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 |
|---|---|---|---|---|
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $102.15 | $226.00 | $99.44 – $219.22 | 13 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $145.54 | $322.00 | $141.68 – $312.34 | 13 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $257.64 | $570.00 | $250.80 – $552.90 | 13 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $96.73 | $214.00 | $94.16 – $207.58 | 13 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $166.16 | $306.00 | $134.64 – $296.82 | 13 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $145.54 | $322.00 | $141.68 – $312.34 | 13 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $213.80 | $473.00 | $208.12 – $458.81 | 13 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $122.04 | $270.00 | $118.80 – $261.90 | 13 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $127.01 | $281.00 | $123.64 – $272.57 | 13 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $107.12 | $237.00 | $104.28 – $229.89 | 13 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $278.02 | $512.00 | $225.28 – $496.64 | 13 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | $217.74 | $401.00 | $117.92 – $259.96 | 13 |
| Excision of tongue lesion CPT 41112 | $229.62 | $508.00 | $223.52 – $492.76 | 13 |
| Excision tongue lesion without closure 41110 CPT 41110 | $122.04 | $270.00 | $118.80 – $261.90 | 13 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | $139.01 | $256.00 | $112.64 – $248.32 | 13 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $117.52 | $260.00 | $114.40 – $252.20 | 13 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $170.40 | $377.00 | $165.88 – $365.69 | 13 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | $265.78 | $588.00 | $258.72 – $570.36 | 13 |
| Exc malig feenl >4cm 11646 CPT 11646 | $368.38 | $815.00 | $358.60 – $790.55 | 13 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $114.36 | $253.00 | $111.32 – $245.41 | 13 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | $139.67 | $309.00 | $135.96 – $299.73 | 13 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $197.07 | $436.00 | $191.84 – $422.92 | 13 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $135.75 | $250.00 | $110.00 – $242.50 | 13 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $138.76 | $307.00 | $135.08 – $297.79 | 13 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $151.42 | $335.00 | $147.40 – $324.95 | 13 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $180.80 | $400.00 | $176.00 – $388.00 | 13 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $199.78 | $442.00 | $194.48 – $428.74 | 13 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $209.60 | $386.00 | $169.84 – $374.42 | 13 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $158.65 | $351.00 | $154.44 – $340.47 | 13 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $223.74 | $495.00 | $217.80 – $480.15 | 13 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | $275.72 | $610.00 | $268.40 – $591.70 | 13 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $287.02 | $635.00 | $279.40 – $615.95 | 13 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $126.52 | $233.00 | $102.52 – $226.01 | 13 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $298.77 | $661.00 | $290.84 – $641.17 | 13 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $6,161.23 | $9,265.00 | $1,185.80 – $2,614.15 | 13 |
| Exploration maxillary sinus CPT 31256 | $253.12 | $560.00 | $164.56 – $362.78 | 13 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $392.59 | $723.00 | $318.12 – $701.31 | 13 |
| Explore wound neck 20100 CPT 20100 | $1,027.36 | $1,892.00 | $554.84 – $1,223.17 | 13 |
| External newborn metabolic screening panel HCPCS S3620 | $102.52 | $157.00 | $69.08 – $152.29 | 13 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $244.08 | $432.00 | $190.08 – $419.04 | 13 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $99.84 | $130.00 | $24.20 – $53.35 | 13 |
| Eye Socket (Orbit) X-ray CPT 70200 | $373.36 | $520.00 | $228.80 – $504.40 | 13 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $2,244.82 | $3,668.00 | $1,613.92 – $3,557.96 | 13 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,870.88 | $3,057.00 | $1,345.08 – $2,965.29 | 13 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,496.34 | $2,445.00 | $1,075.80 – $2,371.65 | 13 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $3,111.41 | $4,464.00 | $1,964.16 – $4,330.08 | 13 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $2,074.27 | $2,976.00 | $1,309.44 – $2,886.72 | 13 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $281.46 | $392.00 | $172.48 – $380.24 | 13 |
| Facial Bones X-ray (complete) CPT 70150 | $328.84 | $458.00 | $201.52 – $444.26 | 13 |
| Factor ix CPT 85250 | $47.56 | $79.00 | $33.00 – $72.75 | 13 |
| Factor viii CPT 85240 | $39.73 | $66.00 | $29.04 – $64.02 | 13 |
| Fat/lipids feces qualitative CPT 82705 | $41.68 | $68.00 | $29.92 – $65.96 | 13 |
| Fatty acids nonesterified CPT 82725 | $42.30 | $69.00 | $30.36 – $66.93 | 13 |
| #fecal-sodium CPT 84302 | $35.55 | $58.00 | $25.52 – $56.26 | 13 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $45.36 | $74.00 | $32.56 – $71.78 | 13 |
| Fern test HCPCS Q0114 | $40.46 | $66.00 | $29.04 – $64.02 | 13 |
| Ferritin CPT 82728 | $36.78 | $60.00 | $26.40 – $58.20 | 13 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $718.26 | $848.00 | $373.12 – $822.56 | 13 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $1,678.89 | $2,278.00 | $1,002.32 – $2,209.66 | 13 |
| Fetal fibronectin CPT 82731 | $118.92 | $194.00 | $85.36 – $188.18 | 13 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $35.52 | $59.00 | $25.96 – $57.23 | 13 |
| Fetal hemoglobin rosette CPT 85461 | $17.46 | $29.00 | $12.76 – $28.13 | 13 |
| Fetal non stress test CPT 59025 | $624.04 | $646.00 | $26.84 – $59.17 | 13 |
| #_fet/norfentcnfrmur CPT 80354 | $41.07 | $67.00 | $24.64 – $54.32 | 13 |
| Fibrin degradation d dimer quantitative CPT 85379 | $18.66 | $31.00 | $13.64 – $30.07 | 13 |
| Fibrin degradation products CPT 85362 | $48.16 | $80.00 | $9.24 – $20.37 | 13 |
| Fibrinogen activity CPT 85384 | $18.06 | $30.00 | $13.20 – $29.10 | 13 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $28.29 | $47.00 | $20.68 – $45.59 | 13 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $42.74 | $71.00 | $25.08 – $55.29 | 13 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $7,700.70 | $11,580.00 | $2,578.84 – $5,685.17 | 13 |
| Filter vena cava fem denali HCPCS C1880 | $6,161.23 | $9,265.00 | $1,183.60 – $2,609.30 | 13 |
| Fine needle asp without image guide 10021 CPT 10021 | $52.43 | $116.00 | $51.04 – $112.52 | 13 |
| Finger X-ray (both hands) CPT 73140 | $188.12 | $262.00 | $115.28 – $254.14 | 13 |
| Floor of mouth biopsy 41108 CPT 41108 | $82.26 | $182.00 | $80.08 – $176.54 | 13 |
| Flow cytometry marker each additional CPT 88185 | $71.19 | $126.00 | $52.36 – $115.43 | 13 |
| Flow cytometry one marker technical component CPT 88184 | $405.67 | $718.00 | $315.92 – $696.46 | 13 |
| Flt3 gene CPT 81245 | $366.29 | $497.00 | $218.68 – $482.09 | 13 |
| Flt3 gene analysis CPT 81246 | $183.51 | $249.00 | $109.56 – $241.53 | 13 |
| Fluidotherapy charges pt CPT 97022 | $75.56 | $119.00 | $52.36 – $115.43 | 13 |
| Fluid pressure muscle 20950 CPT 20950 | $547.95 | $963.00 | $81.40 – $179.45 | 13 |
| Fluorescent antibody titer dna CPT 86256 | $642.82 | $837.00 | $16.28 – $35.89 | 13 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $66.55 | $135.00 | $59.40 – $130.95 | 12 |
| Fluoroguide needle placement CPT 77002 | $484.65 | $675.00 | $297.00 – $654.75 | 13 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $538.50 | $750.00 | $330.00 – $727.50 | 13 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $8.50 | $37.30 | $16.41 – $36.18 | 13 |
| Folic acid CPT 82746 | $27.59 | $45.00 | $19.80 – $43.65 | 13 |
| Foot X-ray CPT 73630 | $318.79 | $444.00 | $195.36 – $430.68 | 13 |
| Foot X-ray (2 views, both feet) CPT 73620 | $222.58 | $310.00 | $136.40 – $300.70 | 13 |
| Forearm X-ray (both sides) CPT 73090 | $231.20 | $322.00 | $141.68 – $312.34 | 13 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $52.92 | $93.00 | $40.92 – $90.21 | 13 |
| Fresh frozen plasma thawing ea un CPT 86927 | $224.63 | $344.00 | $151.36 – $333.68 | 13 |
| Fructosamine glycated protein CPT 82985 | $32.49 | $53.00 | $23.32 – $51.41 | 13 |
| Ftl cgen abnor two proteins CPT 81508 | $191.62 | $260.00 | $114.40 – $252.20 | 13 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $357.56 | $498.00 | $219.12 – $483.06 | 13 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $891.61 | $1,642.00 | $722.48 – $1,592.74 | 13 |
| Gabapentin non-blood CPT 80355 | $34.33 | $56.00 | $24.64 – $54.32 | 13 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $106.05 | $173.00 | $76.12 – $167.81 | 13 |
| Galactose transferase test CPT 82776 | $22.07 | $36.00 | $15.84 – $34.92 | 13 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,207.10 | $1,892.00 | $832.48 – $1,835.24 | 13 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,653.06 | $2,591.00 | $1,140.04 – $2,513.27 | 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.