Ness County Hospital

All Charges

Charge

Type

Setting

Price

INSERT PICC CATH->5YRS W/O GUI

Facility

$1,488.00

Service Code	HCPCS 36569
Hospital Charge Code	3656900
Hospital Revenue Code	761
Min. Negotiated Rate	$1,220.16
Max. Negotiated Rate	$1,443.36
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Health Partners Plans Commercial	$1,413.60
Rate for Payer: UnitedHealthcare Commercial	$1,443.36
Rate for Payer: WPPA Commercial	$1,220.16

INSERT PICC CATH->5YRS W/O GUI

Facility

$1,488.00

Service Code	HCPCS 36569
Hospital Charge Code	3656900
Hospital Revenue Code	761
Min. Negotiated Rate	$687.46
Max. Negotiated Rate	$1,443.36
Rate for Payer: BCBS Commercial	$773.97
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Cash Price	$1,116.00
Rate for Payer: Celtic Commercial/Exchange	$687.46
Rate for Payer: Health Partners Plans Commercial	$1,413.60
Rate for Payer: UnitedHealthcare Commercial	$1,443.36
Rate for Payer: WPPA Commercial	$1,249.92

INSERT TEMP INDWELL CATH COMPL

Facility

$350.00

Service Code	HCPCS 51703
Hospital Charge Code	5170300
Hospital Revenue Code	761
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

INSERT TEMP INDWELL CATH COMPL

Facility

$350.00

Service Code	HCPCS 51703
Hospital Charge Code	5170300
Hospital Revenue Code	761
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$183.86
Rate for Payer: Cash Price	$262.50
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

INSERT TUNNELED CV CATH

Facility

$2,979.00

Service Code	HCPCS 36558
Hospital Charge Code	3655800
Hospital Revenue Code	761
Min. Negotiated Rate	$2,442.78
Max. Negotiated Rate	$2,889.63
Rate for Payer: Cash Price	$2,234.25
Rate for Payer: Health Partners Plans Commercial	$2,830.05
Rate for Payer: UnitedHealthcare Commercial	$2,889.63
Rate for Payer: WPPA Commercial	$2,442.78

INSERT TUNNELED CV CATH

Facility

$2,979.00

Service Code	HCPCS 36558
Hospital Charge Code	3655800
Hospital Revenue Code	761
Min. Negotiated Rate	$1,376.30
Max. Negotiated Rate	$3,934.38
Rate for Payer: BCBS Commercial	$3,934.38
Rate for Payer: Cash Price	$2,234.25
Rate for Payer: Cash Price	$2,234.25
Rate for Payer: Celtic Commercial/Exchange	$1,376.30
Rate for Payer: Health Partners Plans Commercial	$2,830.05
Rate for Payer: UnitedHealthcare Commercial	$2,889.63
Rate for Payer: WPPA Commercial	$2,502.36

INSPIRON (SPIROMETER)

Facility

$42.00

Hospital Charge Code	4100210
Hospital Revenue Code	410
Min. Negotiated Rate	$19.40
Max. Negotiated Rate	$40.74
Rate for Payer: Cash Price	$31.50
Rate for Payer: Celtic Commercial/Exchange	$19.40
Rate for Payer: Health Partners Plans Commercial	$39.90
Rate for Payer: UnitedHealthcare Commercial	$40.74
Rate for Payer: WPPA Commercial	$35.28

INSPIRON (SPIROMETER)

Facility

$42.00

Hospital Charge Code	4100210
Hospital Revenue Code	410
Min. Negotiated Rate	$34.44
Max. Negotiated Rate	$40.74
Rate for Payer: Cash Price	$31.50
Rate for Payer: Health Partners Plans Commercial	$39.90
Rate for Payer: UnitedHealthcare Commercial	$40.74
Rate for Payer: WPPA Commercial	$34.44

INSULIN ANTIBODIES

Facility

$156.00

Service Code	HCPCS 86337
Hospital Charge Code	8633700
Hospital Revenue Code	302
Min. Negotiated Rate	$127.92
Max. Negotiated Rate	$151.32
Rate for Payer: Cash Price	$117.00
Rate for Payer: Health Partners Plans Commercial	$148.20
Rate for Payer: UnitedHealthcare Commercial	$151.32
Rate for Payer: WPPA Commercial	$127.92

INSULIN ANTIBODIES

Facility

$156.00

Service Code	HCPCS 86337
Hospital Charge Code	8633700
Hospital Revenue Code	302
Min. Negotiated Rate	$72.07
Max. Negotiated Rate	$151.32
Rate for Payer: BCBS Commercial	$84.13
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cash Price	$117.00
Rate for Payer: Celtic Commercial/Exchange	$72.07
Rate for Payer: Health Partners Plans Commercial	$148.20
Rate for Payer: UnitedHealthcare Commercial	$151.32
Rate for Payer: WPPA Commercial	$131.04

INSULIN, TOTAL

Facility

$153.00

Service Code	HCPCS 83525
Hospital Charge Code	8352500
Hospital Revenue Code	301
Min. Negotiated Rate	$125.46
Max. Negotiated Rate	$148.41
Rate for Payer: Cash Price	$114.75
Rate for Payer: Health Partners Plans Commercial	$145.35
Rate for Payer: UnitedHealthcare Commercial	$148.41
Rate for Payer: WPPA Commercial	$125.46

INSULIN, TOTAL

Facility

$153.00

Service Code	HCPCS 83525
Hospital Charge Code	8352500
Hospital Revenue Code	301
Min. Negotiated Rate	$50.72
Max. Negotiated Rate	$148.41
Rate for Payer: BCBS Commercial	$50.72
Rate for Payer: Cash Price	$114.75
Rate for Payer: Cash Price	$114.75
Rate for Payer: Celtic Commercial/Exchange	$70.69
Rate for Payer: Health Partners Plans Commercial	$145.35
Rate for Payer: UnitedHealthcare Commercial	$148.41
Rate for Payer: WPPA Commercial	$128.52

INTEC AGNT ANTGN DETEC,RESPIR

Facility

$75.00

Service Code	HCPCS 87280
Hospital Charge Code	8728000
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

INTEC AGNT ANTGN DETEC,RESPIR

Facility

$75.00

Service Code	HCPCS 87280
Hospital Charge Code	8728000
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

INTERSTITIAL LUNG DISEASE WITH CC

Facility

$10,271.45

Service Code	MSDRG 197
Min. Negotiated Rate	$10,271.45
Max. Negotiated Rate	$10,271.45
Rate for Payer: BCBS Commercial	$10,271.45

INTERSTITIAL LUNG DISEASE WITH MCC

Facility

$15,621.37

Service Code	MSDRG 196
Min. Negotiated Rate	$15,621.37
Max. Negotiated Rate	$15,621.37
Rate for Payer: BCBS Commercial	$15,621.37

INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC

Facility

$7,551.39

Service Code	MSDRG 198
Min. Negotiated Rate	$7,551.39
Max. Negotiated Rate	$7,551.39
Rate for Payer: BCBS Commercial	$7,551.39

INTRA-ARTERIAL THER/DIAG INJ

Facility

$209.00

Service Code	HCPCS 96373
Hospital Charge Code	9637300
Hospital Revenue Code	761
Min. Negotiated Rate	$43.43
Max. Negotiated Rate	$202.73
Rate for Payer: BCBS Commercial	$43.43
Rate for Payer: Cash Price	$156.75
Rate for Payer: Cash Price	$156.75
Rate for Payer: Celtic Commercial/Exchange	$96.56
Rate for Payer: Health Partners Plans Commercial	$198.55
Rate for Payer: UnitedHealthcare Commercial	$202.73
Rate for Payer: WPPA Commercial	$175.56

INTRA-ARTERIAL THER/DIAG INJ

Facility

$209.00

Service Code	HCPCS 96373
Hospital Charge Code	9637300
Hospital Revenue Code	761
Min. Negotiated Rate	$171.38
Max. Negotiated Rate	$202.73
Rate for Payer: Cash Price	$156.75
Rate for Payer: Health Partners Plans Commercial	$198.55
Rate for Payer: UnitedHealthcare Commercial	$202.73
Rate for Payer: WPPA Commercial	$171.38

INTRACATH IV

Facility

$39.00

Hospital Charge Code	2580264
Hospital Revenue Code	270
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.85
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

INTRACATH IV

Facility

$39.00

Hospital Charge Code	2580264
Hospital Revenue Code	270
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.85
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$11,282.45

Service Code	MSDRG 065
Min. Negotiated Rate	$11,282.45
Max. Negotiated Rate	$11,282.45
Rate for Payer: BCBS Commercial	$11,282.45

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$17,358.01

Service Code	MSDRG 064
Min. Negotiated Rate	$17,358.01
Max. Negotiated Rate	$17,358.01
Rate for Payer: BCBS Commercial	$17,358.01

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$8,031.16

Service Code	MSDRG 066
Min. Negotiated Rate	$8,031.16
Max. Negotiated Rate	$8,031.16
Rate for Payer: BCBS Commercial	$8,031.16

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$55,662.15

Service Code	MSDRG 021
Min. Negotiated Rate	$55,662.15
Max. Negotiated Rate	$55,662.15
Rate for Payer: BCBS Commercial	$55,662.15

Know your out-of-pocket cost for care.

All Charges