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 |
|---|---|---|---|---|
| Cmv pcr-sendout CPT 87496 | $72.82 | $106.00 | $46.64 – $102.82 | 13 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $0.72 | $1.13 | $0.50 – $1.10 | 13 |
| Coil axium 3d 14mmx40cm qc HCPCS C1770 | $289.28 | $594.00 | $137.72 – $303.61 | 13 |
| Cold agglutinin titer CPT 86157 | $44.54 | $58.00 | $25.52 – $56.26 | 13 |
| Collagen imp urinary 2.5 ml HCPCS L8603 | $13,401.08 | $20,152.00 | $8,866.88 – $19,547.44 | 13 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $254.17 | $354.00 | $155.76 – $343.38 | 13 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $162.26 | $305.00 | $134.20 – $295.85 | 13 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $114.91 | $216.00 | $95.04 – $209.52 | 13 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $161.20 | $303.00 | $133.32 – $293.91 | 13 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $224.63 | $344.00 | $151.36 – $333.68 | 13 |
| Compatibility test each unit electronic CPT 86923 | $224.63 | $344.00 | $151.36 – $333.68 | 13 |
| Compatibility test each unit immediate spin technique CPT 86920 | $224.63 | $344.00 | $151.36 – $333.68 | 13 |
| Complement antigen each component c3 CPT 86160 | $224.26 | $292.00 | $15.84 – $34.92 | 13 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $262.27 | $483.00 | $212.52 – $468.51 | 13 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $280.19 | $516.00 | $227.04 – $500.52 | 13 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $317.11 | $584.00 | $256.96 – $566.48 | 13 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $382.27 | $704.00 | $309.76 – $682.88 | 13 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $158.01 | $291.00 | $128.04 – $282.27 | 13 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $276.39 | $509.00 | $223.96 – $493.73 | 13 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $345.35 | $636.00 | $279.84 – $616.92 | 13 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $144.98 | $267.00 | $117.48 – $258.99 | 13 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $95.03 | $175.00 | $77.00 – $169.75 | 13 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $228.06 | $420.00 | $184.80 – $407.40 | 13 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $82.54 | $152.00 | $66.88 – $147.44 | 13 |
| Concentration infection agents any type CPT 87015 | $87.94 | $128.00 | $9.24 – $20.37 | 13 |
| Condylomata destruction 56420 CPT 56420 | $116.75 | $215.00 | $94.60 – $208.55 | 13 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $569.00 | $898.90 | $395.52 – $871.93 | 13 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $911.91 | $1,614.00 | $710.16 – $1,565.58 | 13 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $41.38 | $66.00 | $29.04 – $64.02 | 13 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $215.69 | $344.00 | $92.18 – $333.68 | 13 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $67.72 | $108.00 | $47.52 – $104.76 | 13 |
| Contrast baths charges CPT 97034 | $38.74 | $61.00 | $26.84 – $59.17 | 13 |
| Contrast x-ray gallbladder CPT 74290 | $317.36 | $442.00 | $194.48 – $428.74 | 13 |
| Contrast x-ray of hip CPT 73525 | $673.89 | $967.00 | $425.48 – $937.99 | 13 |
| Controller infinity pt dbs HCPCS C1787 | $9,240.18 | $13,895.00 | $2,149.40 – $4,738.45 | 13 |
| Control nosebleed pack+caut 30905 CPT 30905 | $120.55 | $222.00 | $97.68 – $215.34 | 13 |
| Control of nosebleed ant comp 30903 CPT 30903 | $134.12 | $247.00 | $72.60 – $160.05 | 13 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $96.65 | $178.00 | $52.36 – $115.43 | 13 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $185.71 | $342.00 | $150.48 – $331.74 | 13 |
| Coombs direct CPT 86880 | $92.16 | $120.00 | $52.80 – $116.40 | 13 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $264.19 | $344.00 | $151.36 – $333.68 | 13 |
| Cortisol total am CPT 82533 | $198.00 | $323.00 | $25.52 – $56.26 | 13 |
| Co-treatment - group 15 mins, st CPT 92508 | $52.27 | $75.00 | $33.00 – $72.75 | 13 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $5,083.26 | $7,644.00 | $73.04 – $161.02 | 13 |
| #covid19rsv-rsv CPT 87634 | $144.96 | $211.00 | $92.84 – $204.67 | 13 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $40.70 | $53.00 | $17.60 – $38.80 | 13 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $500.91 | $885.00 | $389.40 – $858.45 | 13 |
| C-peptide CPT 84681 | $38.62 | $63.00 | $27.72 – $61.11 | 13 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $494.46 | $869.00 | $374.88 – $826.44 | 13 |
| Cptr ophth dx img post segmt CPT 92134 | $79.80 | $150.00 | $66.00 – $145.50 | 13 |
| Cptrz oph img pst sg rta oct CPT 92137 | $250.04 | $470.00 | $206.80 – $455.90 | 13 |
| Crbrospnl fld flw imag cistern CPT 78630 | $749.65 | $1,175.00 | $517.00 – $1,139.75 | 13 |
| C-reactive protein CPT 86140 | $55.30 | $72.00 | $31.68 – $69.84 | 13 |
| C-reactive protein high sensitivity CPT 86141 | $100.61 | $131.00 | $25.08 – $55.29 | 13 |
| C-reactive protein, quantitative CPT 86406 | $62.21 | $81.00 | $25.96 – $57.23 | 13 |
| Create eardrum opening CPT 69436 | $219.67 | $486.00 | $142.56 – $314.28 | 13 |
| Creatine kinase CPT 82550 | $12.26 | $20.00 | $8.80 – $19.40 | 13 |
| Creatine kinase isoenzymes CPT 82552 | $36.17 | $59.00 | $25.96 – $57.23 | 13 |
| Creatine kinase mb CPT 82553 | $21.45 | $35.00 | $15.40 – $33.95 | 13 |
| Creatine - sendout CPT 82540 | $36.78 | $60.00 | $26.40 – $58.20 | 13 |
| Creatinine CPT 82565 | $34.33 | $56.00 | $19.80 – $43.65 | 13 |
| Creatinine 24 hour urine CPT 82570 | $49.04 | $80.00 | $7.04 – $15.52 | 13 |
| Creatinine clearance urine CPT 82575 | $17.78 | $29.00 | $12.76 – $28.13 | 13 |
| #creutz-prot.,western blot CPT 84182 | $95.02 | $155.00 | $38.72 – $85.36 | 13 |
| Critical care each additional 30 minutes CPT 99292 | $546.24 | $960.00 | $220.88 – $486.94 | 13 |
| Critical Care (first 30 to 74 minutes) CPT 99291 | $1,092.48 | $1,920.00 | $439.12 – $968.06 | 13 |
| Cryoprecipitate each unit HCPCS P9012 | $50.64 | $89.00 | $39.16 – $86.33 | 13 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | $102.15 | $226.00 | $99.44 – $219.22 | 13 |
| Cryptosporidium antigen CPT 87272 | $76.26 | $111.00 | $48.84 – $107.67 | 13 |
| Crystal identification light microscopy CPT 89060 | $14.37 | $22.00 | $7.33 – $21.34 | 13 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,647.32 | $2,582.00 | $1,136.08 – $2,504.54 | 13 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $2,134.75 | $3,346.00 | $1,472.24 – $3,245.62 | 13 |
| CT Angiogram of the Abdomen CPT 74175 | $1,370.42 | $2,148.00 | $945.12 – $2,083.56 | 13 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $2,105.84 | $2,987.00 | $1,314.28 – $2,897.39 | 13 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,526.73 | $2,393.00 | $1,052.92 – $2,321.21 | 13 |
| CT Angiogram of the Head CPT 70496 | $1,445.54 | $2,362.00 | $1,039.28 – $2,291.14 | 13 |
| CT Angiogram of the Neck CPT 70498 | $1,588.14 | $2,595.00 | $1,141.80 – $2,517.15 | 13 |
| CT angio pelvis CPT 72191 | $2,997.96 | $4,699.00 | $2,067.56 – $4,558.03 | 13 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,275.11 | $3,566.00 | $1,569.04 – $3,459.02 | 13 |
| CT bone density axial CPT 77078 | $414.70 | $650.00 | $286.00 – $630.50 | 13 |
| CT guidance for needle placement CPT 77012 | $957.39 | $1,358.00 | $597.52 – $1,317.26 | 13 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $857.98 | $1,217.00 | $535.48 – $1,180.49 | 13 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $117.03 | $166.00 | $73.04 – $161.02 | 13 |
| CT limited or localized follow-up study CPT 76380 | $700.06 | $993.00 | $436.92 – $963.21 | 13 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,568.84 | $2,459.00 | $1,081.96 – $2,385.23 | 13 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $153.67 | $283.00 | $124.52 – $274.51 | 13 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $2,032.67 | $3,186.00 | $1,401.84 – $3,090.42 | 13 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,693.89 | $2,655.00 | $1,168.20 – $2,575.35 | 13 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $1,355.11 | $2,124.00 | $934.56 – $2,060.28 | 13 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,166.65 | $3,396.00 | $1,494.24 – $3,294.12 | 13 |
| Culture aerobic additional method definitive id each CPT 87077 | $70.76 | $103.00 | $11.00 – $24.25 | 13 |
| Culture afb any source CPT 87116 | $43.28 | $63.00 | $27.72 – $61.11 | 13 |
| Culture anaerobic additional method definitive id each CPT 87076 | $81.07 | $118.00 | $11.00 – $24.25 | 13 |
| Culture anaerobic except blood CPT 87075 | $19.92 | $29.00 | $12.76 – $28.13 | 13 |
| Culture bact stool aero addl path ea CPT 87046 | $43.28 | $63.00 | $12.76 – $28.13 | 13 |
| Culture body fluid CPT 87070 | $76.94 | $112.00 | $11.44 – $25.22 | 13 |
| Culture fungi definitive id mold CPT 87107 | $94.81 | $138.00 | $27.28 – $60.14 | 13 |
| Culture fungi definitive id yeast CPT 87106 | $42.59 | $62.00 | $27.28 – $60.14 | 13 |
| Culture fungi other (except blood) CPT 87102 | $60.46 | $88.00 | $26.40 – $58.20 | 13 |
| Culture fungi skin/hair/nail CPT 87101 | $40.53 | $59.00 | $25.96 – $57.23 | 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.