Ness County Hospital

All Charges

Charge

Type

Setting

Price

HYDROFERA BLUE

Facility

$40.00

Hospital Charge Code	2725053
Hospital Revenue Code	272
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Celtic Commercial/Exchange	$18.48
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$33.60

HYDROFERA BLUE

Facility

$17.00

Hospital Charge Code	2702469
Hospital Revenue Code	270
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$13.12
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$13.94

HYDROFERA BLUE

Facility

$17.00

Hospital Charge Code	2702469
Hospital Revenue Code	270
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$13.12
Rate for Payer: Celtic Commercial/Exchange	$7.85
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$14.28

HYDROFERA BLUE

Facility

$40.00

Hospital Charge Code	2725053
Hospital Revenue Code	272
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.00
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$32.80

Hydrogen Peroxide 8 oz bottle

Facility

$4.00

Service Code	NDC 87701040242
Hospital Charge Code	2503241
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

Hydrogen Peroxide 8 oz bottle

Facility

$4.00

Service Code	NDC 87701040242
Hospital Charge Code	2503241
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Celtic Commercial/Exchange	$1.85
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.36

HYDROXYINDOLACETIC ACID, 5

Facility

$89.00

Service Code	HCPCS 83497
Hospital Charge Code	8349700
Hospital Revenue Code	301
Min. Negotiated Rate	$72.98
Max. Negotiated Rate	$86.33
Rate for Payer: Cash Price	$66.75
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$72.98

HYDROXYINDOLACETIC ACID, 5

Facility

$89.00

Service Code	HCPCS 83497
Hospital Charge Code	8349700
Hospital Revenue Code	301
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$86.33
Rate for Payer: BCBS Commercial	$48.15
Rate for Payer: Cash Price	$66.75
Rate for Payer: Cash Price	$66.75
Rate for Payer: Celtic Commercial/Exchange	$41.12
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$74.76

HYDROXYPROGESTERONE, 17-D

Facility

$135.00

Service Code	HCPCS 83498
Hospital Charge Code	8349800
Hospital Revenue Code	301
Min. Negotiated Rate	$62.37
Max. Negotiated Rate	$130.95
Rate for Payer: BCBS Commercial	$87.62
Rate for Payer: Cash Price	$101.25
Rate for Payer: Cash Price	$101.25
Rate for Payer: Celtic Commercial/Exchange	$62.37
Rate for Payer: Health Partners Plans Commercial	$128.25
Rate for Payer: UnitedHealthcare Commercial	$130.95
Rate for Payer: WPPA Commercial	$113.40

HYDROXYPROGESTERONE, 17-D

Facility

$135.00

Service Code	HCPCS 83498
Hospital Charge Code	8349800
Hospital Revenue Code	301
Min. Negotiated Rate	$110.70
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$101.25
Rate for Payer: Health Partners Plans Commercial	$128.25
Rate for Payer: UnitedHealthcare Commercial	$130.95
Rate for Payer: WPPA Commercial	$110.70

HYDROXYPROLINE; FREE

Facility

$123.00

Service Code	HCPCS 83500
Hospital Charge Code	8350000
Hospital Revenue Code	301
Min. Negotiated Rate	$56.83
Max. Negotiated Rate	$119.31
Rate for Payer: BCBS Commercial	$99.10
Rate for Payer: Cash Price	$92.25
Rate for Payer: Cash Price	$92.25
Rate for Payer: Celtic Commercial/Exchange	$56.83
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$103.32

HYDROXYPROLINE; FREE

Facility

$123.00

Service Code	HCPCS 83500
Hospital Charge Code	8350000
Hospital Revenue Code	301
Min. Negotiated Rate	$100.86
Max. Negotiated Rate	$119.31
Rate for Payer: Cash Price	$92.25
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$100.86

HYPER PNEUMO EVAL

Facility

$58.00

Service Code	HCPCS 86609
Hospital Charge Code	8660901
Hospital Revenue Code	302
Min. Negotiated Rate	$26.80
Max. Negotiated Rate	$56.26
Rate for Payer: BCBS Commercial	$33.65
Rate for Payer: Cash Price	$43.50
Rate for Payer: Cash Price	$43.50
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

HYPER PNEUMO EVAL

Facility

$58.00

Service Code	HCPCS 86609
Hospital Charge Code	8660901
Hospital Revenue Code	302
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$56.26
Rate for Payer: Cash Price	$43.50
Rate for Payer: Health Partners Plans Commercial	$55.10
Rate for Payer: UnitedHealthcare Commercial	$56.26
Rate for Payer: WPPA Commercial	$47.56

HYPERSENS PHEUMONITIS EVAL

Facility

$650.00

Hospital Charge Code	8888919
Hospital Revenue Code	302
Min. Negotiated Rate	$300.30
Max. Negotiated Rate	$630.50
Rate for Payer: Cash Price	$487.50
Rate for Payer: Celtic Commercial/Exchange	$300.30
Rate for Payer: Health Partners Plans Commercial	$617.50
Rate for Payer: UnitedHealthcare Commercial	$630.50
Rate for Payer: WPPA Commercial	$546.00

HYPERSENS PHEUMONITIS EVAL

Facility

$650.00

Hospital Charge Code	8888919
Hospital Revenue Code	302
Min. Negotiated Rate	$533.00
Max. Negotiated Rate	$630.50
Rate for Payer: Cash Price	$487.50
Rate for Payer: Health Partners Plans Commercial	$617.50
Rate for Payer: UnitedHealthcare Commercial	$630.50
Rate for Payer: WPPA Commercial	$533.00

HYPERTENSION WITH MCC

Facility

$9,835.98

Service Code	MSDRG 304
Min. Negotiated Rate	$9,835.98
Max. Negotiated Rate	$9,835.98
Rate for Payer: BCBS Commercial	$9,835.98

HYPERTENSION WITHOUT MCC

Facility

$6,742.86

Service Code	MSDRG 305
Min. Negotiated Rate	$6,742.86
Max. Negotiated Rate	$6,742.86
Rate for Payer: BCBS Commercial	$6,742.86

HYROXYCORTICOSTEROIDS, 17

Facility

$100.00

Service Code	HCPCS 83491
Hospital Charge Code	8349100
Hospital Revenue Code	301
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$97.00
Rate for Payer: BCBS Commercial	$56.68
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Celtic Commercial/Exchange	$46.20
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$84.00

HYROXYCORTICOSTEROIDS, 17

Facility

$100.00

Service Code	HCPCS 83491
Hospital Charge Code	8349100
Hospital Revenue Code	301
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$82.00

HYTAPE

Facility

$21.00

Hospital Charge Code	2725047
Hospital Revenue Code	272
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

HYTAPE

Facility

$21.00

Hospital Charge Code	2725047
Hospital Revenue Code	272
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

HYTRIN 1 MG CAP (TERAZOSIN)

Facility

$1.00

Service Code	NDC 50268076415
Hospital Charge Code	2513463
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.90
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

HYTRIN 1 MG CAP (TERAZOSIN)

Facility

$1.00

Service Code	NDC 50268076415
Hospital Charge Code	2513463
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.90
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

IA-2 ANTIBODY

Facility

$104.00

Service Code	HCPCS 86341
Hospital Charge Code	8634102
Hospital Revenue Code	302
Min. Negotiated Rate	$48.05
Max. Negotiated Rate	$100.88
Rate for Payer: BCBS Commercial	$79.87
Rate for Payer: Cash Price	$78.00
Rate for Payer: Cash Price	$78.00
Rate for Payer: Celtic Commercial/Exchange	$48.05
Rate for Payer: Health Partners Plans Commercial	$98.80
Rate for Payer: UnitedHealthcare Commercial	$100.88
Rate for Payer: WPPA Commercial	$87.36

Know your out-of-pocket cost for care.

All Charges