Ness County Hospital

All Charges

Charge

Type

Setting

Price

Fluzone Regular 2025-2026 (flu vacc ts 2025-26 (6 mos up)) IM suspension

Facility

$52.00

Service Code	NDC 49281064315
Hospital Charge Code	2510030
Hospital Revenue Code	250
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.38
Rate for Payer: Celtic Commercial/Exchange	$24.02
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$43.68

Fluzone Regular 2025-2026 (flu vacc ts 2025-26 (6 mos up)) IM suspension

Facility

$52.00

Service Code	NDC 49281064315
Hospital Charge Code	2510030
Hospital Revenue Code	250
Min. Negotiated Rate	$42.64
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.38
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$42.64

FOAMLITE 4X4

Facility

$15.00

Hospital Charge Code	2727045
Hospital Revenue Code	270
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Celtic Commercial/Exchange	$6.93
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.60

FOAMLITE 4X4

Facility

$15.00

Hospital Charge Code	2727045
Hospital Revenue Code	270
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.30

FOB,STOOL,ONE STEP HEMOSURE

Facility

$54.00

Service Code	HCPCS 82274
Hospital Charge Code	8227401
Hospital Revenue Code	301
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$52.38
Rate for Payer: BCBS Commercial	$34.14
Rate for Payer: Cash Price	$40.50
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

FOB,STOOL,ONE STEP HEMOSURE

Facility

$54.00

Service Code	HCPCS 82274
Hospital Charge Code	8227401
Hospital Revenue Code	301
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

FOB,STOOL,SCREENING

Facility

$50.00

Service Code	HCPCS G0328
Hospital Charge Code	G032800
Hospital Revenue Code	301
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: BCBS Commercial	$34.14
Rate for Payer: Cash Price	$37.50
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

FOB,STOOL,SCREENING

Facility

$50.00

Service Code	HCPCS G0328
Hospital Charge Code	G032800
Hospital Revenue Code	301
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

FOLDING WALKER

Facility

$139.00

Hospital Charge Code	5710207
Hospital Revenue Code	271
Min. Negotiated Rate	$113.98
Max. Negotiated Rate	$134.83
Rate for Payer: Cash Price	$104.62
Rate for Payer: Health Partners Plans Commercial	$132.05
Rate for Payer: UnitedHealthcare Commercial	$134.83
Rate for Payer: WPPA Commercial	$113.98

FOLDING WALKER

Facility

$139.00

Hospital Charge Code	5710207
Hospital Revenue Code	271
Min. Negotiated Rate	$64.22
Max. Negotiated Rate	$134.83
Rate for Payer: Cash Price	$104.62
Rate for Payer: Celtic Commercial/Exchange	$64.22
Rate for Payer: Health Partners Plans Commercial	$132.05
Rate for Payer: UnitedHealthcare Commercial	$134.83
Rate for Payer: WPPA Commercial	$116.76

FOLEY ANCHOR

Facility

$20.00

Hospital Charge Code	2700716
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.19
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

FOLEY ANCHOR

Facility

$20.00

Hospital Charge Code	2700716
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.19
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

FOLEY CATHETER

Facility

$34.00

Hospital Charge Code	2720472
Hospital Revenue Code	272
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.69
Rate for Payer: Celtic Commercial/Exchange	$15.71
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$28.56

FOLEY CATHETER

Facility

$34.00

Hospital Charge Code	2720472
Hospital Revenue Code	272
Min. Negotiated Rate	$27.88
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.69
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$27.88

FOLEY CATHETER 24/26 3-WAY

Facility

$34.00

Hospital Charge Code	2720647
Hospital Revenue Code	272
Min. Negotiated Rate	$27.88
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.69
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$27.88

FOLEY CATHETER 24/26 3-WAY

Facility

$34.00

Hospital Charge Code	2720647
Hospital Revenue Code	272
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.69
Rate for Payer: Celtic Commercial/Exchange	$15.71
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$28.56

FOLEY CATHETER 5CC 22 FR 3-WAY

Facility

$32.00

Hospital Charge Code	2720589
Hospital Revenue Code	272
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$31.04
Rate for Payer: Cash Price	$24.38
Rate for Payer: Celtic Commercial/Exchange	$14.78
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.88

FOLEY CATHETER 5CC 22 FR 3-WAY

Facility

$32.00

Hospital Charge Code	2720589
Hospital Revenue Code	272
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$31.04
Rate for Payer: Cash Price	$24.38
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.24

FOLEY TRAY WITHOUT CATHETER

Facility

$30.00

Hospital Charge Code	2720225
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.88
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

FOLEY TRAY WITHOUT CATHETER

Facility

$30.00

Hospital Charge Code	2720225
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.88
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

FOLIC ACID 1 MG TAB

Facility

$1.00

Service Code	NDC 60687068111
Hospital Charge Code	2502854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
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

FOLIC ACID 1 MG TAB

Facility

$1.00

Service Code	NDC 60687068111
Hospital Charge Code	2502854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

FOLIC ACID RBC

Facility

$151.00

Service Code	HCPCS 82747
Hospital Charge Code	8274700
Hospital Revenue Code	301
Min. Negotiated Rate	$123.82
Max. Negotiated Rate	$146.47
Rate for Payer: Cash Price	$113.25
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$123.82

FOLIC ACID RBC

Facility

$151.00

Service Code	HCPCS 82747
Hospital Charge Code	8274700
Hospital Revenue Code	301
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$146.47
Rate for Payer: BCBS Commercial	$63.60
Rate for Payer: Cash Price	$113.25
Rate for Payer: Cash Price	$113.25
Rate for Payer: Celtic Commercial/Exchange	$69.76
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$126.84

FOLIC ACID SERUM

Facility

$139.00

Service Code	HCPCS 82746
Hospital Charge Code	8274600
Hospital Revenue Code	301
Min. Negotiated Rate	$61.81
Max. Negotiated Rate	$134.83
Rate for Payer: BCBS Commercial	$61.81
Rate for Payer: Cash Price	$104.25
Rate for Payer: Cash Price	$104.25
Rate for Payer: Celtic Commercial/Exchange	$64.22
Rate for Payer: Health Partners Plans Commercial	$132.05
Rate for Payer: UnitedHealthcare Commercial	$134.83
Rate for Payer: WPPA Commercial	$116.76

Know your out-of-pocket cost for care.

All Charges