MRI lower back without contrast at Ogallala Community Hospital. CPT 72148.
What Ogallala Community Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$1,144cash price (self-pay)
$1,736list price
$764–$1,684range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Banner Health | Banner Choice Plus/Banner Select | $764 |
| Blue Cross Blue Shield of Wyoming | Medicare Advantage | $764 |
| Medica | Medicare Advantage | $764 |
| TriWest Healthcare Alliance Corp - VA CCN | Tricare | $764 |
| United Healthcare | UHC Medicare Advantage | $799 |
| United Healthcare | VA Community Care | $799 |
| Molina Healthcare | Medicaid/CHIP | $851 |
| Nebraska Total Care | Medicaid | $851 |
| United Healthcare | Nebraska Medicaid/CHIP | $851 |
| Keith County Sheriff’s Office | Imate/Detainee Plan | $1,302 |
| Apostrophe, Inc. | Commercial | $1,562 |
| United Healthcare | Commercial/Individual Exchange | $1,649 |
| Medica | Commercial | $1,654 |
| First Health | Medical Rental | $1,667 |
| Blue Cross Blue Shield of Wyoming | Network Blue | $1,667 |
| Coventry | Commercial | $1,667 |
| Coventry | Workers Comp | $1,667 |
| Midlands Choice | Commercial | $1,667 |
| Multiplan | Commercial | $1,684 |
Inpatient
$1,144cash price (self-pay)
$1,736list price
$1,302–$1,684range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Keith County Sheriff’s Office | Imate/Detainee Plan | $1,302 |
| Apostrophe, Inc. | Commercial | $1,562 |
| United Healthcare | Commercial/Individual Exchange | $1,649 |
| First Health | Medical Rental | $1,667 |
| Blue Cross Blue Shield of Wyoming | Network Blue | $1,667 |
| Coventry | Commercial | $1,667 |
| Coventry | Workers Comp | $1,667 |
| Midlands Choice | Commercial | $1,667 |
| Multiplan | Commercial | $1,684 |
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