Ness County Hospital

All Charges

Charge

Type

Setting

Price

ORAL CLEANSING & SUCTION SYST

Facility

$126.00

Hospital Charge Code	2720103
Hospital Revenue Code	270
Min. Negotiated Rate	$103.32
Max. Negotiated Rate	$122.22
Rate for Payer: Cash Price	$94.50
Rate for Payer: Health Partners Plans Commercial	$119.70
Rate for Payer: UnitedHealthcare Commercial	$122.22
Rate for Payer: WPPA Commercial	$103.32

ORAL DENTIFRICE

Facility

$9.00

Hospital Charge Code	2511871
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.79
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ORAL DENTIFRICE

Facility

$9.00

Hospital Charge Code	2511871
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.79
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ORAL/NASAL TRACHEAL TUBE CUFFL

Facility

$5.00

Hospital Charge Code	2721709
Hospital Revenue Code	272
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

ORAL/NASAL TRACHEAL TUBE CUFFL

Facility

$5.00

Hospital Charge Code	2721709
Hospital Revenue Code	272
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

ORAPRED 15 MG/5 ML OS (PRELONE) (PREDNISOLONE SODIUM PHOSPHATE)

Facility

$8.00

Service Code	NDC 00121075908
Hospital Charge Code	2514545
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.45
Rate for Payer: Celtic Commercial/Exchange	$3.70
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.72

ORAPRED 15 MG/5 ML OS (PRELONE) (PREDNISOLONE SODIUM PHOSPHATE)

Facility

$8.00

Service Code	NDC 00121075908
Hospital Charge Code	2514545
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.45
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

ORBITAL PROCEDURES WITH CC/MCC

Facility

$15,053.06

Service Code	MSDRG 113
Min. Negotiated Rate	$15,053.06
Max. Negotiated Rate	$15,053.06
Rate for Payer: BCBS Commercial	$15,053.06

ORBITAL PROCEDURES WITHOUT CC/MCC

Facility

$9,267.36

Service Code	MSDRG 114
Min. Negotiated Rate	$9,267.36
Max. Negotiated Rate	$9,267.36
Rate for Payer: BCBS Commercial	$9,267.36

ORBITS 4V MINIMUM COMPLETE

Facility

$245.00

Service Code	HCPCS 70200
Hospital Charge Code	3260006
Hospital Revenue Code	320
Min. Negotiated Rate	$200.90
Max. Negotiated Rate	$237.65
Rate for Payer: Cash Price	$183.75
Rate for Payer: Health Partners Plans Commercial	$232.75
Rate for Payer: UnitedHealthcare Commercial	$237.65
Rate for Payer: WPPA Commercial	$200.90

ORBITS 4V MINIMUM COMPLETE

Facility

$245.00

Service Code	HCPCS 70200
Hospital Charge Code	3260006
Hospital Revenue Code	320
Min. Negotiated Rate	$113.19
Max. Negotiated Rate	$237.65
Rate for Payer: BCBS Commercial	$182.12
Rate for Payer: Cash Price	$183.75
Rate for Payer: Cash Price	$183.75
Rate for Payer: Celtic Commercial/Exchange	$113.19
Rate for Payer: Health Partners Plans Commercial	$232.75
Rate for Payer: UnitedHealthcare Commercial	$237.65
Rate for Payer: WPPA Commercial	$205.80

ORBITS-FOREIGN BODY DETECTION

Facility

$189.00

Service Code	HCPCS 70030
Hospital Charge Code	7003000
Hospital Revenue Code	320
Min. Negotiated Rate	$87.32
Max. Negotiated Rate	$183.33
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$141.75
Rate for Payer: Cash Price	$141.75
Rate for Payer: Celtic Commercial/Exchange	$87.32
Rate for Payer: Health Partners Plans Commercial	$179.55
Rate for Payer: UnitedHealthcare Commercial	$183.33
Rate for Payer: WPPA Commercial	$158.76

ORBITS-FOREIGN BODY DETECTION

Facility

$189.00

Service Code	HCPCS 70030
Hospital Charge Code	7003000
Hospital Revenue Code	320
Min. Negotiated Rate	$154.98
Max. Negotiated Rate	$183.33
Rate for Payer: Cash Price	$141.75
Rate for Payer: Health Partners Plans Commercial	$179.55
Rate for Payer: UnitedHealthcare Commercial	$183.33
Rate for Payer: WPPA Commercial	$154.98

Orencia (with maltose) (abatacept (with maltose)) IV recon soln

Facility

$4,232.00

Service Code	NDC 00003218713
Hospital Charge Code	2519692
Hospital Revenue Code	250
Min. Negotiated Rate	$3,470.24
Max. Negotiated Rate	$4,105.04
Rate for Payer: Cash Price	$3,174.08
Rate for Payer: Health Partners Plans Commercial	$4,020.40
Rate for Payer: UnitedHealthcare Commercial	$4,105.04
Rate for Payer: WPPA Commercial	$3,470.24

Orencia (with maltose) (abatacept (with maltose)) IV recon soln

Facility

$4,232.00

Service Code	NDC 00003218713
Hospital Charge Code	2519692
Hospital Revenue Code	250
Min. Negotiated Rate	$1,955.18
Max. Negotiated Rate	$4,105.04
Rate for Payer: Cash Price	$3,174.08
Rate for Payer: Celtic Commercial/Exchange	$1,955.18
Rate for Payer: Health Partners Plans Commercial	$4,020.40
Rate for Payer: UnitedHealthcare Commercial	$4,105.04
Rate for Payer: WPPA Commercial	$3,554.88

ORGANIC ACID SNGL QUANTITATIVE

Facility

$195.00

Service Code	HCPCS 83921
Hospital Charge Code	8392100
Hospital Revenue Code	301
Min. Negotiated Rate	$42.99
Max. Negotiated Rate	$189.15
Rate for Payer: BCBS Commercial	$42.99
Rate for Payer: Cash Price	$146.25
Rate for Payer: Cash Price	$146.25
Rate for Payer: Celtic Commercial/Exchange	$90.09
Rate for Payer: Health Partners Plans Commercial	$185.25
Rate for Payer: UnitedHealthcare Commercial	$189.15
Rate for Payer: WPPA Commercial	$163.80

ORGANIC ACID SNGL QUANTITATIVE

Facility

$195.00

Service Code	HCPCS 83921
Hospital Charge Code	8392100
Hospital Revenue Code	301
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$189.15
Rate for Payer: Cash Price	$146.25
Rate for Payer: Health Partners Plans Commercial	$185.25
Rate for Payer: UnitedHealthcare Commercial	$189.15
Rate for Payer: WPPA Commercial	$159.90

ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY

Facility

$15,589.22

Service Code	MSDRG 884
Min. Negotiated Rate	$15,589.22
Max. Negotiated Rate	$15,589.22
Rate for Payer: BCBS Commercial	$15,589.22

ORIDION O2 TUBING

Facility

$110.00

Hospital Charge Code	2708133
Hospital Revenue Code	270
Min. Negotiated Rate	$50.82
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$82.50
Rate for Payer: Celtic Commercial/Exchange	$50.82
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$92.40

ORIDION O2 TUBING

Facility

$110.00

Hospital Charge Code	2708133
Hospital Revenue Code	270
Min. Negotiated Rate	$90.20
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$82.50
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$90.20

OR-PPW-15 SKIN STAPLER 15W

Facility

$107.00

Hospital Charge Code	2720977
Hospital Revenue Code	270
Min. Negotiated Rate	$49.43
Max. Negotiated Rate	$103.79
Rate for Payer: Cash Price	$80.25
Rate for Payer: Celtic Commercial/Exchange	$49.43
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$89.88

OR-PPW-15 SKIN STAPLER 15W

Facility

$107.00

Hospital Charge Code	2720977
Hospital Revenue Code	270
Min. Negotiated Rate	$87.74
Max. Negotiated Rate	$103.79
Rate for Payer: Cash Price	$80.25
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$87.74

O.R. PROCEDURES FOR OBESITY WITH CC

Facility

$16,629.84

Service Code	MSDRG 620
Min. Negotiated Rate	$16,629.84
Max. Negotiated Rate	$16,629.84
Rate for Payer: BCBS Commercial	$16,629.84

O.R. PROCEDURES FOR OBESITY WITH MCC

Facility

$25,584.90

Service Code	MSDRG 619
Min. Negotiated Rate	$25,584.90
Max. Negotiated Rate	$25,584.90
Rate for Payer: BCBS Commercial	$25,584.90

O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC

Facility

$14,713.75

Service Code	MSDRG 621
Min. Negotiated Rate	$14,713.75
Max. Negotiated Rate	$14,713.75
Rate for Payer: BCBS Commercial	$14,713.75

Know your out-of-pocket cost for care.

All Charges