Ness County Hospital

All Charges

Charge

Type

Setting

Price

LIDODERM PATCH

Facility

$28.00

Hospital Charge Code	2516896
Hospital Revenue Code	250
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.08
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$22.96

LIFELINE

Facility

$25.00

Hospital Charge Code	9999001
Hospital Revenue Code	990
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

LIFELINE

Facility

$25.00

Hospital Charge Code	9999001
Hospital Revenue Code	990
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

LIFE PAK MONITOR ELECTRODES

Facility

$30.00

Hospital Charge Code	2700789
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

LIFE PAK MONITOR ELECTRODES

Facility

$30.00

Hospital Charge Code	2700789
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$42,274.78

Service Code	MSDRG 956
Min. Negotiated Rate	$42,274.78
Max. Negotiated Rate	$42,274.78
Rate for Payer: BCBS Commercial	$42,274.78

LINCARE CPAP/BIPAP CHIN STRAP

Facility

$50.00

Hospital Charge Code	4100105
Hospital Revenue Code	272
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

LINCARE CPAP/BIPAP CHIN STRAP

Facility

$50.00

Hospital Charge Code	4100105
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
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

LINCARE CPAP/BIPAP FACE MASK

Facility

$260.00

Hospital Charge Code	4100100
Hospital Revenue Code	272
Min. Negotiated Rate	$213.20
Max. Negotiated Rate	$252.20
Rate for Payer: Cash Price	$195.00
Rate for Payer: Health Partners Plans Commercial	$247.00
Rate for Payer: UnitedHealthcare Commercial	$252.20
Rate for Payer: WPPA Commercial	$213.20

LINCARE CPAP/BIPAP FACE MASK

Facility

$260.00

Hospital Charge Code	4100100
Hospital Revenue Code	272
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$252.20
Rate for Payer: Cash Price	$195.00
Rate for Payer: Celtic Commercial/Exchange	$120.12
Rate for Payer: Health Partners Plans Commercial	$247.00
Rate for Payer: UnitedHealthcare Commercial	$252.20
Rate for Payer: WPPA Commercial	$218.40

LINCARE CPAP/BIPAP FILTER

Facility

$20.00

Hospital Charge Code	4100104
Hospital Revenue Code	272
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

LINCARE CPAP/BIPAP FILTER

Facility

$20.00

Hospital Charge Code	4100104
Hospital Revenue Code	272
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

LINCARE CPAP/BIPAP HEADGEAR

Facility

$120.00

Hospital Charge Code	4100101
Hospital Revenue Code	272
Min. Negotiated Rate	$98.40
Max. Negotiated Rate	$116.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Health Partners Plans Commercial	$114.00
Rate for Payer: UnitedHealthcare Commercial	$116.40
Rate for Payer: WPPA Commercial	$98.40

LINCARE CPAP/BIPAP HEADGEAR

Facility

$120.00

Hospital Charge Code	4100101
Hospital Revenue Code	272
Min. Negotiated Rate	$55.44
Max. Negotiated Rate	$116.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Celtic Commercial/Exchange	$55.44
Rate for Payer: Health Partners Plans Commercial	$114.00
Rate for Payer: UnitedHealthcare Commercial	$116.40
Rate for Payer: WPPA Commercial	$100.80

LINCARE CPAP/BIPAP TUBING

Facility

$110.00

Hospital Charge Code	4100102
Hospital Revenue Code	272
Min. Negotiated Rate	$90.20
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$82.50
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$90.20

LINCARE CPAP/BIPAP TUBING

Facility

$110.00

Hospital Charge Code	4100102
Hospital Revenue Code	272
Min. Negotiated Rate	$50.82
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$82.50
Rate for Payer: Celtic Commercial/Exchange	$50.82
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$92.40

LINCOCIN 600mg/2ml vial

Facility

$154.00

Service Code	NDC 00009055501
Hospital Charge Code	2504033
Hospital Revenue Code	250
Min. Negotiated Rate	$126.28
Max. Negotiated Rate	$149.38
Rate for Payer: Cash Price	$116.18
Rate for Payer: Health Partners Plans Commercial	$146.30
Rate for Payer: UnitedHealthcare Commercial	$149.38
Rate for Payer: WPPA Commercial	$126.28

LINCOCIN 600mg/2ml vial

Facility

$154.00

Service Code	NDC 00009055501
Hospital Charge Code	2504033
Hospital Revenue Code	250
Min. Negotiated Rate	$71.15
Max. Negotiated Rate	$149.38
Rate for Payer: Cash Price	$116.18
Rate for Payer: Celtic Commercial/Exchange	$71.15
Rate for Payer: Health Partners Plans Commercial	$146.30
Rate for Payer: UnitedHealthcare Commercial	$149.38
Rate for Payer: WPPA Commercial	$129.36

LIORESAL 10 MG TAB (BACLOFEN)

Facility

$2.00

Service Code	NDC 50268010611
Hospital Charge Code	2510444
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.65
Rate for Payer: Celtic Commercial/Exchange	$0.92
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.68

LIORESAL 10 MG TAB (BACLOFEN)

Facility

$2.00

Service Code	NDC 50268010611
Hospital Charge Code	2510444
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.65
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.64

LIPASE

Facility

$93.00

Service Code	HCPCS 83690
Hospital Charge Code	8369000
Hospital Revenue Code	301
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

LIPASE

Facility

$93.00

Service Code	HCPCS 83690
Hospital Charge Code	8369000
Hospital Revenue Code	301
Min. Negotiated Rate	$27.78
Max. Negotiated Rate	$90.21
Rate for Payer: BCBS Commercial	$27.78
Rate for Payer: Cash Price	$69.75
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

LIPID FOR PANEL KIT

Facility

$155.00

Service Code	HCPCS 80061
Hospital Charge Code	8006101
Hospital Revenue Code	301
Min. Negotiated Rate	$127.10
Max. Negotiated Rate	$150.35
Rate for Payer: Cash Price	$116.25
Rate for Payer: Health Partners Plans Commercial	$147.25
Rate for Payer: UnitedHealthcare Commercial	$150.35
Rate for Payer: WPPA Commercial	$127.10

LIPID FOR PANEL KIT

Facility

$155.00

Service Code	HCPCS 80061
Hospital Charge Code	8006101
Hospital Revenue Code	301
Min. Negotiated Rate	$43.18
Max. Negotiated Rate	$150.35
Rate for Payer: BCBS Commercial	$43.18
Rate for Payer: Cash Price	$116.25
Rate for Payer: Cash Price	$116.25
Rate for Payer: Celtic Commercial/Exchange	$71.61
Rate for Payer: Health Partners Plans Commercial	$147.25
Rate for Payer: UnitedHealthcare Commercial	$150.35
Rate for Payer: WPPA Commercial	$130.20

LIPID PANEL

Facility

$155.00

Service Code	HCPCS 80061
Hospital Charge Code	8006100
Hospital Revenue Code	301
Min. Negotiated Rate	$127.10
Max. Negotiated Rate	$150.35
Rate for Payer: Cash Price	$116.25
Rate for Payer: Health Partners Plans Commercial	$147.25
Rate for Payer: UnitedHealthcare Commercial	$150.35
Rate for Payer: WPPA Commercial	$127.10

Know your out-of-pocket cost for care.

All Charges