Ness County Hospital

All Charges

Charge

Type

Setting

Price

KALTOSTAT 7.1CM X 11.6CM

Facility

$18.00

Hospital Charge Code	2515617
Hospital Revenue Code	250
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.95
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$14.76

KANGAROO SET 1000ML

Facility

$10.00

Hospital Charge Code	2706845
Hospital Revenue Code	270
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Celtic Commercial/Exchange	$4.62
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.40

KANGAROO SET 1000ML

Facility

$10.00

Hospital Charge Code	2706845
Hospital Revenue Code	270
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

KAOPECTATE OS (BISMUTH SUBSALICYLATE)

Facility

$1.00

Service Code	NDC 24385055940
Hospital Charge Code	2508802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.46
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

KAOPECTATE OS (BISMUTH SUBSALICYLATE)

Facility

$1.00

Service Code	NDC 24385055940
Hospital Charge Code	2508802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

KAPPA/LAMBDA

Facility

$285.00

Service Code	HCPCS 83521
Hospital Charge Code	8352100
Hospital Revenue Code	301
Min. Negotiated Rate	$233.70
Max. Negotiated Rate	$276.45
Rate for Payer: Cash Price	$213.75
Rate for Payer: Health Partners Plans Commercial	$270.75
Rate for Payer: UnitedHealthcare Commercial	$276.45
Rate for Payer: WPPA Commercial	$233.70

KAPPA/LAMBDA

Facility

$285.00

Service Code	HCPCS 83521
Hospital Charge Code	8352100
Hospital Revenue Code	301
Min. Negotiated Rate	$32.39
Max. Negotiated Rate	$276.45
Rate for Payer: BCBS Commercial	$32.39
Rate for Payer: Cash Price	$213.75
Rate for Payer: Cash Price	$213.75
Rate for Payer: Celtic Commercial/Exchange	$131.67
Rate for Payer: Health Partners Plans Commercial	$270.75
Rate for Payer: UnitedHealthcare Commercial	$276.45
Rate for Payer: WPPA Commercial	$239.40

KAYEXALATE SUSP 15 GM/60 ML (SODIUM POLYSTYRENE SULFONATE)

Facility

$71.00

Service Code	NDC 46287000660
Hospital Charge Code	2514552
Hospital Revenue Code	250
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$53.78
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$58.22

KAYEXALATE SUSP 15 GM/60 ML (SODIUM POLYSTYRENE SULFONATE)

Facility

$71.00

Service Code	NDC 46287000660
Hospital Charge Code	2514552
Hospital Revenue Code	250
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$53.78
Rate for Payer: Celtic Commercial/Exchange	$32.80
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$59.64

Kcentra 500 unit range IV recon soln

Facility

$4,500.00

Service Code	NDC 63833038602
Hospital Charge Code	2511848
Hospital Revenue Code	250
Min. Negotiated Rate	$2,079.00
Max. Negotiated Rate	$4,365.00
Rate for Payer: Cash Price	$3,375.00
Rate for Payer: Celtic Commercial/Exchange	$2,079.00
Rate for Payer: Health Partners Plans Commercial	$4,275.00
Rate for Payer: UnitedHealthcare Commercial	$4,365.00
Rate for Payer: WPPA Commercial	$3,780.00

Kcentra 500 unit range IV recon soln

Facility

$4,500.00

Service Code	NDC 63833038602
Hospital Charge Code	2511848
Hospital Revenue Code	250
Min. Negotiated Rate	$3,690.00
Max. Negotiated Rate	$4,365.00
Rate for Payer: Cash Price	$3,375.00
Rate for Payer: Health Partners Plans Commercial	$4,275.00
Rate for Payer: UnitedHealthcare Commercial	$4,365.00
Rate for Payer: WPPA Commercial	$3,690.00

KCI PAD & TUBE

Facility

$50.00

Hospital Charge Code	2725189
Hospital Revenue Code	272
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$38.06
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

KCI PAD & TUBE

Facility

$50.00

Hospital Charge Code	2725189
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$38.06
Rate for Payer: Celtic Commercial/Exchange	$23.10
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$42.00

K-DUR 10 MEQ TAB (POTASSIUM CHLORIDE ER)

Facility

$4.00

Service Code	NDC 00245531789
Hospital Charge Code	2519627
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.38
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

K-DUR 10 MEQ TAB (POTASSIUM CHLORIDE ER)

Facility

$4.00

Service Code	NDC 00245531789
Hospital Charge Code	2519627
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.38
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

Kedrab (PF) (rabies immune globulin (PF)) IM solution

Facility

$1,530.00

Service Code	NDC 76125015002
Hospital Charge Code	2514024
Hospital Revenue Code	250
Min. Negotiated Rate	$1,254.60
Max. Negotiated Rate	$1,484.10
Rate for Payer: Cash Price	$1,147.50
Rate for Payer: Health Partners Plans Commercial	$1,453.50
Rate for Payer: UnitedHealthcare Commercial	$1,484.10
Rate for Payer: WPPA Commercial	$1,254.60

Kedrab (PF) (rabies immune globulin (PF)) IM solution

Facility

$1,530.00

Service Code	NDC 76125015002
Hospital Charge Code	2514024
Hospital Revenue Code	250
Min. Negotiated Rate	$706.86
Max. Negotiated Rate	$1,484.10
Rate for Payer: Cash Price	$1,147.50
Rate for Payer: Celtic Commercial/Exchange	$706.86
Rate for Payer: Health Partners Plans Commercial	$1,453.50
Rate for Payer: UnitedHealthcare Commercial	$1,484.10
Rate for Payer: WPPA Commercial	$1,285.20

KEFLEX 125MG/5ML OS (CEPHALEXIN)

Facility

$141.00

Service Code	NDC 00093417573
Hospital Charge Code	2503787
Hospital Revenue Code	250
Min. Negotiated Rate	$115.62
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$105.79
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$115.62

KEFLEX 125MG/5ML OS (CEPHALEXIN)

Facility

$141.00

Service Code	NDC 00093417573
Hospital Charge Code	2503787
Hospital Revenue Code	250
Min. Negotiated Rate	$65.14
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$105.79
Rate for Payer: Celtic Commercial/Exchange	$65.14
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$118.44

KEFLEX 250 MG CAP (CEPHALEXIN)

Facility

$5.00

Service Code	NDC 60687015211
Hospital Charge Code	2503761
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.82
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

KEFLEX 250 MG CAP (CEPHALEXIN)

Facility

$5.00

Service Code	NDC 60687015211
Hospital Charge Code	2503761
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.82
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

KEFLEX 500 MG CAP (CEPHALEXIN)

Facility

$10.00

Service Code	NDC 50268015211
Hospital Charge Code	2503779
Hospital Revenue Code	250
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Celtic Commercial/Exchange	$4.62
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.40

KEFLEX 500 MG CAP (CEPHALEXIN)

Facility

$10.00

Service Code	NDC 50268015211
Hospital Charge Code	2503779
Hospital Revenue Code	250
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.84
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

Kefzol 1 GM ADV. (ancef/cefazolin)

Facility

$17.00

Service Code	NDC 00409258501
Hospital Charge Code	2518256
Hospital Revenue Code	250
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$13.42
Rate for Payer: Health Partners Plans Commercial	$16.15
Rate for Payer: UnitedHealthcare Commercial	$16.49
Rate for Payer: WPPA Commercial	$13.94

Kefzol 1 GM ADV. (ancef/cefazolin)

Facility

$17.00

Service Code	NDC 00409258501
Hospital Charge Code	2518256
Hospital Revenue Code	250
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$16.49
Rate for Payer: Cash Price	$13.42
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

Know your out-of-pocket cost for care.

All Charges