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 |
|---|---|---|---|---|
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $95.49 | $139.00 | $46.64 – $102.82 | 13 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $72.82 | $106.00 | $46.64 – $102.82 | 13 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $72.82 | $106.00 | $46.64 – $102.82 | 13 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $289.23 | $421.00 | $185.24 – $408.37 | 13 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $88.62 | $129.00 | $56.76 – $125.13 | 13 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $159.93 | $217.00 | $95.48 – $210.49 | 13 |
| Mayo infliximab therapeutic drug level CPT 80230 | $163.06 | $266.00 | $117.04 – $258.02 | 13 |
| Mayo inhab inhibin a CPT 86336 | $59.14 | $77.00 | $25.08 – $55.29 | 13 |
| Mayo insulin antibodies CPT 86337 | $50.69 | $66.00 | $29.04 – $64.02 | 13 |
| Mayo iodine CPT 83789 | $44.75 | $73.00 | $32.12 – $70.81 | 13 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $80.30 | $131.00 | $57.64 – $127.07 | 13 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $50.27 | $82.00 | $36.08 – $79.54 | 13 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $37.39 | $61.00 | $26.84 – $59.17 | 13 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Mayo legionella antibody CPT 86713 | $55.30 | $72.00 | $31.68 – $69.84 | 13 |
| Mayo leptospira antibody igm CPT 86720 | $118.27 | $154.00 | $21.56 – $47.53 | 13 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $46.85 | $61.00 | $26.84 – $59.17 | 13 |
| Mayo manganese CPT 83785 | $49.04 | $80.00 | $35.20 – $77.60 | 13 |
| Mayo metanephrines plasma CPT 83835 | $40.46 | $66.00 | $29.04 – $64.02 | 13 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $101.14 | $165.00 | $24.64 – $54.32 | 13 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $340.99 | $444.00 | $195.36 – $430.68 | 13 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $53.76 | $70.00 | $30.80 – $67.90 | 13 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $48.38 | $63.00 | $19.36 – $42.68 | 13 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $306.50 | $500.00 | $26.40 – $58.20 | 13 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $302.91 | $411.00 | $180.84 – $398.67 | 13 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $409.77 | $556.00 | $244.64 – $539.32 | 13 |
| Mayo muramidase CPT 85549 | $34.31 | $57.00 | $25.08 – $55.29 | 13 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $43.01 | $56.00 | $24.64 – $54.32 | 13 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $33.71 | $55.00 | $24.20 – $53.35 | 13 |
| Mayo myoglobin CPT 83874 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $63.75 | $104.00 | $24.64 – $54.32 | 13 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $63.75 | $104.00 | $24.64 – $54.32 | 13 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $119.53 | $195.00 | $28.16 – $62.08 | 13 |
| Mayo oxalate 24 hour urine CPT 83945 | $66.20 | $108.00 | $29.48 – $64.99 | 13 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $63.75 | $104.00 | $45.76 – $100.88 | 13 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $47.62 | $62.00 | $27.28 – $60.14 | 13 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $403.20 | $525.00 | $16.28 – $35.89 | 13 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $42.74 | $71.00 | $31.24 – $68.87 | 13 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $38.01 | $62.00 | $27.28 – $60.14 | 13 |
| Mayo pregnenolone CPT 84140 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Mayo proinsulin CPT 84206 | $49.65 | $81.00 | $35.64 – $78.57 | 13 |
| Mayo psaft prostate specific antigen free CPT 84154 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $69.88 | $114.00 | $31.68 – $69.84 | 13 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $34.31 | $57.00 | $25.08 – $55.29 | 13 |
| Mayo receptor assay transferrin soluble CPT 84238 | $306.50 | $500.00 | $48.40 – $106.70 | 13 |
| Mayo renin CPT 84244 | $85.82 | $140.00 | $29.04 – $64.02 | 13 |
| Mayo repu protein electrophoresis urine CPT 84166 | $33.10 | $54.00 | $23.76 – $52.38 | 13 |
| Mayo selenium CPT 84255 | $47.20 | $77.00 | $33.88 – $74.69 | 13 |
| Mayo serotonin CPT 84260 | $57.01 | $93.00 | $40.92 – $90.21 | 13 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $54.53 | $71.00 | $31.24 – $68.87 | 13 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $34.94 | $57.00 | $25.08 – $55.29 | 13 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $285.70 | $372.00 | $108.24 – $238.62 | 13 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $102.91 | $134.00 | $22.88 – $50.44 | 13 |
| Mayo tau phosphorylated 217 each CPT 84393 | $276.46 | $451.00 | $154.00 – $339.50 | 13 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $462.10 | $627.00 | $275.88 – $608.19 | 13 |
| Mayo tgrp testosterone free CPT 84402 | $47.20 | $77.00 | $33.88 – $74.69 | 13 |
| Mayo tgrp testosterone total CPT 84403 | $47.81 | $78.00 | $34.32 – $75.66 | 13 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $68.66 | $112.00 | $49.28 – $108.64 | 13 |
| Mayo thyroglobulin CPT 84432 | $50.27 | $82.00 | $25.08 – $55.29 | 13 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $61.44 | $80.00 | $35.20 – $77.60 | 13 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $55.30 | $72.00 | $25.52 – $56.26 | 13 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $41.07 | $67.00 | $24.64 – $54.32 | 13 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | $94.40 | $154.00 | $67.76 – $149.38 | 13 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $76.80 | $100.00 | $44.00 – $97.00 | 13 |
| Mayo vasoactive intestinal peptide CPT 84586 | $98.08 | $160.00 | $70.40 – $155.20 | 13 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $45.36 | $74.00 | $32.56 – $71.78 | 13 |
| Mayo vitamin b3 (niacin) CPT 84591 | $57.62 | $94.00 | $41.36 – $91.18 | 13 |
| Mayo vitamin k CPT 84597 | $52.10 | $85.00 | $37.40 – $82.45 | 13 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $48.43 | $79.00 | $34.76 – $76.63 | 13 |
| #mec-opiates CPT 80356 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Metabolic Blood Panel (Basic) CPT 80048 | $68.04 | $111.00 | $48.84 – $107.67 | 13 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $83.98 | $137.00 | $60.28 – $132.89 | 13 |
| Methylphenidate CPT 80360 | $41.07 | $67.00 | $29.48 – $64.99 | 13 |
| Microdissection laser CPT 88380 | $126.65 | $202.00 | $88.88 – $195.94 | 13 |
| Microsatellite instability CPT 81301 | $770.90 | $1,046.00 | $460.24 – $1,014.62 | 13 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | $188.12 | $262.00 | $115.28 – $254.14 | 13 |
| Mlh1 gene CPT 81288 | $425.25 | $577.00 | $253.88 – $559.69 | 13 |
| Mnpj anes sho jt fixj aprats CPT 23700 | $331.23 | $610.00 | $179.08 – $394.79 | 13 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $16,605.05 | $24,970.00 | $2,686.20 – $5,921.85 | 13 |
| Mopath procedure level 3 CPT 81402 | $332.39 | $451.00 | $198.44 – $437.47 | 13 |
| Mopath procedure level 9 CPT 81408 | $4,422.00 | $6,000.00 | $2,640.00 – $5,820.00 | 13 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $346.73 | $553.00 | $171.36 – $536.41 | 13 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $450.19 | $718.00 | $105.08 – $696.46 | 13 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $234.50 | $374.00 | $107.78 – $362.78 | 13 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $53.92 | $86.00 | $37.84 – $83.42 | 13 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $215.69 | $344.00 | $151.36 – $333.68 | 13 |
| M/phmtrc alysishquant/semiq CPT 88369 | $63.33 | $101.00 | $44.44 – $97.97 | 13 |
| MRA abdomen post contrast CPT 74185 | $3,494.90 | $5,015.00 | $1,471.36 – $3,243.68 | 13 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $3,168.06 | $4,546.00 | $1,333.64 – $2,940.07 | 13 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $2,623.79 | $3,765.00 | $1,104.40 – $2,434.70 | 13 |
| MRA pelvis CPT 72198 | $2,269.77 | $3,257.00 | $955.24 – $2,105.87 | 13 |
| MRI breast c- unilateral CPT 77046 | $795.97 | $1,142.00 | $502.48 – $1,107.74 | 13 |
| MRI breast c-+ w/cad uni CPT 77048 | $1,193.96 | $1,713.00 | $753.72 – $1,661.61 | 13 |
| MRI breast without cont bi CPT 77047 | $1,253.21 | $1,798.00 | $791.12 – $1,744.06 | 13 |
| MRI breast w IV cont bi CPT 77049 | $1,879.81 | $2,697.00 | $1,186.68 – $2,616.09 | 13 |
| MRI chest without contrast CPT 71550 | $2,011.54 | $2,886.00 | $1,269.84 – $2,799.42 | 13 |
| MRI chest without & w/contrast CPT 71552 | $3,017.31 | $4,329.00 | $1,904.76 – $4,199.13 | 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.