Ness County Hospital

All Charges

Charge

Type

Setting

Price

MINI ISLAND

Facility

$9.00

Hospital Charge Code	2722585
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

MINI ISLAND

Facility

$9.00

Hospital Charge Code	2722585
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

MINIPRESS 1 MG CAP (PRAZOSIN HCL)

Facility

$5.00

Service Code	NDC 68084099611
Hospital Charge Code	2504439
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.12
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

MINIPRESS 1 MG CAP (PRAZOSIN HCL)

Facility

$5.00

Service Code	NDC 68084099611
Hospital Charge Code	2504439
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.12
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

MINI RESPIRATORY PANEL

Facility

$350.00

Service Code	HCPCS 87631
Hospital Charge Code	8763100
Hospital Revenue Code	306
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

MINI RESPIRATORY PANEL

Facility

$350.00

Service Code	HCPCS 87631
Hospital Charge Code	8763100
Hospital Revenue Code	306
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$239.95
Rate for Payer: Cash Price	$262.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Celtic Commercial/Exchange	$161.70
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$294.00

Mini Throat Panel

Facility

$350.00

Service Code	HCPCS 87631
Hospital Charge Code	8763101
Hospital Revenue Code	306
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$239.95
Rate for Payer: Cash Price	$262.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Celtic Commercial/Exchange	$161.70
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$294.00

Mini Throat Panel

Facility

$350.00

Service Code	HCPCS 87631
Hospital Charge Code	8763101
Hospital Revenue Code	306
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

MINOCIN 50 MG CAP (MINOCYCLINE HYDROCHLORIDE)

Facility

$5.00

Service Code	NDC 00591569460
Hospital Charge Code	2514776
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.82
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

MINOCIN 50 MG CAP (MINOCYCLINE HYDROCHLORIDE)

Facility

$5.00

Service Code	NDC 00591569460
Hospital Charge Code	2514776
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.82
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

MINOR BLADDER PROCEDURES WITH CC

Facility

$12,006.31

Service Code	MSDRG 663
Min. Negotiated Rate	$12,006.31
Max. Negotiated Rate	$12,006.31
Rate for Payer: BCBS Commercial	$12,006.31

MINOR BLADDER PROCEDURES WITH MCC

Facility

$24,067.36

Service Code	MSDRG 662
Min. Negotiated Rate	$24,067.36
Max. Negotiated Rate	$24,067.36
Rate for Payer: BCBS Commercial	$24,067.36

MINOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$9,758.50

Service Code	MSDRG 664
Min. Negotiated Rate	$9,758.50
Max. Negotiated Rate	$9,758.50
Rate for Payer: BCBS Commercial	$9,758.50

MINOR SKIN DISORDERS WITH MCC

Facility

$11,051.78

Service Code	MSDRG 606
Min. Negotiated Rate	$11,051.78
Max. Negotiated Rate	$11,051.78
Rate for Payer: BCBS Commercial	$11,051.78

MINOR SKIN DISORDERS WITHOUT MCC

Facility

$7,425.83

Service Code	MSDRG 607
Min. Negotiated Rate	$7,425.83
Max. Negotiated Rate	$7,425.83
Rate for Payer: BCBS Commercial	$7,425.83

MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$15,153.37

Service Code	MSDRG 345
Min. Negotiated Rate	$15,153.37
Max. Negotiated Rate	$15,153.37
Rate for Payer: BCBS Commercial	$15,153.37

MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$25,014.74

Service Code	MSDRG 344
Min. Negotiated Rate	$25,014.74
Max. Negotiated Rate	$25,014.74
Rate for Payer: BCBS Commercial	$25,014.74

MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$13,230.01

Service Code	MSDRG 346
Min. Negotiated Rate	$13,230.01
Max. Negotiated Rate	$13,230.01
Rate for Payer: BCBS Commercial	$13,230.01

MINOXIDIL 2.5MG TAB

Facility

$5.00

Hospital Charge Code	2509982
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.28
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

MINOXIDIL 2.5MG TAB

Facility

$5.00

Hospital Charge Code	2509982
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.28
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

MIRALAX 17 GM POWDER (POLYETHYLENE GLYCOL 3350)

Facility

$4.00

Service Code	NDC 87701040587
Hospital Charge Code	2513794
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.41
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

MIRALAX 17 GM POWDER (POLYETHYLENE GLYCOL 3350)

Facility

$4.00

Service Code	NDC 87701040587
Hospital Charge Code	2513794
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.41
Rate for Payer: Celtic Commercial/Exchange	$1.85
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.36

MIRAPEX 0.25 MG TAB (PRAMIPEXOLE)

Facility

$8.00

Service Code	NDC 60687057011
Hospital Charge Code	2513372
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.64
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

MIRAPEX 0.25 MG TAB (PRAMIPEXOLE)

Facility

$8.00

Service Code	NDC 60687057011
Hospital Charge Code	2513372
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.64
Rate for Payer: Celtic Commercial/Exchange	$3.70
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.72

Mirena 52mg (levonorgestrel) utrn intrauterine device

Facility

$4,627.00

Service Code	NDC 50419042301
Hospital Charge Code	2511541
Hospital Revenue Code	250
Min. Negotiated Rate	$3,794.14
Max. Negotiated Rate	$4,488.19
Rate for Payer: Cash Price	$3,470.37
Rate for Payer: Health Partners Plans Commercial	$4,395.65
Rate for Payer: UnitedHealthcare Commercial	$4,488.19
Rate for Payer: WPPA Commercial	$3,794.14

Know your out-of-pocket cost for care.

All Charges