Ness County Hospital

All Charges

Charge

Type

Setting

Price

AIRWAY NASOPHARYNGEAL 34FR

Facility

$14.00

Hospital Charge Code	2721601
Hospital Revenue Code	270
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.50
Rate for Payer: Celtic Commercial/Exchange	$6.47
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.76

AIRWAY NASOPHARYNGEAL 34FR

Facility

$14.00

Hospital Charge Code	2721601
Hospital Revenue Code	270
Min. Negotiated Rate	$11.48
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.50
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.48

AIRWAY NASOPHARYNGEAL 36 FR

Facility

$12.00

Hospital Charge Code	2721599
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

AIRWAY NASOPHARYNGEAL 36 FR

Facility

$12.00

Hospital Charge Code	2721599
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

AIRWAY NASOPHARYNGEAL 60MM

Facility

$11.00

Hospital Charge Code	2721691
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

AIRWAY NASOPHARYNGEAL 60MM

Facility

$11.00

Hospital Charge Code	2721691
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

AIRWAY NASOPHARYNGEAL 70MM

Facility

$11.00

Hospital Charge Code	2721692
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

AIRWAY NASOPHARYNGEAL 70MM

Facility

$11.00

Hospital Charge Code	2721692
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

AIRWAY NASOPHARYNGEAL 80MM

Facility

$11.00

Hospital Charge Code	2721693
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

AIRWAY NASOPHARYNGEAL 80MM

Facility

$11.00

Hospital Charge Code	2721693
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.81
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

AIRWAY NASOPHARYNGEAL 90MM

Facility

$14.00

Hospital Charge Code	2721694
Hospital Revenue Code	272
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.50
Rate for Payer: Celtic Commercial/Exchange	$6.47
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.76

AIRWAY NASOPHARYNGEAL 90MM

Facility

$14.00

Hospital Charge Code	2721694
Hospital Revenue Code	272
Min. Negotiated Rate	$11.48
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.50
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.48

AIRWAY NOVAPLUS LMA SIZE 3

Facility

$27.00

Hospital Charge Code	2709978
Hospital Revenue Code	270
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

AIRWAY NOVAPLUS LMA SIZE 3

Facility

$27.00

Hospital Charge Code	2709978
Hospital Revenue Code	270
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

AIRWAY NOVAPLUS LMA SIZE 4

Facility

$27.00

Hospital Charge Code	2709566
Hospital Revenue Code	270
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

AIRWAY NOVAPLUS LMA SIZE 4

Facility

$27.00

Hospital Charge Code	2709566
Hospital Revenue Code	270
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

AIRWAY NOVAPLUS LMA SIZE 5

Facility

$27.00

Hospital Charge Code	2709567
Hospital Revenue Code	270
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

AIRWAY NOVAPLUS LMA SIZE 5

Facility

$27.00

Hospital Charge Code	2709567
Hospital Revenue Code	270
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

AIRWAY ORAL 70MM

Facility

$10.00

Hospital Charge Code	2700008
Hospital Revenue Code	270
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.69
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

AIRWAY ORAL 70MM

Facility

$10.00

Hospital Charge Code	2700008
Hospital Revenue Code	270
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.69
Rate for Payer: Celtic Commercial/Exchange	$4.62
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.40

ALARM PAD

Facility

$50.00

Hospital Charge Code	9991287
Hospital Revenue Code	990
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Celtic Commercial/Exchange	$23.10
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$42.00

ALARM PAD

Facility

$50.00

Hospital Charge Code	9991287
Hospital Revenue Code	990
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

ALBUMIN 25% 100 ML (HUMAN) IV

Facility

$651.00

Service Code	NDC 76125079211
Hospital Charge Code	2516904
Hospital Revenue Code	250
Min. Negotiated Rate	$533.82
Max. Negotiated Rate	$631.47
Rate for Payer: Cash Price	$488.74
Rate for Payer: Health Partners Plans Commercial	$618.45
Rate for Payer: UnitedHealthcare Commercial	$631.47
Rate for Payer: WPPA Commercial	$533.82

ALBUMIN 25% 100 ML (HUMAN) IV

Facility

$651.00

Service Code	NDC 76125079211
Hospital Charge Code	2516904
Hospital Revenue Code	250
Min. Negotiated Rate	$300.76
Max. Negotiated Rate	$631.47
Rate for Payer: Cash Price	$488.74
Rate for Payer: Celtic Commercial/Exchange	$300.76
Rate for Payer: Health Partners Plans Commercial	$618.45
Rate for Payer: UnitedHealthcare Commercial	$631.47
Rate for Payer: WPPA Commercial	$546.84

ALBUMIN SERUM

Facility

$43.00

Service Code	HCPCS 82040
Hospital Charge Code	8204000
Hospital Revenue Code	301
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$41.71
Rate for Payer: BCBS Commercial	$10.63
Rate for Payer: Cash Price	$32.25
Rate for Payer: Cash Price	$32.25
Rate for Payer: Celtic Commercial/Exchange	$19.87
Rate for Payer: Health Partners Plans Commercial	$40.85
Rate for Payer: UnitedHealthcare Commercial	$41.71
Rate for Payer: WPPA Commercial	$36.12

Know your out-of-pocket cost for care.

All Charges