Ogallala Community Hospital
2601 N Spruce Street, Ogallala, NE · Banner Health · · NPI 1710915467
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $53.94 | $88.00 | $38.72 – $85.36 | 13 |
| 17-hydroxypregnenolone CPT 84143 | $42.30 | $69.00 | $30.36 – $66.93 | 13 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,628.93 | $2,424.00 | $1,066.56 – $2,351.28 | 13 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $791.62 | $1,178.00 | $518.32 – $1,142.66 | 13 |
| 3d recon without postprocess indpndt CPT 76376 | $348.97 | $495.00 | $217.80 – $480.15 | 13 |
| 5' nucleotidase - sendout CPT 83915 | $60.69 | $99.00 | $43.56 – $96.03 | 13 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $36.72 | $65.00 | $28.60 – $63.05 | 13 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $54.53 | $71.00 | $31.24 – $68.87 | 13 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $789.16 | $1,349.00 | $593.56 – $1,308.53 | 13 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $465.66 | $796.00 | $350.24 – $772.12 | 13 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,304.71 | $2,045.00 | $899.80 – $1,983.65 | 13 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,087.15 | $1,704.00 | $749.76 – $1,652.88 | 13 |
| Abdominal CT scan (without contrast) CPT 74150 | $869.59 | $1,363.00 | $599.72 – $1,322.11 | 13 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,328.87 | $4,776.00 | $2,101.44 – $4,632.72 | 13 |
| Abdominal MRI (with contrast) CPT 74182 | $2,774.06 | $3,980.00 | $1,751.20 – $3,860.60 | 13 |
| Abdominal MRI (without contrast) CPT 74181 | $2,219.25 | $3,184.00 | $1,400.96 – $3,088.48 | 13 |
| Abdominal paracentesis w/image guidance CPT 49083 | $122.18 | $225.00 | $99.00 – $218.25 | 13 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,012.16 | $1,195.00 | $525.80 – $1,159.15 | 13 |
| Abdominal Ultrasound (limited) CPT 76705 | $754.68 | $891.00 | $392.04 – $864.27 | 13 |
| Abdominal X-ray (2 views) CPT 74019 | $292.23 | $407.00 | $179.08 – $394.79 | 13 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $353.97 | $493.00 | $216.92 – $478.21 | 13 |
| Abdominal X-ray (single view) CPT 74018 | $161.55 | $225.00 | $99.00 – $218.25 | 13 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $84.17 | $155.00 | $68.20 – $150.35 | 13 |
| Abl1 gene CPT 81170 | $663.30 | $900.00 | $396.00 – $873.00 | 13 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $182.16 | $403.00 | $177.32 – $390.91 | 13 |
| Ablate inf turbinate superf 30801 CPT 30801 | $160.73 | $296.00 | $130.24 – $287.12 | 13 |
| Acetylcholine receptor modulating antibody CPT 86043 | $59.90 | $78.00 | $34.32 – $75.66 | 13 |
| Acne surgery 10040 CPT 10040 | $50.17 | $111.00 | $48.84 – $107.67 | 13 |
| Acute hepatitis panel CPT 80074 | $153.86 | $251.00 | $110.44 – $243.47 | 13 |
| Acyclovir 400 mg tablet HCPCS J8499 | $1.75 | $27.80 | $1.85 – $4.07 | 13 |
| #acylcarnitineprfl CPT 82017 | $70.50 | $115.00 | $50.60 – $111.55 | 13 |
| Adapter b 8 channel 10cm HCPCS C1883 | $4,929.65 | $7,413.00 | $495.44 – $1,092.22 | 13 |
| Adding walker to prev cast CPT 29440 | $48.87 | $90.00 | $26.40 – $58.20 | 13 |
| Adenovirus antibody,serum - quest CPT 86603 | $46.85 | $61.00 | $26.84 – $59.17 | 13 |
| Adh-sendout CPT 84588 | $62.53 | $102.00 | $44.88 – $98.94 | 13 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $32.65 | $88.00 | $38.72 – $85.36 | 13 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $74.20 | $200.00 | $88.00 – $194.00 | 13 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $151.00 | $407.00 | $179.08 – $394.79 | 13 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $200.58 | $391.00 | $172.04 – $379.27 | 13 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $94.90 | $185.00 | $81.40 – $179.45 | 13 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $253.94 | $495.00 | $217.80 – $480.15 | 13 |
| Administration immunization each additional vaccine CPT 90472 | $21.30 | $60.00 | $26.40 – $58.20 | 13 |
| Administration vaccine hepatitis b HCPCS G0010 | $38.34 | $108.00 | $46.14 – $104.76 | 13 |
| Administration vaccine influenza virus HCPCS G0008 | $38.34 | $108.00 | $46.14 – $104.76 | 13 |
| Administration vaccine pneumococcal HCPCS G0009 | $38.34 | $108.00 | $46.14 – $104.76 | 13 |
| _afb id by dna probe rflx ast CPT 87149 | $50.15 | $73.00 | $32.12 – $70.81 | 13 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $238.39 | $347.00 | $115.36 – $336.59 | 13 |
| After cataract laser surgery CPT 66821 | $448.48 | $843.00 | $247.28 – $545.14 | 13 |
| Albumin body fluid quantitative each specimen CPT 82042 | $35.55 | $58.00 | $10.56 – $23.28 | 13 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Albumin serum plasma or whole blood CPT 82040 | $38.62 | $63.00 | $17.16 – $37.83 | 13 |
| Alkaline phosphatase CPT 84075 | $34.94 | $57.00 | $21.56 – $47.53 | 13 |
| Allergen alpha lactalbumin ige CPT 86008 | $61.44 | $80.00 | $28.16 – $62.08 | 13 |
| Allergen egg white ige CPT 86003 | $43.01 | $56.00 | $24.20 – $53.35 | 13 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $45.31 | $59.00 | $24.64 – $54.32 | 13 |
| Allergy Skin Testing CPT 95004 | $117.77 | $169.00 | $74.36 – $163.93 | 13 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $2,562.25 | $3,853.00 | $1,185.80 – $2,614.15 | 13 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $118.92 | $194.00 | $85.36 – $188.18 | 13 |
| Alpha-fetoprotein tumor marker CPT 82105 | $31.26 | $51.00 | $22.44 – $49.47 | 13 |
| Alt/sgpt CPT 84460 | $36.17 | $59.00 | $22.00 – $48.50 | 13 |
| Aluminum - quest CPT 82108 | $47.20 | $77.00 | $33.88 – $74.69 | 13 |
| Amantadine (symmetrel)-sendout CPT 80375 | $198.61 | $324.00 | $64.68 – $142.59 | 13 |
| Aminolevulinic acid delta CPT 82135 | $45.98 | $75.00 | $33.00 – $72.75 | 13 |
| Amitriptyline (elavil) -sendout CPT 80335 | $41.68 | $68.00 | $27.28 – $60.14 | 13 |
| Ammonia CPT 82140 | $70.50 | $115.00 | $19.36 – $42.68 | 13 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $536.14 | $1,068.00 | $469.92 – $1,035.96 | 13 |
| Amniocentesis therapeutic CPT 59001 | $701.80 | $1,398.00 | $615.12 – $1,356.06 | 13 |
| Amphetamine confirm urine -sendout CPT 80324 | $50.88 | $83.00 | $24.64 – $54.32 | 13 |
| Amputate metacarpal bone 26910 CPT 26910 | $828.62 | $1,526.00 | $671.44 – $1,480.22 | 13 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $443.63 | $817.00 | $359.48 – $792.49 | 13 |
| Amylase CPT 82150 | $209.03 | $341.00 | $8.80 – $19.40 | 13 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $94.40 | $154.00 | $59.40 – $130.95 | 13 |
| Analysis gene f2 20210g>a variant CPT 81240 | $145.93 | $198.00 | $87.12 – $192.06 | 13 |
| Analysis gene f5 leiden variant CPT 81241 | $162.88 | $221.00 | $97.24 – $214.37 | 13 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $134.27 | $186.00 | $61.16 – $134.83 | 13 |
| Anca screen with reflex to titer -quest CPT 86021 | $42.24 | $55.00 | $23.76 – $52.38 | 13 |
| An fluoro guide for cvp CPT 77001 | $477.47 | $665.00 | $292.60 – $645.05 | 13 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $3,664.60 | $5,258.50 | $1.63 – $3.59 | 13 |
| Ankle X-ray CPT 73610 | $338.18 | $471.00 | $207.24 – $456.87 | 13 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | $190.27 | $265.00 | $116.60 – $257.05 | 13 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | $293.13 | $551.00 | $93.72 – $242.44 | 13 |
| Anodyne therapy charges pt CPT 97026 | $25.87 | $44.00 | $19.36 – $42.68 | 13 |
| Anoscopy remove fb 46608 CPT 46608 | $96.11 | $177.00 | $77.88 – $171.69 | 13 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $117.50 | $153.00 | $67.32 – $148.41 | 13 |
| Antibody elution rbc reference CPT 86860 | $264.19 | $344.00 | $151.36 – $333.68 | 13 |
| Antibody htlv/hiv confirm test CPT 86689 | $386.30 | $503.00 | $207.68 – $457.84 | 13 |
| Antibody htlv-i CPT 86687 | $21.50 | $28.00 | $12.32 – $27.16 | 13 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $183.55 | $239.00 | $63.80 – $140.65 | 13 |
| Antibody id rbc panel CPT 86870 | $468.85 | $718.00 | $315.92 – $696.46 | 13 |
| Antibody influenza virus CPT 86710 | $52.22 | $68.00 | $29.92 – $65.96 | 13 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $47.62 | $62.00 | $27.28 – $60.14 | 13 |
| Antibody screen rbc CPT 86850 | $76.40 | $117.00 | $9.77 – $104.76 | 13 |
| Antibody tetanus CPT 86774 | $48.38 | $63.00 | $27.72 – $61.11 | 13 |
| Antidepressants class 3-5 CPT 80333 | $59.46 | $97.00 | $42.68 – $94.09 | 13 |
| Anti mog serum - sendout CPT 86362 | $642.82 | $837.00 | $37.84 – $83.42 | 13 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $41.47 | $54.00 | $23.76 – $52.38 | 13 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $47.62 | $62.00 | $27.28 – $60.14 | 13 |
| Antinuclear antibodies CPT 86038 | $40.70 | $53.00 | $23.32 – $51.41 | 13 |
| Antinuclear antibodies titer CPT 86039 | $88.32 | $115.00 | $25.96 – $57.23 | 13 |
| Antiphosphatidylserine antibody CPT 86148 | $43.78 | $57.00 | $25.08 – $55.29 | 13 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.