Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
IMP RV/AD/RP KN TIB/FM TRIAL LVL 09
Ogallala, NE
See all hospitals reporting HCPCS C1776 →Price type
Banner Ogallala Community Hospital’s median price of $8.1k is 168% above the median hospital's median price ($3.0k), higher than 87% of the 1,609 hospitals reporting HCPCS C1776. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 15 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Bcbs Wy medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $5,503 | $8,532 | $261.36 – $59,745 |
| 2 | Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $5,503 | $8,532 | $261.36 – $59,745 |
| 3 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $5,753 | $8,920 | $273.24 – $62,461 |
| 4 | UnitedHealthcare va community care facility · percent of total billed charges · outpatientfrom % of charges | $5,753 | $8,920 | $273.24 – $62,461 |
| 5 | Molina medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $6,128 | $9,501 | $291.06 – $66,534 |
| 6 | UnitedHealthcare nebraska medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $6,128 | $9,501 | $291.06 – $66,534 |
| 7 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $11,881 | $18,421 | $564.30 – $128,995 |
| 8 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $11,881 | $18,421 | $564.30 – $128,995 |
| 9 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $11,918 | $18,479 | $566.08 – $129,402 |
| 10 | Bcbs Wy network blue facility · percent of total billed charges · inpatientfrom % of charges | $12,006 | $18,615 | $570.24 – $130,353 |
| 11 | Bcbs Wy network blue facility · percent of total billed charges · outpatientfrom % of charges | $12,006 | $18,615 | $570.24 – $130,353 |
| 12 | First Health medical rental facility · percent of total billed charges · inpatientfrom % of charges | $12,006 | $18,615 | $570.24 – $130,353 |
| 13 | First Health medical rental facility · percent of total billed charges · outpatientfrom % of charges | $12,006 | $18,615 | $570.24 – $130,353 |
| 14 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $12,131 | $18,809 | $576.18 – $131,710 |
| 15 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $12,131 | $18,809 | $576.18 – $131,710 |
Last updated: Feb 12, 2026
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