Chest X-ray, 2 views at CHI Health Good Samaritan. CPT 71046.
What CHI Health Good Samaritan publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$303cash price (self-pay)
$497list price
$43.72–$462range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica | Commercial|ACO | $43.72 |
| Medica | Commercial|CHI Health | $64.68 |
| Medica | Commercial|All Other Plans | $67.73 |
| Amerigroup | Medicaid|All Plans | $71.71 |
| Centene | Medicaid|IA Total Care | $71.71 |
| IAMolina | Medicaid|All Plans | $73.11 |
| BCBS - NE | Medicare|All Plans | $83.36 |
| Humana | Medicare|All Plans | $83.36 |
| Medica | Medicare|All Plans | $83.36 |
| PACE | Medicare|All Plans | $83.36 |
| United | Medicare|All Plans | $83.36 |
| Centene | Medicare|All Plans | $85.86 |
| Amerigroup | Medicare|All Plans | $87.53 |
| Great Plains | Medicare|All Plans | $87.53 |
| United | Medicaid|Community Plan | $104 |
| Centene | Medicaid|NE Total Care | $105 |
| AMPS | Commercial|All Plans | $185 |
| Creighton University Employees | Commercial|All Plans | $244 |
| ELAP | Commercial|All Plans | $288 |
| United | Commercial|All Plans | $378 |
| Medica | Commercial|Open Access | $388 |
| Midlands Choice | Commercial|Premier | $388 |
| Midlands Choice | Commercial|Standard | $457 |
| MultiPlan PHCS | Commercial|All Plans | $462 |
Inpatient
$303cash price (self-pay)
$497list price
$244–$462range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Creighton University Employees | Commercial|All Plans | $244 |
| United | Commercial|All Plans | $378 |
| Medica | Commercial|Open Access | $388 |
| Midlands Choice | Commercial|Premier | $388 |
| Midlands Choice | Commercial|Standard | $457 |
| MultiPlan PHCS | Commercial|All Plans | $462 |
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