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 |
|---|---|---|---|---|
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $903.87 | $1,699.00 | $200.20 – $747.56 | 13 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $380.91 | $716.00 | $79.20 – $174.60 | 13 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $327.18 | $615.00 | $77.88 – $171.69 | 13 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $348.99 | $656.00 | $87.56 – $193.03 | 13 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $93.32 | $164.00 | $72.16 – $159.08 | 13 |
| Inject sacroiliac joint CPT 27096 | $1,099.11 | $2,066.00 | $167.20 – $605.88 | 13 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $227.74 | $386.00 | $169.84 – $374.42 | 13 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $29.79 | $63.00 | $24.64 – $54.32 | 13 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $4.04 | $5.80 | $0.22 – $0.49 | 13 |
| Ins cerv dilator (sep proc) CPT 59200 | $356.11 | $511.00 | $224.84 – $495.67 | 13 |
| Insertion catheter bladder non indwelling CPT 51701 | $133.71 | $235.00 | $24.20 – $53.35 | 13 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $230.69 | $391.00 | $172.04 – $379.27 | 13 |
| Insert pessary/other device CPT 57160 | $42.03 | $79.00 | $34.76 – $76.63 | 13 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $215.69 | $344.00 | $151.36 – $333.68 | 13 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | $3,405.33 | $6,401.00 | $724.68 – $2,816.44 | 13 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $436.77 | $821.00 | $361.24 – $796.37 | 13 |
| Insulin total CPT 83525 | $34.94 | $57.00 | $25.08 – $55.29 | 13 |
| Intracranial complete study CPT 93886 | $585.00 | $1,000.00 | $440.00 – $970.00 | 13 |
| Intracranial limited study CPT 93888 | $339.30 | $580.00 | $255.20 – $562.60 | 13 |
| Intranasal biopsy 30100 CPT 30100 | $62.38 | $138.00 | $60.72 – $133.86 | 13 |
| Intrapul surf admin endo tube CPT 94610 | $96.54 | $153.00 | $67.32 – $148.41 | 13 |
| Intrinsic factor antibody CPT 86340 | $45.31 | $59.00 | $25.96 – $57.23 | 13 |
| Intro long gi tube w/mult fluo CPT 74340 | $331.72 | $462.00 | $203.28 – $448.14 | 13 |
| Intubation endotracheal emergency procedure CPT 31500 | $388.22 | $658.00 | $155.76 – $343.38 | 13 |
| Iron CPT 83540 | $127.50 | $208.00 | $8.80 – $19.40 | 13 |
| Iron binding capacity CPT 83550 | $16.55 | $27.00 | $11.88 – $26.19 | 13 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $132.08 | $254.00 | $111.76 – $246.38 | 13 |
| IV Fluids (each additional hour) CPT 96361 | $73.30 | $114.00 | $50.16 – $110.58 | 13 |
| IV Fluids (first hour) CPT 96360 | $272.63 | $424.00 | $186.56 – $411.28 | 13 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $162.68 | $253.00 | $111.32 – $245.41 | 13 |
| IV Medicine Infusion (additional drug) CPT 96367 | $85.52 | $133.00 | $58.52 – $129.01 | 13 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $78.45 | $122.00 | $53.68 – $118.34 | 13 |
| IV Medicine Infusion (first hour) CPT 96365 | $289.35 | $450.00 | $198.00 – $436.50 | 13 |
| IV Push Injection (each additional drug) CPT 96375 | $126.32 | $222.00 | $97.68 – $215.34 | 13 |
| IV Push Injection (first drug) CPT 96374 | $182.08 | $320.00 | $140.80 – $310.40 | 13 |
| Ivp w/nephrotomography CPT 74415 | $1,000.17 | $1,393.00 | $612.92 – $1,351.21 | 13 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,107.16 | $1,542.00 | $678.48 – $1,495.74 | 13 |
| Jak2 targeted sequence analysis CPT 81279 | $409.77 | $556.00 | $244.64 – $539.32 | 13 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $280.02 | $390.00 | $171.60 – $378.30 | 13 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $356.85 | $497.00 | $218.68 – $482.09 | 13 |
| John cunningham antibody CPT 86711 | $39.17 | $51.00 | $22.44 – $49.47 | 13 |
| Ketamine and metabolite screen - quest CPT 80357 | $88.89 | $145.00 | $63.80 – $140.65 | 13 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $37.39 | $61.00 | $26.40 – $58.20 | 13 |
| Kidney imaging morphology CPT 78700 | $488.07 | $765.00 | $336.60 – $742.05 | 13 |
| Kidney imag w/bld flow multi CPT 78709 | $1,059.08 | $1,660.00 | $730.40 – $1,610.20 | 13 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $667.99 | $1,047.00 | $460.68 – $1,015.59 | 13 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $869.87 | $1,027.00 | $451.88 – $996.19 | 13 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $285.44 | $337.00 | $148.28 – $326.89 | 13 |
| Kit gene analys d816 variant CPT 81273 | $276.38 | $375.00 | $165.00 – $363.75 | 13 |
| Kit lead specify 5-6-5 HCPCS C1778 | $20,391.56 | $30,664.00 | $3,058.00 – $6,741.50 | 13 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,792.18 | $2,695.00 | $258.72 – $570.36 | 13 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $4,059.83 | $6,105.00 | $1,185.80 – $2,614.15 | 13 |
| Knee MRI (with and without contrast) CPT 73723 | $2,498.74 | $3,585.00 | $1,577.40 – $3,477.45 | 13 |
| Knee MRI (with contrast) CPT 73722 | $2,082.64 | $2,988.00 | $1,314.72 – $2,898.36 | 13 |
| Knee MRI (without contrast) CPT 73721 | $1,665.83 | $2,390.00 | $1,051.60 – $2,318.30 | 13 |
| Knee X-ray CPT 73564 | $420.03 | $585.00 | $257.40 – $567.45 | 13 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $226.17 | $315.00 | $138.60 – $305.55 | 13 |
| Knee X-ray (3 views, both knees) CPT 73562 | $275.71 | $384.00 | $168.96 – $372.48 | 13 |
| Knee X-ray (standing, both knees) CPT 73565 | $377.67 | $526.00 | $231.44 – $510.22 | 13 |
| Kras gene addl variants CPT 81276 | $427.46 | $580.00 | $255.20 – $562.60 | 13 |
| Kras gene variants exon 2 CPT 81275 | $427.46 | $580.00 | $255.20 – $562.60 | 13 |
| Lactate dehydrogenase (ldh) CPT 83615 | $34.94 | $57.00 | $8.36 – $18.43 | 13 |
| Lactic acid CPT 83605 | $79.08 | $129.00 | $15.40 – $33.95 | 13 |
| Lactoferrin fecal qualitative CPT 83630 | $60.07 | $98.00 | $32.12 – $70.81 | 13 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $651.17 | $1,224.00 | $92.40 – $203.70 | 13 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $179.19 | $330.00 | $145.20 – $320.10 | 13 |
| Laryngoscopy w/fb removal CPT 31530 | $223.72 | $412.00 | $181.28 – $399.64 | 13 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $20,391.56 | $30,664.00 | $4,076.60 – $8,987.05 | 13 |
| Lead capillary CPT 83655 | $48.43 | $79.00 | $16.28 – $35.89 | 13 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $20,391.56 | $30,664.00 | $1,185.80 – $2,614.15 | 13 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $13,109.81 | $19,714.00 | $1,185.80 – $2,614.15 | 13 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $870.48 | $1,488.00 | $654.72 – $1,443.36 | 13 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,307.26 | $2,049.00 | $901.56 – $1,987.53 | 13 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,045.68 | $1,639.00 | $721.16 – $1,589.83 | 13 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,003.86 | $1,716.00 | $755.04 – $1,664.52 | 13 |
| Lens, intraocular (new tech) HCPCS C1780 | $2,711.18 | $4,885.00 | $621.72 – $1,370.61 | 13 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,711.18 | $4,885.00 | $261.36 – $576.18 | 13 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $2,711.18 | $4,885.00 | $261.36 – $576.18 | 13 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $1,197.14 | $2,157.00 | $261.36 – $576.18 | 13 |
| Levetiracetam therapeutic drug level CPT 80177 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| Liberta rc ipg HCPCS C1820 | $72,820.16 | $109,504.00 | $2,149.40 – $4,738.45 | 13 |
| Lidocaine therapeutic drug level CPT 80176 | $27.59 | $45.00 | $19.80 – $43.65 | 13 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $2,619,960.74 | $3,759,504.00 | $1,654,181.76 – $3,646,718.88 | 13 |
| Lipase CPT 83690 | $35.55 | $58.00 | $9.24 – $20.37 | 13 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | $328.15 | $726.00 | $319.44 – $704.22 | 13 |
| Lipoprotein blood high res frac & quant CPT 83701 | $62.53 | $102.00 | $44.88 – $98.94 | 13 |
| Lipoprotein blood quant CPT 83704 | $63.14 | $103.00 | $45.32 – $99.91 | 13 |
| Lipoprotein direct measurement hdl CPT 83718 | $39.23 | $64.00 | $28.16 – $62.08 | 13 |
| Lipoprotein direct measurement ldl CPT 83721 | $57.62 | $94.00 | $14.08 – $31.04 | 13 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $63.14 | $103.00 | $45.32 – $99.91 | 13 |
| Lithium therapeutic drug level CPT 80178 | $31.88 | $52.00 | $22.88 – $50.44 | 13 |
| Liver Function Test CPT 80076 | $66.20 | $108.00 | $47.52 – $104.76 | 13 |
| Liver/spleen imag static only CPT 78215 | $921.27 | $1,444.00 | $635.36 – $1,400.68 | 13 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $437.03 | $685.00 | $301.40 – $664.45 | 13 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.56 | $2.24 | $0.99 – $2.17 | 13 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $350.26 | $549.00 | $241.56 – $532.53 | 13 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,991.58 | $4,689.00 | $2,063.16 – $4,548.33 | 13 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,493.30 | $3,908.00 | $1,719.52 – $3,790.76 | 13 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,994.39 | $3,126.00 | $1,375.44 – $3,032.22 | 13 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,716.04 | $2,604.00 | $1,145.76 – $2,525.88 | 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.