Ness County Hospital

All Charges

Charge

Type

Setting

Price

FATTY ACIDS, NONESTERIFIED

Facility

$57.00

Service Code	HCPCS 82725
Hospital Charge Code	8272500
Hospital Revenue Code	301
Min. Negotiated Rate	$46.74
Max. Negotiated Rate	$55.29
Rate for Payer: Cash Price	$42.75
Rate for Payer: Health Partners Plans Commercial	$54.15
Rate for Payer: UnitedHealthcare Commercial	$55.29
Rate for Payer: WPPA Commercial	$46.74

FEBRILE ANTIBODIES PANEL

Facility

$1,034.00

Hospital Charge Code	8888884
Hospital Revenue Code	302
Min. Negotiated Rate	$847.88
Max. Negotiated Rate	$1,002.98
Rate for Payer: Cash Price	$775.50
Rate for Payer: Health Partners Plans Commercial	$982.30
Rate for Payer: UnitedHealthcare Commercial	$1,002.98
Rate for Payer: WPPA Commercial	$847.88

FEBRILE ANTIBODIES PANEL

Facility

$1,034.00

Hospital Charge Code	8888884
Hospital Revenue Code	302
Min. Negotiated Rate	$477.71
Max. Negotiated Rate	$1,002.98
Rate for Payer: Cash Price	$775.50
Rate for Payer: Celtic Commercial/Exchange	$477.71
Rate for Payer: Health Partners Plans Commercial	$982.30
Rate for Payer: UnitedHealthcare Commercial	$1,002.98
Rate for Payer: WPPA Commercial	$868.56

FECES, PH

Facility

$29.00

Service Code	HCPCS 83986
Hospital Charge Code	8398601
Hospital Revenue Code	301
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: BCBS Commercial	$16.05
Rate for Payer: Cash Price	$21.75
Rate for Payer: Cash Price	$21.75
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

FECES, PH

Facility

$29.00

Service Code	HCPCS 83986
Hospital Charge Code	8398601
Hospital Revenue Code	301
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$21.75
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

FELBAMATE (FELBATOL)

Facility

$108.00

Service Code	HCPCS 80299
Hospital Charge Code	8029912
Hospital Revenue Code	301
Min. Negotiated Rate	$49.90
Max. Negotiated Rate	$104.76
Rate for Payer: BCBS Commercial	$65.71
Rate for Payer: Cash Price	$81.00
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

FELBAMATE (FELBATOL)

Facility

$108.00

Service Code	HCPCS 80299
Hospital Charge Code	8029912
Hospital Revenue Code	301
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

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$11,960.63

Service Code	MSDRG 748
Min. Negotiated Rate	$11,960.63
Max. Negotiated Rate	$11,960.63
Rate for Payer: BCBS Commercial	$11,960.63

FEMUR LT 1V

Facility

$176.00

Service Code	HCPCS 73551 LT
Hospital Charge Code	3291235
Hospital Revenue Code	320
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$170.72
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Celtic Commercial/Exchange	$81.31
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$147.84

FEMUR LT 1V

Facility

$176.00

Service Code	HCPCS 73551 LT
Hospital Charge Code	3291235
Hospital Revenue Code	320
Min. Negotiated Rate	$144.32
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$132.00
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$144.32

FEMUR LT 2V

Facility

$257.00

Service Code	HCPCS 73552 LT
Hospital Charge Code	3290027
Hospital Revenue Code	320
Min. Negotiated Rate	$110.06
Max. Negotiated Rate	$249.29
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$192.75
Rate for Payer: Cash Price	$192.75
Rate for Payer: Celtic Commercial/Exchange	$118.73
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$215.88

FEMUR LT 2V

Facility

$257.00

Service Code	HCPCS 73552 LT
Hospital Charge Code	3290027
Hospital Revenue Code	320
Min. Negotiated Rate	$210.74
Max. Negotiated Rate	$249.29
Rate for Payer: Cash Price	$192.75
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$210.74

FEMUR RT 1V

Facility

$176.00

Service Code	HCPCS 73551 RT
Hospital Charge Code	3291234
Hospital Revenue Code	320
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$170.72
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Celtic Commercial/Exchange	$81.31
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$147.84

FEMUR RT 1V

Facility

$176.00

Service Code	HCPCS 73551 RT
Hospital Charge Code	3291234
Hospital Revenue Code	320
Min. Negotiated Rate	$144.32
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$132.00
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$144.32

FEMUR RT 2V

Facility

$257.00

Service Code	HCPCS 73552 RT
Hospital Charge Code	3290026
Hospital Revenue Code	320
Min. Negotiated Rate	$210.74
Max. Negotiated Rate	$249.29
Rate for Payer: Cash Price	$192.75
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$210.74

FEMUR RT 2V

Facility

$257.00

Service Code	HCPCS 73552 RT
Hospital Charge Code	3290026
Hospital Revenue Code	320
Min. Negotiated Rate	$110.06
Max. Negotiated Rate	$249.29
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$192.75
Rate for Payer: Cash Price	$192.75
Rate for Payer: Celtic Commercial/Exchange	$118.73
Rate for Payer: Health Partners Plans Commercial	$244.15
Rate for Payer: UnitedHealthcare Commercial	$249.29
Rate for Payer: WPPA Commercial	$215.88

FENTANYL

Facility

$110.00

Service Code	HCPCS 80354
Hospital Charge Code	8035400
Hospital Revenue Code	300
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$106.70
Rate for Payer: BCBS Commercial	$23.88
Rate for Payer: Cash Price	$82.50
Rate for Payer: Cash Price	$82.50
Rate for Payer: Celtic Commercial/Exchange	$50.82
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$92.40

FENTANYL

Facility

$110.00

Service Code	HCPCS 80354
Hospital Charge Code	8035400
Hospital Revenue Code	300
Min. Negotiated Rate	$90.20
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$82.50
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$90.20

Fentanyl 0.05mg/ml - 5 ml vial inj

Facility

$24.00

Service Code	NDC 00409909335
Hospital Charge Code	2513414
Hospital Revenue Code	250
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

Fentanyl 0.05mg/ml - 5 ml vial inj

Facility

$24.00

Service Code	NDC 00409909335
Hospital Charge Code	2513414
Hospital Revenue Code	250
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

fentanyl citrate 50 mcg/ml (0.05 mg/ml) 1 ml Vial

Facility

$8.00

Service Code	NDC 63323080611
Hospital Charge Code	2512192
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.07
Rate for Payer: Celtic Commercial/Exchange	$3.70
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.72

fentanyl citrate 50 mcg/ml (0.05 mg/ml) 1 ml Vial

Facility

$8.00

Service Code	NDC 63323080611
Hospital Charge Code	2512192
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.07
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

FERAHEME 510 MG/17 ML INJ. (FERUMOXYTOL) IV

Facility

$4,297.00

Service Code	NDC 59338077501
Hospital Charge Code	2513059
Hospital Revenue Code	250
Min. Negotiated Rate	$3,523.54
Max. Negotiated Rate	$4,168.09
Rate for Payer: Cash Price	$3,222.94
Rate for Payer: Health Partners Plans Commercial	$4,082.15
Rate for Payer: UnitedHealthcare Commercial	$4,168.09
Rate for Payer: WPPA Commercial	$3,523.54

FERAHEME 510 MG/17 ML INJ. (FERUMOXYTOL) IV

Facility

$4,297.00

Service Code	NDC 59338077501
Hospital Charge Code	2513059
Hospital Revenue Code	250
Min. Negotiated Rate	$1,985.21
Max. Negotiated Rate	$4,168.09
Rate for Payer: Cash Price	$3,222.94
Rate for Payer: Celtic Commercial/Exchange	$1,985.21
Rate for Payer: Health Partners Plans Commercial	$4,082.15
Rate for Payer: UnitedHealthcare Commercial	$4,168.09
Rate for Payer: WPPA Commercial	$3,609.48

FERRITIN

Facility

$139.00

Service Code	HCPCS 82728
Hospital Charge Code	8272800
Hospital Revenue Code	301
Min. Negotiated Rate	$113.98
Max. Negotiated Rate	$134.83
Rate for Payer: Cash Price	$104.25
Rate for Payer: Health Partners Plans Commercial	$132.05
Rate for Payer: UnitedHealthcare Commercial	$134.83
Rate for Payer: WPPA Commercial	$113.98

Know your out-of-pocket cost for care.

All Charges