Ness County Hospital

All Charges

Charge

Type

Setting

Price

MEASURE POST VOID RESIDUAL UA

Facility

$225.00

Service Code	HCPCS 51798
Hospital Charge Code	5179800
Hospital Revenue Code	920
Min. Negotiated Rate	$184.50
Max. Negotiated Rate	$218.25
Rate for Payer: Cash Price	$168.75
Rate for Payer: Health Partners Plans Commercial	$213.75
Rate for Payer: UnitedHealthcare Commercial	$218.25
Rate for Payer: WPPA Commercial	$184.50

MEASURE POST VOID RESIDUAL UA

Facility

$225.00

Service Code	HCPCS 51798
Hospital Charge Code	5179800
Hospital Revenue Code	920
Min. Negotiated Rate	$67.67
Max. Negotiated Rate	$218.25
Rate for Payer: BCBS Commercial	$67.67
Rate for Payer: Cash Price	$168.75
Rate for Payer: Cash Price	$168.75
Rate for Payer: Celtic Commercial/Exchange	$103.95
Rate for Payer: Health Partners Plans Commercial	$213.75
Rate for Payer: UnitedHealthcare Commercial	$218.25
Rate for Payer: WPPA Commercial	$189.00

MEAT FIBERS, FECES

Facility

$106.00

Service Code	HCPCS 89160
Hospital Charge Code	8916000
Hospital Revenue Code	309
Min. Negotiated Rate	$48.97
Max. Negotiated Rate	$102.82
Rate for Payer: BCBS Commercial	$65.04
Rate for Payer: Cash Price	$79.50
Rate for Payer: Cash Price	$79.50
Rate for Payer: Celtic Commercial/Exchange	$48.97
Rate for Payer: Health Partners Plans Commercial	$100.70
Rate for Payer: UnitedHealthcare Commercial	$102.82
Rate for Payer: WPPA Commercial	$89.04

MEAT FIBERS, FECES

Facility

$106.00

Service Code	HCPCS 89160
Hospital Charge Code	8916000
Hospital Revenue Code	309
Min. Negotiated Rate	$86.92
Max. Negotiated Rate	$102.82
Rate for Payer: Cash Price	$79.50
Rate for Payer: Health Partners Plans Commercial	$100.70
Rate for Payer: UnitedHealthcare Commercial	$102.82
Rate for Payer: WPPA Commercial	$86.92

MECHANICAL TRACTION

Facility

$99.00

Service Code	HCPCS 97012 GP
Hospital Charge Code	4200911
Hospital Revenue Code	420
Min. Negotiated Rate	$36.36
Max. Negotiated Rate	$96.03
Rate for Payer: BCBS Commercial	$36.36
Rate for Payer: Cash Price	$74.25
Rate for Payer: Cash Price	$74.25
Rate for Payer: Celtic Commercial/Exchange	$45.74
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$83.16

MECHANICAL TRACTION

Facility

$99.00

Service Code	HCPCS 97012 GP
Hospital Charge Code	4200911
Hospital Revenue Code	420
Min. Negotiated Rate	$81.18
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.25
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$81.18

MECHAN. TRACTION-HOT/COLD PAKS

Facility

$144.00

Service Code	HCPCS 97012 GP
Hospital Charge Code	4200912
Hospital Revenue Code	420
Min. Negotiated Rate	$36.36
Max. Negotiated Rate	$139.68
Rate for Payer: BCBS Commercial	$36.36
Rate for Payer: Cash Price	$108.38
Rate for Payer: Cash Price	$108.38
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

MECHAN. TRACTION-HOT/COLD PAKS

Facility

$144.00

Service Code	HCPCS 97012 GP
Hospital Charge Code	4200912
Hospital Revenue Code	420
Min. Negotiated Rate	$118.08
Max. Negotiated Rate	$139.68
Rate for Payer: Cash Price	$108.38
Rate for Payer: Health Partners Plans Commercial	$136.80
Rate for Payer: UnitedHealthcare Commercial	$139.68
Rate for Payer: WPPA Commercial	$118.08

MECH REMOV OBSTRUCT COLONIC TB

Facility

$827.00

Service Code	HCPCS 49460
Hospital Charge Code	4946000
Hospital Revenue Code	761
Min. Negotiated Rate	$382.07
Max. Negotiated Rate	$802.19
Rate for Payer: Cash Price	$620.25
Rate for Payer: Celtic Commercial/Exchange	$382.07
Rate for Payer: Health Partners Plans Commercial	$785.65
Rate for Payer: UnitedHealthcare Commercial	$802.19
Rate for Payer: WPPA Commercial	$694.68

MECH REMOV OBSTRUCT COLONIC TB

Facility

$827.00

Service Code	HCPCS 49460
Hospital Charge Code	4946000
Hospital Revenue Code	761
Min. Negotiated Rate	$678.14
Max. Negotiated Rate	$802.19
Rate for Payer: Cash Price	$620.25
Rate for Payer: Health Partners Plans Commercial	$785.65
Rate for Payer: UnitedHealthcare Commercial	$802.19
Rate for Payer: WPPA Commercial	$678.14

MEDICAL BACK PROBLEMS WITH MCC

Facility

$14,591.66

Service Code	MSDRG 551
Min. Negotiated Rate	$14,591.66
Max. Negotiated Rate	$14,591.66
Rate for Payer: BCBS Commercial	$14,591.66

MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$8,373.14

Service Code	MSDRG 552
Min. Negotiated Rate	$8,373.14
Max. Negotiated Rate	$8,373.14
Rate for Payer: BCBS Commercial	$8,373.14

MEDI HONEY ONE APPLICATION

Facility

$3.00

Hospital Charge Code	2720360
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.25
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.46

MEDI HONEY ONE APPLICATION

Facility

$3.00

Hospital Charge Code	2720360
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.25
Rate for Payer: Celtic Commercial/Exchange	$1.39
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.52

MEDI HONEY SHEET

Facility

$28.00

Hospital Charge Code	2720362
Hospital Revenue Code	272
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.00
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$22.96

MEDI HONEY SHEET

Facility

$28.00

Hospital Charge Code	2720362
Hospital Revenue Code	272
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.00
Rate for Payer: Celtic Commercial/Exchange	$12.94
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$23.52

MEDIHONEY SHEET

Facility

$27.00

Hospital Charge Code	2720361
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.79
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

MEDIHONEY SHEET

Facility

$27.00

Hospital Charge Code	2720361
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.79
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

MEDIPORE 3" X 10YDS

Facility

$9.00

Hospital Charge Code	4132963LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
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

MEDIPORE 3" X 10YDS

Facility

$9.00

Hospital Charge Code	4132963LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

MED NUTRITION THER, RE-ASSESS

Facility

$25.00

Service Code	HCPCS 97803
Hospital Charge Code	9780300
Hospital Revenue Code	942
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: BCBS Commercial	$14.70
Rate for Payer: Cash Price	$18.75
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

MED NUTRITION THER, RE-ASSESS

Facility

$25.00

Service Code	HCPCS 97803
Hospital Charge Code	9780300
Hospital Revenue Code	942
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

MED NUTRIT THER.-INITIAL ASSES

Facility

$22.00

Service Code	HCPCS 97802
Hospital Charge Code	9420001
Hospital Revenue Code	942
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$21.34
Rate for Payer: BCBS Commercial	$14.70
Rate for Payer: Cash Price	$16.50
Rate for Payer: Cash Price	$16.50
Rate for Payer: Celtic Commercial/Exchange	$10.16
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.48

MED NUTRIT THER.-INITIAL ASSES

Facility

$22.00

Service Code	HCPCS 97802
Hospital Charge Code	9420001
Hospital Revenue Code	942
Min. Negotiated Rate	$18.04
Max. Negotiated Rate	$21.34
Rate for Payer: Cash Price	$16.50
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.04

MEDROL DOSE PACK 4 MG TAB (METHYLPREDNISOLONE 21 TABS)

Facility

$90.00

Service Code	NDC 68001000501
Hospital Charge Code	2504272
Hospital Revenue Code	250
Min. Negotiated Rate	$41.58
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$67.54
Rate for Payer: Celtic Commercial/Exchange	$41.58
Rate for Payer: Health Partners Plans Commercial	$85.50
Rate for Payer: UnitedHealthcare Commercial	$87.30
Rate for Payer: WPPA Commercial	$75.60

Know your out-of-pocket cost for care.

All Charges