Ness County Hospital

All Charges

Charge

Type

Setting

Price

HCBS (TBI) PERSONAL SERVICES

Facility

$13.00

Hospital Charge Code	8300029
Hospital Revenue Code	271
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.94
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

HCBS WELLNESS

Facility

$39.00

Hospital Charge Code	5910030
Hospital Revenue Code	271
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

HCBS WELLNESS

Facility

$39.00

Hospital Charge Code	5910030
Hospital Revenue Code	271
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

HCG WITH GESTATIONAL TABLE

Facility

$112.00

Service Code	HCPCS 84702
Hospital Charge Code	8470201
Hospital Revenue Code	301
Min. Negotiated Rate	$51.74
Max. Negotiated Rate	$108.64
Rate for Payer: BCBS Commercial	$60.36
Rate for Payer: Cash Price	$84.00
Rate for Payer: Cash Price	$84.00
Rate for Payer: Celtic Commercial/Exchange	$51.74
Rate for Payer: Health Partners Plans Commercial	$106.40
Rate for Payer: UnitedHealthcare Commercial	$108.64
Rate for Payer: WPPA Commercial	$94.08

HCG WITH GESTATIONAL TABLE

Facility

$112.00

Service Code	HCPCS 84702
Hospital Charge Code	8470201
Hospital Revenue Code	301
Min. Negotiated Rate	$91.84
Max. Negotiated Rate	$108.64
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Partners Plans Commercial	$106.40
Rate for Payer: UnitedHealthcare Commercial	$108.64
Rate for Payer: WPPA Commercial	$91.84

HEADACHES WITH MCC

Facility

$10,234.35

Service Code	MSDRG 102
Min. Negotiated Rate	$10,234.35
Max. Negotiated Rate	$10,234.35
Rate for Payer: BCBS Commercial	$10,234.35

HEADACHES WITHOUT MCC

Facility

$5,593.03

Service Code	MSDRG 103
Min. Negotiated Rate	$5,593.03
Max. Negotiated Rate	$5,593.03
Rate for Payer: BCBS Commercial	$5,593.03

HEAD BLOCK 1PR

Facility

$40.00

Hospital Charge Code	2701770
Hospital Revenue Code	270
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$32.80

HEAD BLOCK 1PR

Facility

$40.00

Hospital Charge Code	2701770
Hospital Revenue Code	270
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Celtic Commercial/Exchange	$18.48
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$33.60

HEAD CRADLE ADULT

Facility

$15.00

Hospital Charge Code	2701760
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

HEAD CRADLE ADULT

Facility

$15.00

Hospital Charge Code	2701760
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

HEAD DRESSING

Facility

$10.00

Hospital Charge Code	2720720
Hospital Revenue Code	272
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$8.06
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

HEAD DRESSING

Facility

$10.00

Hospital Charge Code	2720720
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$8.06
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

HEAD POSITIONER ADULT

Facility

$8.00

Hospital Charge Code	2701771
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.00
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

HEAD POSITIONER ADULT

Facility

$8.00

Hospital Charge Code	2701771
Hospital Revenue Code	272
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.00
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

HEARING AID EXAM ONE EAR

Facility

$200.00

Service Code	HCPCS 92590
Hospital Charge Code	9259000
Hospital Revenue Code	761
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$194.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Celtic Commercial/Exchange	$92.40
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$168.00

HEARING AID EXAM ONE EAR

Facility

$200.00

Service Code	HCPCS 92590
Hospital Charge Code	9259000
Hospital Revenue Code	761
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$194.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$164.00

HEART FAILURE AND SHOCK WITH CC

Facility

$7,663.98

Service Code	MSDRG 292
Min. Negotiated Rate	$7,663.98
Max. Negotiated Rate	$7,663.98
Rate for Payer: BCBS Commercial	$7,663.98

HEART FAILURE AND SHOCK WITH MCC

Facility

$13,791.55

Service Code	MSDRG 291
Min. Negotiated Rate	$13,791.55
Max. Negotiated Rate	$13,791.55
Rate for Payer: BCBS Commercial	$13,791.55

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$5,746.99

Service Code	MSDRG 293
Min. Negotiated Rate	$5,746.99
Max. Negotiated Rate	$5,746.99
Rate for Payer: BCBS Commercial	$5,746.99

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$309,859.01

Service Code	MSDRG 001
Min. Negotiated Rate	$309,859.01
Max. Negotiated Rate	$309,859.01
Rate for Payer: BCBS Commercial	$309,859.01

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$113,177.82

Service Code	MSDRG 002
Min. Negotiated Rate	$113,177.82
Max. Negotiated Rate	$113,177.82
Rate for Payer: BCBS Commercial	$113,177.82

HEEL & ELBOW PROTECTOR LG

Facility

$48.00

Hospital Charge Code	2701754
Hospital Revenue Code	270
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

HEEL & ELBOW PROTECTOR LG

Facility

$48.00

Hospital Charge Code	2701754
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

HEEL & ELBOW PROTECTOR MD

Facility

$48.00

Hospital Charge Code	2701755
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

Know your out-of-pocket cost for care.

All Charges