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 |
|---|---|---|---|---|
| Pelvic Ultrasound (complete) CPT 76856 | $885.12 | $1,045.00 | $459.80 – $1,013.65 | 13 |
| Pelvic Ultrasound (limited) CPT 76857 | $648.80 | $766.00 | $337.04 – $743.02 | 13 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $177.35 | $247.00 | $108.68 – $239.59 | 13 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $265.66 | $370.00 | $162.80 – $358.90 | 13 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $14,566.16 | $21,904.00 | $2,149.40 – $4,738.45 | 13 |
| Pericardiocentesis wwo imaging CPT 33016 | $945.11 | $1,661.00 | $217.80 – $480.15 | 13 |
| Perineoplasty rpr per nonob CPT 56810 | $302.99 | $558.00 | $245.52 – $541.26 | 13 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $90,296.36 | $135,784.00 | $261.36 – $576.18 | 13 |
| Ph body fluid CPT 83986 | $63.75 | $104.00 | $22.44 – $49.47 | 13 |
| Phencyclidine (pcp) CPT 83992 | $98.08 | $160.00 | $24.64 – $54.32 | 13 |
| Phenobarbital therapeutic drug level CPT 80184 | $36.17 | $59.00 | $23.76 – $52.38 | 13 |
| Phenytoin total therapeutic drug level CPT 80185 | $33.10 | $54.00 | $23.76 – $52.38 | 13 |
| Phlebotomy therapeutic CPT 99195 | $133.64 | $257.00 | $113.08 – $249.29 | 13 |
| Phosphorus CPT 84100 | $66.82 | $109.00 | $20.68 – $45.59 | 13 |
| Phosphorus 24 hour urine CPT 84105 | $45.36 | $74.00 | $7.92 – $17.46 | 13 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $164.01 | $262.00 | $115.28 – $254.14 | 13 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $163.39 | $261.00 | $114.84 – $253.17 | 13 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $157.75 | $252.00 | $110.88 – $244.44 | 13 |
| Physical Therapy Re-Evaluation CPT 97164 | $140.85 | $225.00 | $99.00 – $218.25 | 13 |
| Pik3ca gene trgt seq alys CPT 81309 | $608.02 | $825.00 | $363.00 – $800.25 | 13 |
| Pin caspar distraction 12mm HCPCS C1821 | $23,304.26 | $35,044.00 | $2,149.40 – $4,738.45 | 13 |
| Pinworm exam CPT 87172 | $8.93 | $13.00 | $5.72 – $12.61 | 13 |
| Platelet automated CPT 85049 | $8.43 | $14.00 | $6.16 – $13.58 | 13 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $415.94 | $731.00 | $321.64 – $709.07 | 13 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $447.80 | $787.00 | $346.28 – $763.39 | 13 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,066.88 | $1,875.00 | $770.88 – $1,699.44 | 13 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $296.57 | $470.00 | $206.80 – $455.90 | 13 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $48.43 | $79.00 | $34.76 – $76.63 | 13 |
| Potassium 24 hour urine CPT 84133 | $42.91 | $70.00 | $24.20 – $53.35 | 13 |
| Potassium serum/plasma/whole blood CPT 84132 | $50.27 | $82.00 | $14.96 – $32.98 | 13 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $750.97 | $1,383.00 | $608.52 – $1,341.51 | 13 |
| Pr application of long arm splint CPT 29105 | $71.68 | $132.00 | $38.72 – $85.36 | 13 |
| Pr application splint static short arm CPT 29125 | $66.79 | $123.00 | $36.08 – $79.54 | 13 |
| Pr biopsy skin punch single lesion CPT 11104 | $244.19 | $459.00 | $44.88 – $98.94 | 13 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $89.10 | $149.00 | $65.56 – $144.53 | 13 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $130.36 | $218.00 | $95.92 – $211.46 | 13 |
| Prealbumin CPT 84134 | $33.10 | $54.00 | $23.76 – $52.38 | 13 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $891.89 | $1,053.00 | $463.32 – $1,021.41 | 13 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $756.37 | $893.00 | $392.92 – $866.21 | 13 |
| Pregnancy Ultrasound (limited) CPT 76815 | $452.30 | $534.00 | $234.96 – $517.98 | 13 |
| Pretreat rbc absorption reference CPT 86978 | $212.74 | $277.00 | $121.88 – $268.69 | 13 |
| Pretreat rbc w enzyme reference CPT 86971 | $224.63 | $344.00 | $151.36 – $333.68 | 13 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $91.77 | $169.00 | $74.36 – $163.93 | 13 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $152.32 | $337.00 | $148.28 – $326.89 | 13 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $114.57 | $211.00 | $53.24 – $117.37 | 13 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $246.97 | $413.00 | $181.72 – $400.61 | 13 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $168.04 | $281.00 | $123.64 – $272.57 | 13 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $124.38 | $208.00 | $91.52 – $201.76 | 13 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $127.37 | $213.00 | $93.72 – $206.61 | 13 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $88.50 | $148.00 | $65.12 – $143.56 | 13 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $48.44 | $81.00 | $35.64 – $78.57 | 13 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $204.71 | $377.00 | $165.88 – $365.69 | 13 |
| Pr incision & drainage abscess simple/single CPT 10060 | $112.94 | $208.00 | $53.24 – $117.37 | 13 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $134.66 | $248.00 | $109.12 – $240.56 | 13 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $115.66 | $213.00 | $93.72 – $206.61 | 13 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $318.99 | $490.00 | $24.64 – $54.32 | 13 |
| Procalcitonin CPT 84145 | $86.43 | $141.00 | $62.04 – $136.77 | 13 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | $54.30 | $100.00 | $44.00 – $97.00 | 13 |
| Progesterone CPT 84144 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| Prolactin CPT 84146 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| _propoxygc/msur CPT 80367 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $4,467.47 | $6,718.00 | $2,955.92 – $6,516.46 | 13 |
| Protein c activity CPT 85303 | $25.28 | $42.00 | $18.48 – $40.74 | 13 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $34.94 | $57.00 | $25.08 – $55.29 | 13 |
| Protein s total CPT 85305 | $34.92 | $58.00 | $25.52 – $56.26 | 13 |
| Protein total 24 hour urine CPT 84156 | $34.33 | $56.00 | $5.28 – $11.64 | 13 |
| Protein total body fluid CPT 84157 | $34.33 | $56.00 | $5.28 – $11.64 | 13 |
| Protein total serum plasma whole blood CPT 84155 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $34.92 | $58.00 | $25.52 – $56.26 | 13 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $79.82 | $147.00 | $43.12 – $95.06 | 13 |
| Pr removal intrauterine device CPT 58301 | $264.58 | $465.00 | $62.04 – $136.77 | 13 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $214.49 | $395.00 | $173.80 – $383.15 | 13 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $64.07 | $118.00 | $51.92 – $114.46 | 13 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $67.88 | $125.00 | $55.00 – $121.25 | 13 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $51.04 | $94.00 | $41.36 – $91.18 | 13 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $67.88 | $125.00 | $55.00 – $121.25 | 13 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $268.24 | $494.00 | $145.20 – $320.10 | 13 |
| PSA (Prostate) Test CPT 84153 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $34.69 | $59.00 | $25.96 – $57.23 | 13 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $93.98 | $148.00 | $65.12 – $143.56 | 13 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $69.85 | $110.00 | $48.40 – $106.70 | 13 |
| Pt application of modality traction mechanical CPT 97012 | $97.79 | $154.00 | $67.76 – $149.38 | 13 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $142.88 | $225.00 | $99.00 – $218.25 | 13 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $48.90 | $77.00 | $33.88 – $74.69 | 13 |
| Pt wheelchair management each 15 minutes CPT 97542 | $53.98 | $85.00 | $37.40 – $82.45 | 13 |
| Pulmonary vent imaging CPT 78579 | $520.61 | $816.00 | $359.04 – $791.52 | 13 |
| Punc of shunt for asp or inj CPT 61070 | $536.26 | $1,008.00 | $113.96 – $251.23 | 13 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $44.40 | $72.00 | $13.51 – $65.96 | 13 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $106.43 | $196.00 | $86.24 – $190.12 | 13 |
| Puncture spinal lumbar diagnostic CPT 62270 | $168.15 | $285.00 | $125.40 – $276.45 | 13 |
| Pyruvate CPT 84210 | $26.97 | $44.00 | $19.36 – $42.68 | 13 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $991.45 | $1,554.00 | $683.76 – $1,507.38 | 13 |
| Quest t3 uptake CPT 84479 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,046.96 | $1,641.00 | $722.04 – $1,591.77 | 13 |
| Radphm lcl tumor plr sgl day CPT 78800 | $523.80 | $821.00 | $361.24 – $796.37 | 13 |
| Ranibizumab injection HCPCS J2778 | $766.18 | $1,210.40 | $182.22 – $1,174.09 | 13 |
| Rapid Strep Test CPT 87880 | $34.35 | $50.00 | $22.00 – $48.50 | 13 |
| Rbc count only automated CPT 85041 | $37.93 | $63.00 | $27.28 – $60.14 | 13 |
| Rbc serum pretx incubj drugs CPT 86975 | $614.40 | $800.00 | $352.00 – $776.00 | 13 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $167.29 | $294.00 | $129.36 – $285.18 | 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.