Ness County Hospital

All Charges

Charge

Type

Setting

Price

ELASTASE EI1, STOOL

Facility

$249.00

Service Code	HCPCS 82653
Hospital Charge Code	8265300
Hospital Revenue Code	300
Min. Negotiated Rate	$204.18
Max. Negotiated Rate	$241.53
Rate for Payer: Cash Price	$186.75
Rate for Payer: Health Partners Plans Commercial	$236.55
Rate for Payer: UnitedHealthcare Commercial	$241.53
Rate for Payer: WPPA Commercial	$204.18

ELASTASE EI1, STOOL

Facility

$249.00

Service Code	HCPCS 82653
Hospital Charge Code	8265300
Hospital Revenue Code	300
Min. Negotiated Rate	$43.07
Max. Negotiated Rate	$241.53
Rate for Payer: BCBS Commercial	$43.07
Rate for Payer: Cash Price	$186.75
Rate for Payer: Cash Price	$186.75
Rate for Payer: Celtic Commercial/Exchange	$115.04
Rate for Payer: Health Partners Plans Commercial	$236.55
Rate for Payer: UnitedHealthcare Commercial	$241.53
Rate for Payer: WPPA Commercial	$209.16

ELASTOPLAST

Facility

$17.00

Hospital Charge Code	2701621
Hospital Revenue Code	270
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.94
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

ELASTOPLAST

Facility

$17.00

Hospital Charge Code	2701621
Hospital Revenue Code	270
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$12.94
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$13.94

ELAVIL 10 MG TAB (AMITRIPTYLINE HCL)

Facility

$1.00

Service Code	NDC 50268003711
Hospital Charge Code	2502516
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.39
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ELAVIL 10 MG TAB (AMITRIPTYLINE HCL)

Facility

$1.00

Service Code	NDC 50268003711
Hospital Charge Code	2502516
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.39
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

ELBOW LT 2V

Facility

$213.00

Service Code	HCPCS 73070 LT
Hospital Charge Code	3280017
Hospital Revenue Code	320
Min. Negotiated Rate	$98.41
Max. Negotiated Rate	$206.61
Rate for Payer: BCBS Commercial	$113.36
Rate for Payer: Cash Price	$159.75
Rate for Payer: Cash Price	$159.75
Rate for Payer: Celtic Commercial/Exchange	$98.41
Rate for Payer: Health Partners Plans Commercial	$202.35
Rate for Payer: UnitedHealthcare Commercial	$206.61
Rate for Payer: WPPA Commercial	$178.92

ELBOW LT 2V

Facility

$213.00

Service Code	HCPCS 73070 LT
Hospital Charge Code	3280017
Hospital Revenue Code	320
Min. Negotiated Rate	$174.66
Max. Negotiated Rate	$206.61
Rate for Payer: Cash Price	$159.75
Rate for Payer: Health Partners Plans Commercial	$202.35
Rate for Payer: UnitedHealthcare Commercial	$206.61
Rate for Payer: WPPA Commercial	$174.66

ELBOW LT 3V

Facility

$271.00

Service Code	HCPCS 73080 LT
Hospital Charge Code	3280019
Hospital Revenue Code	320
Min. Negotiated Rate	$125.20
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$151.46
Rate for Payer: Cash Price	$203.25
Rate for Payer: Cash Price	$203.25
Rate for Payer: Celtic Commercial/Exchange	$125.20
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$227.64

ELBOW LT 3V

Facility

$271.00

Service Code	HCPCS 73080 LT
Hospital Charge Code	3280019
Hospital Revenue Code	320
Min. Negotiated Rate	$222.22
Max. Negotiated Rate	$262.87
Rate for Payer: Cash Price	$203.25
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$222.22

ELBOW PROTECTOR

Facility

$29.00

Hospital Charge Code	2701761
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

ELBOW PROTECTOR

Facility

$29.00

Hospital Charge Code	2701761
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

ELBOW RT 2V

Facility

$213.00

Service Code	HCPCS 73070 RT
Hospital Charge Code	3280016
Hospital Revenue Code	320
Min. Negotiated Rate	$98.41
Max. Negotiated Rate	$206.61
Rate for Payer: BCBS Commercial	$113.36
Rate for Payer: Cash Price	$159.75
Rate for Payer: Cash Price	$159.75
Rate for Payer: Celtic Commercial/Exchange	$98.41
Rate for Payer: Health Partners Plans Commercial	$202.35
Rate for Payer: UnitedHealthcare Commercial	$206.61
Rate for Payer: WPPA Commercial	$178.92

ELBOW RT 2V

Facility

$213.00

Service Code	HCPCS 73070 RT
Hospital Charge Code	3280016
Hospital Revenue Code	320
Min. Negotiated Rate	$174.66
Max. Negotiated Rate	$206.61
Rate for Payer: Cash Price	$159.75
Rate for Payer: Health Partners Plans Commercial	$202.35
Rate for Payer: UnitedHealthcare Commercial	$206.61
Rate for Payer: WPPA Commercial	$174.66

ELBOW RT 3V

Facility

$271.00

Service Code	HCPCS 73080 RT
Hospital Charge Code	3280018
Hospital Revenue Code	320
Min. Negotiated Rate	$125.20
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$151.46
Rate for Payer: Cash Price	$203.25
Rate for Payer: Cash Price	$203.25
Rate for Payer: Celtic Commercial/Exchange	$125.20
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$227.64

ELBOW RT 3V

Facility

$271.00

Service Code	HCPCS 73080 RT
Hospital Charge Code	3280018
Hospital Revenue Code	320
Min. Negotiated Rate	$222.22
Max. Negotiated Rate	$262.87
Rate for Payer: Cash Price	$203.25
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$222.22

ELDERCARE-MEDICATION MGMT

Facility

$40.00

Hospital Charge Code	5910049
Hospital Revenue Code	550
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Celtic Commercial/Exchange	$18.48
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$33.60

ELDERCARE-MEDICATION MGMT

Facility

$40.00

Hospital Charge Code	5910049
Hospital Revenue Code	550
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$32.80

ELEC. STIM. (ATTENDED)

Facility

$88.00

Service Code	HCPCS G0283 GP
Hospital Charge Code	5710734
Hospital Revenue Code	420
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.38
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

ELEC. STIM. (ATTENDED)

Facility

$88.00

Service Code	HCPCS G0283 GP
Hospital Charge Code	5710734
Hospital Revenue Code	420
Min. Negotiated Rate	$31.31
Max. Negotiated Rate	$85.36
Rate for Payer: BCBS Commercial	$31.31
Rate for Payer: Cash Price	$66.38
Rate for Payer: Cash Price	$66.38
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

ELEC.STIM. & HOT/COLD PACKS

Facility

$151.00

Service Code	HCPCS 97014 GP
Hospital Charge Code	4200889
Hospital Revenue Code	420
Min. Negotiated Rate	$31.31
Max. Negotiated Rate	$146.47
Rate for Payer: BCBS Commercial	$31.31
Rate for Payer: Cash Price	$113.25
Rate for Payer: Cash Price	$113.25
Rate for Payer: Celtic Commercial/Exchange	$69.76
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$126.84

ELEC.STIM. & HOT/COLD PACKS

Facility

$151.00

Service Code	HCPCS 97014 GP
Hospital Charge Code	4200889
Hospital Revenue Code	420
Min. Negotiated Rate	$123.82
Max. Negotiated Rate	$146.47
Rate for Payer: Cash Price	$113.25
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$123.82

ELEC.STIM. (UNATTENDED)

Facility

$102.00

Service Code	HCPCS 97014 GP
Hospital Charge Code	4200879
Hospital Revenue Code	420
Min. Negotiated Rate	$83.64
Max. Negotiated Rate	$98.94
Rate for Payer: Cash Price	$76.50
Rate for Payer: Health Partners Plans Commercial	$96.90
Rate for Payer: UnitedHealthcare Commercial	$98.94
Rate for Payer: WPPA Commercial	$83.64

ELEC.STIM. (UNATTENDED)

Facility

$102.00

Service Code	HCPCS 97014 GP
Hospital Charge Code	4200879
Hospital Revenue Code	420
Min. Negotiated Rate	$31.31
Max. Negotiated Rate	$98.94
Rate for Payer: BCBS Commercial	$31.31
Rate for Payer: Cash Price	$76.50
Rate for Payer: Cash Price	$76.50
Rate for Payer: Celtic Commercial/Exchange	$47.12
Rate for Payer: Health Partners Plans Commercial	$96.90
Rate for Payer: UnitedHealthcare Commercial	$98.94
Rate for Payer: WPPA Commercial	$85.68

ELIQUIS 2.5 MG TAB (APIXABAN)

Facility

$216.00

Service Code	NDC 00003089331
Hospital Charge Code	2519338
Hospital Revenue Code	250
Min. Negotiated Rate	$177.12
Max. Negotiated Rate	$209.52
Rate for Payer: Cash Price	$162.00
Rate for Payer: Health Partners Plans Commercial	$205.20
Rate for Payer: UnitedHealthcare Commercial	$209.52
Rate for Payer: WPPA Commercial	$177.12

Know your out-of-pocket cost for care.

All Charges