Ness County Hospital

All Charges

Charge

Type

Setting

Price

MUCINEX DM TAB (GUAIFENESIN + DEXTROMETHORPHAN ER)

Facility

$3.00

Service Code	NDC 63824005634
Hospital Charge Code	2516599
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.36
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

MUCINEX DM TAB (GUAIFENESIN + DEXTROMETHORPHAN ER)

Facility

$3.00

Service Code	NDC 63824005634
Hospital Charge Code	2516599
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.36
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.46

MUCIN, SYNOVIAL FLUID (ROPES)

Facility

$45.00

Service Code	HCPCS 83872
Hospital Charge Code	8387200
Hospital Revenue Code	301
Min. Negotiated Rate	$20.11
Max. Negotiated Rate	$43.65
Rate for Payer: BCBS Commercial	$20.11
Rate for Payer: Cash Price	$33.75
Rate for Payer: Cash Price	$33.75
Rate for Payer: Celtic Commercial/Exchange	$20.79
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$37.80

MUCIN, SYNOVIAL FLUID (ROPES)

Facility

$45.00

Service Code	HCPCS 83872
Hospital Charge Code	8387200
Hospital Revenue Code	301
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$43.65
Rate for Payer: Cash Price	$33.75
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$36.90

MUCOMIST 20% 30 ML SOL (ACETYLCYSTEINE) FOR TYLENOL OVERDOSE ORALLY

Facility

$212.00

Service Code	NDC 00409330803
Hospital Charge Code	2508646
Hospital Revenue Code	250
Min. Negotiated Rate	$173.84
Max. Negotiated Rate	$205.64
Rate for Payer: Cash Price	$159.07
Rate for Payer: Health Partners Plans Commercial	$201.40
Rate for Payer: UnitedHealthcare Commercial	$205.64
Rate for Payer: WPPA Commercial	$173.84

MUCOMIST 20% 30 ML SOL (ACETYLCYSTEINE) FOR TYLENOL OVERDOSE ORALLY

Facility

$212.00

Service Code	NDC 00409330803
Hospital Charge Code	2508646
Hospital Revenue Code	250
Min. Negotiated Rate	$97.94
Max. Negotiated Rate	$205.64
Rate for Payer: Cash Price	$159.07
Rate for Payer: Celtic Commercial/Exchange	$97.94
Rate for Payer: Health Partners Plans Commercial	$201.40
Rate for Payer: UnitedHealthcare Commercial	$205.64
Rate for Payer: WPPA Commercial	$178.08

MUCOUS SPECIMAN TRAP

Facility

$12.00

Hospital Charge Code	2720373
Hospital Revenue Code	272
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

MUCOUS SPECIMAN TRAP

Facility

$12.00

Hospital Charge Code	2720373
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

MULTIDEX PWD WOUND DSG PKG

Facility

$21.00

Hospital Charge Code	2500171
Hospital Revenue Code	270
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.20
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

MULTIDEX PWD WOUND DSG PKG

Facility

$21.00

Hospital Charge Code	2500171
Hospital Revenue Code	270
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.20
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

MULTI LYR COMPRES WRP, LWR EXT

Facility

$515.00

Service Code	HCPCS 29581
Hospital Charge Code	2958123
Hospital Revenue Code	761
Min. Negotiated Rate	$422.30
Max. Negotiated Rate	$499.55
Rate for Payer: Cash Price	$386.25
Rate for Payer: Health Partners Plans Commercial	$489.25
Rate for Payer: UnitedHealthcare Commercial	$499.55
Rate for Payer: WPPA Commercial	$422.30

MULTI LYR COMPRES WRP, LWR EXT

Facility

$515.00

Service Code	HCPCS 29581
Hospital Charge Code	2958123
Hospital Revenue Code	761
Min. Negotiated Rate	$237.93
Max. Negotiated Rate	$499.55
Rate for Payer: BCBS Commercial	$277.75
Rate for Payer: Cash Price	$386.25
Rate for Payer: Cash Price	$386.25
Rate for Payer: Celtic Commercial/Exchange	$237.93
Rate for Payer: Health Partners Plans Commercial	$489.25
Rate for Payer: UnitedHealthcare Commercial	$499.55
Rate for Payer: WPPA Commercial	$432.60

MULTIPLE ENDOCRINE NEOPLASIA 1

Facility

$1,037.00

Service Code	HCPCS 81404
Hospital Charge Code	8140400
Hospital Revenue Code	300
Min. Negotiated Rate	$850.34
Max. Negotiated Rate	$1,005.89
Rate for Payer: Cash Price	$777.75
Rate for Payer: Health Partners Plans Commercial	$985.15
Rate for Payer: UnitedHealthcare Commercial	$1,005.89
Rate for Payer: WPPA Commercial	$850.34

MULTIPLE ENDOCRINE NEOPLASIA 1

Facility

$1,037.00

Service Code	HCPCS 81404
Hospital Charge Code	8140400
Hospital Revenue Code	300
Min. Negotiated Rate	$479.09
Max. Negotiated Rate	$1,005.89
Rate for Payer: BCBS Commercial	$647.50
Rate for Payer: Cash Price	$777.75
Rate for Payer: Cash Price	$777.75
Rate for Payer: Celtic Commercial/Exchange	$479.09
Rate for Payer: Health Partners Plans Commercial	$985.15
Rate for Payer: UnitedHealthcare Commercial	$1,005.89
Rate for Payer: WPPA Commercial	$871.08

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC

Facility

$65,776.85

Service Code	MSDRG 427
Min. Negotiated Rate	$65,776.85
Max. Negotiated Rate	$65,776.85
Rate for Payer: BCBS Commercial	$65,776.85

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$93,424.14

Service Code	MSDRG 426
Min. Negotiated Rate	$93,424.14
Max. Negotiated Rate	$93,424.14
Rate for Payer: BCBS Commercial	$93,424.14

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC

Facility

$50,337.20

Service Code	MSDRG 428
Min. Negotiated Rate	$50,337.20
Max. Negotiated Rate	$50,337.20
Rate for Payer: BCBS Commercial	$50,337.20

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$70,245.84

Service Code	MSDRG 447
Min. Negotiated Rate	$70,245.84
Max. Negotiated Rate	$70,245.84
Rate for Payer: BCBS Commercial	$70,245.84

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC

Facility

$42,783.30

Service Code	MSDRG 448
Min. Negotiated Rate	$42,783.30
Max. Negotiated Rate	$42,783.30
Rate for Payer: BCBS Commercial	$42,783.30

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC

Facility

$10,107.64

Service Code	MSDRG 059
Min. Negotiated Rate	$10,107.64
Max. Negotiated Rate	$10,107.64
Rate for Payer: BCBS Commercial	$10,107.64

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC

Facility

$15,581.54

Service Code	MSDRG 058
Min. Negotiated Rate	$15,581.54
Max. Negotiated Rate	$15,581.54
Rate for Payer: BCBS Commercial	$15,581.54

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC

Facility

$6,522.11

Service Code	MSDRG 060
Min. Negotiated Rate	$6,522.11
Max. Negotiated Rate	$6,522.11
Rate for Payer: BCBS Commercial	$6,522.11

MULTIVITAMIN

Facility

$1.00

Service Code	NDC 09040053061
Hospital Charge Code	2507093
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
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

MULTIVITAMIN

Facility

$1.00

Service Code	NDC 09040053061
Hospital Charge Code	2507093
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

MULTIVITAMIN ¨C 12 IV (INFUVITE-ADULT)(MVI-12)

Facility

$793.00

Service Code	NDC 54643900701
Hospital Charge Code	2508208
Hospital Revenue Code	250
Min. Negotiated Rate	$366.37
Max. Negotiated Rate	$769.21
Rate for Payer: Cash Price	$595.35
Rate for Payer: Celtic Commercial/Exchange	$366.37
Rate for Payer: Health Partners Plans Commercial	$753.35
Rate for Payer: UnitedHealthcare Commercial	$769.21
Rate for Payer: WPPA Commercial	$666.12

Know your out-of-pocket cost for care.

All Charges