Ness County Hospital

All Charges

Charge

Type

Setting

Price

ANTIBODY ID, RBC ANTIB,EA PANL

Facility

$325.00

Service Code	HCPCS 86870
Hospital Charge Code	8687000
Hospital Revenue Code	309
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$315.25
Rate for Payer: BCBS Commercial	$97.50
Rate for Payer: Cash Price	$243.75
Rate for Payer: Cash Price	$243.75
Rate for Payer: Celtic Commercial/Exchange	$150.15
Rate for Payer: Health Partners Plans Commercial	$308.75
Rate for Payer: UnitedHealthcare Commercial	$315.25
Rate for Payer: WPPA Commercial	$273.00

ANTIBODY: INFLUENZA VIRUS

Facility

$93.00

Service Code	HCPCS 86710
Hospital Charge Code	8671000
Hospital Revenue Code	302
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

ANTIBODY: INFLUENZA VIRUS

Facility

$93.00

Service Code	HCPCS 86710
Hospital Charge Code	8671000
Hospital Revenue Code	302
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: BCBS Commercial	$67.89
Rate for Payer: Cash Price	$69.75
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

ANTIBODY LEGIONELLA

Facility

$115.00

Service Code	HCPCS 86713
Hospital Charge Code	8671300
Hospital Revenue Code	302
Min. Negotiated Rate	$94.30
Max. Negotiated Rate	$111.55
Rate for Payer: Cash Price	$86.25
Rate for Payer: Health Partners Plans Commercial	$109.25
Rate for Payer: UnitedHealthcare Commercial	$111.55
Rate for Payer: WPPA Commercial	$94.30

ANTIBODY LEGIONELLA

Facility

$115.00

Service Code	HCPCS 86713
Hospital Charge Code	8671300
Hospital Revenue Code	302
Min. Negotiated Rate	$53.13
Max. Negotiated Rate	$111.55
Rate for Payer: BCBS Commercial	$62.38
Rate for Payer: Cash Price	$86.25
Rate for Payer: Cash Price	$86.25
Rate for Payer: Celtic Commercial/Exchange	$53.13
Rate for Payer: Health Partners Plans Commercial	$109.25
Rate for Payer: UnitedHealthcare Commercial	$111.55
Rate for Payer: WPPA Commercial	$96.60

ANTIBODY: LEPTOSPIRA

Facility

$60.00

Service Code	HCPCS 86720
Hospital Charge Code	8672000
Hospital Revenue Code	302
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$45.00
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$49.20

ANTIBODY: LEPTOSPIRA

Facility

$60.00

Service Code	HCPCS 86720
Hospital Charge Code	8672000
Hospital Revenue Code	302
Min. Negotiated Rate	$27.72
Max. Negotiated Rate	$58.20
Rate for Payer: BCBS Commercial	$35.18
Rate for Payer: Cash Price	$45.00
Rate for Payer: Cash Price	$45.00
Rate for Payer: Celtic Commercial/Exchange	$27.72
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$50.40

ANTIBODY MYCOPLASMA

Facility

$132.00

Service Code	HCPCS 86738
Hospital Charge Code	8673800
Hospital Revenue Code	302
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: BCBS Commercial	$71.08
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

ANTIBODY MYCOPLASMA

Facility

$132.00

Service Code	HCPCS 86738
Hospital Charge Code	8673800
Hospital Revenue Code	302
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

ANTIBODY PARVOVIRUS

Facility

$157.00

Service Code	HCPCS 86747
Hospital Charge Code	8674700
Hospital Revenue Code	302
Min. Negotiated Rate	$128.74
Max. Negotiated Rate	$152.29
Rate for Payer: Cash Price	$117.75
Rate for Payer: Health Partners Plans Commercial	$149.15
Rate for Payer: UnitedHealthcare Commercial	$152.29
Rate for Payer: WPPA Commercial	$128.74

ANTIBODY PARVOVIRUS

Facility

$157.00

Service Code	HCPCS 86747
Hospital Charge Code	8674700
Hospital Revenue Code	302
Min. Negotiated Rate	$72.53
Max. Negotiated Rate	$152.29
Rate for Payer: BCBS Commercial	$79.25
Rate for Payer: Cash Price	$117.75
Rate for Payer: Cash Price	$117.75
Rate for Payer: Celtic Commercial/Exchange	$72.53
Rate for Payer: Health Partners Plans Commercial	$149.15
Rate for Payer: UnitedHealthcare Commercial	$152.29
Rate for Payer: WPPA Commercial	$131.88

ANTIBODY PROTOZOA,NES

Facility

$112.00

Service Code	HCPCS 86753
Hospital Charge Code	8675300
Hospital Revenue Code	302
Min. Negotiated Rate	$91.84
Max. Negotiated Rate	$108.64
Rate for Payer: Cash Price	$84.00
Rate for Payer: Health Partners Plans Commercial	$106.40
Rate for Payer: UnitedHealthcare Commercial	$108.64
Rate for Payer: WPPA Commercial	$91.84

ANTIBODY PROTOZOA,NES

Facility

$112.00

Service Code	HCPCS 86753
Hospital Charge Code	8675300
Hospital Revenue Code	302
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$108.64
Rate for Payer: BCBS Commercial	$33.65
Rate for Payer: Cash Price	$84.00
Rate for Payer: Cash Price	$84.00
Rate for Payer: Celtic Commercial/Exchange	$51.74
Rate for Payer: Health Partners Plans Commercial	$106.40
Rate for Payer: UnitedHealthcare Commercial	$108.64
Rate for Payer: WPPA Commercial	$94.08

ANTIBODY RESP SYNCYTIAL VIRUS

Facility

$119.00

Service Code	HCPCS 86756
Hospital Charge Code	8675600
Hospital Revenue Code	302
Min. Negotiated Rate	$54.98
Max. Negotiated Rate	$115.43
Rate for Payer: BCBS Commercial	$64.08
Rate for Payer: Cash Price	$89.25
Rate for Payer: Cash Price	$89.25
Rate for Payer: Celtic Commercial/Exchange	$54.98
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$99.96

ANTIBODY RESP SYNCYTIAL VIRUS

Facility

$119.00

Service Code	HCPCS 86756
Hospital Charge Code	8675600
Hospital Revenue Code	302
Min. Negotiated Rate	$97.58
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$89.25
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$97.58

ANTIBODY RICKETTSIA

Facility

$176.00

Service Code	HCPCS 86757
Hospital Charge Code	8675700
Hospital Revenue Code	302
Min. Negotiated Rate	$144.32
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$132.00
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$144.32

ANTIBODY RICKETTSIA

Facility

$176.00

Service Code	HCPCS 86757
Hospital Charge Code	8675700
Hospital Revenue Code	302
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$170.72
Rate for Payer: BCBS Commercial	$126.53
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Celtic Commercial/Exchange	$81.31
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$147.84

ANTIBODY RUBELLA

Facility

$99.00

Service Code	HCPCS 86762
Hospital Charge Code	8676200
Hospital Revenue Code	302
Min. Negotiated Rate	$81.18
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.25
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$81.18

ANTIBODY RUBELLA

Facility

$99.00

Service Code	HCPCS 86762
Hospital Charge Code	8676200
Hospital Revenue Code	302
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$96.03
Rate for Payer: BCBS Commercial	$30.90
Rate for Payer: Cash Price	$74.25
Rate for Payer: Cash Price	$74.25
Rate for Payer: Celtic Commercial/Exchange	$45.74
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$83.16

ANTIBODY RUBEOLA

Facility

$124.00

Service Code	HCPCS 86765
Hospital Charge Code	8676500
Hospital Revenue Code	302
Min. Negotiated Rate	$101.68
Max. Negotiated Rate	$120.28
Rate for Payer: Cash Price	$93.00
Rate for Payer: Health Partners Plans Commercial	$117.80
Rate for Payer: UnitedHealthcare Commercial	$120.28
Rate for Payer: WPPA Commercial	$101.68

ANTIBODY RUBEOLA

Facility

$124.00

Service Code	HCPCS 86765
Hospital Charge Code	8676500
Hospital Revenue Code	302
Min. Negotiated Rate	$57.29
Max. Negotiated Rate	$120.28
Rate for Payer: BCBS Commercial	$68.27
Rate for Payer: Cash Price	$93.00
Rate for Payer: Cash Price	$93.00
Rate for Payer: Celtic Commercial/Exchange	$57.29
Rate for Payer: Health Partners Plans Commercial	$117.80
Rate for Payer: UnitedHealthcare Commercial	$120.28
Rate for Payer: WPPA Commercial	$104.16

ANTIBODY SALMONELLA

Facility

$62.00

Service Code	HCPCS 86768
Hospital Charge Code	8676800
Hospital Revenue Code	302
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$46.50
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

ANTIBODY SALMONELLA

Facility

$62.00

Service Code	HCPCS 86768
Hospital Charge Code	8676800
Hospital Revenue Code	302
Min. Negotiated Rate	$28.64
Max. Negotiated Rate	$60.14
Rate for Payer: BCBS Commercial	$50.23
Rate for Payer: Cash Price	$46.50
Rate for Payer: Cash Price	$46.50
Rate for Payer: Celtic Commercial/Exchange	$28.64
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$52.08

ANTIBODY SCREEN, RBC, EA SERUM

Facility

$89.00

Service Code	HCPCS 86850
Hospital Charge Code	8685000
Hospital Revenue Code	309
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$91.28
Rate for Payer: BCBS Commercial	$91.28
Rate for Payer: Cash Price	$66.75
Rate for Payer: Cash Price	$66.75
Rate for Payer: Celtic Commercial/Exchange	$41.12
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$74.76

ANTIBODY SCREEN, RBC, EA SERUM

Facility

$89.00

Service Code	HCPCS 86850
Hospital Charge Code	8685000
Hospital Revenue Code	309
Min. Negotiated Rate	$72.98
Max. Negotiated Rate	$86.33
Rate for Payer: Cash Price	$66.75
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$72.98

Know your out-of-pocket cost for care.

All Charges