Ness County Hospital

All Charges

Charge

Type

Setting

Price

NORFLEX 60 MG/2ML INJ. (ORPHENADRINE CITRATE)

Facility

$67.00

Service Code	NDC 00641618201
Hospital Charge Code	2504967
Hospital Revenue Code	250
Min. Negotiated Rate	$30.95
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.29
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

NORFLEX 60 MG/2ML INJ. (ORPHENADRINE CITRATE)

Facility

$67.00

Service Code	NDC 00641618201
Hospital Charge Code	2504967
Hospital Revenue Code	250
Min. Negotiated Rate	$54.94
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.29
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$54.94

NORMAL NEWBORN

Facility

$1,709.86

Service Code	MSDRG 795
Min. Negotiated Rate	$1,709.86
Max. Negotiated Rate	$1,709.86
Rate for Payer: BCBS Commercial	$1,709.86

NORMAL SALINE (0.9%) 1000ML IV

Facility

$121.00

Service Code	NDC 00264780009
Hospital Charge Code	2580173
Hospital Revenue Code	258
Min. Negotiated Rate	$99.22
Max. Negotiated Rate	$117.37
Rate for Payer: Cash Price	$91.24
Rate for Payer: Health Partners Plans Commercial	$114.95
Rate for Payer: UnitedHealthcare Commercial	$117.37
Rate for Payer: WPPA Commercial	$99.22

NORMAL SALINE (0.9%) 1000ML IV

Facility

$121.00

Service Code	NDC 00264780009
Hospital Charge Code	2580173
Hospital Revenue Code	258
Min. Negotiated Rate	$55.90
Max. Negotiated Rate	$117.37
Rate for Payer: Cash Price	$91.24
Rate for Payer: Celtic Commercial/Exchange	$55.90
Rate for Payer: Health Partners Plans Commercial	$114.95
Rate for Payer: UnitedHealthcare Commercial	$117.37
Rate for Payer: WPPA Commercial	$101.64

NORMAL SALINE 100 ML ADV

Facility

$48.00

Service Code	NDC 00409710167
Hospital Charge Code	2516946
Hospital Revenue Code	258
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

NORMAL SALINE 100 ML ADV

Facility

$48.00

Service Code	NDC 00409710167
Hospital Charge Code	2516946
Hospital Revenue Code	258
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

NORMAL SALINE 100 ML IV

Facility

$48.00

Service Code	NDC 00990798437
Hospital Charge Code	2580157
Hospital Revenue Code	258
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

NORMAL SALINE 100 ML IV

Facility

$48.00

Service Code	NDC 00990798437
Hospital Charge Code	2580157
Hospital Revenue Code	258
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

NORMAL SALINE 100 ML MINI-BAG

Facility

$31.00

Hospital Charge Code	2519817
Hospital Revenue Code	258
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.85
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$25.42

NORMAL SALINE 100 ML MINI-BAG

Facility

$31.00

Hospital Charge Code	2519817
Hospital Revenue Code	258
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.85
Rate for Payer: Celtic Commercial/Exchange	$14.32
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$26.04

NORMAL SALINE 10 ML FLUSH (DAILY

Facility

$100.00

Service Code	NDC 63807010001
Hospital Charge Code	2517100
Hospital Revenue Code	250
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$82.00

NORMAL SALINE 10 ML FLUSH (DAILY

Facility

$100.00

Service Code	NDC 63807010001
Hospital Charge Code	2517100
Hospital Revenue Code	250
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Celtic Commercial/Exchange	$46.20
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$84.00

NORMAL SALINE 10 ML FLUSH x 1 - ER

Facility

$100.00

Service Code	NDC 63807010001
Hospital Charge Code	2517100
Hospital Revenue Code	250
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$82.00

NORMAL SALINE 10 ML FLUSH x 1 - ER

Facility

$100.00

Service Code	NDC 63807010001
Hospital Charge Code	2517100
Hospital Revenue Code	250
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Celtic Commercial/Exchange	$46.20
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$84.00

NORMAL SALINE 250 ML ADV

Facility

$51.00

Service Code	NDC 00409710102
Hospital Charge Code	2516938
Hospital Revenue Code	250
Min. Negotiated Rate	$23.56
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$38.85
Rate for Payer: Celtic Commercial/Exchange	$23.56
Rate for Payer: Health Partners Plans Commercial	$48.45
Rate for Payer: UnitedHealthcare Commercial	$49.47
Rate for Payer: WPPA Commercial	$42.84

NORMAL SALINE 250 ML ADV

Facility

$51.00

Service Code	NDC 00409710102
Hospital Charge Code	2516938
Hospital Revenue Code	250
Min. Negotiated Rate	$41.82
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$38.85
Rate for Payer: Health Partners Plans Commercial	$48.45
Rate for Payer: UnitedHealthcare Commercial	$49.47
Rate for Payer: WPPA Commercial	$41.82

NORMAL SALINE 250 ML IV

Facility

$51.00

Service Code	NDC 65219047005
Hospital Charge Code	2580770
Hospital Revenue Code	258
Min. Negotiated Rate	$41.82
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$38.85
Rate for Payer: Health Partners Plans Commercial	$48.45
Rate for Payer: UnitedHealthcare Commercial	$49.47
Rate for Payer: WPPA Commercial	$41.82

NORMAL SALINE 250 ML IV

Facility

$51.00

Service Code	NDC 65219047005
Hospital Charge Code	2580770
Hospital Revenue Code	258
Min. Negotiated Rate	$23.56
Max. Negotiated Rate	$49.47
Rate for Payer: Cash Price	$38.85
Rate for Payer: Celtic Commercial/Exchange	$23.56
Rate for Payer: Health Partners Plans Commercial	$48.45
Rate for Payer: UnitedHealthcare Commercial	$49.47
Rate for Payer: WPPA Commercial	$42.84

NORMAL SALINE 50 ML ADV

Facility

$48.00

Service Code	NDC 00409710166
Hospital Charge Code	2516854
Hospital Revenue Code	258
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

NORMAL SALINE 50 ML ADV

Facility

$48.00

Service Code	NDC 00409710166
Hospital Charge Code	2516854
Hospital Revenue Code	258
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

Normal saline 50 ml mini-bag

Facility

$31.00

Service Code	NDC 00338004911
Hospital Charge Code	2519833
Hospital Revenue Code	258
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.85
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$25.42

Normal saline 50 ml mini-bag

Facility

$31.00

Service Code	NDC 00338004911
Hospital Charge Code	2519833
Hospital Revenue Code	258
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.85
Rate for Payer: Celtic Commercial/Exchange	$14.32
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$26.04

NORMAL SALINE INJ 500 ML IV

Facility

$57.00

Service Code	NDC 65219047205
Hospital Charge Code	2580165
Hospital Revenue Code	258
Min. Negotiated Rate	$46.74
Max. Negotiated Rate	$55.29
Rate for Payer: Cash Price	$43.35
Rate for Payer: Health Partners Plans Commercial	$54.15
Rate for Payer: UnitedHealthcare Commercial	$55.29
Rate for Payer: WPPA Commercial	$46.74

NORMAL SALINE INJ 500 ML IV

Facility

$57.00

Service Code	NDC 65219047205
Hospital Charge Code	2580165
Hospital Revenue Code	258
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$55.29
Rate for Payer: Cash Price	$43.35
Rate for Payer: Celtic Commercial/Exchange	$26.33
Rate for Payer: Health Partners Plans Commercial	$54.15
Rate for Payer: UnitedHealthcare Commercial	$55.29
Rate for Payer: WPPA Commercial	$47.88

Know your out-of-pocket cost for care.

All Charges