Ness County Hospital

All Charges

Charge

Type

Setting

Price

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$73,451.02

Service Code	MSDRG 020
Min. Negotiated Rate	$73,451.02
Max. Negotiated Rate	$73,451.02
Rate for Payer: BCBS Commercial	$73,451.02

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$34,151.30

Service Code	MSDRG 022
Min. Negotiated Rate	$34,151.30
Max. Negotiated Rate	$34,151.30
Rate for Payer: BCBS Commercial	$34,151.30

INTRAOCULAR PROCEDURES WITH CC/MCC

Facility

$12,918.52

Service Code	MSDRG 116
Min. Negotiated Rate	$12,918.52
Max. Negotiated Rate	$12,918.52
Rate for Payer: BCBS Commercial	$12,918.52

INTRAOCULAR PROCEDURES WITHOUT CC/MCC

Facility

$8,609.49

Service Code	MSDRG 117
Min. Negotiated Rate	$8,609.49
Max. Negotiated Rate	$8,609.49
Rate for Payer: BCBS Commercial	$8,609.49

INTRINSIC FACTOR ANTIBODIES

Facility

$82.00

Service Code	HCPCS 86340
Hospital Charge Code	8634000
Hospital Revenue Code	302
Min. Negotiated Rate	$67.24
Max. Negotiated Rate	$79.54
Rate for Payer: Cash Price	$61.50
Rate for Payer: Health Partners Plans Commercial	$77.90
Rate for Payer: UnitedHealthcare Commercial	$79.54
Rate for Payer: WPPA Commercial	$67.24

INTRINSIC FACTOR ANTIBODIES

Facility

$82.00

Service Code	HCPCS 86340
Hospital Charge Code	8634000
Hospital Revenue Code	302
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$79.54
Rate for Payer: BCBS Commercial	$52.68
Rate for Payer: Cash Price	$61.50
Rate for Payer: Cash Price	$61.50
Rate for Payer: Celtic Commercial/Exchange	$37.88
Rate for Payer: Health Partners Plans Commercial	$77.90
Rate for Payer: UnitedHealthcare Commercial	$79.54
Rate for Payer: WPPA Commercial	$68.88

INTRODUCER BOUGIE

Facility

$33.00

Hospital Charge Code	2709013
Hospital Revenue Code	270
Min. Negotiated Rate	$27.06
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$24.75
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.06

INTRODUCER BOUGIE

Facility

$33.00

Hospital Charge Code	2709013
Hospital Revenue Code	270
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$24.75
Rate for Payer: Celtic Commercial/Exchange	$15.25
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.72

Introduction & Removal catheter into chest to relieve pressure

Facility

$500.00

Hospital Charge Code	3255000
Hospital Revenue Code	459
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$485.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Celtic Commercial/Exchange	$231.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$420.00

Introduction & Removal catheter into chest to relieve pressure

Facility

$500.00

Hospital Charge Code	3255000
Hospital Revenue Code	459
Min. Negotiated Rate	$410.00
Max. Negotiated Rate	$485.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$410.00

INTRODUCT NEEDLE/INTRACATH

Facility

$144.00

Service Code	HCPCS 36000
Hospital Charge Code	3600000
Hospital Revenue Code	761
Min. Negotiated Rate	$66.53
Max. Negotiated Rate	$139.68
Rate for Payer: BCBS Commercial	$67.67
Rate for Payer: Cash Price	$108.00
Rate for Payer: Cash Price	$108.00
Rate for Payer: Celtic Commercial/Exchange	$66.53
Rate for Payer: Health Partners Plans Commercial	$136.80
Rate for Payer: UnitedHealthcare Commercial	$139.68
Rate for Payer: WPPA Commercial	$120.96

INTRODUCT NEEDLE/INTRACATH

Facility

$144.00

Service Code	HCPCS 36000
Hospital Charge Code	3600000
Hospital Revenue Code	761
Min. Negotiated Rate	$118.08
Max. Negotiated Rate	$139.68
Rate for Payer: Cash Price	$108.00
Rate for Payer: Health Partners Plans Commercial	$136.80
Rate for Payer: UnitedHealthcare Commercial	$139.68
Rate for Payer: WPPA Commercial	$118.08

INTUBATED CO2 FILTER LINE

Facility

$26.00

Hospital Charge Code	2720384
Hospital Revenue Code	272
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

INTUBATED CO2 FILTER LINE

Facility

$26.00

Hospital Charge Code	2720384
Hospital Revenue Code	272
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

INTUBATION,ENDOTRACH-ER PROC.

Facility

$512.00

Service Code	HCPCS 31500
Hospital Charge Code	3150000
Hospital Revenue Code	450
Min. Negotiated Rate	$236.54
Max. Negotiated Rate	$496.64
Rate for Payer: BCBS Commercial	$290.28
Rate for Payer: Cash Price	$384.00
Rate for Payer: Cash Price	$384.00
Rate for Payer: Celtic Commercial/Exchange	$236.54
Rate for Payer: Health Partners Plans Commercial	$486.40
Rate for Payer: UnitedHealthcare Commercial	$496.64
Rate for Payer: WPPA Commercial	$430.08

INTUBATION,ENDOTRACH-ER PROC.

Facility

$512.00

Service Code	HCPCS 31500
Hospital Charge Code	3150000
Hospital Revenue Code	450
Min. Negotiated Rate	$419.84
Max. Negotiated Rate	$496.64
Rate for Payer: Cash Price	$384.00
Rate for Payer: Health Partners Plans Commercial	$486.40
Rate for Payer: UnitedHealthcare Commercial	$496.64
Rate for Payer: WPPA Commercial	$419.84

INVANZ 1 GM ADV. INJ.

Facility

$444.00

Hospital Charge Code	2517696
Hospital Revenue Code	250
Min. Negotiated Rate	$205.13
Max. Negotiated Rate	$430.68
Rate for Payer: Cash Price	$333.45
Rate for Payer: Celtic Commercial/Exchange	$205.13
Rate for Payer: Health Partners Plans Commercial	$421.80
Rate for Payer: UnitedHealthcare Commercial	$430.68
Rate for Payer: WPPA Commercial	$372.96

INVANZ 1 GM ADV. INJ.

Facility

$444.00

Hospital Charge Code	2517696
Hospital Revenue Code	250
Min. Negotiated Rate	$364.08
Max. Negotiated Rate	$430.68
Rate for Payer: Cash Price	$333.45
Rate for Payer: Health Partners Plans Commercial	$421.80
Rate for Payer: UnitedHealthcare Commercial	$430.68
Rate for Payer: WPPA Commercial	$364.08

Invanz 1 GM (ertapenem) Inj

Facility

$465.00

Service Code	NDC 00990798413
Hospital Charge Code	2513521
Hospital Revenue Code	250
Min. Negotiated Rate	$381.30
Max. Negotiated Rate	$451.05
Rate for Payer: Cash Price	$349.01
Rate for Payer: Health Partners Plans Commercial	$441.75
Rate for Payer: UnitedHealthcare Commercial	$451.05
Rate for Payer: WPPA Commercial	$381.30

Invanz 1 GM (ertapenem) Inj

Facility

$465.00

Service Code	NDC 00990798413
Hospital Charge Code	2513521
Hospital Revenue Code	250
Min. Negotiated Rate	$214.83
Max. Negotiated Rate	$451.05
Rate for Payer: Cash Price	$349.01
Rate for Payer: Celtic Commercial/Exchange	$214.83
Rate for Payer: Health Partners Plans Commercial	$441.75
Rate for Payer: UnitedHealthcare Commercial	$451.05
Rate for Payer: WPPA Commercial	$390.60

IODOFLEX

Facility

$54.00

Hospital Charge Code	2720943LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

IODOFLEX

Facility

$54.00

Hospital Charge Code	2720943LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

IODOFLEX

Facility

$54.00

Hospital Charge Code	2720943
Hospital Revenue Code	272
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

IODOFLEX

Facility

$54.00

Hospital Charge Code	2720943
Hospital Revenue Code	272
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

IODOFORM GAUZE 1/4 INCH X 5 YD

Facility

$12.00

Hospital Charge Code	2509601
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.19
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

Know your out-of-pocket cost for care.

All Charges