Ness County Hospital

All Charges

Charge

Type

Setting

Price

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

Ferrlecit

Facility

$129.00

Service Code	NDC 00143957001
Hospital Charge Code	2513018
Hospital Revenue Code	250
Min. Negotiated Rate	$59.60
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$96.75
Rate for Payer: Celtic Commercial/Exchange	$59.60
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$108.36

Ferrlecit

Facility

$129.00

Service Code	NDC 00143957001
Hospital Charge Code	2513018
Hospital Revenue Code	250
Min. Negotiated Rate	$105.78
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$96.75
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$105.78

Ferrlecit 62.5mg/5ml

Facility

$129.00

Service Code	NDC 00143957001
Hospital Charge Code	2513018
Hospital Revenue Code	250
Min. Negotiated Rate	$105.78
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$96.75
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$105.78

Ferrlecit 62.5mg/5ml

Facility

$129.00

Service Code	NDC 00143957001
Hospital Charge Code	2513018
Hospital Revenue Code	250
Min. Negotiated Rate	$59.60
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$96.75
Rate for Payer: Celtic Commercial/Exchange	$59.60
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$108.36

FERROUS SULFATE 325 MG TAB

Facility

$1.00

Service Code	NDC 00904759161
Hospital Charge Code	2502789
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

FERROUS SULFATE 325 MG TAB

Facility

$1.00

Service Code	NDC 00904759161
Hospital Charge Code	2502789
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

FEVER AND INFLAMMATORY CONDITIONS

Facility

$7,779.38

Service Code	MSDRG 864
Min. Negotiated Rate	$7,779.38
Max. Negotiated Rate	$7,779.38
Rate for Payer: BCBS Commercial	$7,779.38

FIBEROPTIC ENDOSCOP EVAL SWAL

Facility

$500.00

Service Code	HCPCS 92612
Hospital Charge Code	9261200
Hospital Revenue Code	921
Min. Negotiated Rate	$410.00
Max. Negotiated Rate	$485.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$410.00

FIBEROPTIC ENDOSCOP EVAL SWAL

Facility

$500.00

Service Code	HCPCS 92612
Hospital Charge Code	9261200
Hospital Revenue Code	921
Min. Negotiated Rate	$177.76
Max. Negotiated Rate	$485.00
Rate for Payer: BCBS Commercial	$177.76
Rate for Payer: Cash Price	$375.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Celtic Commercial/Exchange	$231.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$420.00

FIBER OPTIC MAC #3 LARYNGOSCOP

Facility

$14.00

Hospital Charge Code	2700016
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

FIBER OPTIC MAC #3 LARYNGOSCOP

Facility

$14.00

Hospital Charge Code	2700016
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

FIBER OPTIC MAC #4 LARYNGOSCOP

Facility

$14.00

Hospital Charge Code	2700017
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

FIBER OPTIC MAC #4 LARYNGOSCOP

Facility

$14.00

Hospital Charge Code	2700017
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

FIBER OPTIC MILLER#2 LARYNG BL

Facility

$14.00

Hospital Charge Code	2700013
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

FIBER OPTIC MILLER#2 LARYNG BL

Facility

$14.00

Hospital Charge Code	2700013
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

FIBER OPTIC MILLER #3 LARYNGOS

Facility

$14.00

Hospital Charge Code	2700014
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

FIBER OPTIC MILLER #3 LARYNGOS

Facility

$14.00

Hospital Charge Code	2700014
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

FIBER OPT LARYNGOSCOPE #1 PHIL

Facility

$13.00

Hospital Charge Code	2700012
Hospital Revenue Code	272
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.75
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

FIBER OPT LARYNGOSCOPE #1 PHIL

Facility

$13.00

Hospital Charge Code	2700012
Hospital Revenue Code	272
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.75
Rate for Payer: Celtic Commercial/Exchange	$6.01
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.92

FIBRIN DEGRAD PROD D-DIMER

Facility

$162.00

Service Code	HCPCS 85379
Hospital Charge Code	8537900
Hospital Revenue Code	305
Min. Negotiated Rate	$73.62
Max. Negotiated Rate	$157.14
Rate for Payer: BCBS Commercial	$73.62
Rate for Payer: Cash Price	$121.50
Rate for Payer: Cash Price	$121.50
Rate for Payer: Celtic Commercial/Exchange	$74.84
Rate for Payer: Health Partners Plans Commercial	$153.90
Rate for Payer: UnitedHealthcare Commercial	$157.14
Rate for Payer: WPPA Commercial	$136.08

FIBRIN DEGRAD PROD D-DIMER

Facility

$162.00

Service Code	HCPCS 85379
Hospital Charge Code	8537900
Hospital Revenue Code	305
Min. Negotiated Rate	$132.84
Max. Negotiated Rate	$157.14
Rate for Payer: Cash Price	$121.50
Rate for Payer: Health Partners Plans Commercial	$153.90
Rate for Payer: UnitedHealthcare Commercial	$157.14
Rate for Payer: WPPA Commercial	$132.84

FIBRINOGEN ACTIVITY

Facility

$46.00

Service Code	HCPCS 85384
Hospital Charge Code	8538400
Hospital Revenue Code	305
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$44.62
Rate for Payer: BCBS Commercial	$25.65
Rate for Payer: Cash Price	$34.50
Rate for Payer: Cash Price	$34.50
Rate for Payer: Celtic Commercial/Exchange	$21.25
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$38.64

FIBRINOGEN ACTIVITY

Facility

$46.00

Service Code	HCPCS 85384
Hospital Charge Code	8538400
Hospital Revenue Code	305
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$44.62
Rate for Payer: Cash Price	$34.50
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$37.72

FIBRIN(OGEN)DEGRADATION(SPLIT)

Facility

$70.00

Service Code	HCPCS 85362
Hospital Charge Code	8536200
Hospital Revenue Code	305
Min. Negotiated Rate	$32.34
Max. Negotiated Rate	$67.90
Rate for Payer: BCBS Commercial	$42.27
Rate for Payer: Cash Price	$52.50
Rate for Payer: Cash Price	$52.50
Rate for Payer: Celtic Commercial/Exchange	$32.34
Rate for Payer: Health Partners Plans Commercial	$66.50
Rate for Payer: UnitedHealthcare Commercial	$67.90
Rate for Payer: WPPA Commercial	$58.80

Know your out-of-pocket cost for care.

All Charges