Ness County Hospital

All Charges

Charge

Type

Setting

Price

ENDOTRACH TUBE 6.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721704
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

ENDOTRACH TUBE 6.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721704
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

ENDOTRACH TUBE 7.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721705
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

ENDOTRACH TUBE 7.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721705
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

ENDOTRACH TUBE 8.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721706
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

ENDOTRACH TUBE 8.0MM CUFFED

Facility

$26.00

Hospital Charge Code	2721706
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

ENDOTRACH TUBE 8.5MM CUFFED

Facility

$26.00

Hospital Charge Code	2721707
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

ENDOTRACH TUBE 8.5MM CUFFED

Facility

$26.00

Hospital Charge Code	2721707
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

ENDOTRACH TUBE STYLET 14FR

Facility

$24.00

Hospital Charge Code	2721708
Hospital Revenue Code	270
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$19.68

ENDOTRACH TUBE STYLET 14FR

Facility

$24.00

Hospital Charge Code	2721708
Hospital Revenue Code	270
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Celtic Commercial/Exchange	$11.09
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$20.16

ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC

Facility

$62,554.34

Service Code	MSDRG 266
Min. Negotiated Rate	$62,554.34
Max. Negotiated Rate	$62,554.34
Rate for Payer: BCBS Commercial	$62,554.34

ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC

Facility

$52,498.09

Service Code	MSDRG 267
Min. Negotiated Rate	$52,498.09
Max. Negotiated Rate	$52,498.09
Rate for Payer: BCBS Commercial	$52,498.09

enoxaparin (enoxaparin) subQ solution

Facility

$297.00

Service Code	NDC 00548560800
Hospital Charge Code	2513323
Hospital Revenue Code	250
Min. Negotiated Rate	$137.21
Max. Negotiated Rate	$288.09
Rate for Payer: Cash Price	$223.27
Rate for Payer: Celtic Commercial/Exchange	$137.21
Rate for Payer: Health Partners Plans Commercial	$282.15
Rate for Payer: UnitedHealthcare Commercial	$288.09
Rate for Payer: WPPA Commercial	$249.48

enoxaparin (enoxaparin) subQ solution

Facility

$297.00

Service Code	NDC 00548560800
Hospital Charge Code	2513323
Hospital Revenue Code	250
Min. Negotiated Rate	$243.54
Max. Negotiated Rate	$288.09
Rate for Payer: Cash Price	$223.27
Rate for Payer: Health Partners Plans Commercial	$282.15
Rate for Payer: UnitedHealthcare Commercial	$288.09
Rate for Payer: WPPA Commercial	$243.54

ENTAMOEBA HISTOLYTICA AG EIA

Facility

$66.00

Service Code	HCPCS 87337
Hospital Charge Code	8733700
Hospital Revenue Code	306
Min. Negotiated Rate	$54.12
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$49.50
Rate for Payer: Health Partners Plans Commercial	$62.70
Rate for Payer: UnitedHealthcare Commercial	$64.02
Rate for Payer: WPPA Commercial	$54.12

ENTAMOEBA HISTOLYTICA AG EIA

Facility

$66.00

Service Code	HCPCS 87337
Hospital Charge Code	8733700
Hospital Revenue Code	306
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$64.02
Rate for Payer: BCBS Commercial	$60.95
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
Rate for Payer: Celtic Commercial/Exchange	$30.49
Rate for Payer: Health Partners Plans Commercial	$62.70
Rate for Payer: UnitedHealthcare Commercial	$64.02
Rate for Payer: WPPA Commercial	$55.44

ENTERAL FEEDING TUBE-GRAVITY

Facility

$49.00

Hospital Charge Code	2580546
Hospital Revenue Code	270
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$47.53
Rate for Payer: Cash Price	$37.35
Rate for Payer: Celtic Commercial/Exchange	$22.64
Rate for Payer: Health Partners Plans Commercial	$46.55
Rate for Payer: UnitedHealthcare Commercial	$47.53
Rate for Payer: WPPA Commercial	$41.16

ENTERAL FEEDING TUBE-GRAVITY

Facility

$49.00

Hospital Charge Code	2580546
Hospital Revenue Code	270
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$47.53
Rate for Payer: Cash Price	$37.35
Rate for Payer: Health Partners Plans Commercial	$46.55
Rate for Payer: UnitedHealthcare Commercial	$47.53
Rate for Payer: WPPA Commercial	$40.18

ENTEROVIRUS RNA RT-PC

Facility

$350.00

Service Code	HCPCS 87498
Hospital Charge Code	8749800
Hospital Revenue Code	306
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$76.59
Rate for Payer: Cash Price	$262.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Celtic Commercial/Exchange	$161.70
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$294.00

ENTEROVIRUS RNA RT-PC

Facility

$350.00

Service Code	HCPCS 87498
Hospital Charge Code	8749800
Hospital Revenue Code	306
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

EOSINOPHIL COUNT, BLOOD

Facility

$88.00

Hospital Charge Code	8888917
Hospital Revenue Code	305
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
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

EOSINOPHIL COUNT, BLOOD

Facility

$88.00

Hospital Charge Code	8888917
Hospital Revenue Code	305
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

EPHEDRINE 50 MG/ML INJ

Facility

$170.00

Service Code	NDC 17478041510
Hospital Charge Code	2502599
Hospital Revenue Code	250
Min. Negotiated Rate	$139.40
Max. Negotiated Rate	$164.90
Rate for Payer: Cash Price	$127.69
Rate for Payer: Health Partners Plans Commercial	$161.50
Rate for Payer: UnitedHealthcare Commercial	$164.90
Rate for Payer: WPPA Commercial	$139.40

EPHEDRINE 50 MG/ML INJ

Facility

$170.00

Service Code	NDC 17478041510
Hospital Charge Code	2502599
Hospital Revenue Code	250
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$164.90
Rate for Payer: Cash Price	$127.69
Rate for Payer: Celtic Commercial/Exchange	$78.54
Rate for Payer: Health Partners Plans Commercial	$161.50
Rate for Payer: UnitedHealthcare Commercial	$164.90
Rate for Payer: WPPA Commercial	$142.80

EPIDERM AUTOGRFT,F/H/FT 100SQC

Facility

$2,450.00

Service Code	HCPCS 15115
Hospital Charge Code	1511523
Hospital Revenue Code	761
Min. Negotiated Rate	$1,131.90
Max. Negotiated Rate	$2,376.50
Rate for Payer: Cash Price	$1,837.50
Rate for Payer: Celtic Commercial/Exchange	$1,131.90
Rate for Payer: Health Partners Plans Commercial	$2,327.50
Rate for Payer: UnitedHealthcare Commercial	$2,376.50
Rate for Payer: WPPA Commercial	$2,058.00

Know your out-of-pocket cost for care.

All Charges