Ness County Hospital

All Charges

Charge

Type

Setting

Price

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	$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 PT,NEW PT,WNDMGMT11-25CM

Facility

$129.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	9920210
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 PT,NEW PT,WNDMGMT11-25CM

Facility

$129.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	9920210
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 PT, SELFCARE/HOME MGMNT

Facility

$58.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5720588
Hospital Revenue Code	421
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$56.26
Rate for Payer: Cash Price	$43.69
Rate for Payer: Health Partners Plans Commercial	$55.10
Rate for Payer: UnitedHealthcare Commercial	$56.26
Rate for Payer: WPPA Commercial	$47.56

HH BY PT, SELFCARE/HOME MGMNT

Facility

$58.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5720588
Hospital Revenue Code	421
Min. Negotiated Rate	$26.80
Max. Negotiated Rate	$56.26
Rate for Payer: Cash Price	$43.69
Rate for Payer: Celtic Commercial/Exchange	$26.80
Rate for Payer: Health Partners Plans Commercial	$55.10
Rate for Payer: UnitedHealthcare Commercial	$56.26
Rate for Payer: WPPA Commercial	$48.72

HH BY PT, THER EXERCISE EA 15'

Facility

$77.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710314
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 PT, THER EXERCISE EA 15'

Facility

$77.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710314
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, ULTRASOUND, EA 15MIN

Facility

$106.00

Service Code	HCPCS 97035 GP
Hospital Charge Code	5710371
Hospital Revenue Code	420
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 PT, ULTRASOUND, EA 15MIN

Facility

$106.00

Service Code	HCPCS 97035 GP
Hospital Charge Code	5710371
Hospital Revenue Code	420
Min. Negotiated Rate	$29.29
Max. Negotiated Rate	$102.82
Rate for Payer: BCBS Commercial	$29.29
Rate for Payer: Cash Price	$79.50
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-Canalith Reposition Proc-Eply

Facility

$132.00

Service Code	HCPCS 95992
Hospital Charge Code	4202379
Hospital Revenue Code	420
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

HH-Canalith Reposition Proc-Eply

Facility

$132.00

Service Code	HCPCS 95992
Hospital Charge Code	4202379
Hospital Revenue Code	420
Min. Negotiated Rate	$40.14
Max. Negotiated Rate	$128.04
Rate for Payer: BCBS Commercial	$40.14
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

HH DIR SKILLED SERV EA 15 MIN

Facility

$141.00

Service Code	HCPCS G0299
Hospital Charge Code	5710017
Hospital Revenue Code	551
Min. Negotiated Rate	$115.62
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$105.75
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$115.62

HH DIR SKILLED SERV EA 15 MIN

Facility

$141.00

Service Code	HCPCS G0299
Hospital Charge Code	5710017
Hospital Revenue Code	551
Min. Negotiated Rate	$65.14
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$105.75
Rate for Payer: Celtic Commercial/Exchange	$65.14
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$118.44

H H P T EVALUATION

Facility

$181.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710033
Hospital Revenue Code	421
Min. Negotiated Rate	$148.42
Max. Negotiated Rate	$175.57
Rate for Payer: Cash Price	$135.75
Rate for Payer: Health Partners Plans Commercial	$171.95
Rate for Payer: UnitedHealthcare Commercial	$175.57
Rate for Payer: WPPA Commercial	$148.42

H H P T EVALUATION

Facility

$181.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710033
Hospital Revenue Code	421
Min. Negotiated Rate	$83.62
Max. Negotiated Rate	$175.57
Rate for Payer: Cash Price	$135.75
Rate for Payer: Celtic Commercial/Exchange	$83.62
Rate for Payer: Health Partners Plans Commercial	$171.95
Rate for Payer: UnitedHealthcare Commercial	$175.57
Rate for Payer: WPPA Commercial	$152.04

HH PT RE-EVALUATION/FOLLOWUP

Facility

$103.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710322
Hospital Revenue Code	421
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$84.46

HH PT RE-EVALUATION/FOLLOWUP

Facility

$103.00

Service Code	HCPCS G0151 GP
Hospital Charge Code	5710322
Hospital Revenue Code	421
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

HH ROUTINE, BRIEF SKILLED VIS

Facility

$32.00

Service Code	HCPCS 99600
Hospital Charge Code	9960000
Hospital Revenue Code	271
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

HH ROUTINE, BRIEF SKILLED VIS

Facility

$32.00

Service Code	HCPCS 99600
Hospital Charge Code	9960000
Hospital Revenue Code	271
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

HH SKLD SVC-MGMT/EVAL CAREPLAN

Facility

$131.00

Service Code	HCPCS G0162
Hospital Charge Code	5710018
Hospital Revenue Code	551
Min. Negotiated Rate	$107.42
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$107.42

HH SKLD SVC-MGMT/EVAL CAREPLAN

Facility

$131.00

Service Code	HCPCS G0162
Hospital Charge Code	5710018
Hospital Revenue Code	551
Min. Negotiated Rate	$60.52
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Celtic Commercial/Exchange	$60.52
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$110.04

HH SKLD SVC OBSERV/ASSESS

Facility

$131.00

Service Code	HCPCS S9123
Hospital Charge Code	5710019
Hospital Revenue Code	550
Min. Negotiated Rate	$60.52
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Celtic Commercial/Exchange	$60.52
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$110.04

HH SKLD SVC OBSERV/ASSESS

Facility

$131.00

Service Code	HCPCS S9123
Hospital Charge Code	5710019
Hospital Revenue Code	550
Min. Negotiated Rate	$107.42
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$107.42

HH SKLD SVC TRAIN/EDUCATION

Facility

$131.00

Service Code	HCPCS G0495
Hospital Charge Code	5710020
Hospital Revenue Code	550
Min. Negotiated Rate	$60.52
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Celtic Commercial/Exchange	$60.52
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$110.04

HH SKLD SVC TRAIN/EDUCATION

Facility

$131.00

Service Code	HCPCS G0495
Hospital Charge Code	5710020
Hospital Revenue Code	550
Min. Negotiated Rate	$107.42
Max. Negotiated Rate	$127.07
Rate for Payer: Cash Price	$98.25
Rate for Payer: Health Partners Plans Commercial	$124.45
Rate for Payer: UnitedHealthcare Commercial	$127.07
Rate for Payer: WPPA Commercial	$107.42

Know your out-of-pocket cost for care.

All Charges