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 |
|---|---|---|---|---|
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $396.04 | $677.00 | $198.44 – $437.47 | 13 |
| Dornhoffer fixed part w/window HCPCS L8614 | $145,637.66 | $219,004.00 | $22,162.80 – $48,858.90 | 13 |
| Dpyd gene common variants CPT 81232 | $386.92 | $525.00 | $231.00 – $509.25 | 13 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $139.55 | $257.00 | $113.08 – $249.29 | 13 |
| Drainage external ear complex 69005 CPT 69005 | $220.58 | $488.00 | $143.00 – $315.25 | 13 |
| Drainage external ear simple 69000 CPT 69000 | $204.17 | $376.00 | $110.44 – $243.47 | 13 |
| Drainage mouth roof lesion CPT 42000 | $117.29 | $216.00 | $95.04 – $209.52 | 13 |
| Drainage of arm bursa 23931 CPT 23931 | $262.81 | $484.00 | $142.12 – $313.31 | 13 |
| Drainage of nose lesion int 30000 CPT 30000 | $110.29 | $244.00 | $107.36 – $236.68 | 13 |
| Drainage of nose lesion sept 30020 CPT 30020 | $111.19 | $246.00 | $108.24 – $238.62 | 13 |
| Drain blood from under nail 11740 CPT 11740 | $35.30 | $65.00 | $28.60 – $63.05 | 13 |
| Drain finger abscess;simple 26010 CPT 26010 | $155.84 | $287.00 | $126.28 – $278.39 | 13 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $124.89 | $230.00 | $101.20 – $223.10 | 13 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $61.36 | $113.00 | $49.72 – $109.61 | 13 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $150.95 | $278.00 | $122.32 – $269.66 | 13 |
| Drng of eyelid abscess 67700 CPT 67700 | $193.31 | $356.00 | $104.28 – $229.89 | 13 |
| Drng of scrotum abscess 55100 CPT 55100 | $188.42 | $347.00 | $152.68 – $336.59 | 13 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $6,161.23 | $9,265.00 | $374.00 – $824.50 | 13 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $280.63 | $422.00 | $185.68 – $409.34 | 13 |
| Drug assay caffeine CPT 80155 | $71.11 | $116.00 | $51.04 – $112.52 | 13 |
| Drug assay posaconazole CPT 80187 | $72.33 | $118.00 | $51.92 – $114.46 | 13 |
| Drug assay vedolizumab CPT 80280 | $194.32 | $317.00 | $139.48 – $307.49 | 13 |
| Drug assay voriconazole CPT 80285 | $77.85 | $127.00 | $55.88 – $123.19 | 13 |
| Drug of abuse screen urine CPT 80305 | $23.29 | $38.00 | $16.72 – $36.86 | 13 |
| Drug screening tapentadol CPT 80372 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Drug test prsmv instrmnt CPT 80306 | $31.88 | $52.00 | $22.88 – $50.44 | 13 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $275.24 | $449.00 | $82.28 – $181.39 | 13 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | $191.20 | $423.00 | $186.12 – $410.31 | 13 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | $162.27 | $359.00 | $157.96 – $348.23 | 13 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | $189.39 | $419.00 | $184.36 – $406.43 | 13 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | $256.74 | $568.00 | $249.92 – $550.96 | 13 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $502.52 | $859.00 | $377.96 – $833.23 | 13 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $751.72 | $1,285.00 | $565.40 – $1,246.45 | 13 |
| Ear canal biopsy 69105 CPT 69105 | $87.24 | $193.00 | $56.76 – $125.13 | 13 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $108.40 | $174.00 | $76.56 – $168.78 | 13 |
| Ecg external < 48 hours recording CPT 93225 | $278.88 | $420.00 | $184.80 – $407.40 | 13 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $359.89 | $542.00 | $238.48 – $525.74 | 13 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $270.91 | $408.00 | $179.52 – $395.76 | 13 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,989.12 | $2,960.00 | $1,302.40 – $2,871.20 | 13 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $449.57 | $669.00 | $294.36 – $648.93 | 13 |
| Echocardiography doppler color flow mapping CPT 93325 | $360.19 | $536.00 | $235.84 – $519.92 | 13 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,486.40 | $3,700.00 | $1,628.00 – $3,589.00 | 13 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $562.46 | $837.00 | $368.28 – $811.89 | 13 |
| Echo exam of fetal heart CPT 76825 | $914.76 | $1,080.00 | $475.20 – $1,047.60 | 13 |
| Echo exam of fetal heart CPT 76826 | $420.96 | $497.00 | $218.68 – $482.09 | 13 |
| Echo exam of fetal heart CPT 76827 | $431.97 | $510.00 | $224.40 – $494.70 | 13 |
| Echo guide for amniocentesis CPT 76946 | $426.04 | $503.00 | $221.32 – $487.91 | 13 |
| Echo stress CPT 93350 | $866.21 | $1,289.00 | $567.16 – $1,250.33 | 13 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,303.01 | $1,939.00 | $853.16 – $1,880.83 | 13 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $633.02 | $942.00 | $414.48 – $913.74 | 13 |
| E equine encephalitis igg CPT 86652 | $49.92 | $65.00 | $28.60 – $63.05 | 13 |
| Egfr gene com variants CPT 81235 | $717.84 | $974.00 | $428.56 – $944.78 | 13 |
| EKG (Tracing Only) CPT 93005 | $205.59 | $330.00 | $103.00 – $320.10 | 13 |
| Elbow X-ray (2 views, both sides) CPT 73070 | $280.02 | $390.00 | $171.60 – $378.30 | 13 |
| Elbow X-ray (3 or more views, both sides) CPT 73080 | $345.36 | $481.00 | $211.64 – $466.57 | 13 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | $289.94 | $545.00 | $72.16 – $239.80 | 13 |
| Elect analysis of infusion pump 62367 CPT 62367 | $240.46 | $452.00 | $198.88 – $438.44 | 13 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | $269.19 | $506.00 | $72.16 – $222.64 | 13 |
| Electrd sq emblem s-icd HCPCS C1896 | $7,700.70 | $11,580.00 | $3,058.00 – $6,741.50 | 13 |
| Electrical Stimulation Therapy (each 15 minutes) CPT 97032 | $87.00 | $137.00 | $60.28 – $132.89 | 13 |
| Electrical stimulation/unattended 97014 CPT 97014 | $69.85 | $110.00 | $48.40 – $106.70 | 13 |
| Electrolyte panel CPT 80051 | $47.81 | $78.00 | $34.32 – $75.66 | 13 |
| Electron microscopy diagnostic CPT 88348 | $1,011.98 | $1,614.00 | $439.28 – $1,565.58 | 13 |
| Electrophysiologic study CPT 93624 | $3,580.06 | $6,581.00 | $2,895.64 – $6,383.57 | 13 |
| Electrophysiology evaluation CPT 93642 | $3,059.46 | $5,624.00 | $2,474.56 – $5,455.28 | 13 |
| Emb without cervical dilation 58100 CPT 58100 | $161.20 | $303.00 | $133.32 – $293.91 | 13 |
| Encephalitis, california igg/igm CPT 86651 | $49.92 | $65.00 | $28.60 – $63.05 | 13 |
| Encephalitis, st louis igg/igm CPT 86653 | $49.92 | $65.00 | $28.60 – $63.05 | 13 |
| Encephalitis, western equine igg/igm CPT 86654 | $49.92 | $65.00 | $28.60 – $63.05 | 13 |
| Ep induct arrhy by elect pacing CPT 93618 | $1,002.59 | $1,843.00 | $810.92 – $1,787.71 | 13 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $18.54 | $26.60 | $0.37 – $0.81 | 13 |
| Epstein barr early antigen antibody CPT 86663 | $42.24 | $55.00 | $24.20 – $53.35 | 13 |
| Epstein barr nuclear antigen antibody CPT 86664 | $41.47 | $54.00 | $20.24 – $44.62 | 13 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $47.62 | $62.00 | $24.20 – $53.35 | 13 |
| ER Visit (level 1, minor) CPT 99281 | $293.00 | $190.00 | $44.88 – $98.94 | 13 |
| ER Visit (level 2) CPT 99282 | $373.72 | $350.00 | $86.24 – $190.12 | 13 |
| ER Visit (level 3) CPT 99283 | $894.62 | $615.00 | $128.92 – $284.21 | 13 |
| ER Visit (level 4) CPT 99284 | $2,004.83 | $1,005.00 | $236.28 – $520.89 | 13 |
| ER Visit (level 5, high severity) CPT 99285 | $3,172.59 | $1,460.00 | $343.20 – $756.60 | 13 |
| Esophageal motility CPT 78258 | $630.98 | $989.00 | $435.16 – $959.33 | 13 |
| Established Patient Office Visit (level 1) CPT 99211 | $73.95 | $150.00 | $46.20 – $101.85 | 13 |
| Established Patient Office Visit (level 2) CPT 99212 | $160.46 | $284.00 | $79.20 – $174.60 | 13 |
| Established Patient Office Visit (level 3) CPT 99213 | $314.70 | $557.00 | $94.60 – $208.55 | 13 |
| Established Patient Office Visit (level 4) CPT 99214 | $483.64 | $856.00 | $111.32 – $245.41 | 13 |
| Established Patient Office Visit (level 5) CPT 99215 | $682.52 | $1,208.00 | $156.20 – $344.35 | 13 |
| Estradiol total CPT 82670 | $51.49 | $84.00 | $36.96 – $81.48 | 13 |
| Estrogens total-sendout CPT 82672 | $40.46 | $66.00 | $29.04 – $64.02 | 13 |
| Ethylene glycol -sendout CPT 82693 | $49.65 | $81.00 | $35.64 – $78.57 | 13 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $222.30 | $380.00 | $167.20 – $368.60 | 13 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $180.84 | $295.00 | $129.80 – $286.15 | 13 |
| Evaluation of speech fluency 92521 CPT 92521 | $284.42 | $335.00 | $147.40 – $324.95 | 13 |
| Event monitor CPT 93270 | $272.24 | $410.00 | $180.40 – $397.70 | 13 |
| Evoked oa emissions ltd CPT 92587 | $167.95 | $241.00 | $106.04 – $233.77 | 13 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $211.99 | $469.00 | $206.36 – $454.93 | 13 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | $302.39 | $669.00 | $294.36 – $648.93 | 13 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $166.79 | $369.00 | $162.36 – $357.93 | 13 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $91.77 | $169.00 | $74.36 – $163.93 | 13 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $96.28 | $213.00 | $93.72 – $206.61 | 13 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $135.15 | $299.00 | $131.56 – $290.03 | 13 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $165.88 | $367.00 | $161.48 – $355.99 | 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.