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 |
|---|---|---|---|---|
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $199.15 | $350.00 | $154.00 – $339.50 | 13 |
| Refill maint impl spine pump CPT 95991 | $231.40 | $445.00 | $81.40 – $195.80 | 13 |
| Refill/maint pump/resvr syst CPT 96522 | $132.08 | $254.00 | $111.76 – $246.38 | 13 |
| Removal cerumen impacted (both sides) CPT 69210 | $38.01 | $70.00 | $30.80 – $67.90 | 13 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $125.73 | $198.00 | $87.12 – $192.06 | 13 |
| Removal foreign body foot subcutaneous right CPT 28190 | $226.43 | $417.00 | $122.32 – $269.66 | 13 |
| Removal of adenoids CPT 42830 | $194.36 | $430.00 | $189.20 – $417.10 | 13 |
| Removal of adenoids CPT 42831 | $210.18 | $465.00 | $204.60 – $451.05 | 13 |
| Removal of adenoids <12yrs 42835 CPT 42835 | $179.90 | $398.00 | $175.12 – $386.06 | 13 |
| Removal of foreign body CPT 27372 | $681.46 | $1,255.00 | $368.28 – $811.89 | 13 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $147.36 | $277.00 | $66.88 – $147.44 | 13 |
| Removal sutr and stapl no anes CPT 15854 | $125.18 | $220.00 | $96.80 – $213.40 | 13 |
| Removal sutr or stapl no anes CPT 15853 | $93.88 | $165.00 | $72.60 – $160.05 | 13 |
| Remove hip foreign body 27086 CPT 27086 | $283.45 | $522.00 | $153.12 – $337.56 | 13 |
| Remove spine eltrd perq aray CPT 63661 | $1,549.18 | $2,912.00 | $652.08 – $1,437.54 | 13 |
| Remove tonsils and adenoids CPT 42820 | $269.84 | $597.00 | $262.68 – $579.09 | 13 |
| Remove tonsils and adenoids CPT 42821 | $281.60 | $623.00 | $274.12 – $604.31 | 13 |
| Remove ventilating tube CPT 69424 | $84.98 | $188.00 | $55.00 – $121.25 | 13 |
| Renal cyst study s&i CPT 74470 | $338.90 | $472.00 | $207.68 – $457.84 | 13 |
| Renal function panel CPT 80069 | $95.63 | $156.00 | $68.64 – $151.32 | 13 |
| Repair blood vessel direct hand finger CPT 35207 | $1,279.31 | $2,356.00 | $691.24 – $1,523.87 | 13 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $294.31 | $542.00 | $238.48 – $525.74 | 13 |
| Repair extns tendon finger without grft ea CPT 26418 | $667.89 | $1,230.00 | $541.20 – $1,193.10 | 13 |
| Repair finger/hand tendon CPT 26350 | $816.13 | $1,503.00 | $661.32 – $1,457.91 | 13 |
| Repair lac palate<2 cm CPT 42180 | $207.43 | $382.00 | $168.08 – $370.54 | 13 |
| Repair of nasal septum CPT 30520 | $601.61 | $1,331.00 | $585.64 – $1,291.07 | 13 |
| Repair of toe dislocation CPT 28675 | $455.58 | $839.00 | $369.16 – $813.83 | 13 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $235.66 | $434.00 | $190.96 – $420.98 | 13 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $344.80 | $635.00 | $279.40 – $615.95 | 13 |
| Resect inferior turbinate CPT 30140 | $250.41 | $554.00 | $162.36 – $357.93 | 13 |
| Resp virus 6-11 targets CPT 87632 | $449.98 | $655.00 | $288.20 – $635.35 | 13 |
| Resuscitation delivery/birthing room CPT 99465 | $687.83 | $987.00 | $434.28 – $957.39 | 13 |
| Reticulated platelet assay CPT 85055 | $65.02 | $108.00 | $47.52 – $104.76 | 13 |
| Reticulocyte direct measurement automated CPT 85046 | $10.23 | $17.00 | $7.48 – $16.49 | 13 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $838.10 | $1,700.00 | $748.00 – $1,649.00 | 12 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | $295.61 | $654.00 | $287.76 – $634.38 | 13 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | $261.71 | $579.00 | $254.76 – $561.63 | 13 |
| Rheumatoid factor quantitative CPT 86431 | $42.24 | $55.00 | $7.92 – $17.46 | 13 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $320.23 | $446.00 | $196.24 – $432.62 | 13 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $402.80 | $561.00 | $246.84 – $544.17 | 13 |
| Rib X-ray (3 views, both sides) CPT 71110 | $328.13 | $457.00 | $201.08 – $443.29 | 13 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $159.10 | $293.00 | $128.92 – $284.21 | 13 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $554.42 | $869.00 | $382.36 – $842.93 | 13 |
| Rsv assay w/optic CPT 87807 | $27.48 | $40.00 | $17.60 – $38.80 | 13 |
| Rubella antibody igg CPT 86762 | $43.01 | $56.00 | $24.64 – $54.32 | 13 |
| Rubeola antibody igg CPT 86765 | $46.08 | $60.00 | $24.64 – $54.32 | 13 |
| Russell viper venom diluted CPT 85613 | $36.12 | $60.00 | $26.40 – $58.20 | 13 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $2,028.22 | $2,752.00 | $1,210.88 – $2,669.44 | 13 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $377.67 | $526.00 | $231.44 – $510.22 | 13 |
| Salmonella antibody CPT 86768 | $56.06 | $73.00 | $32.12 – $70.81 | 13 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $148.78 | $274.00 | $120.56 – $265.78 | 13 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $76.56 | $141.00 | $62.04 – $136.77 | 13 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $101.00 | $186.00 | $81.84 – $180.42 | 13 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $48.87 | $90.00 | $39.60 – $87.30 | 13 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $438.75 | $750.00 | $330.00 – $727.50 | 13 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $339.88 | $581.00 | $255.64 – $563.57 | 13 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $459.22 | $785.00 | $345.40 – $761.45 | 13 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $761.67 | $1,302.00 | $572.88 – $1,262.94 | 13 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $565.11 | $966.00 | $425.04 – $937.02 | 13 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $628.88 | $1,075.00 | $473.00 – $1,042.75 | 13 |
| Screening Mammogram CPT 77067 | $267.68 | $341.00 | $99.88 – $220.19 | 13 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $87,383.66 | $131,404.00 | $30.80 – $67.90 | 13 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $814.81 | $962.00 | $423.28 – $933.14 | 13 |
| Sedimentation rate erythrocyte automated CPT 85652 | $5.42 | $9.00 | $3.96 – $8.73 | 13 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $61.59 | $97.00 | $42.68 – $94.09 | 13 |
| Semen analysis w/count CPT 89310 | $16.98 | $26.00 | $8.61 – $25.22 | 13 |
| Sept9 promoter methylation analysis CPT 81327 | $424.51 | $576.00 | $253.44 – $558.72 | 13 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $43.84 | $97.00 | $42.68 – $94.09 | 13 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $159.60 | $300.00 | $58.52 – $129.01 | 13 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $37.06 | $82.00 | $36.08 – $79.54 | 13 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $47.46 | $105.00 | $46.20 – $101.85 | 13 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $61.02 | $135.00 | $59.40 – $130.95 | 13 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | $69.16 | $153.00 | $67.32 – $148.41 | 13 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $32.54 | $72.00 | $31.68 – $69.84 | 13 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $49.27 | $109.00 | $47.96 – $105.73 | 13 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $57.86 | $128.00 | $56.32 – $124.16 | 13 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $6,766.86 | $13,895.00 | $137.72 – $303.61 | 13 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $100.71 | $177.00 | $77.88 – $171.69 | 13 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $270.69 | $377.00 | $165.88 – $365.69 | 13 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $192.42 | $268.00 | $117.92 – $259.96 | 13 |
| Shoulder MRI (with and without contrast) CPT 73223 | $1,985.75 | $2,849.00 | $1,253.56 – $2,763.53 | 13 |
| Shoulder MRI (with contrast) CPT 73222 | $1,654.68 | $2,374.00 | $1,044.56 – $2,302.78 | 13 |
| Shoulder MRI (without contrast) CPT 73221 | $1,323.60 | $1,899.00 | $835.56 – $1,842.03 | 13 |
| Shoulder X-ray CPT 73030 | $318.79 | $444.00 | $195.36 – $430.68 | 13 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $231.20 | $322.00 | $141.68 – $312.34 | 13 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $364.74 | $508.00 | $47.08 – $103.79 | 13 |
| Sickling rbc CPT 85660 | $33.71 | $56.00 | $24.64 – $54.32 | 13 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,254.61 | $3,684.00 | $1,620.96 – $3,573.48 | 13 |
| Sinus CT scan (with contrast) CPT 70487 | $1,878.84 | $3,070.00 | $1,350.80 – $2,977.90 | 13 |
| Sinus CT scan (without contrast) CPT 70486 | $1,503.07 | $2,456.00 | $1,080.64 – $2,382.32 | 13 |
| Sinus X-ray (complete) CPT 70220 | $312.33 | $435.00 | $191.40 – $421.95 | 13 |
| Sinus X-ray (limited) CPT 70210 | $198.89 | $277.00 | $121.88 – $268.69 | 13 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $94.40 | $154.00 | $67.76 – $149.38 | 13 |
| Skin Biopsy CPT 11102 | $196.31 | $369.00 | $35.64 – $78.57 | 13 |
| Skull X-ray (1 to 3 views) CPT 70250 | $295.10 | $411.00 | $180.84 – $398.67 | 13 |
| Skull X-ray (complete) CPT 70260 | $338.90 | $472.00 | $207.68 – $457.84 | 13 |
| Slco1b1 gene com variants CPT 81328 | $386.92 | $525.00 | $231.00 – $509.25 | 13 |
| Sleep study unattended CPT 95806 | $561.25 | $581.00 | $255.64 – $563.57 | 13 |
| Sling suprapubic suburetheral HCPCS C1771 | $11,944.73 | $17,962.00 | $1,183.60 – $2,609.30 | 13 |
| Slp eval non-spch gen comm dev CPT 92605 | $129.28 | $221.00 | $97.24 – $214.37 | 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.