Ness County Hospital

All Charges

Charge

Type

Setting

Price

ANTIEPILEPTICS LVL NOS 4-6

Facility

$271.00

Service Code	HCPCS 80340
Hospital Charge Code	8034000
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

ANTIGEN TEST DONOR BLD USING

Facility

$325.00

Service Code	HCPCS 86902
Hospital Charge Code	8690200
Hospital Revenue Code	309
Min. Negotiated Rate	$14.90
Max. Negotiated Rate	$315.25
Rate for Payer: BCBS Commercial	$14.90
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

ANTIGEN TEST DONOR BLD USING

Facility

$325.00

Service Code	HCPCS 86902
Hospital Charge Code	8690200
Hospital Revenue Code	309
Min. Negotiated Rate	$266.50
Max. Negotiated Rate	$315.25
Rate for Payer: Cash Price	$243.75
Rate for Payer: Health Partners Plans Commercial	$308.75
Rate for Payer: UnitedHealthcare Commercial	$315.25
Rate for Payer: WPPA Commercial	$266.50

ANTIHUMAN GLOBULIN TEST,COOMBS

Facility

$58.00

Service Code	HCPCS 86880
Hospital Charge Code	8688000
Hospital Revenue Code	309
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$56.26
Rate for Payer: Cash Price	$43.50
Rate for Payer: Health Partners Plans Commercial	$55.10
Rate for Payer: UnitedHealthcare Commercial	$56.26
Rate for Payer: WPPA Commercial	$47.56

ANTIHUMAN GLOBULIN TEST,COOMBS

Facility

$58.00

Service Code	HCPCS 86880
Hospital Charge Code	8688000
Hospital Revenue Code	309
Min. Negotiated Rate	$23.24
Max. Negotiated Rate	$56.26
Rate for Payer: BCBS Commercial	$23.24
Rate for Payer: Cash Price	$43.50
Rate for Payer: Cash Price	$43.50
Rate for Payer: Celtic Commercial/Exchange	$26.80
Rate for Payer: Health Partners Plans Commercial	$55.10
Rate for Payer: UnitedHealthcare Commercial	$56.26
Rate for Payer: WPPA Commercial	$48.72

ANTIHUM GLOB TEST,INDIR,QUAL

Facility

$158.00

Service Code	HCPCS 86885
Hospital Charge Code	8688500
Hospital Revenue Code	309
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$153.26
Rate for Payer: BCBS Commercial	$18.73
Rate for Payer: Cash Price	$118.50
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

ANTIHUM GLOB TEST,INDIR,QUAL

Facility

$158.00

Service Code	HCPCS 86885
Hospital Charge Code	8688500
Hospital Revenue Code	309
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

ANTIHUM GLOB TEST INDIR TITER

Facility

$158.00

Service Code	HCPCS 86886
Hospital Charge Code	8688600
Hospital Revenue Code	309
Min. Negotiated Rate	$29.18
Max. Negotiated Rate	$153.26
Rate for Payer: BCBS Commercial	$29.18
Rate for Payer: Cash Price	$118.50
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

ANTIHUM GLOB TEST INDIR TITER

Facility

$158.00

Service Code	HCPCS 86886
Hospital Charge Code	8688600
Hospital Revenue Code	309
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

ANTI-MULLERIAN HORMONE (AMH)

Facility

$127.00

Service Code	HCPCS 82166
Hospital Charge Code	8216600
Hospital Revenue Code	302
Min. Negotiated Rate	$104.14
Max. Negotiated Rate	$123.19
Rate for Payer: Cash Price	$95.25
Rate for Payer: Health Partners Plans Commercial	$120.65
Rate for Payer: UnitedHealthcare Commercial	$123.19
Rate for Payer: WPPA Commercial	$104.14

ANTI-MULLERIAN HORMONE (AMH)

Facility

$127.00

Service Code	HCPCS 82166
Hospital Charge Code	8216600
Hospital Revenue Code	302
Min. Negotiated Rate	$58.67
Max. Negotiated Rate	$123.19
Rate for Payer: BCBS Commercial	$72.42
Rate for Payer: Cash Price	$95.25
Rate for Payer: Cash Price	$95.25
Rate for Payer: Celtic Commercial/Exchange	$58.67
Rate for Payer: Health Partners Plans Commercial	$120.65
Rate for Payer: UnitedHealthcare Commercial	$123.19
Rate for Payer: WPPA Commercial	$106.68

ANTINEUTROPHIL CYTO ANTIBODY

Facility

$85.00

Service Code	HCPCS 86036
Hospital Charge Code	8603600
Hospital Revenue Code	302
Min. Negotiated Rate	$22.59
Max. Negotiated Rate	$82.45
Rate for Payer: BCBS Commercial	$22.59
Rate for Payer: Cash Price	$63.75
Rate for Payer: Cash Price	$63.75
Rate for Payer: Celtic Commercial/Exchange	$39.27
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$71.40

ANTINEUTROPHIL CYTO ANTIBODY

Facility

$85.00

Service Code	HCPCS 86036
Hospital Charge Code	8603600
Hospital Revenue Code	302
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$69.70

ANTINUCLEAR ANTIBODIES (ANA)

Facility

$112.00

Service Code	HCPCS 86038
Hospital Charge Code	8603800
Hospital Revenue Code	302
Min. Negotiated Rate	$44.30
Max. Negotiated Rate	$108.64
Rate for Payer: BCBS Commercial	$44.30
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

ANTINUCLEAR ANTIBODIES (ANA)

Facility

$112.00

Service Code	HCPCS 86038
Hospital Charge Code	8603800
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

ANTINUCLEAR ANTIBODY TITER

Facility

$110.00

Service Code	HCPCS 86039
Hospital Charge Code	8603900
Hospital Revenue Code	302
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$106.70
Rate for Payer: BCBS Commercial	$41.77
Rate for Payer: Cash Price	$82.50
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

ANTINUCLEAR ANTIBODY TITER

Facility

$110.00

Service Code	HCPCS 86039
Hospital Charge Code	8603900
Hospital Revenue Code	302
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

ANTI-PHOSPHATIDYLSERINE ANTIBO

Facility

$73.00

Service Code	HCPCS 86148
Hospital Charge Code	8614800
Hospital Revenue Code	302
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$70.81
Rate for Payer: BCBS Commercial	$49.06
Rate for Payer: Cash Price	$54.75
Rate for Payer: Cash Price	$54.75
Rate for Payer: Celtic Commercial/Exchange	$33.73
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$61.32

ANTI-PHOSPHATIDYLSERINE ANTIBO

Facility

$73.00

Service Code	HCPCS 86148
Hospital Charge Code	8614800
Hospital Revenue Code	302
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$70.81
Rate for Payer: Cash Price	$54.75
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$59.86

ANTIPSYCHOTICS, NOS 1-3

Facility

$88.00

Service Code	HCPCS 80342
Hospital Charge Code	8034200
Hospital Revenue Code	300
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$85.36
Rate for Payer: BCBS Commercial	$62.66
Rate for Payer: Cash Price	$66.00
Rate for Payer: Cash Price	$66.00
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

ANTIPSYCHOTICS, NOS 1-3

Facility

$88.00

Service Code	HCPCS 80342
Hospital Charge Code	8034200
Hospital Revenue Code	300
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

ANTIPSYCHOTICS NOS LVL 7+

Facility

$271.00

Service Code	HCPCS 80344
Hospital Charge Code	8034400
Hospital Revenue Code	300
Min. Negotiated Rate	$93.99
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$93.99
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

ANTIPSYCHOTICS NOS LVL 7+

Facility

$271.00

Service Code	HCPCS 80344
Hospital Charge Code	8034400
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

ANTISTREPTOLYSIN 0 TITER

Facility

$96.00

Service Code	HCPCS 86060
Hospital Charge Code	8606000
Hospital Revenue Code	302
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$78.72

ANTISTREPTOLYSIN 0 TITER

Facility

$96.00

Service Code	HCPCS 86060
Hospital Charge Code	8606000
Hospital Revenue Code	302
Min. Negotiated Rate	$33.20
Max. Negotiated Rate	$93.12
Rate for Payer: BCBS Commercial	$33.20
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cash Price	$72.00
Rate for Payer: Celtic Commercial/Exchange	$44.35
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$80.64

Know your out-of-pocket cost for care.

All Charges