Ness County Hospital

All Charges

Charge

Type

Setting

Price

ANTIB EPSTEIN-BARR VIRUS,EARLY

Facility

$142.00

Service Code	HCPCS 86663
Hospital Charge Code	8666300
Hospital Revenue Code	302
Min. Negotiated Rate	$59.89
Max. Negotiated Rate	$137.74
Rate for Payer: BCBS Commercial	$59.89
Rate for Payer: Cash Price	$106.50
Rate for Payer: Cash Price	$106.50
Rate for Payer: Celtic Commercial/Exchange	$65.60
Rate for Payer: Health Partners Plans Commercial	$134.90
Rate for Payer: UnitedHealthcare Commercial	$137.74
Rate for Payer: WPPA Commercial	$119.28

ANTIB EPSTEIN-BARR VIRUS,EARLY

Facility

$142.00

Service Code	HCPCS 86663
Hospital Charge Code	8666300
Hospital Revenue Code	302
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$137.74
Rate for Payer: Cash Price	$106.50
Rate for Payer: Health Partners Plans Commercial	$134.90
Rate for Payer: UnitedHealthcare Commercial	$137.74
Rate for Payer: WPPA Commercial	$116.44

ANTIB,EPSTEIN-BARR VIRUS NUCLR

Facility

$149.00

Service Code	HCPCS 86664
Hospital Charge Code	8666400
Hospital Revenue Code	302
Min. Negotiated Rate	$122.18
Max. Negotiated Rate	$144.53
Rate for Payer: Cash Price	$111.75
Rate for Payer: Health Partners Plans Commercial	$141.55
Rate for Payer: UnitedHealthcare Commercial	$144.53
Rate for Payer: WPPA Commercial	$122.18

ANTIB,EPSTEIN-BARR VIRUS NUCLR

Facility

$149.00

Service Code	HCPCS 86664
Hospital Charge Code	8666400
Hospital Revenue Code	302
Min. Negotiated Rate	$62.59
Max. Negotiated Rate	$144.53
Rate for Payer: BCBS Commercial	$62.59
Rate for Payer: Cash Price	$111.75
Rate for Payer: Cash Price	$111.75
Rate for Payer: Celtic Commercial/Exchange	$68.84
Rate for Payer: Health Partners Plans Commercial	$141.55
Rate for Payer: UnitedHealthcare Commercial	$144.53
Rate for Payer: WPPA Commercial	$125.16

ANTIB,EPSTEIN-BARR VIRUS,VIRAL

Facility

$143.00

Service Code	HCPCS 86665
Hospital Charge Code	8666500
Hospital Revenue Code	302
Min. Negotiated Rate	$117.26
Max. Negotiated Rate	$138.71
Rate for Payer: Cash Price	$107.25
Rate for Payer: Health Partners Plans Commercial	$135.85
Rate for Payer: UnitedHealthcare Commercial	$138.71
Rate for Payer: WPPA Commercial	$117.26

ANTIB,EPSTEIN-BARR VIRUS,VIRAL

Facility

$143.00

Service Code	HCPCS 86665
Hospital Charge Code	8666500
Hospital Revenue Code	302
Min. Negotiated Rate	$64.87
Max. Negotiated Rate	$138.71
Rate for Payer: BCBS Commercial	$64.87
Rate for Payer: Cash Price	$107.25
Rate for Payer: Cash Price	$107.25
Rate for Payer: Celtic Commercial/Exchange	$66.07
Rate for Payer: Health Partners Plans Commercial	$135.85
Rate for Payer: UnitedHealthcare Commercial	$138.71
Rate for Payer: WPPA Commercial	$120.12

ANTIB, HELICOBACTER PYLORI

Facility

$86.00

Service Code	HCPCS 86677
Hospital Charge Code	8667700
Hospital Revenue Code	302
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$83.42
Rate for Payer: BCBS Commercial	$39.75
Rate for Payer: Cash Price	$64.50
Rate for Payer: Cash Price	$64.50
Rate for Payer: Celtic Commercial/Exchange	$39.73
Rate for Payer: Health Partners Plans Commercial	$81.70
Rate for Payer: UnitedHealthcare Commercial	$83.42
Rate for Payer: WPPA Commercial	$72.24

ANTIB, HELICOBACTER PYLORI

Facility

$86.00

Service Code	HCPCS 86677
Hospital Charge Code	8667700
Hospital Revenue Code	302
Min. Negotiated Rate	$70.52
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$64.50
Rate for Payer: Health Partners Plans Commercial	$81.70
Rate for Payer: UnitedHealthcare Commercial	$83.42
Rate for Payer: WPPA Commercial	$70.52

ANTIB HIV-1 & HIV-2,SINGL ASAY

Facility

$73.00

Service Code	HCPCS 86703
Hospital Charge Code	8670300
Hospital Revenue Code	302
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$70.81
Rate for Payer: Cash Price	$54.75
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$59.86

ANTIB HIV-1 & HIV-2,SINGL ASAY

Facility

$73.00

Service Code	HCPCS 86703
Hospital Charge Code	8670300
Hospital Revenue Code	302
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$70.81
Rate for Payer: BCBS Commercial	$44.09
Rate for Payer: Cash Price	$54.75
Rate for Payer: Cash Price	$54.75
Rate for Payer: Celtic Commercial/Exchange	$33.73
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$61.32

ANTIBODY, ADENOVIRUS

Facility

$80.00

Service Code	HCPCS 86603
Hospital Charge Code	8660300
Hospital Revenue Code	302
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

ANTIBODY, ADENOVIRUS

Facility

$80.00

Service Code	HCPCS 86603
Hospital Charge Code	8660300
Hospital Revenue Code	302
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$77.60
Rate for Payer: BCBS Commercial	$13.48
Rate for Payer: Cash Price	$60.00
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

ANTIBODY ASPERGILLUS

Facility

$78.00

Service Code	HCPCS 86606
Hospital Charge Code	8660600
Hospital Revenue Code	302
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

ANTIBODY ASPERGILLUS

Facility

$78.00

Service Code	HCPCS 86606
Hospital Charge Code	8660600
Hospital Revenue Code	302
Min. Negotiated Rate	$36.04
Max. Negotiated Rate	$75.66
Rate for Payer: BCBS Commercial	$57.98
Rate for Payer: Cash Price	$58.50
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

ANTIBODY, BARTONELLA

Facility

$44.00

Service Code	HCPCS 86611
Hospital Charge Code	8661100
Hospital Revenue Code	302
Min. Negotiated Rate	$36.08
Max. Negotiated Rate	$42.68
Rate for Payer: Cash Price	$33.00
Rate for Payer: Health Partners Plans Commercial	$41.80
Rate for Payer: UnitedHealthcare Commercial	$42.68
Rate for Payer: WPPA Commercial	$36.08

ANTIBODY, BARTONELLA

Facility

$44.00

Service Code	HCPCS 86611
Hospital Charge Code	8661100
Hospital Revenue Code	302
Min. Negotiated Rate	$19.23
Max. Negotiated Rate	$42.68
Rate for Payer: BCBS Commercial	$19.23
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cash Price	$33.00
Rate for Payer: Celtic Commercial/Exchange	$20.33
Rate for Payer: Health Partners Plans Commercial	$41.80
Rate for Payer: UnitedHealthcare Commercial	$42.68
Rate for Payer: WPPA Commercial	$36.96

ANTIBODY BLASTOMYCES

Facility

$159.00

Service Code	HCPCS 86612
Hospital Charge Code	8661200
Hospital Revenue Code	302
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$119.25
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$130.38

ANTIBODY BLASTOMYCES

Facility

$159.00

Service Code	HCPCS 86612
Hospital Charge Code	8661200
Hospital Revenue Code	302
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$154.23
Rate for Payer: BCBS Commercial	$13.48
Rate for Payer: Cash Price	$119.25
Rate for Payer: Cash Price	$119.25
Rate for Payer: Celtic Commercial/Exchange	$73.46
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$133.56

ANTIBODY, BORDETELLA

Facility

$35.00

Service Code	HCPCS 86615
Hospital Charge Code	8661500
Hospital Revenue Code	302
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$33.95
Rate for Payer: BCBS Commercial	$19.36
Rate for Payer: Cash Price	$26.25
Rate for Payer: Cash Price	$26.25
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

ANTIBODY, BORDETELLA

Facility

$35.00

Service Code	HCPCS 86615
Hospital Charge Code	8661500
Hospital Revenue Code	302
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.25
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$28.70

ANTIBODY BORRELIA BURGDORFERI

Facility

$168.00

Service Code	HCPCS 86617
Hospital Charge Code	8661700
Hospital Revenue Code	302
Min. Negotiated Rate	$137.76
Max. Negotiated Rate	$162.96
Rate for Payer: Cash Price	$126.00
Rate for Payer: Health Partners Plans Commercial	$159.60
Rate for Payer: UnitedHealthcare Commercial	$162.96
Rate for Payer: WPPA Commercial	$137.76

ANTIBODY BORRELIA BURGDORFERI

Facility

$168.00

Service Code	HCPCS 86617
Hospital Charge Code	8661700
Hospital Revenue Code	302
Min. Negotiated Rate	$77.62
Max. Negotiated Rate	$162.96
Rate for Payer: BCBS Commercial	$101.71
Rate for Payer: Cash Price	$126.00
Rate for Payer: Cash Price	$126.00
Rate for Payer: Celtic Commercial/Exchange	$77.62
Rate for Payer: Health Partners Plans Commercial	$159.60
Rate for Payer: UnitedHealthcare Commercial	$162.96
Rate for Payer: WPPA Commercial	$141.12

ANTIBODY, BORRELIA BURGDORFERI

Facility

$159.00

Service Code	HCPCS 86618
Hospital Charge Code	8661800
Hospital Revenue Code	302
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$119.25
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$130.38

ANTIBODY, BORRELIA BURGDORFERI

Facility

$159.00

Service Code	HCPCS 86618
Hospital Charge Code	8661800
Hospital Revenue Code	302
Min. Negotiated Rate	$73.46
Max. Negotiated Rate	$154.23
Rate for Payer: BCBS Commercial	$76.68
Rate for Payer: Cash Price	$119.25
Rate for Payer: Cash Price	$119.25
Rate for Payer: Celtic Commercial/Exchange	$73.46
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$133.56

ANTIBODY BRUCELLA

Facility

$62.00

Service Code	HCPCS 86622
Hospital Charge Code	8662200
Hospital Revenue Code	302
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$46.50
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

Know your out-of-pocket cost for care.

All Charges