | $21,252 | $21,252 | $21,252 – $21,252 |
| 7 | UnitedHealthcare commercial|all plans fee schedule · inpatient | $31,768 | $31,768 | $31,768 – $31,768 |
| 8 | UnitedHealthcare commercial|all plans fee schedule · outpatient | $31,768 | $31,768 | $31,768 – $31,768 |
| 9 | Medica commercial|open access fee schedule · inpatient | $32,604 | $32,604 | $32,604 – $32,604 |
| 10 | Medica commercial|open access fee schedule · outpatient | $32,604 | $32,604 | $32,604 – $32,604 |
| 11 | MultiPlan commercial|all plans fee schedule · inpatient | $38,874 | $38,874 | $38,874 – $38,874 |
| 12 | MultiPlan commercial|all plans fee schedule · outpatient | $38,874 | $38,874 | $38,874 – $38,874 |
| 13 | Medica commercial|chi health case rate · outpatient | $54,349 | $54,349 | $54,349 – $54,349 |
| 14 | Medica commercial|all other plans case rate · outpatient | $63,861 | $63,861 | $63,861 – $63,861 |
Last updated: Feb 28, 2026
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