Ness County Hospital

All Charges

Charge

Type

Setting

Price

Mepilex (foam bandage) Top Bandage 4 x 4 in.

Facility

$33.00

Service Code	NDC 10791010331
Hospital Charge Code	2516706
Hospital Revenue Code	270
Min. Negotiated Rate	$27.06
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.05
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.06

Mepilex (foam bandage) Top Bandage 4 x 4 in.

Facility

$33.00

Service Code	NDC 10791010331
Hospital Charge Code	2516706
Hospital Revenue Code	270
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.05
Rate for Payer: Celtic Commercial/Exchange	$15.25
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.72

MEPILEX SILICONE FOAM

Facility

$9.00

Hospital Charge Code	2720728
Hospital Revenue Code	272
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

MEPILEX SILICONE FOAM

Facility

$9.00

Hospital Charge Code	2720728
Hospital Revenue Code	272
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

MERCURY, QUANTITATIVE

Facility

$122.00

Service Code	HCPCS 83825
Hospital Charge Code	8382500
Hospital Revenue Code	301
Min. Negotiated Rate	$49.74
Max. Negotiated Rate	$118.34
Rate for Payer: BCBS Commercial	$49.74
Rate for Payer: Cash Price	$91.50
Rate for Payer: Cash Price	$91.50
Rate for Payer: Celtic Commercial/Exchange	$56.36
Rate for Payer: Health Partners Plans Commercial	$115.90
Rate for Payer: UnitedHealthcare Commercial	$118.34
Rate for Payer: WPPA Commercial	$102.48

MERCURY, QUANTITATIVE

Facility

$122.00

Service Code	HCPCS 83825
Hospital Charge Code	8382500
Hospital Revenue Code	301
Min. Negotiated Rate	$100.04
Max. Negotiated Rate	$118.34
Rate for Payer: Cash Price	$91.50
Rate for Payer: Health Partners Plans Commercial	$115.90
Rate for Payer: UnitedHealthcare Commercial	$118.34
Rate for Payer: WPPA Commercial	$100.04

Meropenem 1 gm IV (merrem)

Facility

$241.00

Service Code	NDC 55150020830
Hospital Charge Code	2518967
Hospital Revenue Code	250
Min. Negotiated Rate	$197.62
Max. Negotiated Rate	$233.77
Rate for Payer: Cash Price	$181.20
Rate for Payer: Health Partners Plans Commercial	$228.95
Rate for Payer: UnitedHealthcare Commercial	$233.77
Rate for Payer: WPPA Commercial	$197.62

Meropenem 1 gm IV (merrem)

Facility

$241.00

Service Code	NDC 55150020830
Hospital Charge Code	2518967
Hospital Revenue Code	250
Min. Negotiated Rate	$111.34
Max. Negotiated Rate	$233.77
Rate for Payer: Cash Price	$181.20
Rate for Payer: Celtic Commercial/Exchange	$111.34
Rate for Payer: Health Partners Plans Commercial	$228.95
Rate for Payer: UnitedHealthcare Commercial	$233.77
Rate for Payer: WPPA Commercial	$202.44

Meropenem 1 GM IV Premix

Facility

$89.00

Service Code	NDC 00264318311
Hospital Charge Code	2519254
Hospital Revenue Code	250
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$86.33
Rate for Payer: Cash Price	$67.05
Rate for Payer: Celtic Commercial/Exchange	$41.12
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$74.76

Meropenem 1 GM IV Premix

Facility

$89.00

Service Code	NDC 00264318311
Hospital Charge Code	2519254
Hospital Revenue Code	250
Min. Negotiated Rate	$72.98
Max. Negotiated Rate	$86.33
Rate for Payer: Cash Price	$67.05
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$72.98

MESALT 2" RIBBON

Facility

$9.00

Hospital Charge Code	2720735
Hospital Revenue Code	272
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

MESALT 2" RIBBON

Facility

$9.00

Hospital Charge Code	2720735
Hospital Revenue Code	272
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

MESALT 4 X 4"

Facility

$9.00

Hospital Charge Code	2720734
Hospital Revenue Code	272
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

MESALT 4 X 4"

Facility

$9.00

Hospital Charge Code	2720734
Hospital Revenue Code	272
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

METAMUCIL POWDER PACKET (KONSYL)

Facility

$1.00

Service Code	NDC 37000002310
Hospital Charge Code	2504389
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.05
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

METAMUCIL POWDER PACKET (KONSYL)

Facility

$1.00

Service Code	NDC 37000002310
Hospital Charge Code	2504389
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.05
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

METANEPHRINES,FRAC,FREE PLASMA

Facility

$123.00

Service Code	HCPCS 83835
Hospital Charge Code	8383501
Hospital Revenue Code	301
Min. Negotiated Rate	$100.86
Max. Negotiated Rate	$119.31
Rate for Payer: Cash Price	$92.25
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$100.86

METANEPHRINES,FRAC,FREE PLASMA

Facility

$123.00

Service Code	HCPCS 83835
Hospital Charge Code	8383501
Hospital Revenue Code	301
Min. Negotiated Rate	$56.83
Max. Negotiated Rate	$119.31
Rate for Payer: BCBS Commercial	$65.77
Rate for Payer: Cash Price	$92.25
Rate for Payer: Cash Price	$92.25
Rate for Payer: Celtic Commercial/Exchange	$56.83
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$103.32

METANEPHRINES,FRAC,LC/MS/MS 24

Facility

$150.00

Service Code	HCPCS 83835
Hospital Charge Code	8383500
Hospital Revenue Code	301
Min. Negotiated Rate	$65.77
Max. Negotiated Rate	$145.50
Rate for Payer: BCBS Commercial	$65.77
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Celtic Commercial/Exchange	$69.30
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$126.00

METANEPHRINES,FRAC,LC/MS/MS 24

Facility

$150.00

Service Code	HCPCS 83835
Hospital Charge Code	8383500
Hospital Revenue Code	301
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$123.00

METHADONE

Facility

$110.00

Service Code	HCPCS 80358
Hospital Charge Code	8035800
Hospital Revenue Code	300
Min. Negotiated Rate	$50.82
Max. Negotiated Rate	$106.70
Rate for Payer: BCBS Commercial	$56.02
Rate for Payer: Cash Price	$82.50
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

METHADONE

Facility

$110.00

Service Code	HCPCS 80358
Hospital Charge Code	8035800
Hospital Revenue Code	300
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

METHERGINE 0.2MG/ML INJ. (METHYLERGONOVINE MALEATE)

Facility

$94.00

Service Code	NDC 51991014417
Hospital Charge Code	2517241
Hospital Revenue Code	250
Min. Negotiated Rate	$43.43
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$71.14
Rate for Payer: Celtic Commercial/Exchange	$43.43
Rate for Payer: Health Partners Plans Commercial	$89.30
Rate for Payer: UnitedHealthcare Commercial	$91.18
Rate for Payer: WPPA Commercial	$78.96

METHERGINE 0.2MG/ML INJ. (METHYLERGONOVINE MALEATE)

Facility

$94.00

Service Code	NDC 51991014417
Hospital Charge Code	2517241
Hospital Revenue Code	250
Min. Negotiated Rate	$77.08
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$71.14
Rate for Payer: Health Partners Plans Commercial	$89.30
Rate for Payer: UnitedHealthcare Commercial	$91.18
Rate for Payer: WPPA Commercial	$77.08

METHERGINE 0.2 MG TAB (METHYLERGONOVINE)

Facility

$201.00

Service Code	NDC 60687041094
Hospital Charge Code	2504397
Hospital Revenue Code	250
Min. Negotiated Rate	$164.82
Max. Negotiated Rate	$194.97
Rate for Payer: Cash Price	$151.27
Rate for Payer: Health Partners Plans Commercial	$190.95
Rate for Payer: UnitedHealthcare Commercial	$194.97
Rate for Payer: WPPA Commercial	$164.82

Know your out-of-pocket cost for care.

All Charges