Ness County Hospital

All Charges

Charge

Type

Setting

Price

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

INF AGNT DETECT,NUCLEIC ACID

Facility

$92.00

Service Code	HCPCS 87525
Hospital Charge Code	8752500
Hospital Revenue Code	306
Min. Negotiated Rate	$75.44
Max. Negotiated Rate	$89.24
Rate for Payer: Cash Price	$69.00
Rate for Payer: Health Partners Plans Commercial	$87.40
Rate for Payer: UnitedHealthcare Commercial	$89.24
Rate for Payer: WPPA Commercial	$75.44

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

$250.00

Service Code	HCPCS 87535
Hospital Charge Code	8753500
Hospital Revenue Code	306
Min. Negotiated Rate	$205.00
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.95
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$205.00

INF AGNT DETECT-NUCLEIC ACID

Facility

$250.00

Service Code	HCPCS 87535
Hospital Charge Code	8753500
Hospital Revenue Code	306
Min. Negotiated Rate	$75.32
Max. Negotiated Rate	$242.50
Rate for Payer: BCBS Commercial	$75.32
Rate for Payer: Cash Price	$187.95
Rate for Payer: Cash Price	$187.95
Rate for Payer: Celtic Commercial/Exchange	$115.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$210.00

INF AGNT GENO ANAL NUCL ACID

Facility

$1,040.00

Service Code	HCPCS 87902
Hospital Charge Code	8790200
Hospital Revenue Code	306
Min. Negotiated Rate	$852.80
Max. Negotiated Rate	$1,008.80
Rate for Payer: Cash Price	$780.00
Rate for Payer: Health Partners Plans Commercial	$988.00
Rate for Payer: UnitedHealthcare Commercial	$1,008.80
Rate for Payer: WPPA Commercial	$852.80

INF AGNT GENO ANAL NUCL ACID

Facility

$1,040.00

Service Code	HCPCS 87902
Hospital Charge Code	8790200
Hospital Revenue Code	306
Min. Negotiated Rate	$480.48
Max. Negotiated Rate	$1,008.80
Rate for Payer: BCBS Commercial	$552.43
Rate for Payer: Cash Price	$780.00
Rate for Payer: Cash Price	$780.00
Rate for Payer: Celtic Commercial/Exchange	$480.48
Rate for Payer: Health Partners Plans Commercial	$988.00
Rate for Payer: UnitedHealthcare Commercial	$1,008.80
Rate for Payer: WPPA Commercial	$873.60

INF AGNT NUCL ACID MULT ORGAN

Facility

$319.00

Service Code	HCPCS 87801
Hospital Charge Code	8780100
Hospital Revenue Code	306
Min. Negotiated Rate	$261.58
Max. Negotiated Rate	$309.43
Rate for Payer: Cash Price	$239.25
Rate for Payer: Health Partners Plans Commercial	$303.05
Rate for Payer: UnitedHealthcare Commercial	$309.43
Rate for Payer: WPPA Commercial	$261.58

INF AGNT NUCL ACID MULT ORGAN

Facility

$319.00

Service Code	HCPCS 87801
Hospital Charge Code	8780100
Hospital Revenue Code	306
Min. Negotiated Rate	$147.38
Max. Negotiated Rate	$309.43
Rate for Payer: BCBS Commercial	$150.62
Rate for Payer: Cash Price	$239.25
Rate for Payer: Cash Price	$239.25
Rate for Payer: Celtic Commercial/Exchange	$147.38
Rate for Payer: Health Partners Plans Commercial	$303.05
Rate for Payer: UnitedHealthcare Commercial	$309.43
Rate for Payer: WPPA Commercial	$267.96

INFANT CATHETER KIT

Facility

$7.00

Hospital Charge Code	2708266
Hospital Revenue Code	270
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.44
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

INFANT CATHETER KIT

Facility

$7.00

Hospital Charge Code	2708266
Hospital Revenue Code	270
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.44
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

INFEC AGENT DETEC BY NUCLEIC

Facility

$75.00

Service Code	HCPCS 87481
Hospital Charge Code	8748100
Hospital Revenue Code	306
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$61.41
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

INFEC AGENT DETEC BY NUCLEIC

Facility

$75.00

Service Code	HCPCS 87481
Hospital Charge Code	8748100
Hospital Revenue Code	306
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

INFEC AGENT DETEC,HIV-1,QUANT

Facility

$181.00

Service Code	HCPCS 87536
Hospital Charge Code	8753600
Hospital Revenue Code	306
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

INFEC AGENT DETEC,HIV-1,QUANT

Facility

$181.00

Service Code	HCPCS 87536
Hospital Charge Code	8753600
Hospital Revenue Code	306
Min. Negotiated Rate	$83.62
Max. Negotiated Rate	$182.59
Rate for Payer: BCBS Commercial	$182.59
Rate for Payer: Cash Price	$135.75
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

INFEC AGENT DETECT,CLOSTRIDIUM

Facility

$105.00

Service Code	HCPCS 87493
Hospital Charge Code	8749300
Hospital Revenue Code	306
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

INFEC AGENT DETECT,CLOSTRIDIUM

Facility

$105.00

Service Code	HCPCS 87493
Hospital Charge Code	8749300
Hospital Revenue Code	306
Min. Negotiated Rate	$48.51
Max. Negotiated Rate	$101.85
Rate for Payer: BCBS Commercial	$75.32
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

INFEC AGNT ANTG DETEC BY ENZYM

Facility

$89.00

Service Code	HCPCS 87301
Hospital Charge Code	8730100
Hospital Revenue Code	306
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$86.33
Rate for Payer: BCBS Commercial	$60.95
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

INFEC AGNT ANTG DETEC BY ENZYM

Facility

$89.00

Service Code	HCPCS 87301
Hospital Charge Code	8730100
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

INFEC AGNT ANTGN DETEC,PARAIN

Facility

$75.00

Service Code	HCPCS 87279
Hospital Charge Code	8727900
Hospital Revenue Code	306
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

INFEC AGNT ANTGN DETEC,PARAIN

Facility

$75.00

Service Code	HCPCS 87279
Hospital Charge Code	8727900
Hospital Revenue Code	306
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

INFEC AGNT ANTIGEN DETEC,FLU B

Facility

$75.00

Service Code	HCPCS 87275
Hospital Charge Code	8727500
Hospital Revenue Code	306
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

INFEC AGNT ANTIGEN DETEC,FLU B

Facility

$75.00

Service Code	HCPCS 87275
Hospital Charge Code	8727500
Hospital Revenue Code	306
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

INFEC AGNT DETEC BY NUCLEIC AC

Facility

$250.00

Service Code	HCPCS 87799
Hospital Charge Code	8779900
Hospital Revenue Code	306
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$251.58
Rate for Payer: BCBS Commercial	$251.58
Rate for Payer: Cash Price	$187.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Celtic Commercial/Exchange	$115.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$210.00

INFEC AGNT DETEC BY NUCLEIC AC

Facility

$250.00

Service Code	HCPCS 87799
Hospital Charge Code	8779900
Hospital Revenue Code	306
Min. Negotiated Rate	$205.00
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$205.00

Know your out-of-pocket cost for care.

All Charges