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 |
|---|---|---|---|---|
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $692.00 | $817.00 | $359.48 – $792.49 | 13 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $583.58 | $689.00 | $303.16 – $668.33 | 13 |
| Trauma partial team response w/critical care services level 4 HCPCS G0390 | $2,232.29 | $3,965.00 | $1,161.60 – $2,560.80 | 13 |
| Treat ankle dislocation CPT 27842 | $835.13 | $1,538.00 | $451.00 – $994.25 | 13 |
| Treat elbow dislocation CPT 24605 | $802.01 | $1,477.00 | $433.40 – $955.45 | 13 |
| Treat eyelid lesion 67850 CPT 67850 | $183.96 | $407.00 | $119.24 – $262.87 | 13 |
| Treat finger fracture each CPT 26742 | $377.93 | $696.00 | $306.24 – $675.12 | 13 |
| Treat foot dislocation CPT 28600 | $207.97 | $383.00 | $168.52 – $371.51 | 13 |
| Treat fracture of radius CPT 25505 | $777.03 | $1,431.00 | $419.76 – $925.38 | 13 |
| Treat fracture of ulna CPT 25535 | $766.72 | $1,412.00 | $414.48 – $913.74 | 13 |
| Treat hip dislocation CPT 27252 | $1,283.11 | $2,363.00 | $693.00 – $1,527.75 | 13 |
| Treat hip socket fracture CPT 27222 | $1,653.98 | $3,046.00 | $893.64 – $1,970.07 | 13 |
| Treat humerus fracture CPT 24535 | $961.11 | $1,770.00 | $519.20 – $1,144.60 | 13 |
| Treat kneecap dislocation CPT 27562 | $823.73 | $1,517.00 | $445.28 – $981.64 | 13 |
| Treat knee dislocation CPT 27552 | $1,066.45 | $1,964.00 | $576.40 – $1,270.70 | 13 |
| Treat knee fracture 27530 CPT 27530 | $479.47 | $883.00 | $259.16 – $571.33 | 13 |
| Treat lower leg dislocation CPT 27830 | $604.90 | $1,114.00 | $326.92 – $720.71 | 13 |
| Treat lower leg dislocation CPT 27831 | $684.18 | $1,260.00 | $369.60 – $814.80 | 13 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $344.80 | $635.00 | $279.40 – $615.95 | 13 |
| Treatment of ankle fracture 27786 CPT 27786 | $485.44 | $894.00 | $262.24 – $578.12 | 13 |
| Treatment of fibula fracture 27780 CPT 27780 | $475.13 | $875.00 | $256.96 – $566.48 | 13 |
| Treatment of heel fracture 28400 CPT 28400 | $385.53 | $710.00 | $208.12 – $458.81 | 13 |
| Treatment of thigh fracture CPT 27510 | $1,154.96 | $2,127.00 | $623.92 – $1,375.46 | 13 |
| Treatment of thigh fracture CPT 27514 | $1,645.83 | $3,031.00 | $889.24 – $1,960.37 | 13 |
| Treat midfoot fracture each CPT 28455 | $290.50 | $535.00 | $235.40 – $518.95 | 13 |
| Treat thigh fracture CPT 27230 | $804.73 | $1,482.00 | $434.72 – $958.36 | 13 |
| Treat thigh fx growth plate CPT 27516 | $813.41 | $1,498.00 | $439.56 – $969.03 | 13 |
| Treat ulnar fracture CPT 24675 | $705.36 | $1,299.00 | $381.04 – $840.02 | 13 |
| Treponema pallidum antibody CPT 86780 | $56.83 | $74.00 | $17.60 – $38.80 | 13 |
| Trg gene rearrangement anal CPT 81342 | $445.88 | $605.00 | $266.20 – $586.85 | 13 |
| Trichinella antibody CPT 86784 | $52.99 | $69.00 | $30.36 – $66.93 | 13 |
| #tricyclicantidprssnt CPT 80337 | $53.33 | $87.00 | $38.28 – $84.39 | 13 |
| Triglycerides CPT 84478 | $33.10 | $54.00 | $23.76 – $52.38 | 13 |
| Trim nondyst nails CPT 11719 | $33.52 | $63.00 | $27.72 – $61.11 | 13 |
| Troponin quantitative CPT 84484 | $84.59 | $138.00 | $16.72 – $36.86 | 13 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,083.26 | $1,612.00 | $709.28 – $1,563.64 | 13 |
| Tx closed hip disl traumatic without anes CPT 27250 | $313.85 | $578.00 | $169.40 – $373.45 | 13 |
| Tx closed tib shaft fx without manip CPT 27750 | $539.74 | $994.00 | $291.72 – $643.11 | 13 |
| Tx open nsl fx uncomp CPT 21325 | $488.16 | $899.00 | $395.56 – $872.03 | 13 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $214.49 | $395.00 | $173.80 – $383.15 | 13 |
| Tympanic membrane repair CPT 69610 | $403.64 | $893.00 | $261.80 – $577.15 | 13 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $182.16 | $403.00 | $118.36 – $260.93 | 13 |
| Ugt1a1 gene analy common variants CPT 81350 | $517.37 | $702.00 | $308.88 – $680.94 | 13 |
| Ultrasound breast complete CPT 76641 | $899.51 | $1,062.00 | $311.52 – $686.76 | 13 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $738.58 | $872.00 | $255.64 – $563.57 | 13 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $253.25 | $299.00 | $131.56 – $290.03 | 13 |
| Ultrasound encephalogram CPT 76506 | $439.59 | $519.00 | $228.36 – $503.43 | 13 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $661.51 | $781.00 | $343.64 – $757.57 | 13 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $481.10 | $568.00 | $62.92 – $138.71 | 13 |
| Ultrasound joint complete left CPT 76881 | $769.92 | $909.00 | $399.96 – $881.73 | 13 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $348.96 | $412.00 | $181.28 – $399.64 | 13 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $238.85 | $282.00 | $124.08 – $273.54 | 13 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $528.53 | $624.00 | $274.56 – $605.28 | 13 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $459.92 | $543.00 | $238.92 – $526.71 | 13 |
| Ultrasound prostate/transrectal CPT 76872 | $509.05 | $601.00 | $264.44 – $582.97 | 13 |
| Ultrasound spinal canal and contents CPT 76800 | $344.73 | $407.00 | $179.08 – $394.79 | 13 |
| Unlisted hematology&coagj px CPT 85999 | $34.31 | $57.00 | $25.08 – $55.29 | 13 |
| Unlisted transfusion med px CPT 86999 | $175.00 | $268.00 | $24.49 – $259.96 | 13 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | $307.30 | $428.00 | $188.32 – $415.16 | 13 |
| Upper Back (Thoracic Spine) CT Scan (with contrast) CPT 72129 | $2,512.44 | $3,938.00 | $1,732.72 – $3,819.86 | 13 |
| Upper Back (Thoracic Spine) CT Scan (without contrast) CPT 72128 | $2,009.70 | $3,150.00 | $1,386.00 – $3,055.50 | 13 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $1,716.04 | $2,604.00 | $1,145.76 – $2,525.88 | 13 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $1,430.03 | $2,170.00 | $954.80 – $2,104.90 | 13 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $1,144.02 | $1,736.00 | $763.84 – $1,683.92 | 13 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | $353.97 | $493.00 | $216.92 – $478.21 | 13 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | $366.90 | $511.00 | $224.84 – $495.67 | 13 |
| Upper GI Barium X-ray (barium and gas) CPT 74246 | $634.71 | $884.00 | $388.96 – $857.48 | 13 |
| Upper GI Barium X-ray (barium only) CPT 74240 | $478.19 | $666.00 | $293.04 – $646.02 | 13 |
| Urea nitrogen CPT 84520 | $26.36 | $43.00 | $17.16 – $37.83 | 13 |
| Urea nitrogen 24 hour urine CPT 84540 | $31.88 | $52.00 | $22.88 – $50.44 | 13 |
| Ureteral reflux study CPT 78740 | $537.83 | $843.00 | $370.92 – $817.71 | 13 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $510.50 | $711.00 | $312.84 – $689.67 | 13 |
| Urethrocystography void s&i CPT 74455 | $577.99 | $805.00 | $354.20 – $780.85 | 13 |
| Uric acid blood CPT 84550 | $8.58 | $14.00 | $6.16 – $13.58 | 13 |
| Uric acid urine CPT 84560 | $44.14 | $72.00 | $24.64 – $54.32 | 13 |
| Urinalysis microscopic only CPT 81015 | $6.52 | $10.00 | $3.05 – $9.70 | 13 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $4.56 | $7.00 | $2.17 – $6.79 | 13 |
| Urinalysis (with microscopy) CPT 81001 | $35.86 | $55.00 | $3.17 – $53.35 | 13 |
| Urinalysis (without microscopy) CPT 81003 | $4.56 | $7.00 | $2.25 – $6.79 | 13 |
| Urine Culture Test CPT 87086 | $17.18 | $25.00 | $11.00 – $24.25 | 13 |
| Urine pregnancy test CPT 81025 | $37.82 | $58.00 | $8.61 – $25.22 | 13 |
| Vaccine Administration (one shot) CPT 90471 | $38.34 | $108.00 | $47.52 – $104.76 | 13 |
| Vaccine tdap >=7 years im CPT 90715 | $48.70 | $213.60 | $93.98 – $207.19 | 13 |
| Valproic acid total therapeutic drug level CPT 80164 | $32.49 | $53.00 | $23.32 – $51.41 | 13 |
| Vancomycin peak therapeutic drug level CPT 80202 | $25.13 | $41.00 | $18.04 – $39.77 | 13 |
| Varicella zoster antibody igg CPT 86787 | $29.95 | $39.00 | $17.16 – $37.83 | 13 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $25.37 | $43.00 | $18.92 – $41.71 | 13 |
| Venipuncture <3 yrs other vein CPT 36406 | $23.60 | $40.00 | $17.60 – $38.80 | 13 |
| Ven thrombosis images bilat CPT 78458 | $604.19 | $947.00 | $416.68 – $918.59 | 13 |
| Ventilator each subsequent day CPT 94003 | $555.81 | $982.00 | $432.08 – $952.54 | 13 |
| Ventilator Management (first day) CPT 94002 | $688.82 | $1,217.00 | $535.48 – $1,180.49 | 13 |
| Version cephalic external CPT 59412 | $543.57 | $780.00 | $343.20 – $756.60 | 13 |
| Very long chain fatty acids CPT 82726 | $125.66 | $205.00 | $90.20 – $198.85 | 13 |
| Virus isolation addl studies ea CPT 87253 | $44.66 | $65.00 | $26.84 – $59.17 | 13 |
| Vital capacity test CPT 94150 | $54.90 | $87.00 | $38.28 – $84.39 | 13 |
| Vitamin b-12 CPT 82607 | $33.10 | $54.00 | $23.76 – $52.38 | 13 |
| Vitamin D Test CPT 82306 | $98.69 | $161.00 | $39.16 – $86.33 | 13 |
| Vkorc1 gene CPT 81355 | $195.30 | $265.00 | $116.60 – $257.05 | 13 |
| Volume measurement urine timed CPT 81050 | $7.17 | $11.00 | $3.64 – $10.67 | 13 |
| Walking (Gait) Training (each 15 minutes) CPT 97116 | $53.34 | $84.00 | $36.96 – $81.48 | 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.