Ness County Hospital

All Charges

Charge

Type

Setting

Price

Pradaxa 75 mg cap (dabigatran etexilate)

Facility

$28.00

Service Code	NDC 00597035556
Hospital Charge Code	2519189
Hospital Revenue Code	250
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.45
Rate for Payer: Celtic Commercial/Exchange	$12.94
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$23.52

Pradaxa 75 mg cap (dabigatran etexilate)

Facility

$28.00

Service Code	NDC 00597035556
Hospital Charge Code	2519189
Hospital Revenue Code	250
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.45
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$22.96

PRAVACHOL 10 MG TAB (PRAVASTATIN)

Facility

$9.00

Service Code	NDC 60687088611
Hospital Charge Code	2518934
Hospital Revenue Code	250
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.20
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

PRAVACHOL 10 MG TAB (PRAVASTATIN)

Facility

$9.00

Service Code	NDC 60687088611
Hospital Charge Code	2518934
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.20
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

PREALBUMIN

Facility

$120.00

Service Code	HCPCS 84134
Hospital Charge Code	8413400
Hospital Revenue Code	301
Min. Negotiated Rate	$48.81
Max. Negotiated Rate	$116.40
Rate for Payer: BCBS Commercial	$48.81
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Celtic Commercial/Exchange	$55.44
Rate for Payer: Health Partners Plans Commercial	$114.00
Rate for Payer: UnitedHealthcare Commercial	$116.40
Rate for Payer: WPPA Commercial	$100.80

PREALBUMIN

Facility

$120.00

Service Code	HCPCS 84134
Hospital Charge Code	8413400
Hospital Revenue Code	301
Min. Negotiated Rate	$98.40
Max. Negotiated Rate	$116.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Health Partners Plans Commercial	$114.00
Rate for Payer: UnitedHealthcare Commercial	$116.40
Rate for Payer: WPPA Commercial	$98.40

PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC

Facility

$12,599.50

Service Code	MSDRG 067
Min. Negotiated Rate	$12,599.50
Max. Negotiated Rate	$12,599.50
Rate for Payer: BCBS Commercial	$12,599.50

PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC

Facility

$8,483.56

Service Code	MSDRG 068
Min. Negotiated Rate	$8,483.56
Max. Negotiated Rate	$8,483.56
Rate for Payer: BCBS Commercial	$8,483.56

PREDNISONE 5 MG TAB

Facility

$1.00

Service Code	NDC 60687012211
Hospital Charge Code	2505840
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.82
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

PREDNISONE 5 MG TAB

Facility

$1.00

Service Code	NDC 60687012211
Hospital Charge Code	2505840
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.82
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

PREGABALIN SCREEN

Facility

$271.00

Service Code	HCPCS 80366
Hospital Charge Code	8036600
Hospital Revenue Code	300
Min. Negotiated Rate	$222.22
Max. Negotiated Rate	$262.87
Rate for Payer: Cash Price	$203.25
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$222.22

PREGABALIN SCREEN

Facility

$271.00

Service Code	HCPCS 80366
Hospital Charge Code	8036600
Hospital Revenue Code	300
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$23.88
Rate for Payer: Cash Price	$203.25
Rate for Payer: Cash Price	$203.25
Rate for Payer: Celtic Commercial/Exchange	$125.20
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$227.64

PREMATURITY WITH MAJOR PROBLEMS

Facility

$34,733.45

Service Code	MSDRG 791
Min. Negotiated Rate	$34,733.45
Max. Negotiated Rate	$34,733.45
Rate for Payer: BCBS Commercial	$34,733.45

PREMATURITY WITHOUT MAJOR PROBLEMS

Facility

$20,957.70

Service Code	MSDRG 792
Min. Negotiated Rate	$20,957.70
Max. Negotiated Rate	$20,957.70
Rate for Payer: BCBS Commercial	$20,957.70

PREMIUM HEEL PROTECTOR

Facility

$80.00

Hospital Charge Code	7201762
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

PREMIUM HEEL PROTECTOR

Facility

$80.00

Hospital Charge Code	7201762
Hospital Revenue Code	270
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

PrePack PAXLOVID (EUA) ORAL TABS, DOSE PACK

Facility

$4,488.00

Service Code	NDC 00069034530
Hospital Charge Code	2513000
Hospital Revenue Code	250
Min. Negotiated Rate	$3,680.16
Max. Negotiated Rate	$4,353.36
Rate for Payer: Cash Price	$3,366.29
Rate for Payer: Health Partners Plans Commercial	$4,263.60
Rate for Payer: UnitedHealthcare Commercial	$4,353.36
Rate for Payer: WPPA Commercial	$3,680.16

PrePack PAXLOVID (EUA) ORAL TABS, DOSE PACK

Facility

$4,488.00

Service Code	NDC 00069034530
Hospital Charge Code	2513000
Hospital Revenue Code	250
Min. Negotiated Rate	$2,073.46
Max. Negotiated Rate	$4,353.36
Rate for Payer: Cash Price	$3,366.29
Rate for Payer: Celtic Commercial/Exchange	$2,073.46
Rate for Payer: Health Partners Plans Commercial	$4,263.60
Rate for Payer: UnitedHealthcare Commercial	$4,353.36
Rate for Payer: WPPA Commercial	$3,769.92

Preparation H (phenyleph-shark liv oil-mo-pet) Rect Ointment

Facility

$32.00

Service Code	NDC 46122010346
Hospital Charge Code	2509883
Hospital Revenue Code	250
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$31.04
Rate for Payer: Cash Price	$24.34
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.24

Preparation H (phenyleph-shark liv oil-mo-pet) Rect Ointment

Facility

$32.00

Service Code	NDC 46122010346
Hospital Charge Code	2509883
Hospital Revenue Code	250
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$31.04
Rate for Payer: Cash Price	$24.34
Rate for Payer: Celtic Commercial/Exchange	$14.78
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.88

PREP RAZOR

Facility

$4.00

Hospital Charge Code	2700912
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.19
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

PREP RAZOR

Facility

$4.00

Hospital Charge Code	2700912
Hospital Revenue Code	270
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.19
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

PRETX RBC ANTIBODY;BY DENSITY

Facility

$158.00

Service Code	HCPCS 86972
Hospital Charge Code	8697200
Hospital Revenue Code	302
Min. Negotiated Rate	$129.56
Max. Negotiated Rate	$153.26
Rate for Payer: Cash Price	$118.50
Rate for Payer: Health Partners Plans Commercial	$150.10
Rate for Payer: UnitedHealthcare Commercial	$153.26
Rate for Payer: WPPA Commercial	$129.56

PRETX RBC ANTIBODY;BY DENSITY

Facility

$158.00

Service Code	HCPCS 86972
Hospital Charge Code	8697200
Hospital Revenue Code	302
Min. Negotiated Rate	$73.00
Max. Negotiated Rate	$153.26
Rate for Payer: Cash Price	$118.50
Rate for Payer: Celtic Commercial/Exchange	$73.00
Rate for Payer: Health Partners Plans Commercial	$150.10
Rate for Payer: UnitedHealthcare Commercial	$153.26
Rate for Payer: WPPA Commercial	$132.72

PREVACID 15 MG CAP (LANSOPRAZOLE)

Facility

$18.00

Service Code	NDC 60687011111
Hospital Charge Code	2514644
Hospital Revenue Code	250
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$14.06
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$14.76

Know your out-of-pocket cost for care.

All Charges