Ness County Hospital

All Charges

Charge

Type

Setting

Price

EXC/BEN/LES-SCALP/NECK-1.1-2.0

Facility

$1,500.00

Service Code	HCPCS 11422
Hospital Charge Code	1142200
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

EXCISION BENIGH LESION 2.1-3.0

Facility

$1,545.00

Service Code	HCPCS 11443
Hospital Charge Code	1144300
Hospital Revenue Code	450
Min. Negotiated Rate	$713.79
Max. Negotiated Rate	$1,498.65
Rate for Payer: BCBS Commercial	$1,407.94
Rate for Payer: Cash Price	$1,158.75
Rate for Payer: Cash Price	$1,158.75
Rate for Payer: Celtic Commercial/Exchange	$713.79
Rate for Payer: Health Partners Plans Commercial	$1,467.75
Rate for Payer: UnitedHealthcare Commercial	$1,498.65
Rate for Payer: WPPA Commercial	$1,297.80

EXCISION BENIGH LESION 2.1-3.0

Facility

$1,545.00

Service Code	HCPCS 11443
Hospital Charge Code	1144300
Hospital Revenue Code	450
Min. Negotiated Rate	$1,266.90
Max. Negotiated Rate	$1,498.65
Rate for Payer: Cash Price	$1,158.75
Rate for Payer: Health Partners Plans Commercial	$1,467.75
Rate for Payer: UnitedHealthcare Commercial	$1,498.65
Rate for Payer: WPPA Commercial	$1,266.90

EXCISION BENIGH LESION/MARGINS

Facility

$1,200.00

Service Code	HCPCS 11403
Hospital Charge Code	1140300
Hospital Revenue Code	761
Min. Negotiated Rate	$554.40
Max. Negotiated Rate	$1,164.00
Rate for Payer: UnitedHealthcare Commercial	$1,164.00
Rate for Payer: BCBS Commercial	$879.49
Rate for Payer: Cash Price	$900.00
Rate for Payer: Cash Price	$900.00
Rate for Payer: Celtic Commercial/Exchange	$554.40
Rate for Payer: Health Partners Plans Commercial	$1,140.00
Rate for Payer: WPPA Commercial	$1,008.00

EXCISION BENIGH LESION/MARGINS

Facility

$1,200.00

Service Code	HCPCS 11403
Hospital Charge Code	1140300
Hospital Revenue Code	761
Min. Negotiated Rate	$984.00
Max. Negotiated Rate	$1,164.00
Rate for Payer: Cash Price	$900.00
Rate for Payer: Health Partners Plans Commercial	$1,140.00
Rate for Payer: UnitedHealthcare Commercial	$1,164.00
Rate for Payer: WPPA Commercial	$984.00

EXCISION BENIGN LES 2.1-3.0 CM

Facility

$1,500.00

Service Code	HCPCS 11423
Hospital Charge Code	1142300
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

EXCISION BENIGN LES 2.1-3.0 CM

Facility

$1,500.00

Service Code	HCPCS 11423
Hospital Charge Code	1142300
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$2,025.30
Rate for Payer: BCBS Commercial	$2,025.30
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Celtic Commercial/Exchange	$693.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,260.00

EXCISION BENIGN LESIONS > 4 CM

Facility

$1,500.00

Service Code	HCPCS 11406
Hospital Charge Code	1140600
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$2,077.57
Rate for Payer: BCBS Commercial	$2,077.57
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Celtic Commercial/Exchange	$693.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,260.00

EXCISION BENIGN LESIONS > 4 CM

Facility

$1,500.00

Service Code	HCPCS 11406
Hospital Charge Code	1140600
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

EXCISION-MALIG LESION 1.1-2.CM

Facility

$684.00

Service Code	HCPCS 11642
Hospital Charge Code	1164200
Hospital Revenue Code	450
Min. Negotiated Rate	$316.01
Max. Negotiated Rate	$793.86
Rate for Payer: BCBS Commercial	$793.86
Rate for Payer: Cash Price	$513.00
Rate for Payer: Cash Price	$513.00
Rate for Payer: Celtic Commercial/Exchange	$316.01
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$574.56

EXCISION-MALIG LESION 1.1-2.CM

Facility

$684.00

Service Code	HCPCS 11642
Hospital Charge Code	1164200
Hospital Revenue Code	450
Min. Negotiated Rate	$560.88
Max. Negotiated Rate	$663.48
Rate for Payer: Cash Price	$513.00
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$560.88

EXCISION MALIG LISION2.1-3.0CM

Facility

$1,500.00

Service Code	HCPCS 11643
Hospital Charge Code	1164300
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

EXCISION MALIG LISION2.1-3.0CM

Facility

$1,500.00

Service Code	HCPCS 11643
Hospital Charge Code	1164300
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: BCBS Commercial	$1,036.26
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Celtic Commercial/Exchange	$693.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,260.00

EXCISION-MALIGNANT LES 06TO1.0

Facility

$684.00

Service Code	HCPCS 11601
Hospital Charge Code	1160100
Hospital Revenue Code	450
Min. Negotiated Rate	$316.01
Max. Negotiated Rate	$783.57
Rate for Payer: BCBS Commercial	$783.57
Rate for Payer: Cash Price	$513.00
Rate for Payer: Cash Price	$513.00
Rate for Payer: Celtic Commercial/Exchange	$316.01
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$574.56

EXCISION-MALIGNANT LES 06TO1.0

Facility

$684.00

Service Code	HCPCS 11601
Hospital Charge Code	1160100
Hospital Revenue Code	450
Min. Negotiated Rate	$560.88
Max. Negotiated Rate	$663.48
Rate for Payer: Cash Price	$513.00
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$560.88

EXCISION-MALIGNANT LES 1.1/2.0

Facility

$700.00

Service Code	HCPCS 11602
Hospital Charge Code	1160200
Hospital Revenue Code	982
Min. Negotiated Rate	$323.40
Max. Negotiated Rate	$679.00
Rate for Payer: BCBS Commercial	$451.17
Rate for Payer: Cash Price	$525.00
Rate for Payer: Cash Price	$525.00
Rate for Payer: Celtic Commercial/Exchange	$323.40
Rate for Payer: Health Partners Plans Commercial	$665.00
Rate for Payer: UnitedHealthcare Commercial	$679.00
Rate for Payer: WPPA Commercial	$588.00

EXCISION-MALIGNANT LES 1.1/2.0

Facility

$700.00

Service Code	HCPCS 11602
Hospital Charge Code	1160200
Hospital Revenue Code	982
Min. Negotiated Rate	$574.00
Max. Negotiated Rate	$679.00
Rate for Payer: Cash Price	$525.00
Rate for Payer: Health Partners Plans Commercial	$665.00
Rate for Payer: UnitedHealthcare Commercial	$679.00
Rate for Payer: WPPA Commercial	$574.00

EXCISION-MALIGNANT LES2.1-3.0

Facility

$649.00

Service Code	HCPCS 11603
Hospital Charge Code	1160300
Hospital Revenue Code	761
Min. Negotiated Rate	$532.18
Max. Negotiated Rate	$629.53
Rate for Payer: Cash Price	$486.75
Rate for Payer: Health Partners Plans Commercial	$616.55
Rate for Payer: UnitedHealthcare Commercial	$629.53
Rate for Payer: WPPA Commercial	$532.18

EXCISION-MALIGNANT LES2.1-3.0

Facility

$649.00

Service Code	HCPCS 11603
Hospital Charge Code	1160300
Hospital Revenue Code	761
Min. Negotiated Rate	$299.84
Max. Negotiated Rate	$783.57
Rate for Payer: BCBS Commercial	$783.57
Rate for Payer: Cash Price	$486.75
Rate for Payer: Cash Price	$486.75
Rate for Payer: Celtic Commercial/Exchange	$299.84
Rate for Payer: Health Partners Plans Commercial	$616.55
Rate for Payer: UnitedHealthcare Commercial	$629.53
Rate for Payer: WPPA Commercial	$545.16

EXCISION,MALIGNANT LESION

Facility

$1,500.00

Service Code	HCPCS 11623
Hospital Charge Code	1162300
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

EXCISION,MALIGNANT LESION

Facility

$1,500.00

Service Code	HCPCS 11623
Hospital Charge Code	1162300
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$1,805.43
Rate for Payer: BCBS Commercial	$1,805.43
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Celtic Commercial/Exchange	$693.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,260.00

EXCISION MALIGNANT LESION.5OR

Facility

$684.00

Service Code	HCPCS 11640
Hospital Charge Code	1164000
Hospital Revenue Code	450
Min. Negotiated Rate	$560.88
Max. Negotiated Rate	$663.48
Rate for Payer: Cash Price	$513.00
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$560.88

EXCISION MALIGNANT LESION.5OR

Facility

$684.00

Service Code	HCPCS 11640
Hospital Charge Code	1164000
Hospital Revenue Code	450
Min. Negotiated Rate	$316.01
Max. Negotiated Rate	$663.48
Rate for Payer: BCBS Commercial	$506.01
Rate for Payer: Cash Price	$513.00
Rate for Payer: Cash Price	$513.00
Rate for Payer: Celtic Commercial/Exchange	$316.01
Rate for Payer: Health Partners Plans Commercial	$649.80
Rate for Payer: UnitedHealthcare Commercial	$663.48
Rate for Payer: WPPA Commercial	$574.56

EXCISION OF NAIL &NAIL MATRIX

Facility

$374.00

Service Code	HCPCS 11750
Hospital Charge Code	1175000
Hospital Revenue Code	761
Min. Negotiated Rate	$172.79
Max. Negotiated Rate	$499.41
Rate for Payer: BCBS Commercial	$499.41
Rate for Payer: Cash Price	$280.50
Rate for Payer: Cash Price	$280.50
Rate for Payer: Celtic Commercial/Exchange	$172.79
Rate for Payer: Health Partners Plans Commercial	$355.30
Rate for Payer: UnitedHealthcare Commercial	$362.78
Rate for Payer: WPPA Commercial	$314.16

EXCISION OF NAIL &NAIL MATRIX

Facility

$374.00

Service Code	HCPCS 11750
Hospital Charge Code	1175000
Hospital Revenue Code	761
Min. Negotiated Rate	$306.68
Max. Negotiated Rate	$362.78
Rate for Payer: Cash Price	$280.50
Rate for Payer: Health Partners Plans Commercial	$355.30
Rate for Payer: UnitedHealthcare Commercial	$362.78
Rate for Payer: WPPA Commercial	$306.68

Know your out-of-pocket cost for care.

All Charges