Ness County Hospital

All Charges

Charge

Type

Setting

Price

INF AGNT ANTIGEN DETECTION BY

Facility

$73.00

Service Code	HCPCS 87260
Hospital Charge Code	8726000
Hospital Revenue Code	306
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$70.81
Rate for Payer: BCBS Commercial	$60.95
Rate for Payer: Cash Price	$54.75
Rate for Payer: Cash Price	$54.75
Rate for Payer: Celtic Commercial/Exchange	$33.73
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$61.32

INF AGNT ANTIGEN DETECTION BY

Facility

$73.00

Service Code	HCPCS 87260
Hospital Charge Code	8726000
Hospital Revenue Code	306
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$70.81
Rate for Payer: Cash Price	$54.75
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$59.86

INF AGNT DETEC BY NUCLEIC ACID DNA/RNA, RESP SYNCY

Facility

$383.00

Service Code	HCPCS 87634
Hospital Charge Code	8763400
Hospital Revenue Code	306
Min. Negotiated Rate	$157.55
Max. Negotiated Rate	$371.51
Rate for Payer: BCBS Commercial	$157.55
Rate for Payer: Cash Price	$287.25
Rate for Payer: Cash Price	$287.25
Rate for Payer: Celtic Commercial/Exchange	$176.95
Rate for Payer: Health Partners Plans Commercial	$363.85
Rate for Payer: UnitedHealthcare Commercial	$371.51
Rate for Payer: WPPA Commercial	$321.72

INF AGNT DETEC BY NUCLEIC ACID DNA/RNA, RESP SYNCY

Facility

$383.00

Service Code	HCPCS 87634
Hospital Charge Code	8763400
Hospital Revenue Code	306
Min. Negotiated Rate	$314.06
Max. Negotiated Rate	$371.51
Rate for Payer: Cash Price	$287.25
Rate for Payer: Health Partners Plans Commercial	$363.85
Rate for Payer: UnitedHealthcare Commercial	$371.51
Rate for Payer: WPPA Commercial	$314.06

INF AGNT DETEC CHLAMYDIA TRACH

Facility

$90.00

Service Code	HCPCS 87490
Hospital Charge Code	8749000
Hospital Revenue Code	300
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$67.50
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$73.80

INF AGNT DETEC CHLAMYDIA TRACH

Facility

$90.00

Service Code	HCPCS 87490
Hospital Charge Code	8749000
Hospital Revenue Code	300
Min. Negotiated Rate	$41.58
Max. Negotiated Rate	$87.30
Rate for Payer: BCBS Commercial	$58.09
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Celtic Commercial/Exchange	$41.58
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$75.60

INF AGNT DETEC NEISSERIA GONOR

Facility

$90.00

Service Code	HCPCS 87590
Hospital Charge Code	8759000
Hospital Revenue Code	306
Min. Negotiated Rate	$41.58
Max. Negotiated Rate	$87.30
Rate for Payer: BCBS Commercial	$58.09
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Celtic Commercial/Exchange	$41.58
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$75.60

INF AGNT DETEC NEISSERIA GONOR

Facility

$90.00

Service Code	HCPCS 87590
Hospital Charge Code	8759000
Hospital Revenue Code	306
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$67.50
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$73.80

INF AGNT DETEC, NUCLEIC ACID

Facility

$159.00

Service Code	HCPCS 87591
Hospital Charge Code	8759100
Hospital Revenue Code	306
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$119.25
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$130.38

INF AGNT DETEC, NUCLEIC ACID

Facility

$159.00

Service Code	HCPCS 87591
Hospital Charge Code	8759100
Hospital Revenue Code	306
Min. Negotiated Rate	$73.46
Max. Negotiated Rate	$154.23
Rate for Payer: BCBS Commercial	$75.32
Rate for Payer: Cash Price	$119.25
Rate for Payer: Cash Price	$119.25
Rate for Payer: Celtic Commercial/Exchange	$73.46
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$133.56

INF AGNT DETECT,DIR OPT OBSER

Facility

$89.00

Service Code	HCPCS 87899
Hospital Charge Code	8789900
Hospital Revenue Code	306
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$86.33
Rate for Payer: BCBS Commercial	$54.84
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

INF AGNT DETECT,DIR OPT OBSER

Facility

$89.00

Service Code	HCPCS 87899
Hospital Charge Code	8789900
Hospital Revenue Code	306
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

INF AGNT DETECT,DIR OPT OBSERV

Facility

$103.00

Service Code	HCPCS 87880
Hospital Charge Code	8788000
Hospital Revenue Code	306
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$99.91
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$77.25
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

INF AGNT DETECT,DIR OPT OBSERV

Facility

$103.00

Service Code	HCPCS 87880
Hospital Charge Code	8788000
Hospital Revenue Code	306
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

INF AGNT DETECT, NUCLEIC ACID

Facility

$194.00

Service Code	HCPCS 87522
Hospital Charge Code	8752200
Hospital Revenue Code	306
Min. Negotiated Rate	$89.63
Max. Negotiated Rate	$188.18
Rate for Payer: BCBS Commercial	$91.91
Rate for Payer: Cash Price	$145.50
Rate for Payer: Cash Price	$145.50
Rate for Payer: Celtic Commercial/Exchange	$89.63
Rate for Payer: Health Partners Plans Commercial	$184.30
Rate for Payer: UnitedHealthcare Commercial	$188.18
Rate for Payer: WPPA Commercial	$162.96

INF AGNT DETECT, NUCLEIC ACID

Facility

$211.00

Service Code	HCPCS 87798
Hospital Charge Code	8779800
Hospital Revenue Code	306
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$204.67
Rate for Payer: BCBS Commercial	$185.64
Rate for Payer: Cash Price	$158.25
Rate for Payer: Cash Price	$158.25
Rate for Payer: Celtic Commercial/Exchange	$97.48
Rate for Payer: Health Partners Plans Commercial	$200.45
Rate for Payer: UnitedHealthcare Commercial	$204.67
Rate for Payer: WPPA Commercial	$177.24

INF AGNT DETECT, NUCLEIC ACID

Facility

$194.00

Service Code	HCPCS 87522
Hospital Charge Code	8752200
Hospital Revenue Code	306
Min. Negotiated Rate	$159.08
Max. Negotiated Rate	$188.18
Rate for Payer: Cash Price	$145.50
Rate for Payer: Health Partners Plans Commercial	$184.30
Rate for Payer: UnitedHealthcare Commercial	$188.18
Rate for Payer: WPPA Commercial	$159.08

INF AGNT DETECT, NUCLEIC ACID

Facility

$276.00

Service Code	HCPCS 87521
Hospital Charge Code	8752100
Hospital Revenue Code	306
Min. Negotiated Rate	$75.32
Max. Negotiated Rate	$267.72
Rate for Payer: BCBS Commercial	$75.32
Rate for Payer: Cash Price	$207.00
Rate for Payer: Cash Price	$207.00
Rate for Payer: Celtic Commercial/Exchange	$127.51
Rate for Payer: Health Partners Plans Commercial	$262.20
Rate for Payer: UnitedHealthcare Commercial	$267.72
Rate for Payer: WPPA Commercial	$231.84

INF AGNT DETECT, NUCLEIC ACID

Facility

$211.00

Service Code	HCPCS 87798
Hospital Charge Code	8779800
Hospital Revenue Code	306
Min. Negotiated Rate	$173.02
Max. Negotiated Rate	$204.67
Rate for Payer: Cash Price	$158.25
Rate for Payer: Health Partners Plans Commercial	$200.45
Rate for Payer: UnitedHealthcare Commercial	$204.67
Rate for Payer: WPPA Commercial	$173.02

INF AGNT DETECT, NUCLEIC ACID

Facility

$276.00

Service Code	HCPCS 87521
Hospital Charge Code	8752100
Hospital Revenue Code	306
Min. Negotiated Rate	$226.32
Max. Negotiated Rate	$267.72
Rate for Payer: Cash Price	$207.00
Rate for Payer: Health Partners Plans Commercial	$262.20
Rate for Payer: UnitedHealthcare Commercial	$267.72
Rate for Payer: WPPA Commercial	$226.32

INF AGNT DETECT,NUCLEIC ACID

Facility

$159.00

Service Code	HCPCS 87491
Hospital Charge Code	8749100
Hospital Revenue Code	306
Min. Negotiated Rate	$73.46
Max. Negotiated Rate	$154.23
Rate for Payer: BCBS Commercial	$75.32
Rate for Payer: Cash Price	$119.25
Rate for Payer: Cash Price	$119.25
Rate for Payer: Celtic Commercial/Exchange	$73.46
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$133.56

INF AGNT DETECT,NUCLEIC ACID

Facility

$159.00

Service Code	HCPCS 87491
Hospital Charge Code	8749100
Hospital Revenue Code	306
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$119.25
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$130.38

INF AGNT DETECT,NUCLEIC ACID

Facility

$182.00

Service Code	HCPCS 87800
Hospital Charge Code	8780000
Hospital Revenue Code	306
Min. Negotiated Rate	$149.24
Max. Negotiated Rate	$176.54
Rate for Payer: Cash Price	$136.50
Rate for Payer: Health Partners Plans Commercial	$172.90
Rate for Payer: UnitedHealthcare Commercial	$176.54
Rate for Payer: WPPA Commercial	$149.24

INF AGNT DETECT,NUCLEIC ACID

Facility

$90.00

Service Code	HCPCS 87797
Hospital Charge Code	8779700
Hospital Revenue Code	301
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$67.50
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$73.80

INF AGNT DETECT,NUCLEIC ACID

Facility

$90.00

Service Code	HCPCS 87797
Hospital Charge Code	8779700
Hospital Revenue Code	301
Min. Negotiated Rate	$41.58
Max. Negotiated Rate	$87.30
Rate for Payer: BCBS Commercial	$57.89
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Celtic Commercial/Exchange	$41.58
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$75.60

Know your out-of-pocket cost for care.

All Charges