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 |
|---|---|---|---|---|
| MRI chest w IV cont CPT 71551 | $2,514.78 | $3,608.00 | $1,587.52 – $3,499.76 | 13 |
| MRI loex nonjt w IV cont CPT 73719 | $1,548.73 | $2,222.00 | $977.68 – $2,155.34 | 13 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,238.57 | $1,777.00 | $781.88 – $1,723.69 | 13 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $1,858.20 | $2,666.00 | $1,173.04 – $2,586.02 | 13 |
| MRI orbit fac&nck w IV cont CPT 70542 | $2,592.84 | $3,720.00 | $1,636.80 – $3,608.40 | 13 |
| MRI tmj CPT 70336 | $3,238.26 | $4,646.00 | $1,362.68 – $3,004.09 | 13 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,617.04 | $2,320.00 | $1,020.80 – $2,250.40 | 13 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,425.56 | $3,480.00 | $1,531.20 – $3,375.60 | 13 |
| MRI upper extremity w/dye CPT 73219 | $2,021.30 | $2,900.00 | $1,276.00 – $2,813.00 | 13 |
| Mr safety determination physician/other qhp CPT 76016 | $95.49 | $133.00 | $58.52 – $129.01 | 13 |
| Mr safety implant elec prepj CPT 76018 | $147.19 | $205.00 | $90.20 – $198.85 | 13 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $131.39 | $183.00 | $80.52 – $177.51 | 13 |
| Mr safety implt pos&/immoblj CPT 76019 | $224.73 | $313.00 | $137.72 – $303.61 | 13 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $27.28 | $38.00 | $16.72 – $36.86 | 13 |
| Mr sfty med physics xm cstmz CPT 76017 | $349.67 | $487.00 | $214.28 – $472.39 | 13 |
| Mthfr gene analy common variants CPT 81291 | $145.19 | $197.00 | $86.68 – $191.09 | 13 |
| Mumps antibody igg CPT 86735 | $47.62 | $62.00 | $24.64 – $54.32 | 13 |
| Mycobacteria dna amp probe CPT 87551 | $309.15 | $450.00 | $198.00 – $436.50 | 13 |
| Mycoplasma antibody igm CPT 86738 | $42.24 | $55.00 | $24.20 – $53.35 | 13 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $388.40 | $527.00 | $231.88 – $511.19 | 13 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $82.75 | $135.00 | $11.53 – $33.95 | 13 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $549.02 | $1,032.00 | $58.08 – $128.04 | 13 |
| Nasal/sinus endoscopy surg CPT 31287 | $282.95 | $626.00 | $183.92 – $405.46 | 13 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | $222.38 | $492.00 | $144.32 – $318.16 | 13 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | $341.71 | $756.00 | $221.76 – $488.88 | 13 |
| Nasal/sinus endo w/ethmoidectomy tot 31255 CPT 31255 | $455.62 | $1,008.00 | $295.68 – $651.84 | 13 |
| Nasal/sinus maxillary endoscopy dx 31233 CPT 31233 | $1,137.95 | $2,139.00 | $627.44 – $1,383.22 | 13 |
| Nasal/sinus sphenoid endoscopy dx 31235 CPT 31235 | $2,060.44 | $3,873.00 | $1,136.08 – $2,504.54 | 13 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $35.26 | $78.00 | $34.32 – $75.66 | 13 |
| Natriuretic peptide CPT 83880 | $112.18 | $183.00 | $80.52 – $177.51 | 13 |
| Natural killer cells total count CPT 86357 | $87.55 | $114.00 | $50.16 – $110.58 | 13 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $34.64 | $69.00 | $30.36 – $66.93 | 13 |
| Ndl insj without njx 3+ musc CPT 20561 | $37.65 | $75.00 | $33.00 – $72.75 | 13 |
| Ndl round specialty proguide HCPCS C1715 | $286.36 | $588.00 | $73.04 – $161.02 | 13 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $223.30 | $311.00 | $136.84 – $301.67 | 13 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $2,834.63 | $4,443.00 | $1,954.92 – $4,309.71 | 13 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,362.51 | $3,703.00 | $1,629.32 – $3,591.91 | 13 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,889.76 | $2,962.00 | $1,303.28 – $2,873.14 | 13 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $1,716.04 | $2,604.00 | $1,145.76 – $2,525.88 | 13 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $1,430.03 | $2,170.00 | $954.80 – $2,104.90 | 13 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $1,144.02 | $1,736.00 | $763.84 – $1,683.92 | 13 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $337.46 | $470.00 | $206.80 – $455.90 | 13 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $464.55 | $647.00 | $284.68 – $627.59 | 13 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $547.83 | $763.00 | $335.72 – $740.11 | 13 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $3,378.24 | $5,511.00 | $2,424.84 – $5,345.67 | 13 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,815.51 | $4,593.00 | $2,020.92 – $4,455.21 | 13 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,252.16 | $3,674.00 | $1,616.56 – $3,563.78 | 13 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $1,512.25 | $2,471.00 | $1,087.24 – $2,396.87 | 13 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $1,260.11 | $2,059.00 | $905.96 – $1,997.23 | 13 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $1,007.96 | $1,647.00 | $724.68 – $1,597.59 | 13 |
| Neuroeltrd stim post tibial CPT 64566 | $229.82 | $432.00 | $190.08 – $419.04 | 13 |
| New Patient Office Visit (level 2) CPT 99202 | $314.70 | $557.00 | $59.40 – $130.95 | 13 |
| New Patient Office Visit (level 3) CPT 99203 | $471.78 | $835.00 | $96.80 – $213.40 | 13 |
| New Patient Office Visit (level 4) CPT 99204 | $566.69 | $1,003.00 | $144.76 – $319.13 | 13 |
| New Patient Office Visit (level 5) CPT 99205 | $759.36 | $1,344.00 | $190.96 – $420.98 | 13 |
| Nintedanib 150 mg capsule HCPCS J8999 | $28.85 | $458.00 | $201.52 – $444.26 | 13 |
| Njx interlaminar crv/thrc CPT 62324 | $241.90 | $410.00 | $180.40 – $397.70 | 13 |
| Njx interlaminar crv/thrc CPT 62325 | $711.82 | $1,338.00 | $588.72 – $1,297.86 | 13 |
| Njx interlaminar lmbr/sac CPT 62327 | $711.82 | $1,338.00 | $588.72 – $1,297.86 | 13 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,212.20 | $1,900.00 | $836.00 – $1,843.00 | 13 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,139.47 | $1,786.00 | $785.84 – $1,732.42 | 13 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $508.49 | $797.00 | $350.68 – $773.09 | 13 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,162.44 | $1,822.00 | $801.68 – $1,767.34 | 13 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $844.07 | $1,323.00 | $582.12 – $1,283.31 | 13 |
| Non-card vasc flow imaging CPT 78445 | $515.50 | $808.00 | $355.52 – $783.76 | 13 |
| Noninv pace analysis CPT 93724 | $245.89 | $452.00 | $198.88 – $438.44 | 13 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $246.99 | $344.00 | $151.36 – $333.68 | 13 |
| Npm1 gene CPT 81310 | $545.38 | $740.00 | $325.60 – $717.80 | 13 |
| Nuclear Stress Test (Heart) CPT 78452 | $3,399.90 | $5,329.00 | $2,344.76 – $5,169.13 | 13 |
| Nudt15 gene common variants CPT 81306 | $644.88 | $875.00 | $385.00 – $848.75 | 13 |
| Nursing facility discharge management > 30 min 99316 CPT 99316 | $116.75 | $215.00 | $94.60 – $208.55 | 13 |
| Nursing facility discharge management 30 min/less than 99315 CPT 99315 | $81.45 | $150.00 | $66.00 – $145.50 | 13 |
| Observation direct referral from physician office for admission HCPCS G0379 | $357.74 | $654.00 | $287.76 – $634.38 | 12 |
| Observation/inpatient hospital care hi severity 99236 CPT 99236 | $241.09 | $444.00 | $195.36 – $430.68 | 13 |
| Observation/inpatient hospital care low severity 99234 CPT 99234 | $148.24 | $273.00 | $120.12 – $264.81 | 13 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $187.34 | $345.00 | $151.80 – $334.65 | 13 |
| Observation per hour HCPCS G0378 | $53.01 | $95.00 | $41.80 – $92.15 | 13 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $356.59 | $421.00 | $185.24 – $408.37 | 13 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $142.53 | $262.00 | $115.28 – $254.14 | 13 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $141.98 | $261.00 | $114.84 – $253.17 | 13 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $137.09 | $252.00 | $110.88 – $244.44 | 13 |
| Organic acids total quant ea spec CPT 83918 | $61.91 | $101.00 | $44.44 – $97.97 | 13 |
| Oropharyngeal biopsy 42800 CPT 42800 | $105.32 | $233.00 | $102.52 – $226.01 | 13 |
| Oscillation chest wall mechanical per session CPT 94669 | $173.76 | $307.00 | $135.08 – $297.79 | 13 |
| Osmolality blood CPT 83930 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Osmolality urine CPT 83935 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $83.18 | $131.00 | $57.64 – $127.07 | 13 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $9.04 | $20.00 | $8.80 – $19.40 | 13 |
| Ot re-evaluation patient/family CPT 97168 | $122.40 | $225.00 | $99.00 – $218.25 | 13 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $78.96 | $93.00 | $40.92 – $90.21 | 13 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $84.05 | $99.00 | $43.56 – $96.03 | 13 |
| Parathormone (pth) intact CPT 83970 | $76.01 | $124.00 | $54.56 – $120.28 | 13 |
| Parathyroid planar imaging CPT 78070 | $734.34 | $1,151.00 | $506.44 – $1,116.47 | 13 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $64.37 | $121.00 | $53.24 – $117.37 | 13 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,855.05 | $4,475.00 | $1,969.00 – $4,340.75 | 13 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,379.10 | $3,729.00 | $1,640.76 – $3,617.13 | 13 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,903.15 | $2,983.00 | $1,312.52 – $2,893.51 | 13 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,161.40 | $3,101.00 | $1,364.44 – $3,007.97 | 13 |
| Pelvic MRI (with contrast) CPT 72196 | $1,801.05 | $2,584.00 | $1,136.96 – $2,506.48 | 13 |
| Pelvic MRI (without contrast) CPT 72195 | $1,440.70 | $2,067.00 | $909.48 – $2,004.99 | 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.