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 |
|---|---|---|---|---|
| Culture mycobacteria definitive id each isolate CPT 87118 | $43.97 | $64.00 | $28.16 – $62.08 | 13 |
| Culture mycoplasma any source CPT 87109 | $43.28 | $63.00 | $27.72 – $61.11 | 13 |
| Culture quantitative aerobic other source CPT 87071 | $41.91 | $61.00 | $26.84 – $59.17 | 13 |
| Culture screening strep group a CPT 87081 | $45.34 | $66.00 | $8.80 – $19.40 | 13 |
| Culture typing glc/hplc CPT 87143 | $26.11 | $38.00 | $16.72 – $36.86 | 13 |
| Culture typing immunologic CPT 87147 | $58.40 | $85.00 | $7.04 – $15.52 | 13 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $94.12 | $137.00 | $60.28 – $132.89 | 13 |
| Culture urine each isolate CPT 87088 | $17.18 | $25.00 | $11.00 – $24.25 | 13 |
| Cutter lead HCPCS C1773 | $15,466.63 | $31,759.00 | $498.08 – $1,098.04 | 13 |
| Cv stress test i&r only 93018 CPT 93018 | $21.60 | $31.00 | $13.64 – $30.07 | 13 |
| Cv stress test/supervision only 93016 CPT 93016 | $24.98 | $46.00 | $20.24 – $44.62 | 13 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $40.46 | $66.00 | $29.04 – $64.02 | 13 |
| Cyclic citrullinated peptide antibody CPT 86200 | $46.08 | $60.00 | $26.40 – $58.20 | 13 |
| Cyclosporine 2 hour CPT 80158 | $35.55 | $58.00 | $25.52 – $56.26 | 13 |
| Cyclosporine oral 100 mg HCPCS J7502 | $0.46 | $2.03 | $0.89 – $1.97 | 13 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $43,693.16 | $65,704.00 | $2,149.40 – $4,738.45 | 13 |
| Cyp2c19 gene com variants CPT 81225 | $644.88 | $875.00 | $385.00 – $848.75 | 13 |
| Cyp2c9 gene com variants CPT 81227 | $386.92 | $525.00 | $231.00 – $509.25 | 13 |
| Cyp2d6 gene com variants CPT 81226 | $997.16 | $1,353.00 | $595.32 – $1,312.41 | 13 |
| Cyp3a4 gene common variants CPT 81230 | $386.92 | $525.00 | $231.00 – $509.25 | 13 |
| Cyp3a5 gene common variants CPT 81231 | $386.92 | $525.00 | $231.00 – $509.25 | 13 |
| Cystatin c CPT 82610 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Cystic fibrosis cftr CPT 81223 | $1,103.29 | $1,497.00 | $658.68 – $1,452.09 | 13 |
| Cystine urine quantitative CPT 82131 | $55.78 | $91.00 | $40.04 – $88.27 | 13 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $387.00 | $539.00 | $237.16 – $522.83 | 13 |
| Cystoscopy and treatment CPT 52310 | $229.82 | $432.00 | $190.08 – $419.04 | 13 |
| Cystoscopy (Bladder Scope) CPT 52000 | $534.13 | $1,004.00 | $441.76 – $973.88 | 13 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $862.90 | $1,622.00 | $713.68 – $1,573.34 | 13 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $390.49 | $734.00 | $322.96 – $711.98 | 13 |
| Cytogenetics 25-99 CPT 88274 | $72.32 | $128.00 | $56.32 – $124.16 | 13 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $46.08 | $60.00 | $26.40 – $58.20 | 13 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $46.85 | $61.00 | $26.84 – $59.17 | 13 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $61.02 | $108.00 | $47.52 – $104.76 | 13 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $91.53 | $162.00 | $71.28 – $157.14 | 13 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $34.46 | $61.00 | $26.84 – $59.17 | 13 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $44.63 | $79.00 | $34.76 – $76.63 | 13 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $44.63 | $79.00 | $34.76 – $76.63 | 13 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $61.02 | $108.00 | $47.52 – $104.76 | 13 |
| Cytopath smear other source CPT 88160 | $40.11 | $71.00 | $31.24 – $68.87 | 13 |
| Cytopath smear oth prep screen & interp CPT 88161 | $38.42 | $68.00 | $29.92 – $65.96 | 13 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $257.38 | $474.00 | $208.56 – $459.78 | 13 |
| Dch validity tests CPT 81002 | $7.17 | $11.00 | $3.48 – $10.67 | 13 |
| Deamidated gliadin antibody iga CPT 86258 | $45.31 | $59.00 | $16.28 – $35.89 | 13 |
| Debridement (>20 cm) charge pt CPT 97598 | $67.95 | $107.00 | $23.76 – $52.38 | 13 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $327.71 | $616.00 | $55.88 – $123.19 | 13 |
| Debride nail1-5 11720 CPT 11720 | $38.30 | $72.00 | $13.64 – $30.07 | 13 |
| Debride nail6 or more 11721 CPT 11721 | $59.05 | $111.00 | $48.84 – $107.67 | 13 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | $71.87 | $159.00 | $46.64 – $102.82 | 13 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $312.22 | $575.00 | $253.00 – $557.75 | 13 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $883.12 | $1,660.00 | $730.40 – $1,610.20 | 13 |
| Decalcification CPT 88311 | $16.30 | $26.00 | $11.44 – $25.22 | 13 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $222.91 | $419.00 | $184.36 – $406.43 | 13 |
| Delivery of placenta 59414 CPT 59414 | $1,418.17 | $2,035.00 | $895.40 – $1,973.95 | 13 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $140.93 | $249.00 | $109.56 – $241.53 | 13 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $171.59 | $316.00 | $139.04 – $306.52 | 13 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | $81.36 | $180.00 | $79.20 – $174.60 | 13 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | $111.64 | $247.00 | $108.68 – $239.59 | 13 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | $129.72 | $287.00 | $126.28 – $278.39 | 13 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | $89.50 | $198.00 | $87.12 – $192.06 | 13 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | $98.54 | $218.00 | $95.92 – $211.46 | 13 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | $115.26 | $255.00 | $112.20 – $247.35 | 13 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | $65.54 | $145.00 | $63.80 – $140.65 | 13 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | $81.36 | $180.00 | $79.20 – $174.60 | 13 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | $104.41 | $231.00 | $101.64 – $224.07 | 13 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | $116.16 | $257.00 | $113.08 – $249.29 | 13 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $1,960.95 | $3,686.00 | $451.44 – $1,081.08 | 13 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $588.92 | $1,107.00 | $137.28 – $324.72 | 13 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $50.17 | $111.00 | $35.64 – $78.57 | 13 |
| Destroy vulva lesion simple 56501 CPT 56501 | $117.52 | $260.00 | $114.40 – $252.20 | 13 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $76.39 | $169.00 | $74.36 – $163.93 | 13 |
| Destruction 2-14 lesions 17003 CPT 17003 | $3.72 | $7.00 | $2.20 – $4.85 | 13 |
| Destruction benign lesions < 14 lesions CPT 17110 | $137.26 | $258.00 | $60.72 – $133.86 | 13 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $531.47 | $999.00 | $120.56 – $293.04 | 13 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $1,943.40 | $3,653.00 | $445.28 – $1,071.40 | 13 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | $130.18 | $288.00 | $126.72 – $279.36 | 13 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | $159.56 | $353.00 | $155.32 – $342.41 | 13 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | $123.85 | $274.00 | $120.56 – $265.78 | 13 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | $146.00 | $323.00 | $142.12 – $313.31 | 13 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $91.30 | $202.00 | $88.88 – $195.94 | 13 |
| Device sut capio slim opn HCPCS C2631 | $7,700.70 | $11,580.00 | $1,065.24 – $2,348.37 | 13 |
| Device tiss remov myosure reach HCPCS C1782 | $6,766.86 | $13,895.00 | $1,183.60 – $2,609.30 | 13 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $41.07 | $67.00 | $29.48 – $64.99 | 13 |
| Diabetes (HbA1c) Test CPT 83036 | $18.39 | $30.00 | $13.20 – $29.10 | 13 |
| Diab manage trn ind/group HCPCS G0109 | $28.58 | $38.00 | $16.72 – $36.86 | 13 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $46.16 | $85.00 | $37.40 – $82.45 | 13 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $54.84 | $101.00 | $44.44 – $97.97 | 13 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $155.88 | $293.00 | $60.72 – $133.86 | 13 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $339.39 | $434.00 | $190.96 – $420.98 | 13 |
| Diagnostic Mammogram (one breast) CPT 77065 | $225.22 | $288.00 | $126.72 – $279.36 | 13 |
| Diffusing capacity CPT 94729 | $259.34 | $411.00 | $180.84 – $398.67 | 13 |
| Digoxin total therapeutic drug level CPT 80162 | $32.49 | $53.00 | $23.32 – $51.41 | 13 |
| Dilation of salivary duct CPT 42660 | $82.26 | $182.00 | $80.08 – $176.54 | 13 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,050.46 | $2,157.00 | $110.44 – $243.47 | 13 |
| Disability dlco CPT 94727 | $259.97 | $412.00 | $181.28 – $399.64 | 13 |
| Disaccharidases CPT 82657 | $221.91 | $362.00 | $49.28 – $108.64 | 13 |
| Dna antibody native/double stranded CPT 86225 | $47.62 | $62.00 | $18.48 – $40.74 | 13 |
| Dna gardnerella CPT 87510 | $61.83 | $90.00 | $39.60 – $87.30 | 13 |
| Dna trichomonas CPT 87660 | $41.91 | $61.00 | $26.84 – $59.17 | 13 |
| Doppler echo complete CPT 93320 | $456.29 | $679.00 | $298.76 – $658.63 | 13 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $608.98 | $1,041.00 | $458.04 – $1,009.77 | 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.