Ness County Hospital

All Charges

Charge

Type

Setting

Price

DRESSING KERRAMAX 4X4

Facility

$12.00

Hospital Charge Code	2722604
Hospital Revenue Code	272
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

DRESSING KERRAMAX 4X4

Facility

$12.00

Hospital Charge Code	2722604
Hospital Revenue Code	272
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

DRESSING KERRAMAX 8X9

Facility

$15.00

Hospital Charge Code	2722603
Hospital Revenue Code	272
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Celtic Commercial/Exchange	$6.93
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.60

DRESSING KERRAMAX 8X9

Facility

$15.00

Hospital Charge Code	2722603
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.30

DRESSING OIL EMULSION

Facility

$9.00

Hospital Charge Code	2720861
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

DRESSING OIL EMULSION

Facility

$9.00

Hospital Charge Code	2720861
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

DRESSING OPTICELL 6X6

Facility

$23.00

Hospital Charge Code	2709416
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Celtic Commercial/Exchange	$10.63
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$19.32

DRESSING OPTICELL 6X6

Facility

$23.00

Hospital Charge Code	2709416
Hospital Revenue Code	272
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$18.86

DRESSING OPTILOCK 3X3

Facility

$9.00

Hospital Charge Code	2723154
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

DRESSING OPTILOCK 3X3

Facility

$9.00

Hospital Charge Code	2723154
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

DRESSING OPTILOCK 4X4

Facility

$9.00

Hospital Charge Code	2723147
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

DRESSING OPTILOCK 4X4

Facility

$9.00

Hospital Charge Code	2723147
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

DRESSING OPTILOCK 5X5.5

Facility

$9.00

Hospital Charge Code	2723148
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

DRESSING OPTILOCK 5X5.5

Facility

$9.00

Hospital Charge Code	2723148
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

DRESSING OPTILOCK 6.5X10

Facility

$16.00

Hospital Charge Code	2723153
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.00
Rate for Payer: Celtic Commercial/Exchange	$7.39
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.44

DRESSING OPTILOCK 6.5X10

Facility

$16.00

Hospital Charge Code	2723153
Hospital Revenue Code	272
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.00
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.12

DRESSING PROMOGRAN PRISMA

Facility

$27.00

Hospital Charge Code	2723150
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

DRESSING PROMOGRAN PRISMA

Facility

$27.00

Hospital Charge Code	2723150
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

DRESSING SKIN FOLD INTERDRY AG

Facility

$217.00

Hospital Charge Code	2726480
Hospital Revenue Code	272
Min. Negotiated Rate	$177.94
Max. Negotiated Rate	$210.49
Rate for Payer: Cash Price	$162.75
Rate for Payer: Health Partners Plans Commercial	$206.15
Rate for Payer: UnitedHealthcare Commercial	$210.49
Rate for Payer: WPPA Commercial	$177.94

DRESSING SKIN FOLD INTERDRY AG

Facility

$217.00

Hospital Charge Code	2726480
Hospital Revenue Code	272
Min. Negotiated Rate	$100.25
Max. Negotiated Rate	$210.49
Rate for Payer: Cash Price	$162.75
Rate for Payer: Celtic Commercial/Exchange	$100.25
Rate for Payer: Health Partners Plans Commercial	$206.15
Rate for Payer: UnitedHealthcare Commercial	$210.49
Rate for Payer: WPPA Commercial	$182.28

DRESSING SKIN FOLD INTERDRYLTC

Facility

$210.00

Hospital Charge Code	2726480LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$97.02
Max. Negotiated Rate	$203.70
Rate for Payer: Cash Price	$157.50
Rate for Payer: Celtic Commercial/Exchange	$97.02
Rate for Payer: Health Partners Plans Commercial	$199.50
Rate for Payer: UnitedHealthcare Commercial	$203.70
Rate for Payer: WPPA Commercial	$176.40

DRESSING SKIN FOLD INTERDRYLTC

Facility

$210.00

Hospital Charge Code	2726480LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$172.20
Max. Negotiated Rate	$203.70
Rate for Payer: Cash Price	$157.50
Rate for Payer: Health Partners Plans Commercial	$199.50
Rate for Payer: UnitedHealthcare Commercial	$203.70
Rate for Payer: WPPA Commercial	$172.20

DRESSING SPONGE

Facility

$9.00

Hospital Charge Code	2720787
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

DRESSING SPONGE

Facility

$9.00

Hospital Charge Code	2720787
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

DRESSING TELFA 3X4

Facility

$9.00

Hospital Charge Code	2720845
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

Know your out-of-pocket cost for care.

All Charges