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 |
|---|---|---|---|---|
| Ghs nerve block sciatic nerve CPT 64445 | $218.89 | $371.00 | $108.68 – $239.59 | 13 |
| Ghs nerve block suprascapular CPT 64418 | $770.87 | $1,449.00 | $114.84 – $253.17 | 13 |
| Ghs ng placement w fluoro guidance CPT 43752 | $46.70 | $86.00 | $37.84 – $83.42 | 13 |
| Ghs o2 saturation CPT 82810 | $60.07 | $98.00 | $43.12 – $95.06 | 13 |
| Ghs ot group caregiver training CPT 97552 | $55.18 | $65.00 | $28.60 – $63.05 | 13 |
| Ghs ot prosthetic training/15 min CPT 97761 | $66.67 | $105.00 | $46.20 – $101.85 | 13 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $78.20 | $133.00 | $58.52 – $129.01 | 13 |
| Ghs pacing - transcutaneous CPT 92953 | $561.60 | $987.00 | $1.32 – $2.91 | 13 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $946.43 | $1,779.00 | $122.32 – $521.84 | 13 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,458.21 | $2,741.00 | $105.60 – $803.88 | 13 |
| Ghs peritonsillar abscess i andd CPT 42700 | $151.50 | $279.00 | $122.76 – $270.63 | 13 |
| Ghs phenylketonurid CPT 84030 | $10.42 | $17.00 | $7.48 – $16.49 | 13 |
| Ghs plngl fx pm cl CPT 26725 | $342.63 | $631.00 | $277.64 – $612.07 | 13 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $36.78 | $60.00 | $26.40 – $58.20 | 13 |
| Ghs protoporphyrins fract CPT 84202 | $68.04 | $111.00 | $48.84 – $107.67 | 13 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $162.88 | $277.00 | $121.88 – $268.69 | 13 |
| Ghs quinidine CPT 80194 | $36.78 | $60.00 | $26.40 – $58.20 | 13 |
| Ghs removal intranasal foreign body CPT 30300 | $127.06 | $234.00 | $102.96 – $226.98 | 13 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $649.43 | $1,196.00 | $526.24 – $1,160.12 | 13 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $556.58 | $1,025.00 | $451.00 – $994.25 | 13 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $55.30 | $72.00 | $31.68 – $69.84 | 13 |
| Ghs reticulocyte count CPT 85044 | $7.83 | $13.00 | $5.72 – $12.61 | 13 |
| Ghs sedimentation rate CPT 85651 | $7.83 | $13.00 | $5.72 – $12.61 | 13 |
| Ghs sensitivity (per antimicro) CPT 87184 | $15.80 | $23.00 | $10.12 – $22.31 | 13 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $110.23 | $203.00 | $89.32 – $196.91 | 13 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $148.24 | $273.00 | $120.12 – $264.81 | 13 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $134.66 | $248.00 | $109.12 – $240.56 | 13 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $175.93 | $324.00 | $142.56 – $314.28 | 13 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $86.34 | $159.00 | $69.96 – $154.23 | 13 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $84.71 | $156.00 | $68.64 – $151.32 | 13 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $109.14 | $201.00 | $88.44 – $194.97 | 13 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $166.16 | $306.00 | $134.64 – $296.82 | 13 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $199.28 | $367.00 | $161.48 – $355.99 | 13 |
| Ghs sleep study unattended CPT 95800 | $603.75 | $625.00 | $275.00 – $606.25 | 13 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $71.96 | $123.00 | $54.12 – $119.31 | 13 |
| Ghs sphenopalatine ganglion block CPT 64505 | $392.94 | $666.00 | $195.36 – $430.68 | 13 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $220.74 | $260.00 | $114.40 – $252.20 | 13 |
| Ghs strapping shoulder - 29240 CPT 29240 | $32.04 | $59.00 | $17.16 – $37.83 | 13 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $212.86 | $392.00 | $172.48 – $380.24 | 13 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $364.90 | $672.00 | $295.68 – $651.84 | 13 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $308.97 | $569.00 | $250.36 – $551.93 | 13 |
| Ghs urine, porphyrins quant CPT 84120 | $38.01 | $62.00 | $27.28 – $60.14 | 13 |
| Ghs vaginal delivery only CPT 59409 | $922.56 | $1,699.00 | $747.56 – $1,648.03 | 13 |
| Giardia lamblia antibody CPT 86674 | $51.46 | $67.00 | $29.48 – $64.99 | 13 |
| Gi inhouse confirmation CPT 87045 | $43.28 | $63.00 | $12.76 – $28.13 | 13 |
| Glucose 1 hr post dose CPT 82950 | $9.20 | $15.00 | $6.60 – $14.55 | 13 |
| Glucose body fluid CPT 82945 | $34.33 | $56.00 | $5.28 – $11.64 | 13 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $23.91 | $39.00 | $17.16 – $37.83 | 13 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $7.36 | $12.00 | $5.28 – $11.64 | 13 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $35.55 | $58.00 | $24.64 – $54.32 | 13 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $35.55 | $58.00 | $25.08 – $55.29 | 13 |
| Graft axiofill 1000mg HCPCS J3590 | $32.89 | $47.20 | $2.97 – $6.56 | 13 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $45,149.51 | $67,894.00 | $1,185.80 – $2,614.15 | 13 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $36,411.41 | $54,754.00 | $261.36 – $576.18 | 13 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $30,586.01 | $45,994.00 | $137.72 – $303.61 | 13 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $3,573.04 | $5,373.00 | $374.00 – $824.50 | 13 |
| Great toe with reduction 28495 CPT 28495 | $250.32 | $461.00 | $135.08 – $297.79 | 13 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $6,766.86 | $13,895.00 | $73.04 – $161.02 | 13 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $2,141.34 | $4,397.00 | $137.72 – $303.61 | 13 |
| Gw stiffened micro access kit HCPCS C1894 | $3,835.61 | $7,876.00 | $42.24 – $93.12 | 13 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $96.52 | $152.00 | $66.88 – $147.44 | 13 |
| Hand X-ray CPT 73130 | $255.61 | $356.00 | $156.64 – $345.32 | 13 |
| Hand X-ray (2 views, both hands) CPT 73120 | $164.42 | $229.00 | $100.76 – $222.13 | 13 |
| Haptoglobin quantitative CPT 83010 | $36.17 | $59.00 | $23.32 – $51.41 | 13 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,326.60 | $1,800.00 | $792.00 – $1,746.00 | 13 |
| Hcg qualitative CPT 84703 | $14.10 | $23.00 | $10.12 – $22.31 | 13 |
| Hcg quantitative CPT 84702 | $41.07 | $67.00 | $20.24 – $44.62 | 13 |
| Head CT scan (with and without contrast) CPT 70470 | $1,376.39 | $2,249.00 | $989.56 – $2,181.53 | 13 |
| Head CT scan (with contrast) CPT 70460 | $1,146.89 | $1,874.00 | $824.56 – $1,817.78 | 13 |
| Head CT scan (without contrast) CPT 70450 | $917.39 | $1,499.00 | $659.56 – $1,454.03 | 13 |
| Heart infarct image CPT 78466 | $647.57 | $1,015.00 | $446.60 – $984.55 | 13 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $168.01 | $234.00 | $102.96 – $226.98 | 13 |
| Helicobacter pylori antibody igm CPT 86677 | $59.90 | $78.00 | $34.32 – $75.66 | 13 |
| Hematocrit CPT 85014 | $41.54 | $69.00 | $3.52 – $7.76 | 13 |
| Hemoglobin CPT 85018 | $36.12 | $60.00 | $3.52 – $7.76 | 13 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Hemoglobin plasma CPT 83051 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Hemophilus influenza antibdy CPT 86684 | $47.62 | $62.00 | $27.28 – $60.14 | 13 |
| Heparin assay CPT 85520 | $39.13 | $65.00 | $28.60 – $63.05 | 13 |
| Hepatitis a antibody igm CPT 86709 | $66.05 | $86.00 | $37.84 – $83.42 | 13 |
| Hepatitis b core antibody igm CPT 86705 | $73.73 | $96.00 | $42.24 – $93.12 | 13 |
| Hepatitis b core antibody total CPT 86704 | $42.24 | $55.00 | $24.20 – $53.35 | 13 |
| Hepatitis b surface antibody CPT 86706 | $42.24 | $55.00 | $24.20 – $53.35 | 13 |
| Hepatitis c antibody CPT 86803 | $72.96 | $95.00 | $41.80 – $92.15 | 13 |
| Herpes simplex 1 ag if CPT 87274 | $41.22 | $60.00 | $26.40 – $58.20 | 13 |
| Herpes simplex 2 ag if CPT 87273 | $41.22 | $60.00 | $26.40 – $58.20 | 13 |
| Herpes simplex type 1 antibody igg CPT 86695 | $40.70 | $53.00 | $17.60 – $38.80 | 13 |
| Herpes simplex type 2 antibody igg CPT 86696 | $45.31 | $59.00 | $25.96 – $57.23 | 13 |
| Herpes simplex virus isolation CPT 87255 | $70.07 | $102.00 | $44.88 – $98.94 | 13 |
| Heterophile antibodies screening CPT 86308 | $12.29 | $16.00 | $7.04 – $15.52 | 13 |
| Hhv-6 dna quant CPT 87533 | $86.56 | $126.00 | $55.44 – $122.22 | 13 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $196.01 | $273.00 | $120.12 – $264.81 | 13 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $158.68 | $221.00 | $97.24 – $214.37 | 13 |
| Hip X-ray CPT 73502 | $297.97 | $415.00 | $182.60 – $402.55 | 13 |
| Hla i & ii type verify lr CPT 81371 | $894.72 | $1,214.00 | $534.16 – $1,177.58 | 13 |
| Hla ii typing 1 loc hr CPT 81382 | $274.16 | $372.00 | $163.68 – $360.84 | 13 |
| Hla i low res one antigen equiv ea CPT 81374 | $164.35 | $223.00 | $98.12 – $216.31 | 13 |
| Hla i typing low res one locus ea CPT 81373 | $282.27 | $383.00 | $168.52 – $371.51 | 13 |
| Hla typing dr/dq CPT 86816 | $69.89 | $91.00 | $40.04 – $88.27 | 13 |
| Homocysteine CPT 83090 | $35.55 | $58.00 | $25.52 – $56.26 | 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.