In-111 pentetate dtpa / 0.5 mci at Ogallala Community Hospital

2601 N Spruce Street, Ogallala, NE · Banner Health · · NPI 1710915467

Source: hospital's published price file ↗ · Published Feb 12, 2026 · Ingested Aug 12, 2026

$330.46

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$533.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$234.52 with Blue Cross Blue Shield of Wyoming vs $517.01 with Multiplan — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
Blue Cross Blue Shield of Wyoming Medicare Advantage $234.52 ↓ -29%
Medica Medicare Advantage $234.52 ↓ -29%
TriWest Healthcare Alliance Corp - VA CCN Tricare $234.52 ↓ -29%
Banner Health Banner Choice Plus/Banner Select $234.52 ↓ -29%
United Healthcare VA Community Care $245.18 ↓ -26%
United Healthcare UHC Medicare Advantage $245.18 ↓ -26%
Nebraska Total Care Medicaid $261.17 ↓ -21%
United Healthcare Nebraska Medicaid/CHIP $261.17 ↓ -21%
Molina Healthcare Medicaid/CHIP $261.17 ↓ -21%
Keith County Sheriff’s Office Imate/Detainee Plan $399.75 ↑ +21%
Apostrophe, Inc. Commercial $479.70 ↑ +45%
United Healthcare Commercial/Individual Exchange $506.35 ↑ +53%
Medica Commercial $507.95 ↑ +54%
Coventry Commercial $511.68 ↑ +55%
Midlands Choice Commercial $511.68 ↑ +55%
First Health Medical Rental $511.68 ↑ +55%
Blue Cross Blue Shield of Wyoming Network Blue $511.68 ↑ +55%
Coventry Workers Comp $511.68 ↑ +55%
Multiplan Commercial $517.01 ↑ +56%

Visitor-reported prices

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In-111 pentetate dtpa / 0.5 mci at other Nebraska hospitals

Hospital City Cash price Negotiated range
CHI Health Midlands Papillion $6,500.34 $1,180.23 – $13,155.45
CHI Health Schuyler Schuyler $11,182.60 $2,818.02 – $14,895.23
CHI Health Immanuel Omaha $6,500.34 $1,180.23 – $13,155.45
Lasting Hope Recovery Center Omaha $6,500.34 $1,180.23 – $13,155.45
CHI Health Good Samaritan Kearney $1,728.13 $594.93 – $2,634.69
CHI Health St. Francis Grand Island $2,311.03 $900.91 – $3,681.98
CHI Health Creighton University Medical Center - Bergan Mercy Omaha $6,500.34 $1,180.23 – $13,155.45
CHI Health St. Elizabeth Lincoln $1,686.50 $775.79 – $2,698.40

All Nebraska hospitals for this procedure →