Ness County Hospital

All Charges

Charge

Type

Setting

Price

AEROBIC CULTURE

Facility

$62.00

Service Code	HCPCS 87070
Hospital Charge Code	8707001
Hospital Revenue Code	306
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$46.50
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

AEROBIKA OSCILLATING THERAPY

Facility

$142.00

Hospital Charge Code	4100179
Hospital Revenue Code	272
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$106.50
Rate for Payer: Celtic Commercial/Exchange	$65.60
Rate for Payer: Health Partners Plans Commercial	$134.90
Rate for Payer: UnitedHealthcare Commercial	$137.74
Rate for Payer: WPPA Commercial	$119.28

AEROBIKA OSCILLATING THERAPY

Facility

$142.00

Hospital Charge Code	4100179
Hospital Revenue Code	272
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$106.50
Rate for Payer: Health Partners Plans Commercial	$134.90
Rate for Payer: UnitedHealthcare Commercial	$137.74
Rate for Payer: WPPA Commercial	$116.44

AEROECLIPSE II BREATHE ACT NEB

Facility

$17.00

Hospital Charge Code	4100180
Hospital Revenue Code	272
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.75
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$13.94

AEROECLIPSE II BREATHE ACT NEB

Facility

$17.00

Hospital Charge Code	4100180
Hospital Revenue Code	272
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.75
Rate for Payer: Celtic Commercial/Exchange	$7.85
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$14.28

AEROECLIPSE II NEB LTC

Facility

$17.00

Hospital Charge Code	4100180LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.75
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$13.94

AEROECLIPSE II NEB LTC

Facility

$17.00

Hospital Charge Code	4100180LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.75
Rate for Payer: Celtic Commercial/Exchange	$7.85
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$14.28

AEROECLIPSE MASK LARGE LTC

Facility

$4.00

Hospital Charge Code	4100182LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

AEROECLIPSE MASK LARGE LTC

Facility

$4.00

Hospital Charge Code	4100182LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Celtic Commercial/Exchange	$1.85
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.36

AFFINITY 2.5X2.5CM PER SQ

Facility

$2,980.00

Service Code	HCPCS Q4159
Hospital Charge Code	Q415923
Hospital Revenue Code	636
Min. Negotiated Rate	$430.92
Max. Negotiated Rate	$2,890.60
Rate for Payer: BCBS Commercial	$430.92
Rate for Payer: Cash Price	$2,235.00
Rate for Payer: Cash Price	$2,235.00
Rate for Payer: Celtic Commercial/Exchange	$1,376.76
Rate for Payer: Health Partners Plans Commercial	$2,831.00
Rate for Payer: UnitedHealthcare Commercial	$2,890.60
Rate for Payer: WPPA Commercial	$2,503.20

AFFINITY 2.5X2.5CM PER SQ

Facility

$2,980.00

Service Code	HCPCS Q4159
Hospital Charge Code	Q415923
Hospital Revenue Code	636
Min. Negotiated Rate	$2,443.60
Max. Negotiated Rate	$2,890.60
Rate for Payer: Cash Price	$2,235.00
Rate for Payer: Health Partners Plans Commercial	$2,831.00
Rate for Payer: UnitedHealthcare Commercial	$2,890.60
Rate for Payer: WPPA Commercial	$2,443.60

AFRIN NASAL SPR.0.05%15ML

Facility

$18.00

Service Code	NDC 46122016510
Hospital Charge Code	2500130
Hospital Revenue Code	250
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.50
Rate for Payer: Celtic Commercial/Exchange	$8.32
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$15.12

AFRIN NASAL SPR.0.05%15ML

Facility

$18.00

Service Code	NDC 46122016510
Hospital Charge Code	2500130
Hospital Revenue Code	250
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.50
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$14.76

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$9,647.67

Service Code	MSDRG 560
Min. Negotiated Rate	$9,647.67
Max. Negotiated Rate	$9,647.67
Rate for Payer: BCBS Commercial	$9,647.67

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$16,555.48

Service Code	MSDRG 559
Min. Negotiated Rate	$16,555.48
Max. Negotiated Rate	$16,555.48
Rate for Payer: BCBS Commercial	$16,555.48

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$7,104.84

Service Code	MSDRG 561
Min. Negotiated Rate	$7,104.84
Max. Negotiated Rate	$7,104.84
Rate for Payer: BCBS Commercial	$7,104.84

AFTERCARE WITH CC/MCC

Facility

$9,850.92

Service Code	MSDRG 949
Min. Negotiated Rate	$9,850.92
Max. Negotiated Rate	$9,850.92
Rate for Payer: BCBS Commercial	$9,850.92

AFTERCARE WITHOUT CC/MCC

Facility

$6,461.52

Service Code	MSDRG 950
Min. Negotiated Rate	$6,461.52
Max. Negotiated Rate	$6,461.52
Rate for Payer: BCBS Commercial	$6,461.52

AGGLUTININS, FEBRILE,EA ANTIGN

Facility

$107.00

Service Code	HCPCS 86000
Hospital Charge Code	8600000
Hospital Revenue Code	302
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$103.79
Rate for Payer: BCBS Commercial	$32.80
Rate for Payer: Cash Price	$80.25
Rate for Payer: Cash Price	$80.25
Rate for Payer: Celtic Commercial/Exchange	$49.43
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$89.88

AGGLUTININS, FEBRILE,EA ANTIGN

Facility

$107.00

Service Code	HCPCS 86000
Hospital Charge Code	8600000
Hospital Revenue Code	302
Min. Negotiated Rate	$87.74
Max. Negotiated Rate	$103.79
Rate for Payer: Cash Price	$80.25
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$87.74

AG MESH

Facility

$10.00

Hospital Charge Code	2720666
Hospital Revenue Code	272
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.80
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

AG MESH

Facility

$10.00

Hospital Charge Code	2720666
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.80
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

AICD GENERATOR PROCEDURES

Facility

$50,922.12

Service Code	MSDRG 245
Min. Negotiated Rate	$50,922.12
Max. Negotiated Rate	$50,922.12
Rate for Payer: BCBS Commercial	$50,922.12

AICD LEAD PROCEDURES

Facility

$29,704.08

Service Code	MSDRG 265
Min. Negotiated Rate	$29,704.08
Max. Negotiated Rate	$29,704.08
Rate for Payer: BCBS Commercial	$29,704.08

AIRCAST, ANKLE BRACE

Facility

$105.00

Hospital Charge Code	2702389
Hospital Revenue Code	270
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$101.85
Rate for Payer: Cash Price	$78.75
Rate for Payer: Health Partners Plans Commercial	$99.75
Rate for Payer: UnitedHealthcare Commercial	$101.85
Rate for Payer: WPPA Commercial	$86.10

Know your out-of-pocket cost for care.

All Charges