Ness County Hospital

All Charges

Charge

Type

Setting

Price

H H SPEECH PATH/CONSULT

Facility

$59.00

Service Code	HCPCS 92507 GN
Hospital Charge Code	5850037
Hospital Revenue Code	441
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$57.23
Rate for Payer: Cash Price	$44.25
Rate for Payer: Health Partners Plans Commercial	$56.05
Rate for Payer: UnitedHealthcare Commercial	$57.23
Rate for Payer: WPPA Commercial	$48.38

H H SPEECH PATH/CONSULT

Facility

$59.00

Service Code	HCPCS 92507 GN
Hospital Charge Code	5850037
Hospital Revenue Code	441
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$77.77
Rate for Payer: BCBS Commercial	$77.77
Rate for Payer: Cash Price	$44.25
Rate for Payer: Cash Price	$44.25
Rate for Payer: Celtic Commercial/Exchange	$27.26
Rate for Payer: Health Partners Plans Commercial	$56.05
Rate for Payer: UnitedHealthcare Commercial	$57.23
Rate for Payer: WPPA Commercial	$49.56

HH SPEECH THERAPY

Facility

$105.00

Service Code	HCPCS 92507 GN
Hospital Charge Code	5850011
Hospital Revenue Code	441
Min. Negotiated Rate	$48.51
Max. Negotiated Rate	$101.85
Rate for Payer: BCBS Commercial	$77.77
Rate for Payer: Cash Price	$78.75
Rate for Payer: Cash Price	$78.75
Rate for Payer: Celtic Commercial/Exchange	$48.51
Rate for Payer: Health Partners Plans Commercial	$99.75
Rate for Payer: UnitedHealthcare Commercial	$101.85
Rate for Payer: WPPA Commercial	$88.20

HH SPEECH THERAPY

Facility

$105.00

Service Code	HCPCS 92507 GN
Hospital Charge Code	5850011
Hospital Revenue Code	441
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$101.85
Rate for Payer: Cash Price	$78.75
Rate for Payer: Health Partners Plans Commercial	$99.75
Rate for Payer: UnitedHealthcare Commercial	$101.85
Rate for Payer: WPPA Commercial	$86.10

HH SPEECH THERAPY EVALUATION

Facility

$150.00

Service Code	HCPCS 92506 GN
Hospital Charge Code	5850003
Hospital Revenue Code	441
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Celtic Commercial/Exchange	$69.30
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$126.00

HH SPEECH THERAPY EVALUATION

Facility

$150.00

Service Code	HCPCS 92506 GN
Hospital Charge Code	5850003
Hospital Revenue Code	441
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$123.00

HH-TX SWALLOWING DYSFUNC/ORAL

Facility

$350.00

Service Code	HCPCS G0153
Hospital Charge Code	5850047
Hospital Revenue Code	441
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Celtic Commercial/Exchange	$161.70
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$294.00

HH-TX SWALLOWING DYSFUNC/ORAL

Facility

$350.00

Service Code	HCPCS G0153
Hospital Charge Code	5850047
Hospital Revenue Code	441
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

Hibiclens 4% scrub 118 ml (chlorhexidine gluconate)

Facility

$20.00

Service Code	NDC 00116106104
Hospital Charge Code	2516540
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.52
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

Hibiclens 4% scrub 118 ml (chlorhexidine gluconate)

Facility

$20.00

Service Code	NDC 00116106104
Hospital Charge Code	2516540
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.52
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

HI-LO TRACHEAL TUBE CUFFED

Facility

$26.00

Hospital Charge Code	2721739
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

HI-LO TRACHEAL TUBE CUFFED

Facility

$26.00

Hospital Charge Code	2721739
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$21,225.02

Service Code	MSDRG 481
Min. Negotiated Rate	$21,225.02
Max. Negotiated Rate	$21,225.02
Rate for Payer: BCBS Commercial	$21,225.02

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$28,746.17

Service Code	MSDRG 480
Min. Negotiated Rate	$28,746.17
Max. Negotiated Rate	$28,746.17
Rate for Payer: BCBS Commercial	$28,746.17

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$14,691.01

Service Code	MSDRG 482
Min. Negotiated Rate	$14,691.01
Max. Negotiated Rate	$14,691.01
Rate for Payer: BCBS Commercial	$14,691.01

HIP LT 1V

Facility

$243.00

Service Code	HCPCS 73501 LT
Hospital Charge Code	3290140
Hospital Revenue Code	320
Min. Negotiated Rate	$112.27
Max. Negotiated Rate	$235.71
Rate for Payer: BCBS Commercial	$142.01
Rate for Payer: Cash Price	$182.25
Rate for Payer: Cash Price	$182.25
Rate for Payer: Celtic Commercial/Exchange	$112.27
Rate for Payer: Health Partners Plans Commercial	$230.85
Rate for Payer: UnitedHealthcare Commercial	$235.71
Rate for Payer: WPPA Commercial	$204.12

HIP LT 1V

Facility

$243.00

Service Code	HCPCS 73501 LT
Hospital Charge Code	3290140
Hospital Revenue Code	320
Min. Negotiated Rate	$199.26
Max. Negotiated Rate	$235.71
Rate for Payer: Cash Price	$182.25
Rate for Payer: Health Partners Plans Commercial	$230.85
Rate for Payer: UnitedHealthcare Commercial	$235.71
Rate for Payer: WPPA Commercial	$199.26

HIP LT 1V W PELVIS

Facility

$160.00

Service Code	HCPCS 73501 LT
Hospital Charge Code	3290141
Hospital Revenue Code	320
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$155.20
Rate for Payer: BCBS Commercial	$142.01
Rate for Payer: Cash Price	$120.45
Rate for Payer: Cash Price	$120.45
Rate for Payer: Celtic Commercial/Exchange	$73.92
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$134.40

HIP LT 1V W PELVIS

Facility

$160.00

Service Code	HCPCS 73501 LT
Hospital Charge Code	3290141
Hospital Revenue Code	320
Min. Negotiated Rate	$131.20
Max. Negotiated Rate	$155.20
Rate for Payer: Cash Price	$120.45
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$131.20

HIP LT 2V

Facility

$332.00

Service Code	HCPCS 73502 LT
Hospital Charge Code	3290142
Hospital Revenue Code	320
Min. Negotiated Rate	$272.24
Max. Negotiated Rate	$322.04
Rate for Payer: Cash Price	$249.00
Rate for Payer: Health Partners Plans Commercial	$315.40
Rate for Payer: UnitedHealthcare Commercial	$322.04
Rate for Payer: WPPA Commercial	$272.24

HIP LT 2V

Facility

$332.00

Service Code	HCPCS 73502 LT
Hospital Charge Code	3290142
Hospital Revenue Code	320
Min. Negotiated Rate	$153.38
Max. Negotiated Rate	$322.04
Rate for Payer: BCBS Commercial	$173.25
Rate for Payer: Cash Price	$249.00
Rate for Payer: Cash Price	$249.00
Rate for Payer: Celtic Commercial/Exchange	$153.38
Rate for Payer: Health Partners Plans Commercial	$315.40
Rate for Payer: UnitedHealthcare Commercial	$322.04
Rate for Payer: WPPA Commercial	$278.88

HIP LT 2V W PELVIS

Facility

$357.00

Service Code	HCPCS 73502 LT
Hospital Charge Code	3290143
Hospital Revenue Code	320
Min. Negotiated Rate	$292.74
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$267.75
Rate for Payer: Health Partners Plans Commercial	$339.15
Rate for Payer: UnitedHealthcare Commercial	$346.29
Rate for Payer: WPPA Commercial	$292.74

HIP LT 2V W PELVIS

Facility

$357.00

Service Code	HCPCS 73502 LT
Hospital Charge Code	3290143
Hospital Revenue Code	320
Min. Negotiated Rate	$164.93
Max. Negotiated Rate	$346.29
Rate for Payer: BCBS Commercial	$173.25
Rate for Payer: Cash Price	$267.75
Rate for Payer: Cash Price	$267.75
Rate for Payer: Celtic Commercial/Exchange	$164.93
Rate for Payer: Health Partners Plans Commercial	$339.15
Rate for Payer: UnitedHealthcare Commercial	$346.29
Rate for Payer: WPPA Commercial	$299.88

HIP MIN OF 4 VIEWS

Facility

$264.00

Service Code	HCPCS 73503
Hospital Charge Code	3292567
Hospital Revenue Code	320
Min. Negotiated Rate	$216.48
Max. Negotiated Rate	$256.08
Rate for Payer: Cash Price	$198.00
Rate for Payer: Health Partners Plans Commercial	$250.80
Rate for Payer: UnitedHealthcare Commercial	$256.08
Rate for Payer: WPPA Commercial	$216.48

HIP MIN OF 4 VIEWS

Facility

$264.00

Service Code	HCPCS 73503
Hospital Charge Code	3292567
Hospital Revenue Code	320
Min. Negotiated Rate	$121.97
Max. Negotiated Rate	$256.08
Rate for Payer: BCBS Commercial	$213.01
Rate for Payer: Cash Price	$198.00
Rate for Payer: Cash Price	$198.00
Rate for Payer: Celtic Commercial/Exchange	$121.97
Rate for Payer: Health Partners Plans Commercial	$250.80
Rate for Payer: UnitedHealthcare Commercial	$256.08
Rate for Payer: WPPA Commercial	$221.76

Know your out-of-pocket cost for care.

All Charges