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 |
|---|---|---|---|---|
| Antistreptolysin o titer CPT 86060 | $43.78 | $57.00 | $25.08 – $55.29 | 13 |
| Antithrombin iii activity CPT 85300 | $37.93 | $63.00 | $24.64 – $54.32 | 13 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $325.25 | $384.00 | $168.96 – $372.48 | 13 |
| Application finger splntstatic 29130 CPT 29130 | $50.50 | $93.00 | $27.28 – $60.14 | 13 |
| Application long leg splint 29505 CPT 29505 | $85.25 | $157.00 | $46.20 – $101.85 | 13 |
| Application lower leg splint 29515 CPT 29515 | $83.62 | $154.00 | $45.32 – $99.91 | 13 |
| Application multi layer compression below knee (both sides) CPT 29581 | $226.70 | $357.00 | $104.72 – $230.86 | 13 |
| Application of forearm cast 29075 CPT 29075 | $103.71 | $191.00 | $56.32 – $124.16 | 13 |
| Application of long arm cast 29065 CPT 29065 | $115.12 | $212.00 | $62.04 – $136.77 | 13 |
| Application of long leg cast CPT 29355 | $180.82 | $333.00 | $97.68 – $215.34 | 13 |
| Application of long leg cast 29345 CPT 29345 | $168.87 | $311.00 | $91.52 – $201.76 | 13 |
| Application of paste boot 29580 CPT 29580 | $224.16 | $353.00 | $25.52 – $56.26 | 13 |
| Application short leg cast 29405 CPT 29405 | $99.37 | $183.00 | $53.68 – $118.34 | 13 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $41.27 | $65.00 | $28.60 – $63.05 | 13 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $68.58 | $108.00 | $47.52 – $104.76 | 13 |
| Appl modality 1+lllt po pain CPT 97037 | $54.61 | $86.00 | $37.84 – $83.42 | 13 |
| Appl patllr tdn bearing cast CPT 29435 | $138.46 | $255.00 | $74.80 – $164.90 | 13 |
| Apply hand/wrist cast 29085 CPT 29085 | $112.94 | $208.00 | $61.16 – $134.83 | 13 |
| Apply of finger splint 29131 CPT 29131 | $58.10 | $107.00 | $31.24 – $68.87 | 13 |
| Apply rigid leg cast 29445 CPT 29445 | $763.90 | $1,203.00 | $352.88 – $777.94 | 13 |
| Apply short leg castambul type 29425 CPT 29425 | $93.94 | $173.00 | $50.60 – $111.55 | 13 |
| #aptt mix-1:1 incubated CPT 87532 | $82.44 | $120.00 | $52.80 – $116.40 | 13 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $90.62 | $118.00 | $51.92 – $114.46 | 13 |
| Aquaporin-4 antibody cba each CPT 86052 | $268.80 | $350.00 | $99.00 – $218.25 | 13 |
| Aquaporin-4 antibody elisa CPT 86051 | $205.82 | $268.00 | $117.92 – $259.96 | 13 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $69.85 | $110.00 | $48.40 – $106.70 | 13 |
| Aquatic exercise - group charge CPT 97150 | $50.87 | $73.00 | $32.12 – $70.81 | 13 |
| Arm CT Scan (with contrast, both arms) CPT 73201 | $1,805.54 | $2,830.00 | $1,245.20 – $2,745.10 | 13 |
| Arm CT Scan (without contrast, both arms) CPT 73200 | $1,444.43 | $2,264.00 | $996.16 – $2,196.08 | 13 |
| Arm or Leg Ultrasound (limited, left side) CPT 76882 | $496.34 | $586.00 | $257.84 – $568.42 | 13 |
| Arterial blood draw/perc 36620 CPT 36620 | $146.23 | $257.00 | $89.76 – $197.88 | 13 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $416.56 | $783.00 | $75.68 – $166.84 | 13 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $404.85 | $761.00 | $73.04 – $161.02 | 13 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $526.15 | $989.00 | $289.96 – $639.23 | 13 |
| Ascenda two piece catheter HCPCS C1772 | $34,081.25 | $51,250.00 | $2,686.20 – $5,921.85 | 13 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $165.07 | $304.00 | $133.76 – $294.88 | 13 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $169.18 | $318.00 | $83.16 – $183.33 | 13 |
| Aspirate pleura without imaging 32554 CPT 32554 | $152.58 | $281.00 | $82.28 – $181.39 | 13 |
| Assay acid phosphatase CPT 84060 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| Assay dir meas fr estradiol CPT 82681 | $51.49 | $84.00 | $36.96 – $81.48 | 13 |
| Assay free hydroxyproline CPT 83500 | $68.66 | $112.00 | $49.28 – $108.64 | 13 |
| Assay of breath ethanol CPT 82075 | $55.17 | $90.00 | $39.60 – $87.30 | 13 |
| Assay of corticosterone CPT 82528 | $50.88 | $83.00 | $36.52 – $80.51 | 13 |
| Assay of digoxin free CPT 80163 | $24.52 | $40.00 | $17.60 – $38.80 | 13 |
| Assay of glutathione CPT 82978 | $52.10 | $85.00 | $37.40 – $82.45 | 13 |
| Assay of interleukin-6 (il-6) CPT 83529 | $66.82 | $109.00 | $47.96 – $105.73 | 13 |
| Assay of neonatal thyroxine CPT 84437 | $12.26 | $20.00 | $8.80 – $19.40 | 13 |
| Assay of osteocalcin CPT 83937 | $55.17 | $90.00 | $39.60 – $87.30 | 13 |
| Assay of prostaglandin CPT 84150 | $171.64 | $280.00 | $123.20 – $271.60 | 13 |
| Assay of somatostatin CPT 84307 | $50.27 | $82.00 | $36.08 – $79.54 | 13 |
| Assay of thiocyanate CPT 84430 | $21.45 | $35.00 | $15.40 – $33.95 | 13 |
| Assay of urine sulfate CPT 84392 | $44.14 | $72.00 | $7.48 – $16.49 | 13 |
| Assay toxin or antitoxin CPT 87230 | $54.27 | $79.00 | $34.76 – $76.63 | 13 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $245.36 | $289.00 | $127.16 – $280.33 | 13 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $8.49 | $13.00 | $4.27 – $12.61 | 13 |
| Ast/sgot CPT 84450 | $46.59 | $76.00 | $22.00 – $48.50 | 13 |
| Avul nail plate addl CPT 11732 | $20.09 | $37.00 | $16.28 – $35.89 | 13 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $64.37 | $121.00 | $50.16 – $110.58 | 13 |
| Baclofen eval charges CPT 97750 | $59.06 | $93.00 | $40.92 – $90.21 | 13 |
| Bacterial meningitis antigen CPT 86403 | $56.83 | $74.00 | $23.32 – $51.41 | 13 |
| Bacterial vaginosis pcr CPT 87801 | $942.56 | $1,372.00 | $92.84 – $204.67 | 13 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $91.44 | $144.00 | $63.36 – $139.68 | 13 |
| Barium Enema (Colon X-ray, barium and air) CPT 74280 | $727.33 | $1,013.00 | $445.72 – $982.61 | 13 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | $313.77 | $437.00 | $192.28 – $423.89 | 13 |
| B cells total count CPT 86355 | $87.55 | $114.00 | $50.16 – $110.58 | 13 |
| Benign lesion paring 2-4 CPT 11056 | $89.38 | $168.00 | $73.92 – $162.96 | 13 |
| #_benzodiazconfur CPT 80346 | $51.49 | $84.00 | $24.64 – $54.32 | 13 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $59.14 | $77.00 | $33.88 – $74.69 | 13 |
| Beta-2 microglobulin CPT 82232 | $35.55 | $58.00 | $25.52 – $56.26 | 13 |
| Beta-amyloid 1-40 CPT 82233 | $183.90 | $300.00 | $132.00 – $291.00 | 13 |
| Beta-amyloid 1-42 CPT 82234 | $276.46 | $451.00 | $198.44 – $437.47 | 13 |
| Bilateral n block inj occipital 64405 CPT 64405 | $424.00 | $797.00 | $108.68 – $239.59 | 13 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $448.37 | $788.00 | $100.76 – $222.13 | 13 |
| Bilicheck CPT 88720 | $9.81 | $16.00 | $7.04 – $15.52 | 13 |
| Bilirubin direct CPT 82248 | $25.13 | $41.00 | $18.04 – $39.77 | 13 |
| Bilirubin total CPT 82247 | $35.55 | $58.00 | $20.68 – $45.59 | 13 |
| Biopsy abdominal mass CPT 49180 | $616.96 | $1,229.00 | $540.76 – $1,192.13 | 13 |
| Biopsy external ear 69100 CPT 69100 | $44.75 | $99.00 | $43.56 – $96.03 | 13 |
| Biopsy eyelid & lid margin CPT 67810 | $98.08 | $217.00 | $63.80 – $140.65 | 13 |
| Biopsy of lip 40490 CPT 40490 | $66.44 | $147.00 | $64.68 – $142.59 | 13 |
| Biopsy of penis 54100 CPT 54100 | $114.36 | $253.00 | $111.32 – $245.41 | 13 |
| Biopsy of salivary gland 42400 CPT 42400 | $50.62 | $112.00 | $49.28 – $108.64 | 13 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,718.35 | $3,423.00 | $1,004.08 – $2,213.54 | 13 |
| Biopsy roof of mouth CPT 42100 | $100.80 | $223.00 | $98.12 – $216.31 | 13 |
| Biopsy skin incisional single lesion CPT 11106 | $298.98 | $562.00 | $53.68 – $118.34 | 13 |
| Biopsy tongue anterior two-thirds CPT 41100 | $98.54 | $218.00 | $95.92 – $211.46 | 13 |
| Biopsy vestibule of mouth 40808 CPT 40808 | $80.91 | $179.00 | $78.76 – $173.63 | 13 |
| Biotinidase - quest CPT 82261 | $68.66 | $112.00 | $49.28 – $108.64 | 13 |
| Bladder Catheter Insertion (simple) CPT 51702 | $159.89 | $281.00 | $23.76 – $52.38 | 13 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $203.70 | $358.00 | $157.52 – $347.26 | 13 |
| Bld prd mix CPT 86965 | $195.74 | $344.00 | $151.36 – $333.68 | 13 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $6,315.90 | $12,969.00 | $374.00 – $824.50 | 13 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $4,512.06 | $9,265.00 | $621.72 – $1,370.61 | 13 |
| Bln press regulation 71-80cm HCPCS C1815 | $16,896.32 | $25,408.00 | $5,095.20 – $11,232.60 | 13 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $23,304.26 | $35,044.00 | $196.68 – $433.59 | 13 |
| Block plantar digital nerve CPT 64455 | $338.35 | $636.00 | $69.96 – $186.56 | 13 |
| Blood Clotting (PT/INR) Test CPT 85610 | $30.70 | $51.00 | $5.72 – $12.61 | 13 |
| Blood Clotting (PTT) Test CPT 85730 | $32.51 | $54.00 | $8.36 – $18.43 | 13 |
| Blood Count (CBC) Test CPT 85025 | $39.13 | $65.00 | $10.56 – $23.28 | 13 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $32.51 | $54.00 | $23.76 – $52.38 | 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.