Ness County Hospital

All Charges

Charge

Type

Setting

Price

REMOV FOREIGN BODY,DEEP THIGH

Facility

$3,225.00

Service Code	HCPCS 27372
Hospital Charge Code	2737200
Hospital Revenue Code	450
Min. Negotiated Rate	$2,644.50
Max. Negotiated Rate	$3,128.25
Rate for Payer: Cash Price	$2,418.75
Rate for Payer: Health Partners Plans Commercial	$3,063.75
Rate for Payer: UnitedHealthcare Commercial	$3,128.25
Rate for Payer: WPPA Commercial	$2,644.50

REMOV FOREIGN BODY,MUSCLE/TEND

Facility

$2,604.00

Service Code	HCPCS 20525
Hospital Charge Code	2052500
Hospital Revenue Code	450
Min. Negotiated Rate	$2,135.28
Max. Negotiated Rate	$2,525.88
Rate for Payer: Cash Price	$1,953.00
Rate for Payer: Health Partners Plans Commercial	$2,473.80
Rate for Payer: UnitedHealthcare Commercial	$2,525.88
Rate for Payer: WPPA Commercial	$2,135.28

REMOV FOREIGN BODY,MUSCLE/TEND

Facility

$2,604.00

Service Code	HCPCS 20525
Hospital Charge Code	2052500
Hospital Revenue Code	450
Min. Negotiated Rate	$1,203.05
Max. Negotiated Rate	$2,525.88
Rate for Payer: BCBS Commercial	$2,288.66
Rate for Payer: Cash Price	$1,953.00
Rate for Payer: Cash Price	$1,953.00
Rate for Payer: Celtic Commercial/Exchange	$1,203.05
Rate for Payer: Health Partners Plans Commercial	$2,473.80
Rate for Payer: UnitedHealthcare Commercial	$2,525.88
Rate for Payer: WPPA Commercial	$2,187.36

REM SUTURE AND STAPLES WO ANES

Facility

$80.00

Service Code	HCPCS 15854
Hospital Charge Code	1585400
Hospital Revenue Code	761
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

REM SUTURE AND STAPLES WO ANES

Facility

$80.00

Service Code	HCPCS 15854
Hospital Charge Code	1585400
Hospital Revenue Code	761
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

REM SUTURE OR STAPLES WO ANES

Facility

$65.00

Service Code	HCPCS 15853
Hospital Charge Code	1585300
Hospital Revenue Code	761
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$63.05
Rate for Payer: Cash Price	$48.75
Rate for Payer: Health Partners Plans Commercial	$61.75
Rate for Payer: UnitedHealthcare Commercial	$63.05
Rate for Payer: WPPA Commercial	$53.30

REM SUTURE OR STAPLES WO ANES

Facility

$65.00

Service Code	HCPCS 15853
Hospital Charge Code	1585300
Hospital Revenue Code	761
Min. Negotiated Rate	$30.03
Max. Negotiated Rate	$63.05
Rate for Payer: Cash Price	$48.75
Rate for Payer: Celtic Commercial/Exchange	$30.03
Rate for Payer: Health Partners Plans Commercial	$61.75
Rate for Payer: UnitedHealthcare Commercial	$63.05
Rate for Payer: WPPA Commercial	$54.60

RENAL FAILURE WITH CC

Facility

$9,957.33

Service Code	MSDRG 683
Min. Negotiated Rate	$9,957.33
Max. Negotiated Rate	$9,957.33
Rate for Payer: BCBS Commercial	$9,957.33

RENAL FAILURE WITH MCC

Facility

$14,420.48

Service Code	MSDRG 682
Min. Negotiated Rate	$14,420.48
Max. Negotiated Rate	$14,420.48
Rate for Payer: BCBS Commercial	$14,420.48

RENAL FAILURE WITHOUT CC/MCC

Facility

$7,015.17

Service Code	MSDRG 684
Min. Negotiated Rate	$7,015.17
Max. Negotiated Rate	$7,015.17
Rate for Payer: BCBS Commercial	$7,015.17

RENAL FUNCTION PANEL

Facility

$120.00

Service Code	HCPCS 80069
Hospital Charge Code	8006900
Hospital Revenue Code	301
Min. Negotiated Rate	$20.32
Max. Negotiated Rate	$116.40
Rate for Payer: BCBS Commercial	$20.32
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

RENAL FUNCTION PANEL

Facility

$120.00

Service Code	HCPCS 80069
Hospital Charge Code	8006900
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

RENEW LIFE PROBIOTIC XTRA

Facility

$12.00

Hospital Charge Code	2512945
Hospital Revenue Code	250
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

RENEW LIFE PROBIOTIC XTRA

Facility

$12.00

Hospital Charge Code	2512945
Hospital Revenue Code	250
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

RENIN

Facility

$134.00

Service Code	HCPCS 84244
Hospital Charge Code	8424400
Hospital Revenue Code	301
Min. Negotiated Rate	$61.91
Max. Negotiated Rate	$129.98
Rate for Payer: BCBS Commercial	$80.38
Rate for Payer: Cash Price	$100.50
Rate for Payer: Cash Price	$100.50
Rate for Payer: Celtic Commercial/Exchange	$61.91
Rate for Payer: Health Partners Plans Commercial	$127.30
Rate for Payer: UnitedHealthcare Commercial	$129.98
Rate for Payer: WPPA Commercial	$112.56

RENIN

Facility

$134.00

Service Code	HCPCS 84244
Hospital Charge Code	8424400
Hospital Revenue Code	301
Min. Negotiated Rate	$109.88
Max. Negotiated Rate	$129.98
Rate for Payer: Cash Price	$100.50
Rate for Payer: Health Partners Plans Commercial	$127.30
Rate for Payer: UnitedHealthcare Commercial	$129.98
Rate for Payer: WPPA Commercial	$109.88

REPAIR COMPLES 1.1-2.5CM

Facility

$581.00

Service Code	HCPCS 13151
Hospital Charge Code	1315100
Hospital Revenue Code	450
Min. Negotiated Rate	$476.42
Max. Negotiated Rate	$563.57
Rate for Payer: Cash Price	$435.75
Rate for Payer: Health Partners Plans Commercial	$551.95
Rate for Payer: UnitedHealthcare Commercial	$563.57
Rate for Payer: WPPA Commercial	$476.42

REPAIR COMPLES 1.1-2.5CM

Facility

$581.00

Service Code	HCPCS 13151
Hospital Charge Code	1315100
Hospital Revenue Code	450
Min. Negotiated Rate	$268.42
Max. Negotiated Rate	$1,315.02
Rate for Payer: BCBS Commercial	$1,315.02
Rate for Payer: Cash Price	$435.75
Rate for Payer: Cash Price	$435.75
Rate for Payer: Celtic Commercial/Exchange	$268.42
Rate for Payer: Health Partners Plans Commercial	$551.95
Rate for Payer: UnitedHealthcare Commercial	$563.57
Rate for Payer: WPPA Commercial	$488.04

REPAIR COMPLEX 1.1-2.5 CM

Facility

$380.00

Service Code	HCPCS 13131
Hospital Charge Code	1313100
Hospital Revenue Code	450
Min. Negotiated Rate	$311.60
Max. Negotiated Rate	$368.60
Rate for Payer: Cash Price	$285.00
Rate for Payer: Health Partners Plans Commercial	$361.00
Rate for Payer: UnitedHealthcare Commercial	$368.60
Rate for Payer: WPPA Commercial	$311.60

REPAIR COMPLEX 1.1-2.5 CM

Facility

$380.00

Service Code	HCPCS 13131
Hospital Charge Code	1313100
Hospital Revenue Code	450
Min. Negotiated Rate	$175.56
Max. Negotiated Rate	$787.80
Rate for Payer: BCBS Commercial	$787.80
Rate for Payer: Cash Price	$285.00
Rate for Payer: Cash Price	$285.00
Rate for Payer: Celtic Commercial/Exchange	$175.56
Rate for Payer: Health Partners Plans Commercial	$361.00
Rate for Payer: UnitedHealthcare Commercial	$368.60
Rate for Payer: WPPA Commercial	$319.20

REPAIR COMPLEX 2.6CM TO 7.5CM

Facility

$645.00

Service Code	HCPCS 13152
Hospital Charge Code	1315200
Hospital Revenue Code	450
Min. Negotiated Rate	$297.99
Max. Negotiated Rate	$1,618.02
Rate for Payer: BCBS Commercial	$1,618.02
Rate for Payer: Cash Price	$483.75
Rate for Payer: Cash Price	$483.75
Rate for Payer: Celtic Commercial/Exchange	$297.99
Rate for Payer: Health Partners Plans Commercial	$612.75
Rate for Payer: UnitedHealthcare Commercial	$625.65
Rate for Payer: WPPA Commercial	$541.80

REPAIR COMPLEX 2.6CM TO 7.5CM

Facility

$645.00

Service Code	HCPCS 13152
Hospital Charge Code	1315200
Hospital Revenue Code	450
Min. Negotiated Rate	$528.90
Max. Negotiated Rate	$625.65
Rate for Payer: Cash Price	$483.75
Rate for Payer: Health Partners Plans Commercial	$612.75
Rate for Payer: UnitedHealthcare Commercial	$625.65
Rate for Payer: WPPA Commercial	$528.90

REPAIR COMPLEX EA ADDTL 5CM

Facility

$430.00

Service Code	HCPCS 13122
Hospital Charge Code	1312200
Hospital Revenue Code	761
Min. Negotiated Rate	$352.60
Max. Negotiated Rate	$417.10
Rate for Payer: Cash Price	$322.50
Rate for Payer: Health Partners Plans Commercial	$408.50
Rate for Payer: UnitedHealthcare Commercial	$417.10
Rate for Payer: WPPA Commercial	$352.60

REPAIR COMPLEX EA ADDTL 5CM

Facility

$430.00

Service Code	HCPCS 13122
Hospital Charge Code	1312200
Hospital Revenue Code	761
Min. Negotiated Rate	$198.66
Max. Negotiated Rate	$417.10
Rate for Payer: Cash Price	$322.50
Rate for Payer: Celtic Commercial/Exchange	$198.66
Rate for Payer: Health Partners Plans Commercial	$408.50
Rate for Payer: UnitedHealthcare Commercial	$417.10
Rate for Payer: WPPA Commercial	$361.20

REPAIR COMPLEX TRUNK 1.1-2.5CM

Facility

$645.00

Service Code	HCPCS 13100
Hospital Charge Code	1310000
Hospital Revenue Code	450
Min. Negotiated Rate	$528.90
Max. Negotiated Rate	$625.65
Rate for Payer: Cash Price	$483.75
Rate for Payer: Health Partners Plans Commercial	$612.75
Rate for Payer: UnitedHealthcare Commercial	$625.65
Rate for Payer: WPPA Commercial	$528.90

Know your out-of-pocket cost for care.

All Charges