Ness County Hospital

All Charges

Charge

Type

Setting

Price

ANKLE LT 3V

Facility

$262.00

Service Code	HCPCS 73610 LT
Hospital Charge Code	3290013
Hospital Revenue Code	320
Min. Negotiated Rate	$214.84
Max. Negotiated Rate	$254.14
Rate for Payer: Cash Price	$196.50
Rate for Payer: Health Partners Plans Commercial	$248.90
Rate for Payer: UnitedHealthcare Commercial	$254.14
Rate for Payer: WPPA Commercial	$214.84

ANKLE MAXTRAX 2.0 AIR WALKER LARGE

Facility

$132.00

Hospital Charge Code	2704323
Hospital Revenue Code	270
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANKLE MAXTRAX 2.0 AIR WALKER LARGE

Facility

$132.00

Hospital Charge Code	2704323
Hospital Revenue Code	270
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANKLE MAXTRAX 2.0 AIR WALKER MEDIUM

Facility

$132.00

Hospital Charge Code	2704322
Hospital Revenue Code	270
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANKLE MAXTRAX 2.0 AIR WALKER MEDIUM

Facility

$132.00

Hospital Charge Code	2704322
Hospital Revenue Code	270
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANKLE MAXTRAX 2.0 AIR WALKER SMALL

Facility

$132.00

Hospital Charge Code	2704321
Hospital Revenue Code	270
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANKLE MAXTRAX 2.0 AIR WALKER SMALL

Facility

$132.00

Hospital Charge Code	2704321
Hospital Revenue Code	270
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANKLE MAXTRAX 2.0 AIR WALKER XLARGE

Facility

$132.00

Hospital Charge Code	2704324
Hospital Revenue Code	270
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANKLE MAXTRAX 2.0 AIR WALKER XLARGE

Facility

$132.00

Hospital Charge Code	2704324
Hospital Revenue Code	270
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANKLE MAXTRAX 2.0 AIR WALKER XSMALL

Facility

$132.00

Hospital Charge Code	2704320
Hospital Revenue Code	270
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANKLE MAXTRAX 2.0 AIR WALKER XSMALL

Facility

$132.00

Hospital Charge Code	2704320
Hospital Revenue Code	270
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANKLE RT 2V

Facility

$216.00

Service Code	HCPCS 73600 RT
Hospital Charge Code	3290010
Hospital Revenue Code	320
Min. Negotiated Rate	$99.79
Max. Negotiated Rate	$209.52
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$162.00
Rate for Payer: Cash Price	$162.00
Rate for Payer: Celtic Commercial/Exchange	$99.79
Rate for Payer: Health Partners Plans Commercial	$205.20
Rate for Payer: UnitedHealthcare Commercial	$209.52
Rate for Payer: WPPA Commercial	$181.44

ANKLE RT 2V

Facility

$216.00

Service Code	HCPCS 73600 RT
Hospital Charge Code	3290010
Hospital Revenue Code	320
Min. Negotiated Rate	$177.12
Max. Negotiated Rate	$209.52
Rate for Payer: Cash Price	$162.00
Rate for Payer: Health Partners Plans Commercial	$205.20
Rate for Payer: UnitedHealthcare Commercial	$209.52
Rate for Payer: WPPA Commercial	$177.12

ANKLE RT 3V

Facility

$262.00

Service Code	HCPCS 73610 RT
Hospital Charge Code	3290012
Hospital Revenue Code	320
Min. Negotiated Rate	$121.04
Max. Negotiated Rate	$254.14
Rate for Payer: BCBS Commercial	$139.38
Rate for Payer: Cash Price	$196.50
Rate for Payer: Cash Price	$196.50
Rate for Payer: Celtic Commercial/Exchange	$121.04
Rate for Payer: Health Partners Plans Commercial	$248.90
Rate for Payer: UnitedHealthcare Commercial	$254.14
Rate for Payer: WPPA Commercial	$220.08

ANKLE RT 3V

Facility

$262.00

Service Code	HCPCS 73610 RT
Hospital Charge Code	3290012
Hospital Revenue Code	320
Min. Negotiated Rate	$214.84
Max. Negotiated Rate	$254.14
Rate for Payer: Cash Price	$196.50
Rate for Payer: Health Partners Plans Commercial	$248.90
Rate for Payer: UnitedHealthcare Commercial	$254.14
Rate for Payer: WPPA Commercial	$214.84

ANKLE SUPPORT LG

Facility

$78.00

Hospital Charge Code	2701266
Hospital Revenue Code	270
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$63.96

ANKLE SUPPORT LG

Facility

$78.00

Hospital Charge Code	2701266
Hospital Revenue Code	270
Min. Negotiated Rate	$36.04
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Celtic Commercial/Exchange	$36.04
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$65.52

ANKLE SUPPORT MD

Facility

$78.00

Hospital Charge Code	2701267
Hospital Revenue Code	270
Min. Negotiated Rate	$36.04
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Celtic Commercial/Exchange	$36.04
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$65.52

ANKLE SUPPORT MD

Facility

$78.00

Hospital Charge Code	2701267
Hospital Revenue Code	270
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$63.96

ANKLE SUPPORT SM

Facility

$78.00

Hospital Charge Code	2701268
Hospital Revenue Code	270
Min. Negotiated Rate	$36.04
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Celtic Commercial/Exchange	$36.04
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$65.52

ANKLE SUPPORT SM

Facility

$78.00

Hospital Charge Code	2701268
Hospital Revenue Code	270
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$63.96

ANKLE SUPPORT XL

Facility

$78.00

Hospital Charge Code	2701269
Hospital Revenue Code	270
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$63.96

ANKLE SUPPORT XL

Facility

$78.00

Hospital Charge Code	2701269
Hospital Revenue Code	270
Min. Negotiated Rate	$36.04
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Celtic Commercial/Exchange	$36.04
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$65.52

ANOSCOPY DIAGN W W/ COL SPECIM

Facility

$129.00

Service Code	HCPCS 46600
Hospital Charge Code	4660000
Hospital Revenue Code	450
Min. Negotiated Rate	$59.60
Max. Negotiated Rate	$140.50
Rate for Payer: BCBS Commercial	$140.50
Rate for Payer: Cash Price	$96.75
Rate for Payer: Cash Price	$96.75
Rate for Payer: Celtic Commercial/Exchange	$59.60
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$108.36

ANOSCOPY DIAGN W W/ COL SPECIM

Facility

$129.00

Service Code	HCPCS 46600
Hospital Charge Code	4660000
Hospital Revenue Code	450
Min. Negotiated Rate	$105.78
Max. Negotiated Rate	$125.13
Rate for Payer: Cash Price	$96.75
Rate for Payer: Health Partners Plans Commercial	$122.55
Rate for Payer: UnitedHealthcare Commercial	$125.13
Rate for Payer: WPPA Commercial	$105.78

Know your out-of-pocket cost for care.

All Charges