Ness County Hospital

All Charges

Charge

Type

Setting

Price

HH BY ASST,EST PT,WNDMGMT11-25

Facility

$118.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	9921211
Hospital Revenue Code	421
Min. Negotiated Rate	$96.76
Max. Negotiated Rate	$114.46
Rate for Payer: Cash Price	$88.69
Rate for Payer: Health Partners Plans Commercial	$112.10
Rate for Payer: UnitedHealthcare Commercial	$114.46
Rate for Payer: WPPA Commercial	$96.76

HH BY ASST,EST PT,WNDMGMT11-25

Facility

$118.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	9921211
Hospital Revenue Code	421
Min. Negotiated Rate	$54.52
Max. Negotiated Rate	$114.46
Rate for Payer: Cash Price	$88.69
Rate for Payer: Celtic Commercial/Exchange	$54.52
Rate for Payer: Health Partners Plans Commercial	$112.10
Rate for Payer: UnitedHealthcare Commercial	$114.46
Rate for Payer: WPPA Commercial	$99.12

HH BY ASST,GAIT TRNG, EA 15MIN

Facility

$93.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720355
Hospital Revenue Code	421
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

HH BY ASST,GAIT TRNG, EA 15MIN

Facility

$93.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720355
Hospital Revenue Code	421
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

HH BY ASST,MAN THER(MOB/MANIP/

Facility

$88.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720492
Hospital Revenue Code	421
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

HH BY ASST,MAN THER(MOB/MANIP/

Facility

$88.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720492
Hospital Revenue Code	421
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

HH BY ASST,MASSAGE EA 15 MIN.

Facility

$80.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720397
Hospital Revenue Code	421
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

HH BY ASST,MASSAGE EA 15 MIN.

Facility

$80.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720397
Hospital Revenue Code	421
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

HH BY ASST,NEW PT,WNDMGMT11-25

Facility

$129.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	9920211
Hospital Revenue Code	421
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

HH BY ASST,NEW PT,WNDMGMT11-25

Facility

$129.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	9920211
Hospital Revenue Code	421
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

HH BY ASST,THER EXERCISE EA15"

Facility

$77.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720314
Hospital Revenue Code	421
Min. Negotiated Rate	$63.14
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$57.75
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$63.14

HH BY ASST,THER EXERCISE EA15"

Facility

$77.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720314
Hospital Revenue Code	421
Min. Negotiated Rate	$35.57
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$57.75
Rate for Payer: Celtic Commercial/Exchange	$35.57
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$64.68

HH BY ASST,ULTRASOUND,EA 15MIN

Facility

$106.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720371
Hospital Revenue Code	421
Min. Negotiated Rate	$86.92
Max. Negotiated Rate	$102.82
Rate for Payer: Cash Price	$79.50
Rate for Payer: Health Partners Plans Commercial	$100.70
Rate for Payer: UnitedHealthcare Commercial	$102.82
Rate for Payer: WPPA Commercial	$86.92

HH BY ASST,ULTRASOUND,EA 15MIN

Facility

$106.00

Service Code	HCPCS G0157 GP
Hospital Charge Code	5720371
Hospital Revenue Code	421
Min. Negotiated Rate	$48.97
Max. Negotiated Rate	$102.82
Rate for Payer: Cash Price	$79.50
Rate for Payer: Celtic Commercial/Exchange	$48.97
Rate for Payer: Health Partners Plans Commercial	$100.70
Rate for Payer: UnitedHealthcare Commercial	$102.82
Rate for Payer: WPPA Commercial	$89.04

HH BY PT-ELEC STIM-ATTENDED

Facility

$113.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5711147
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

HH BY PT-ELEC STIM-ATTENDED

Facility

$113.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5711147
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 PT,EST PT,WNDMGMT11-25CM

Facility

$118.00

Service Code	HCPCS S9131 GP
Hospital Charge Code	9921210
Hospital Revenue Code	421
Min. Negotiated Rate	$96.76
Max. Negotiated Rate	$114.46
Rate for Payer: Cash Price	$88.69
Rate for Payer: Health Partners Plans Commercial	$112.10
Rate for Payer: UnitedHealthcare Commercial	$114.46
Rate for Payer: WPPA Commercial	$96.76

HH BY PT,EST PT,WNDMGMT11-25CM

Facility

$118.00

Service Code	HCPCS S9131 GP
Hospital Charge Code	9921210
Hospital Revenue Code	421
Min. Negotiated Rate	$54.52
Max. Negotiated Rate	$114.46
Rate for Payer: Cash Price	$88.69
Rate for Payer: Celtic Commercial/Exchange	$54.52
Rate for Payer: Health Partners Plans Commercial	$112.10
Rate for Payer: UnitedHealthcare Commercial	$114.46
Rate for Payer: WPPA Commercial	$99.12

HH BY PT, GAIT TRAINING EA 15"

Facility

$93.00

Service Code	HCPCS 97116 GP
Hospital Charge Code	5710355
Hospital Revenue Code	420
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: BCBS Commercial	$46.46
Rate for Payer: Cash Price	$69.75
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

HH BY PT, GAIT TRAINING EA 15"

Facility

$93.00

Service Code	HCPCS 97116 GP
Hospital Charge Code	5710355
Hospital Revenue Code	420
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

HH BY PT, HOME ASSESS EA 15"

Facility

$77.00

Service Code	HCPCS 97535 GP
Hospital Charge Code	5710335
Hospital Revenue Code	421
Min. Negotiated Rate	$63.14
Max. Negotiated Rate	$74.69
Rate for Payer: Cash Price	$57.75
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$63.14

HH BY PT, HOME ASSESS EA 15"

Facility

$77.00

Service Code	HCPCS 97535 GP
Hospital Charge Code	5710335
Hospital Revenue Code	421
Min. Negotiated Rate	$34.17
Max. Negotiated Rate	$74.69
Rate for Payer: BCBS Commercial	$34.17
Rate for Payer: Cash Price	$57.75
Rate for Payer: Cash Price	$57.75
Rate for Payer: Celtic Commercial/Exchange	$35.57
Rate for Payer: Health Partners Plans Commercial	$73.15
Rate for Payer: UnitedHealthcare Commercial	$74.69
Rate for Payer: WPPA Commercial	$64.68

HH BY PT, MAN THER(MOB/MANIP/

Facility

$88.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710492
Hospital Revenue Code	421
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

HH BY PT, MAN THER(MOB/MANIP/

Facility

$88.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710492
Hospital Revenue Code	421
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

HH BY PT, MASSAGE EA 15 MIN.

Facility

$80.00

Service Code	HCPCS 97124 GP
Hospital Charge Code	5710397
Hospital Revenue Code	420
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: BCBS Commercial	$42.42
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

Know your out-of-pocket cost for care.

All Charges