Ness County Hospital

All Charges

Charge

Type

Setting

Price

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC

Facility

$31,210.73

Service Code	MSDRG 420
Min. Negotiated Rate	$31,210.73
Max. Negotiated Rate	$31,210.73
Rate for Payer: BCBS Commercial	$31,210.73

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$12,096.16

Service Code	MSDRG 422
Min. Negotiated Rate	$12,096.16
Max. Negotiated Rate	$12,096.16
Rate for Payer: BCBS Commercial	$12,096.16

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC

Facility

$15,841.00

Service Code	MSDRG 354
Min. Negotiated Rate	$15,841.00
Max. Negotiated Rate	$15,841.00
Rate for Payer: BCBS Commercial	$15,841.00

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC

Facility

$26,847.51

Service Code	MSDRG 353
Min. Negotiated Rate	$26,847.51
Max. Negotiated Rate	$26,847.51
Rate for Payer: BCBS Commercial	$26,847.51

HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC

Facility

$12,072.46

Service Code	MSDRG 355
Min. Negotiated Rate	$12,072.46
Max. Negotiated Rate	$12,072.46
Rate for Payer: BCBS Commercial	$12,072.46

HEROIN METABOLITE SCREEN

Facility

$271.00

Service Code	HCPCS 80356
Hospital Charge Code	8035600
Hospital Revenue Code	300
Min. Negotiated Rate	$222.22
Max. Negotiated Rate	$262.87
Rate for Payer: Cash Price	$203.25
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$222.22

HEROIN METABOLITE SCREEN

Facility

$271.00

Service Code	HCPCS 80356
Hospital Charge Code	8035600
Hospital Revenue Code	300
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$23.88
Rate for Payer: Cash Price	$203.25
Rate for Payer: Cash Price	$203.25
Rate for Payer: Celtic Commercial/Exchange	$125.20
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$227.64

HERPES SIMPLEX VIRUS, AMP TECH

Facility

$125.00

Service Code	HCPCS 87529
Hospital Charge Code	8752900
Hospital Revenue Code	306
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$121.25
Rate for Payer: BCBS Commercial	$75.32
Rate for Payer: Cash Price	$93.75
Rate for Payer: Cash Price	$93.75
Rate for Payer: Celtic Commercial/Exchange	$57.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$105.00

HERPES SIMPLEX VIRUS, AMP TECH

Facility

$125.00

Service Code	HCPCS 87529
Hospital Charge Code	8752900
Hospital Revenue Code	306
Min. Negotiated Rate	$102.50
Max. Negotiated Rate	$121.25
Rate for Payer: Cash Price	$93.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$102.50

HERPES SIMPLEX VIRUS TYPE 1

Facility

$71.00

Service Code	HCPCS 87274
Hospital Charge Code	8727400
Hospital Revenue Code	306
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$53.25
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$58.22

HERPES SIMPLEX VIRUS TYPE 1

Facility

$71.00

Service Code	HCPCS 87274
Hospital Charge Code	8727400
Hospital Revenue Code	306
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$68.87
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$53.25
Rate for Payer: Cash Price	$53.25
Rate for Payer: Celtic Commercial/Exchange	$32.80
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$59.64

HERPES SIMPLEX VIRUS TYPE 2

Facility

$79.00

Service Code	HCPCS 87273
Hospital Charge Code	8727300
Hospital Revenue Code	306
Min. Negotiated Rate	$36.50
Max. Negotiated Rate	$76.63
Rate for Payer: BCBS Commercial	$60.95
Rate for Payer: Cash Price	$59.25
Rate for Payer: Cash Price	$59.25
Rate for Payer: Celtic Commercial/Exchange	$36.50
Rate for Payer: Health Partners Plans Commercial	$75.05
Rate for Payer: UnitedHealthcare Commercial	$76.63
Rate for Payer: WPPA Commercial	$66.36

HERPES SIMPLEX VIRUS TYPE 2

Facility

$79.00

Service Code	HCPCS 87273
Hospital Charge Code	8727300
Hospital Revenue Code	306
Min. Negotiated Rate	$64.78
Max. Negotiated Rate	$76.63
Rate for Payer: Cash Price	$59.25
Rate for Payer: Health Partners Plans Commercial	$75.05
Rate for Payer: UnitedHealthcare Commercial	$76.63
Rate for Payer: WPPA Commercial	$64.78

HETEROPHILE ANTIBODIES, SCREEN

Facility

$71.00

Service Code	HCPCS 86308
Hospital Charge Code	8630800
Hospital Revenue Code	302
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$68.87
Rate for Payer: BCBS Commercial	$19.50
Rate for Payer: Cash Price	$53.25
Rate for Payer: Cash Price	$53.25
Rate for Payer: Celtic Commercial/Exchange	$32.80
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$59.64

HETEROPHILE ANTIBODIES, SCREEN

Facility

$71.00

Service Code	HCPCS 86308
Hospital Charge Code	8630800
Hospital Revenue Code	302
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$53.25
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$58.22

HETEROPHILE, MONO SCREEN

Facility

$37.00

Service Code	HCPCS 86308
Hospital Charge Code	8630801
Hospital Revenue Code	302
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$27.75
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$30.34

HETEROPHILE, MONO SCREEN

Facility

$37.00

Service Code	HCPCS 86308
Hospital Charge Code	8630801
Hospital Revenue Code	302
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$35.89
Rate for Payer: BCBS Commercial	$19.50
Rate for Payer: Cash Price	$27.75
Rate for Payer: Cash Price	$27.75
Rate for Payer: Celtic Commercial/Exchange	$17.09
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$31.08

HEXAGONAL PHOSPHOLIPID NETRUAL

Facility

$175.00

Service Code	HCPCS 85598
Hospital Charge Code	8559800
Hospital Revenue Code	305
Min. Negotiated Rate	$143.50
Max. Negotiated Rate	$169.75
Rate for Payer: Cash Price	$131.25
Rate for Payer: Health Partners Plans Commercial	$166.25
Rate for Payer: UnitedHealthcare Commercial	$169.75
Rate for Payer: WPPA Commercial	$143.50

HEXAGONAL PHOSPHOLIPID NETRUAL

Facility

$175.00

Service Code	HCPCS 85598
Hospital Charge Code	8559800
Hospital Revenue Code	305
Min. Negotiated Rate	$80.85
Max. Negotiated Rate	$169.75
Rate for Payer: BCBS Commercial	$150.26
Rate for Payer: Cash Price	$131.25
Rate for Payer: Cash Price	$131.25
Rate for Payer: Celtic Commercial/Exchange	$80.85
Rate for Payer: Health Partners Plans Commercial	$166.25
Rate for Payer: UnitedHealthcare Commercial	$169.75
Rate for Payer: WPPA Commercial	$147.00

HFE GENE ANALYSIS,COMMON VARIA

Facility

$376.00

Service Code	HCPCS 81256
Hospital Charge Code	8125600
Hospital Revenue Code	301
Min. Negotiated Rate	$308.32
Max. Negotiated Rate	$364.72
Rate for Payer: Cash Price	$282.00
Rate for Payer: Health Partners Plans Commercial	$357.20
Rate for Payer: UnitedHealthcare Commercial	$364.72
Rate for Payer: WPPA Commercial	$308.32

HFE GENE ANALYSIS,COMMON VARIA

Facility

$376.00

Service Code	HCPCS 81256
Hospital Charge Code	8125600
Hospital Revenue Code	301
Min. Negotiated Rate	$173.71
Max. Negotiated Rate	$379.30
Rate for Payer: BCBS Commercial	$379.30
Rate for Payer: Cash Price	$282.00
Rate for Payer: Cash Price	$282.00
Rate for Payer: Celtic Commercial/Exchange	$173.71
Rate for Payer: Health Partners Plans Commercial	$357.20
Rate for Payer: UnitedHealthcare Commercial	$364.72
Rate for Payer: WPPA Commercial	$315.84

HH ASSESSMENT OF APHASIA,HRLY

Facility

$200.00

Service Code	HCPCS 96105 GN
Hospital Charge Code	9610501
Hospital Revenue Code	444
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

HH ASSESSMENT OF APHASIA,HRLY

Facility

$200.00

Service Code	HCPCS 96105 GN
Hospital Charge Code	9610501
Hospital Revenue Code	444
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$194.00
Rate for Payer: BCBS Commercial	$136.68
Rate for Payer: Cash Price	$150.00
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

HH BY ASST-ELEC STIM-ATTENDED

Facility

$113.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5711091
Hospital Revenue Code	421
Min. Negotiated Rate	$52.21
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$85.12
Rate for Payer: Celtic Commercial/Exchange	$52.21
Rate for Payer: Health Partners Plans Commercial	$107.35
Rate for Payer: UnitedHealthcare Commercial	$109.61
Rate for Payer: WPPA Commercial	$94.92

HH BY ASST-ELEC STIM-ATTENDED

Facility

$113.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5711091
Hospital Revenue Code	421
Min. Negotiated Rate	$92.66
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$85.12
Rate for Payer: Health Partners Plans Commercial	$107.35
Rate for Payer: UnitedHealthcare Commercial	$109.61
Rate for Payer: WPPA Commercial	$92.66

Know your out-of-pocket cost for care.

All Charges