Ness County Hospital

All Charges

Charge

Type

Setting

Price

0-10 ROUND TRIP MILES OF NC

Facility

$6.00

Hospital Charge Code	5710846
Hospital Revenue Code	990
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$4.50
Rate for Payer: Celtic Commercial/Exchange	$2.77
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$5.04

0-10 ROUND TRIP MILES OF NC

Facility

$6.00

Hospital Charge Code	5710846
Hospital Revenue Code	990
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$4.50
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$4.92

10/14/18 SUCTION CATHETER

Facility

$10.00

Hospital Charge Code	2720381
Hospital Revenue Code	272
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.69
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

10/14/18 SUCTION CATHETER

Facility

$10.00

Hospital Charge Code	2720381
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.69
Rate for Payer: Celtic Commercial/Exchange	$4.62
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.40

10CC CONTROL SYRINGES

Facility

$9.00

Hospital Charge Code	2720183
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.12
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

10CC CONTROL SYRINGES

Facility

$9.00

Hospital Charge Code	2720183
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.12
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

11-20 ROUND TRIP MILES OF NC

Facility

$12.00

Hospital Charge Code	5710851
Hospital Revenue Code	990
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

11-20 ROUND TRIP MILES OF NC

Facility

$12.00

Hospital Charge Code	5710851
Hospital Revenue Code	990
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

12.6-20.0CM SIMPLE REPAIR WOUN

Facility

$810.00

Service Code	HCPCS 12005
Hospital Charge Code	1200500
Hospital Revenue Code	450
Min. Negotiated Rate	$664.20
Max. Negotiated Rate	$785.70
Rate for Payer: Cash Price	$607.50
Rate for Payer: Health Partners Plans Commercial	$769.50
Rate for Payer: UnitedHealthcare Commercial	$785.70
Rate for Payer: WPPA Commercial	$664.20

12.6-20.0CM SIMPLE REPAIR WOUN

Facility

$810.00

Service Code	HCPCS 12005
Hospital Charge Code	1200500
Hospital Revenue Code	450
Min. Negotiated Rate	$374.22
Max. Negotiated Rate	$809.01
Rate for Payer: BCBS Commercial	$809.01
Rate for Payer: Cash Price	$607.50
Rate for Payer: Cash Price	$607.50
Rate for Payer: Celtic Commercial/Exchange	$374.22
Rate for Payer: Health Partners Plans Commercial	$769.50
Rate for Payer: UnitedHealthcare Commercial	$785.70
Rate for Payer: WPPA Commercial	$680.40

1/2 NORMAL SALINE (0.45%)1000 ML IV

Facility

$77.00

Service Code	NDC 00990798509
Hospital Charge Code	2580504
Hospital Revenue Code	258
Min. Negotiated Rate	$35.57
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$58.35
Rate for Payer: Celtic Commercial/Exchange	$35.57
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$64.68

1/2 NORMAL SALINE (0.45%)1000 ML IV

Facility

$77.00

Service Code	NDC 00990798509
Hospital Charge Code	2580504
Hospital Revenue Code	258
Min. Negotiated Rate	$63.14
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$58.35
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$63.14

1654G CHROMIC 4-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721355
Hospital Revenue Code	270
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

1654G CHROMIC 4-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721355
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

16 FR 5CC CATHETER W/TRAY

Facility

$39.00

Hospital Charge Code	2729777
Hospital Revenue Code	272
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

16 FR 5CC CATHETER W/TRAY

Facility

$39.00

Hospital Charge Code	2729777
Hospital Revenue Code	272
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

18 FR SILVER FOLEY TRAY

Facility

$84.00

Hospital Charge Code	2726589
Hospital Revenue Code	272
Min. Negotiated Rate	$38.81
Max. Negotiated Rate	$81.48
Rate for Payer: Cash Price	$63.00
Rate for Payer: Celtic Commercial/Exchange	$38.81
Rate for Payer: Health Partners Plans Commercial	$79.80
Rate for Payer: UnitedHealthcare Commercial	$81.48
Rate for Payer: WPPA Commercial	$70.56

18 FR SILVER FOLEY TRAY

Facility

$84.00

Hospital Charge Code	2726589
Hospital Revenue Code	272
Min. Negotiated Rate	$68.88
Max. Negotiated Rate	$81.48
Rate for Payer: Cash Price	$63.00
Rate for Payer: Health Partners Plans Commercial	$79.80
Rate for Payer: UnitedHealthcare Commercial	$81.48
Rate for Payer: WPPA Commercial	$68.88

18FR SUCTION CATHETER

Facility

$9.00

Hospital Charge Code	2700385
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

18FR SUCTION CATHETER

Facility

$9.00

Hospital Charge Code	2700385
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

19 GA BUTTERFLY/HUBER NEEDLE

Facility

$21.00

Hospital Charge Code	2702500
Hospital Revenue Code	270
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

19 GA BUTTERFLY/HUBER NEEDLE

Facility

$21.00

Hospital Charge Code	2702500
Hospital Revenue Code	270
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

1" COBAN

Facility

$9.00

Hospital Charge Code	2722593
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

1" COBAN

Facility

$9.00

Hospital Charge Code	2722593
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

1 PIECE DRAINABLE OSTOMY POUCH

Facility

$6.00

Hospital Charge Code	2720378
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$4.50
Rate for Payer: Celtic Commercial/Exchange	$2.77
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$5.04

Know your out-of-pocket cost for care.

All Charges