Ness County Hospital

All Charges

Charge

Type

Setting

Price

NITROGLYCERIN 50 MG/250 ML D5W IV

Facility

$81.00

Service Code	NDC 00338104902
Hospital Charge Code	2517233
Hospital Revenue Code	250
Min. Negotiated Rate	$66.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.86
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$66.42

NITROGLYCERIN 50 MG/250 ML D5W IV

Facility

$81.00

Service Code	NDC 00338104902
Hospital Charge Code	2517233
Hospital Revenue Code	250
Min. Negotiated Rate	$37.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.86
Rate for Payer: Celtic Commercial/Exchange	$37.42
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$68.04

NITROPRESS 50 MG/2 ML INJ.(nitroprusside)

Facility

$3,171.00

Service Code	NDC 70069026101
Hospital Charge Code	2504868
Hospital Revenue Code	250
Min. Negotiated Rate	$1,465.00
Max. Negotiated Rate	$3,075.87
Rate for Payer: Cash Price	$2,378.40
Rate for Payer: Celtic Commercial/Exchange	$1,465.00
Rate for Payer: Health Partners Plans Commercial	$3,012.45
Rate for Payer: UnitedHealthcare Commercial	$3,075.87
Rate for Payer: WPPA Commercial	$2,663.64

NITROPRESS 50 MG/2 ML INJ.(nitroprusside)

Facility

$3,171.00

Service Code	NDC 70069026101
Hospital Charge Code	2504868
Hospital Revenue Code	250
Min. Negotiated Rate	$2,600.22
Max. Negotiated Rate	$3,075.87
Rate for Payer: Cash Price	$2,378.40
Rate for Payer: Health Partners Plans Commercial	$3,012.45
Rate for Payer: UnitedHealthcare Commercial	$3,075.87
Rate for Payer: WPPA Commercial	$2,600.22

NITROSTAT 0.4 MG SL TAB (NITROGLYCERIN)

Facility

$4.00

Service Code	NDC 68462063945
Hospital Charge Code	2513604
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.38
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

NITROSTAT 0.4 MG SL TAB (NITROGLYCERIN)

Facility

$4.00

Service Code	NDC 68462063945
Hospital Charge Code	2513604
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.38
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC

Facility

$18,749.50

Service Code	MSDRG 098
Min. Negotiated Rate	$18,749.50
Max. Negotiated Rate	$18,749.50
Rate for Payer: BCBS Commercial	$18,749.50

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC

Facility

$33,375.46

Service Code	MSDRG 097
Min. Negotiated Rate	$33,375.46
Max. Negotiated Rate	$33,375.46
Rate for Payer: BCBS Commercial	$33,375.46

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC

Facility

$12,442.56

Service Code	MSDRG 099
Min. Negotiated Rate	$12,442.56
Max. Negotiated Rate	$12,442.56
Rate for Payer: BCBS Commercial	$12,442.56

NON-EXTENSIVE BURNS

Facility

$17,330.86

Service Code	MSDRG 935
Min. Negotiated Rate	$17,330.86
Max. Negotiated Rate	$17,330.86
Rate for Payer: BCBS Commercial	$17,330.86

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$16,358.66

Service Code	MSDRG 988
Min. Negotiated Rate	$16,358.66
Max. Negotiated Rate	$16,358.66
Rate for Payer: BCBS Commercial	$16,358.66

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$29,372.53

Service Code	MSDRG 987
Min. Negotiated Rate	$29,372.53
Max. Negotiated Rate	$29,372.53
Rate for Payer: BCBS Commercial	$29,372.53

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$10,514.91

Service Code	MSDRG 989
Min. Negotiated Rate	$10,514.91
Max. Negotiated Rate	$10,514.91
Rate for Payer: BCBS Commercial	$10,514.91

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility

$8,847.98

Service Code	MSDRG 600
Min. Negotiated Rate	$8,847.98
Max. Negotiated Rate	$8,847.98
Rate for Payer: BCBS Commercial	$8,847.98

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$6,072.75

Service Code	MSDRG 601
Min. Negotiated Rate	$6,072.75
Max. Negotiated Rate	$6,072.75
Rate for Payer: BCBS Commercial	$6,072.75

NON-REBREATHER MASK

Facility

$5.00

Hospital Charge Code	4100246
Hospital Revenue Code	270
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

NON-REBREATHER MASK

Facility

$5.00

Hospital Charge Code	4100246
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
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

NON REBREATHER PED

Facility

$19.00

Hospital Charge Code	2700756LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$15.58
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.62
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.58

NON REBREATHER PED

Facility

$19.00

Hospital Charge Code	2700756LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.62
Rate for Payer: Celtic Commercial/Exchange	$8.78
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.96

NON-SELECTIVE WOUNDCARE

Facility

$258.00

Service Code	HCPCS 97602
Hospital Charge Code	9760223
Hospital Revenue Code	761
Min. Negotiated Rate	$211.56
Max. Negotiated Rate	$250.26
Rate for Payer: Cash Price	$193.50
Rate for Payer: Health Partners Plans Commercial	$245.10
Rate for Payer: UnitedHealthcare Commercial	$250.26
Rate for Payer: WPPA Commercial	$211.56

NON-SELECTIVE WOUNDCARE

Facility

$258.00

Service Code	HCPCS 97602
Hospital Charge Code	9760223
Hospital Revenue Code	761
Min. Negotiated Rate	$119.20
Max. Negotiated Rate	$250.26
Rate for Payer: BCBS Commercial	$200.20
Rate for Payer: Cash Price	$193.50
Rate for Payer: Cash Price	$193.50
Rate for Payer: Celtic Commercial/Exchange	$119.20
Rate for Payer: Health Partners Plans Commercial	$245.10
Rate for Payer: UnitedHealthcare Commercial	$250.26
Rate for Payer: WPPA Commercial	$216.72

NONTRAUMATIC STUPOR AND COMA WITH MCC

Facility

$11,063.98

Service Code	MSDRG 080
Min. Negotiated Rate	$11,063.98
Max. Negotiated Rate	$11,063.98
Rate for Payer: BCBS Commercial	$11,063.98

NONTRAUMATIC STUPOR AND COMA WITHOUT MCC

Facility

$7,421.91

Service Code	MSDRG 081
Min. Negotiated Rate	$7,421.91
Max. Negotiated Rate	$7,421.91
Rate for Payer: BCBS Commercial	$7,421.91

NORFLEX 100 MG TAB (ORPHENADRINE CITRATE ER)

Facility

$6.00

Service Code	NDC 43386048024
Hospital Charge Code	2504975
Hospital Revenue Code	250
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$5.21
Rate for Payer: Celtic Commercial/Exchange	$2.77
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$5.04

NORFLEX 100 MG TAB (ORPHENADRINE CITRATE ER)

Facility

$6.00

Service Code	NDC 43386048024
Hospital Charge Code	2504975
Hospital Revenue Code	250
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$5.21
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$4.92

Know your out-of-pocket cost for care.

All Charges