Ness County Hospital

All Charges

Charge

Type

Setting

Price

HUMALOG INSULIN ¨C 3 ML VIAL(novolog)(admelog)(lispro)

Facility

$298.00

Service Code	NDC 00024592605
Hospital Charge Code	2500460
Hospital Revenue Code	250
Min. Negotiated Rate	$244.36
Max. Negotiated Rate	$289.06
Rate for Payer: Cash Price	$223.54
Rate for Payer: Health Partners Plans Commercial	$283.10
Rate for Payer: UnitedHealthcare Commercial	$289.06
Rate for Payer: WPPA Commercial	$244.36

HUMAN PAPILLOMAVIRUS HIGH RISK

Facility

$85.00

Service Code	HCPCS 87624
Hospital Charge Code	8762400
Hospital Revenue Code	306
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$82.45
Rate for Payer: BCBS Commercial	$60.95
Rate for Payer: Cash Price	$63.75
Rate for Payer: Cash Price	$63.75
Rate for Payer: Celtic Commercial/Exchange	$39.27
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$71.40

HUMAN PAPILLOMAVIRUS HIGH RISK

Facility

$85.00

Service Code	HCPCS 87624
Hospital Charge Code	8762400
Hospital Revenue Code	306
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$69.70

HUMERUS LT

Facility

$253.00

Service Code	HCPCS 73060 LT
Hospital Charge Code	3280021
Hospital Revenue Code	320
Min. Negotiated Rate	$207.46
Max. Negotiated Rate	$245.41
Rate for Payer: Cash Price	$189.75
Rate for Payer: Health Partners Plans Commercial	$240.35
Rate for Payer: UnitedHealthcare Commercial	$245.41
Rate for Payer: WPPA Commercial	$207.46

HUMERUS LT

Facility

$253.00

Service Code	HCPCS 73060 LT
Hospital Charge Code	3280021
Hospital Revenue Code	320
Min. Negotiated Rate	$116.89
Max. Negotiated Rate	$245.41
Rate for Payer: BCBS Commercial	$137.52
Rate for Payer: Cash Price	$189.75
Rate for Payer: Cash Price	$189.75
Rate for Payer: Celtic Commercial/Exchange	$116.89
Rate for Payer: Health Partners Plans Commercial	$240.35
Rate for Payer: UnitedHealthcare Commercial	$245.41
Rate for Payer: WPPA Commercial	$212.52

HUMERUS RT

Facility

$253.00

Service Code	HCPCS 73060 RT
Hospital Charge Code	3280020
Hospital Revenue Code	320
Min. Negotiated Rate	$116.89
Max. Negotiated Rate	$245.41
Rate for Payer: BCBS Commercial	$137.52
Rate for Payer: Cash Price	$189.75
Rate for Payer: Cash Price	$189.75
Rate for Payer: Celtic Commercial/Exchange	$116.89
Rate for Payer: Health Partners Plans Commercial	$240.35
Rate for Payer: UnitedHealthcare Commercial	$245.41
Rate for Payer: WPPA Commercial	$212.52

HUMERUS RT

Facility

$253.00

Service Code	HCPCS 73060 RT
Hospital Charge Code	3280020
Hospital Revenue Code	320
Min. Negotiated Rate	$207.46
Max. Negotiated Rate	$245.41
Rate for Payer: Cash Price	$189.75
Rate for Payer: Health Partners Plans Commercial	$240.35
Rate for Payer: UnitedHealthcare Commercial	$245.41
Rate for Payer: WPPA Commercial	$207.46

HUMIDIFIER DISPOSABLE 6 PSI

Facility

$7.00

Hospital Charge Code	4100201
Hospital Revenue Code	270
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Celtic Commercial/Exchange	$3.23
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.88

HUMIDIFIER DISPOSABLE 6 PSI

Facility

$7.00

Hospital Charge Code	4100201
Hospital Revenue Code	270
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

HUMIDIFIER DISPOSABLE LTC

Facility

$7.00

Hospital Charge Code	4100201LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Celtic Commercial/Exchange	$3.23
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.88

HUMIDIFIER DISPOSABLE LTC

Facility

$7.00

Hospital Charge Code	4100201LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

HUMIDIFIER O2

Facility

$5.00

Hospital Charge Code	4100202
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

HUMIDIFIER O2

Facility

$5.00

Hospital Charge Code	4100202
Hospital Revenue Code	270
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

Humulin 70/30 (insulin NPH & regular human) SubQ Suspension

Facility

$495.00

Service Code	NDC 00169183711
Hospital Charge Code	2514735
Hospital Revenue Code	250
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$480.15
Rate for Payer: Cash Price	$371.78
Rate for Payer: Celtic Commercial/Exchange	$228.69
Rate for Payer: Health Partners Plans Commercial	$470.25
Rate for Payer: UnitedHealthcare Commercial	$480.15
Rate for Payer: WPPA Commercial	$415.80

Humulin 70/30 (insulin NPH & regular human) SubQ Suspension

Facility

$495.00

Service Code	NDC 00169183711
Hospital Charge Code	2514735
Hospital Revenue Code	250
Min. Negotiated Rate	$405.90
Max. Negotiated Rate	$480.15
Rate for Payer: Cash Price	$371.78
Rate for Payer: Health Partners Plans Commercial	$470.25
Rate for Payer: UnitedHealthcare Commercial	$480.15
Rate for Payer: WPPA Commercial	$405.90

HYBRESIS PAD

Facility

$27.00

Hospital Charge Code	2705513
Hospital Revenue Code	270
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.44
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

HYBRESIS PAD

Facility

$27.00

Hospital Charge Code	2705513
Hospital Revenue Code	270
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.44
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

HYDROCELLULAR FOAM DRESSING NA

Facility

$9.00

Hospital Charge Code	2720762
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

HYDROCELLULAR FOAM DRESSING NA

Facility

$9.00

Hospital Charge Code	2720762
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

HYDROCHLOROTHIAZIDE 12.5 MG CAP (HCTZ)

Facility

$1.00

Service Code	NDC 60687068311
Hospital Charge Code	2519361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.98
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

HYDROCHLOROTHIAZIDE 12.5 MG CAP (HCTZ)

Facility

$1.00

Service Code	NDC 60687068311
Hospital Charge Code	2519361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.98
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

HYDROCORTISONE CREAM 1 %

Facility

$12.00

Service Code	NDC 45802043803
Hospital Charge Code	2503217
Hospital Revenue Code	250
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

HYDROCORTISONE CREAM 1 %

Facility

$12.00

Service Code	NDC 45802043803
Hospital Charge Code	2503217
Hospital Revenue Code	250
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

HYDROCORTISONE CREAM 2.5%

Facility

$25.00

Service Code	NDC 45802000402
Hospital Charge Code	2514610
Hospital Revenue Code	250
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$19.20
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

HYDROCORTISONE CREAM 2.5%

Facility

$25.00

Service Code	NDC 45802000402
Hospital Charge Code	2514610
Hospital Revenue Code	250
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$19.20
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

Know your out-of-pocket cost for care.

All Charges