Ness County Hospital

All Charges

Charge

Type

Setting

Price

LYRICA 50 MG CAP

Facility

$32.00

Hospital Charge Code	2519270
Hospital Revenue Code	250
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$31.04
Rate for Payer: Cash Price	$24.30
Rate for Payer: Celtic Commercial/Exchange	$14.78
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.88

LYSOZYME (MURAMIDASE)

Facility

$74.00

Service Code	HCPCS 85549
Hospital Charge Code	8554900
Hospital Revenue Code	305
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$71.78
Rate for Payer: BCBS Commercial	$49.80
Rate for Payer: Cash Price	$55.50
Rate for Payer: Cash Price	$55.50
Rate for Payer: Celtic Commercial/Exchange	$34.19
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$62.16

LYSOZYME (MURAMIDASE)

Facility

$74.00

Service Code	HCPCS 85549
Hospital Charge Code	8554900
Hospital Revenue Code	305
Min. Negotiated Rate	$60.68
Max. Negotiated Rate	$71.78
Rate for Payer: Cash Price	$55.50
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$60.68

MACROBID 100MG CAP (NITROFURANTOIN MONOHYDRATE)

Facility

$48.00

Service Code	NDC 68001060600
Hospital Charge Code	2515096
Hospital Revenue Code	250
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.67
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

MACROBID 100MG CAP (NITROFURANTOIN MONOHYDRATE)

Facility

$48.00

Service Code	NDC 68001060600
Hospital Charge Code	2515096
Hospital Revenue Code	250
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.67
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

MACRODANTIN 50 MG CAP(NITROFURANTOIN MACROCRYSTALS)

Facility

$13.00

Service Code	NDC 60687047201
Hospital Charge Code	2504124
Hospital Revenue Code	250
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.94
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

MACRODANTIN 50 MG CAP(NITROFURANTOIN MACROCRYSTALS)

Facility

$13.00

Service Code	NDC 60687047201
Hospital Charge Code	2504124
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.94
Rate for Payer: Celtic Commercial/Exchange	$6.01
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.92

MAGNESIUM

Facility

$88.00

Service Code	HCPCS 83735
Hospital Charge Code	8373500
Hospital Revenue Code	301
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

MAGNESIUM

Facility

$88.00

Service Code	HCPCS 83735
Hospital Charge Code	8373500
Hospital Revenue Code	301
Min. Negotiated Rate	$25.85
Max. Negotiated Rate	$85.36
Rate for Payer: BCBS Commercial	$25.85
Rate for Payer: Cash Price	$66.00
Rate for Payer: Cash Price	$66.00
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

MAGNESIUM CITRATE OS 10 OZ. BOTTLE

Facility

$9.00

Service Code	NDC 00904678744
Hospital Charge Code	2504025
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.43
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

MAGNESIUM CITRATE OS 10 OZ. BOTTLE

Facility

$9.00

Service Code	NDC 00904678744
Hospital Charge Code	2504025
Hospital Revenue Code	250
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.43
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

MAGNESIUM-OX TAB 400 mg

Facility

$1.00

Service Code	NDC 10006070028
Hospital Charge Code	2511038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

MAGNESIUM-OX TAB 400 mg

Facility

$1.00

Service Code	NDC 10006070028
Hospital Charge Code	2511038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
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

Magnesium Sulfate 1 GM/2 ml inj.

Facility

$35.00

Service Code	NDC 63323006403
Hospital Charge Code	2504132
Hospital Revenue Code	250
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.55
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$28.70

Magnesium Sulfate 1 GM/2 ml inj.

Facility

$35.00

Service Code	NDC 63323006403
Hospital Charge Code	2504132
Hospital Revenue Code	250
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.55
Rate for Payer: Celtic Commercial/Exchange	$16.17
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$29.40

MAG-OX 400 MG TAB

Facility

$1.00

Service Code	NDC 10006070028
Hospital Charge Code	2511038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

MAG-OX 400 MG TAB

Facility

$1.00

Service Code	NDC 10006070028
Hospital Charge Code	2511038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
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

MAJOR BLADDER PROCEDURES WITH CC

Facility

$25,763.83

Service Code	MSDRG 654
Min. Negotiated Rate	$25,763.83
Max. Negotiated Rate	$25,763.83
Rate for Payer: BCBS Commercial	$25,763.83

MAJOR BLADDER PROCEDURES WITH MCC

Facility

$48,453.18

Service Code	MSDRG 653
Min. Negotiated Rate	$48,453.18
Max. Negotiated Rate	$48,453.18
Rate for Payer: BCBS Commercial	$48,453.18

MAJOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$18,463.72

Service Code	MSDRG 655
Min. Negotiated Rate	$18,463.72
Max. Negotiated Rate	$18,463.72
Rate for Payer: BCBS Commercial	$18,463.72

MAJOR CHEST PROCEDURES WITH CC

Facility

$26,149.02

Service Code	MSDRG 164
Min. Negotiated Rate	$26,149.02
Max. Negotiated Rate	$26,149.02
Rate for Payer: BCBS Commercial	$26,149.02

MAJOR CHEST PROCEDURES WITH MCC

Facility

$44,437.91

Service Code	MSDRG 163
Min. Negotiated Rate	$44,437.91
Max. Negotiated Rate	$44,437.91
Rate for Payer: BCBS Commercial	$44,437.91

MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility

$20,771.54

Service Code	MSDRG 165
Min. Negotiated Rate	$20,771.54
Max. Negotiated Rate	$20,771.54
Rate for Payer: BCBS Commercial	$20,771.54

MAJOR CHEST TRAUMA WITH CC

Facility

$10,161.33

Service Code	MSDRG 184
Min. Negotiated Rate	$10,161.33
Max. Negotiated Rate	$10,161.33
Rate for Payer: BCBS Commercial	$10,161.33

MAJOR CHEST TRAUMA WITH MCC

Facility

$13,999.46

Service Code	MSDRG 183
Min. Negotiated Rate	$13,999.46
Max. Negotiated Rate	$13,999.46
Rate for Payer: BCBS Commercial	$13,999.46

Know your out-of-pocket cost for care.

All Charges