Emergency visit, high (level 4) at Ogallala Community Hospital. CPT 99284.
What Ogallala Community Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$2,005cash price (self-pay)
$1,005list price
$236–$975range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Banner Health | Banner Choice Plus/Banner Select | $339 |
| Blue Cross Blue Shield of Wyoming | Medicare Advantage | $339 |
| Medica | Medicare Advantage | $339 |
| TriWest Healthcare Alliance Corp - VA CCN | Tricare | $339 |
| United Healthcare | UHC Medicare Advantage | $355 |
| Molina Healthcare | Medicaid/CHIP | $378 |
| Nebraska Total Care | Medicaid | $378 |
| United Healthcare | VA Community Care | $462 |
| United Healthcare | Nebraska Medicaid/CHIP | $492 |
| Keith County Sheriff’s Office | Imate/Detainee Plan | $578 |
| Apostrophe, Inc. | Commercial | $694 |
| United Healthcare | Commercial/Individual Exchange | $732 |
| Medica | Commercial | $735 |
| First Health | Medical Rental | $740 |
| Blue Cross Blue Shield of Wyoming | Network Blue | $740 |
| Coventry | Commercial | $740 |
| Coventry | Workers Comp | $740 |
| Midlands Choice | Commercial | $740 |
| Multiplan | Commercial | $748 |
Inpatient
$2,005cash price (self-pay)
$771list price
$403–$975range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Keith County Sheriff’s Office | Imate/Detainee Plan | $578 |
| Apostrophe, Inc. | Commercial | $694 |
| United Healthcare | Commercial/Individual Exchange | $732 |
| First Health | Medical Rental | $740 |
| Blue Cross Blue Shield of Wyoming | Network Blue | $740 |
| Coventry | Commercial | $740 |
| Coventry | Workers Comp | $740 |
| Midlands Choice | Commercial | $740 |
| Multiplan | Commercial | $748 |
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