Ness County Hospital

All Charges

Charge

Type

Setting

Price

ELIQUIS 2.5 MG TAB (APIXABAN)

Facility

$216.00

Service Code	NDC 00003089331
Hospital Charge Code	2519338
Hospital Revenue Code	250
Min. Negotiated Rate	$99.79
Max. Negotiated Rate	$209.52
Rate for Payer: Cash Price	$162.00
Rate for Payer: Celtic Commercial/Exchange	$99.79
Rate for Payer: Health Partners Plans Commercial	$205.20
Rate for Payer: UnitedHealthcare Commercial	$209.52
Rate for Payer: WPPA Commercial	$181.44

EMERGENCY BLANKET

Facility

$25.00

Hospital Charge Code	2705142
Hospital Revenue Code	272
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

EMERGENCY BLANKET

Facility

$25.00

Hospital Charge Code	2705142
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

EMERGENCY CLASS #1

Facility

$241.00

Service Code	HCPCS 99281
Hospital Charge Code	4500081
Hospital Revenue Code	450
Min. Negotiated Rate	$197.62
Max. Negotiated Rate	$233.77
Rate for Payer: Cash Price	$180.75
Rate for Payer: Health Partners Plans Commercial	$228.95
Rate for Payer: UnitedHealthcare Commercial	$233.77
Rate for Payer: WPPA Commercial	$197.62

EMERGENCY CLASS #1

Facility

$241.00

Service Code	HCPCS 99281
Hospital Charge Code	4500081
Hospital Revenue Code	450
Min. Negotiated Rate	$111.34
Max. Negotiated Rate	$233.77
Rate for Payer: BCBS Commercial	$170.31
Rate for Payer: Cash Price	$180.75
Rate for Payer: Cash Price	$180.75
Rate for Payer: Celtic Commercial/Exchange	$111.34
Rate for Payer: Health Partners Plans Commercial	$228.95
Rate for Payer: UnitedHealthcare Commercial	$233.77
Rate for Payer: WPPA Commercial	$202.44

EMERGENCY CLASS #2

Facility

$391.00

Service Code	HCPCS 99282 25
Hospital Charge Code	4500082
Hospital Revenue Code	450
Min. Negotiated Rate	$320.62
Max. Negotiated Rate	$379.27
Rate for Payer: Cash Price	$293.25
Rate for Payer: Health Partners Plans Commercial	$371.45
Rate for Payer: UnitedHealthcare Commercial	$379.27
Rate for Payer: WPPA Commercial	$320.62

EMERGENCY CLASS #2

Facility

$391.00

Service Code	HCPCS 99282 25
Hospital Charge Code	4500082
Hospital Revenue Code	450
Min. Negotiated Rate	$180.64
Max. Negotiated Rate	$379.27
Rate for Payer: BCBS Commercial	$265.31
Rate for Payer: Cash Price	$293.25
Rate for Payer: Cash Price	$293.25
Rate for Payer: Celtic Commercial/Exchange	$180.64
Rate for Payer: Health Partners Plans Commercial	$371.45
Rate for Payer: UnitedHealthcare Commercial	$379.27
Rate for Payer: WPPA Commercial	$328.44

EMERGENCY CLASS #4

Facility

$978.00

Service Code	HCPCS 99284 25
Hospital Charge Code	4500084
Hospital Revenue Code	450
Min. Negotiated Rate	$801.96
Max. Negotiated Rate	$948.66
Rate for Payer: Cash Price	$733.50
Rate for Payer: Health Partners Plans Commercial	$929.10
Rate for Payer: UnitedHealthcare Commercial	$948.66
Rate for Payer: WPPA Commercial	$801.96

EMERGENCY CLASS #4

Facility

$978.00

Service Code	HCPCS 99284 25
Hospital Charge Code	4500084
Hospital Revenue Code	450
Min. Negotiated Rate	$451.84
Max. Negotiated Rate	$948.66
Rate for Payer: BCBS Commercial	$695.24
Rate for Payer: Cash Price	$733.50
Rate for Payer: Cash Price	$733.50
Rate for Payer: Celtic Commercial/Exchange	$451.84
Rate for Payer: Health Partners Plans Commercial	$929.10
Rate for Payer: UnitedHealthcare Commercial	$948.66
Rate for Payer: WPPA Commercial	$821.52

EMERGENCY CLASS #5

Facility

$1,485.00

Service Code	HCPCS 99285 25
Hospital Charge Code	4500085
Hospital Revenue Code	450
Min. Negotiated Rate	$686.07
Max. Negotiated Rate	$1,440.45
Rate for Payer: BCBS Commercial	$1,080.54
Rate for Payer: Cash Price	$1,113.75
Rate for Payer: Cash Price	$1,113.75
Rate for Payer: Celtic Commercial/Exchange	$686.07
Rate for Payer: Health Partners Plans Commercial	$1,410.75
Rate for Payer: UnitedHealthcare Commercial	$1,440.45
Rate for Payer: WPPA Commercial	$1,247.40

EMERGENCY CLASS #5

Facility

$1,485.00

Service Code	HCPCS 99285 25
Hospital Charge Code	4500085
Hospital Revenue Code	450
Min. Negotiated Rate	$1,217.70
Max. Negotiated Rate	$1,440.45
Rate for Payer: Cash Price	$1,113.75
Rate for Payer: Health Partners Plans Commercial	$1,410.75
Rate for Payer: UnitedHealthcare Commercial	$1,440.45
Rate for Payer: WPPA Commercial	$1,217.70

EMERGENCY ROOM #3

Facility

$638.00

Service Code	HCPCS 99283 25
Hospital Charge Code	4500083
Hospital Revenue Code	450
Min. Negotiated Rate	$523.16
Max. Negotiated Rate	$618.86
Rate for Payer: Cash Price	$478.50
Rate for Payer: Health Partners Plans Commercial	$606.10
Rate for Payer: UnitedHealthcare Commercial	$618.86
Rate for Payer: WPPA Commercial	$523.16

EMERGENCY ROOM #3

Facility

$638.00

Service Code	HCPCS 99283 25
Hospital Charge Code	4500083
Hospital Revenue Code	450
Min. Negotiated Rate	$294.76
Max. Negotiated Rate	$618.86
Rate for Payer: BCBS Commercial	$407.79
Rate for Payer: Cash Price	$478.50
Rate for Payer: Cash Price	$478.50
Rate for Payer: Celtic Commercial/Exchange	$294.76
Rate for Payer: Health Partners Plans Commercial	$606.10
Rate for Payer: UnitedHealthcare Commercial	$618.86
Rate for Payer: WPPA Commercial	$535.92

EMPTY STERILE VACUUM BOTTLE IV

Facility

$84.00

Hospital Charge Code	2580389
Hospital Revenue Code	270
Min. Negotiated Rate	$38.81
Max. Negotiated Rate	$81.48
Rate for Payer: Cash Price	$63.38
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

EMPTY STERILE VACUUM BOTTLE IV

Facility

$84.00

Hospital Charge Code	2580389
Hospital Revenue Code	270
Min. Negotiated Rate	$68.88
Max. Negotiated Rate	$81.48
Rate for Payer: Cash Price	$63.38
Rate for Payer: Health Partners Plans Commercial	$79.80
Rate for Payer: UnitedHealthcare Commercial	$81.48
Rate for Payer: WPPA Commercial	$68.88

ENABLEX 7.5 MG TAB

Facility

$33.00

Hospital Charge Code	2514057
Hospital Revenue Code	250
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$24.90
Rate for Payer: Celtic Commercial/Exchange	$15.25
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.72

ENABLEX 7.5 MG TAB

Facility

$33.00

Hospital Charge Code	2514057
Hospital Revenue Code	250
Min. Negotiated Rate	$27.06
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$24.90
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.06

ENDOCLIP

Facility

$250.00

Hospital Charge Code	2726869
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Celtic Commercial/Exchange	$115.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$210.00

ENDOCLIP

Facility

$250.00

Hospital Charge Code	2726869
Hospital Revenue Code	272
Min. Negotiated Rate	$205.00
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$205.00

ENDOCRINE DISORDERS WITH CC

Facility

$9,051.23

Service Code	MSDRG 644
Min. Negotiated Rate	$9,051.23
Max. Negotiated Rate	$9,051.23
Rate for Payer: BCBS Commercial	$9,051.23

ENDOCRINE DISORDERS WITH MCC

Facility

$14,801.68

Service Code	MSDRG 643
Min. Negotiated Rate	$14,801.68
Max. Negotiated Rate	$14,801.68
Rate for Payer: BCBS Commercial	$14,801.68

ENDOCRINE DISORDERS WITHOUT CC/MCC

Facility

$6,821.70

Service Code	MSDRG 645
Min. Negotiated Rate	$6,821.70
Max. Negotiated Rate	$6,821.70
Rate for Payer: BCBS Commercial	$6,821.70

ENDOGATOR

Facility

$108.00

Hospital Charge Code	2700037
Hospital Revenue Code	270
Min. Negotiated Rate	$88.56
Max. Negotiated Rate	$104.76
Rate for Payer: Cash Price	$81.00
Rate for Payer: Health Partners Plans Commercial	$102.60
Rate for Payer: UnitedHealthcare Commercial	$104.76
Rate for Payer: WPPA Commercial	$88.56

ENDOGATOR

Facility

$108.00

Hospital Charge Code	2700037
Hospital Revenue Code	270
Min. Negotiated Rate	$49.90
Max. Negotiated Rate	$104.76
Rate for Payer: Cash Price	$81.00
Rate for Payer: Celtic Commercial/Exchange	$49.90
Rate for Payer: Health Partners Plans Commercial	$102.60
Rate for Payer: UnitedHealthcare Commercial	$104.76
Rate for Payer: WPPA Commercial	$90.72

ENDOMYSIAL ANTIBODY (IGA)SCREE

Facility

$93.00

Service Code	HCPCS 86255
Hospital Charge Code	8625503
Hospital Revenue Code	302
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: BCBS Commercial	$49.98
Rate for Payer: Cash Price	$69.75
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

Know your out-of-pocket cost for care.

All Charges