Ness County Hospital

All Charges

Charge

Type

Setting

Price

NEBULIZER WITH HAND HELD

Facility

$15.00

Hospital Charge Code	4100285
Hospital Revenue Code	270
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Celtic Commercial/Exchange	$6.93
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.60

NEG PRESSURE WND TX >50 SQ CM

Facility

$425.00

Service Code	HCPCS 97606
Hospital Charge Code	9760623
Hospital Revenue Code	761
Min. Negotiated Rate	$348.50
Max. Negotiated Rate	$412.25
Rate for Payer: Cash Price	$318.75
Rate for Payer: Health Partners Plans Commercial	$403.75
Rate for Payer: UnitedHealthcare Commercial	$412.25
Rate for Payer: WPPA Commercial	$348.50

NEG PRESSURE WND TX >50 SQ CM

Facility

$425.00

Service Code	HCPCS 97606
Hospital Charge Code	9760623
Hospital Revenue Code	761
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$412.25
Rate for Payer: BCBS Commercial	$331.25
Rate for Payer: Cash Price	$318.75
Rate for Payer: Cash Price	$318.75
Rate for Payer: Celtic Commercial/Exchange	$196.35
Rate for Payer: Health Partners Plans Commercial	$403.75
Rate for Payer: UnitedHealthcare Commercial	$412.25
Rate for Payer: WPPA Commercial	$357.00

NEG PRES WND TX <50 SQCM, DISP

Facility

$425.00

Service Code	HCPCS 97607
Hospital Charge Code	9760723
Hospital Revenue Code	761
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$499.41
Rate for Payer: BCBS Commercial	$499.41
Rate for Payer: Cash Price	$318.75
Rate for Payer: Cash Price	$318.75
Rate for Payer: Celtic Commercial/Exchange	$196.35
Rate for Payer: Health Partners Plans Commercial	$403.75
Rate for Payer: UnitedHealthcare Commercial	$412.25
Rate for Payer: WPPA Commercial	$357.00

NEG PRES WND TX <50 SQCM, DISP

Facility

$425.00

Service Code	HCPCS 97607
Hospital Charge Code	9760723
Hospital Revenue Code	761
Min. Negotiated Rate	$348.50
Max. Negotiated Rate	$412.25
Rate for Payer: Cash Price	$318.75
Rate for Payer: Health Partners Plans Commercial	$403.75
Rate for Payer: UnitedHealthcare Commercial	$412.25
Rate for Payer: WPPA Commercial	$348.50

NEG PRES WND TX >50 SQ CM DISP

Facility

$475.00

Service Code	HCPCS 97608
Hospital Charge Code	9760823
Hospital Revenue Code	761
Min. Negotiated Rate	$389.50
Max. Negotiated Rate	$460.75
Rate for Payer: Cash Price	$356.25
Rate for Payer: Health Partners Plans Commercial	$451.25
Rate for Payer: UnitedHealthcare Commercial	$460.75
Rate for Payer: WPPA Commercial	$389.50

NEG PRES WND TX >50 SQ CM DISP

Facility

$475.00

Service Code	HCPCS 97608
Hospital Charge Code	9760823
Hospital Revenue Code	761
Min. Negotiated Rate	$219.45
Max. Negotiated Rate	$460.75
Rate for Payer: Cash Price	$356.25
Rate for Payer: Celtic Commercial/Exchange	$219.45
Rate for Payer: Health Partners Plans Commercial	$451.25
Rate for Payer: UnitedHealthcare Commercial	$460.75
Rate for Payer: WPPA Commercial	$399.00

NEG PRES WOUND TX < 50 SQ CM

Facility

$350.00

Service Code	HCPCS 97605
Hospital Charge Code	9760523
Hospital Revenue Code	761
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

NEG PRES WOUND TX < 50 SQ CM

Facility

$350.00

Service Code	HCPCS 97605
Hospital Charge Code	9760523
Hospital Revenue Code	761
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$223.75
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

NEO-DECADRON OPHTH. OINT. 3.5 GM tube (NEOMYCIN & POLYMYXIN B SULFATES & DEXAMETHASONE)(Maxitrol)

Facility

$701.00

Service Code	NDC 00065063136
Hospital Charge Code	2513497
Hospital Revenue Code	250
Min. Negotiated Rate	$323.86
Max. Negotiated Rate	$679.97
Rate for Payer: Cash Price	$526.20
Rate for Payer: Celtic Commercial/Exchange	$323.86
Rate for Payer: Health Partners Plans Commercial	$665.95
Rate for Payer: UnitedHealthcare Commercial	$679.97
Rate for Payer: WPPA Commercial	$588.84

NEO-DECADRON OPHTH. OINT. 3.5 GM tube (NEOMYCIN & POLYMYXIN B SULFATES & DEXAMETHASONE)(Maxitrol)

Facility

$701.00

Service Code	NDC 00065063136
Hospital Charge Code	2513497
Hospital Revenue Code	250
Min. Negotiated Rate	$574.82
Max. Negotiated Rate	$679.97
Rate for Payer: Cash Price	$526.20
Rate for Payer: Health Partners Plans Commercial	$665.95
Rate for Payer: UnitedHealthcare Commercial	$679.97
Rate for Payer: WPPA Commercial	$574.82

NEO-DECADRON OPHTH. SOL. 5 ml (NEOMYCIN-POLYMYXIN B-DEXAMETHASONE)

Facility

$190.00

Service Code	NDC 24208083060
Hospital Charge Code	2504736
Hospital Revenue Code	250
Min. Negotiated Rate	$155.80
Max. Negotiated Rate	$184.30
Rate for Payer: Cash Price	$142.73
Rate for Payer: Health Partners Plans Commercial	$180.50
Rate for Payer: UnitedHealthcare Commercial	$184.30
Rate for Payer: WPPA Commercial	$155.80

NEO-DECADRON OPHTH. SOL. 5 ml (NEOMYCIN-POLYMYXIN B-DEXAMETHASONE)

Facility

$190.00

Service Code	NDC 24208083060
Hospital Charge Code	2504736
Hospital Revenue Code	250
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$184.30
Rate for Payer: Cash Price	$142.73
Rate for Payer: Celtic Commercial/Exchange	$87.78
Rate for Payer: Health Partners Plans Commercial	$180.50
Rate for Payer: UnitedHealthcare Commercial	$184.30
Rate for Payer: WPPA Commercial	$159.60

NEONATAL CENSOR

Facility

$55.00

Hospital Charge Code	2708872
Hospital Revenue Code	270
Min. Negotiated Rate	$45.10
Max. Negotiated Rate	$53.35
Rate for Payer: Cash Price	$41.25
Rate for Payer: Health Partners Plans Commercial	$52.25
Rate for Payer: UnitedHealthcare Commercial	$53.35
Rate for Payer: WPPA Commercial	$45.10

NEONATAL CENSOR

Facility

$55.00

Hospital Charge Code	2708872
Hospital Revenue Code	270
Min. Negotiated Rate	$25.41
Max. Negotiated Rate	$53.35
Rate for Payer: Cash Price	$41.25
Rate for Payer: Celtic Commercial/Exchange	$25.41
Rate for Payer: Health Partners Plans Commercial	$52.25
Rate for Payer: UnitedHealthcare Commercial	$53.35
Rate for Payer: WPPA Commercial	$46.20

NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

Facility

$16,024.22

Service Code	MSDRG 789
Min. Negotiated Rate	$16,024.22
Max. Negotiated Rate	$16,024.22
Rate for Payer: BCBS Commercial	$16,024.22

NEONATE WITH OTHER SIGNIFICANT PROBLEMS

Facility

$13,030.22

Service Code	MSDRG 794
Min. Negotiated Rate	$13,030.22
Max. Negotiated Rate	$13,030.22
Rate for Payer: BCBS Commercial	$13,030.22

NEOPRENE KNEE SUPPORT

Facility

$67.00

Hospital Charge Code	9907012
Hospital Revenue Code	270
Min. Negotiated Rate	$30.95
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.25
Rate for Payer: Celtic Commercial/Exchange	$30.95
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$56.28

NEOPRENE KNEE SUPPORT

Facility

$67.00

Hospital Charge Code	9907012
Hospital Revenue Code	270
Min. Negotiated Rate	$54.94
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.25
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$54.94

NEOSPORIN 0.9 GM (3pk) FOILPACK OINTMENT (TRIPLE ANTIBIOTIC)

Facility

$4.00

Service Code	NDC 45802014370
Hospital Charge Code	2504801
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

NEOSPORIN 0.9 GM (3pk) FOILPACK OINTMENT (TRIPLE ANTIBIOTIC)

Facility

$4.00

Service Code	NDC 45802014370
Hospital Charge Code	2504801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
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

NEOSPORIN 10 ML OPTHAMLMIC SOLUTION(NEOMYCIN & POLYMYXIN B SULFATES & GRAMICIDIN)

Facility

$204.00

Service Code	NDC 24208079062
Hospital Charge Code	2504835
Hospital Revenue Code	250
Min. Negotiated Rate	$94.25
Max. Negotiated Rate	$197.88
Rate for Payer: Cash Price	$153.15
Rate for Payer: Celtic Commercial/Exchange	$94.25
Rate for Payer: Health Partners Plans Commercial	$193.80
Rate for Payer: UnitedHealthcare Commercial	$197.88
Rate for Payer: WPPA Commercial	$171.36

NEOSPORIN 10 ML OPTHAMLMIC SOLUTION(NEOMYCIN & POLYMYXIN B SULFATES & GRAMICIDIN)

Facility

$204.00

Service Code	NDC 24208079062
Hospital Charge Code	2504835
Hospital Revenue Code	250
Min. Negotiated Rate	$167.28
Max. Negotiated Rate	$197.88
Rate for Payer: Cash Price	$153.15
Rate for Payer: Health Partners Plans Commercial	$193.80
Rate for Payer: UnitedHealthcare Commercial	$197.88
Rate for Payer: WPPA Commercial	$167.28

NEOSPORIN 30 GM OINTMENT (TRIPLE ANTIBIOTIC)

Facility

$34.00

Service Code	NDC 46122041403
Hospital Charge Code	2504793
Hospital Revenue Code	250
Min. Negotiated Rate	$27.88
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.58
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$27.88

NEOSPORIN 30 GM OINTMENT (TRIPLE ANTIBIOTIC)

Facility

$34.00

Service Code	NDC 46122041403
Hospital Charge Code	2504793
Hospital Revenue Code	250
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.58
Rate for Payer: Celtic Commercial/Exchange	$15.71
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$28.56

Know your out-of-pocket cost for care.

All Charges