Ness County Hospital

All Charges

Charge

Type

Setting

Price

RESPIRATORY EDUCATION-1 ON 1

Facility

$103.00

Service Code	HCPCS G0238
Hospital Charge Code	G023800
Hospital Revenue Code	410
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$84.46

RESPIRATORY EDUCATION-1 ON 1

Facility

$103.00

Service Code	HCPCS G0238
Hospital Charge Code	G023800
Hospital Revenue Code	410
Min. Negotiated Rate	$47.47
Max. Negotiated Rate	$99.91
Rate for Payer: BCBS Commercial	$47.47
Rate for Payer: Cash Price	$77.25
Rate for Payer: Cash Price	$77.25
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC

Facility

$11,509.42

Service Code	MSDRG 178
Min. Negotiated Rate	$11,509.42
Max. Negotiated Rate	$11,509.42
Rate for Payer: BCBS Commercial	$11,509.42

RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC

Facility

$18,910.58

Service Code	MSDRG 177
Min. Negotiated Rate	$18,910.58
Max. Negotiated Rate	$18,910.58
Rate for Payer: BCBS Commercial	$18,910.58

RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC

Facility

$9,200.03

Service Code	MSDRG 179
Min. Negotiated Rate	$9,200.03
Max. Negotiated Rate	$9,200.03
Rate for Payer: BCBS Commercial	$9,200.03

RESPIRATORY NEOPLASMS WITH CC

Facility

$12,640.34

Service Code	MSDRG 181
Min. Negotiated Rate	$12,640.34
Max. Negotiated Rate	$12,640.34
Rate for Payer: BCBS Commercial	$12,640.34

RESPIRATORY NEOPLASMS WITH MCC

Facility

$18,995.13

Service Code	MSDRG 180
Min. Negotiated Rate	$18,995.13
Max. Negotiated Rate	$18,995.13
Rate for Payer: BCBS Commercial	$18,995.13

RESPIRATORY NEOPLASMS WITHOUT CC/MCC

Facility

$9,650.87

Service Code	MSDRG 182
Min. Negotiated Rate	$9,650.87
Max. Negotiated Rate	$9,650.87
Rate for Payer: BCBS Commercial	$9,650.87

RESPIRATORY SIGNS AND SYMPTOMS

Facility

$7,252.46

Service Code	MSDRG 204
Min. Negotiated Rate	$7,252.46
Max. Negotiated Rate	$7,252.46
Rate for Payer: BCBS Commercial	$7,252.46

RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS

Facility

$30,189.22

Service Code	MSDRG 208
Min. Negotiated Rate	$30,189.22
Max. Negotiated Rate	$30,189.22
Rate for Payer: BCBS Commercial	$30,189.22

RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS

Facility

$62,055.73

Service Code	MSDRG 207
Min. Negotiated Rate	$62,055.73
Max. Negotiated Rate	$62,055.73
Rate for Payer: BCBS Commercial	$62,055.73

RESPIRATORY VIRUS PCR PANEL A

Facility

$1,385.00

Service Code	HCPCS 87632
Hospital Charge Code	8763200
Hospital Revenue Code	306
Min. Negotiated Rate	$605.44
Max. Negotiated Rate	$1,343.45
Rate for Payer: BCBS Commercial	$605.44
Rate for Payer: Cash Price	$1,038.75
Rate for Payer: Cash Price	$1,038.75
Rate for Payer: Celtic Commercial/Exchange	$639.87
Rate for Payer: Health Partners Plans Commercial	$1,315.75
Rate for Payer: UnitedHealthcare Commercial	$1,343.45
Rate for Payer: WPPA Commercial	$1,163.40

RESPIRATORY VIRUS PCR PANEL A

Facility

$1,385.00

Service Code	HCPCS 87632
Hospital Charge Code	8763200
Hospital Revenue Code	306
Min. Negotiated Rate	$1,135.70
Max. Negotiated Rate	$1,343.45
Rate for Payer: Cash Price	$1,038.75
Rate for Payer: Health Partners Plans Commercial	$1,315.75
Rate for Payer: UnitedHealthcare Commercial	$1,343.45
Rate for Payer: WPPA Commercial	$1,135.70

RESP VIRUS SCREEN,DFA W/REFLEX

Facility

$75.00

Service Code	HCPCS 87300
Hospital Charge Code	8730001
Hospital Revenue Code	306
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

RESP VIRUS SCREEN,DFA W/REFLEX

Facility

$75.00

Service Code	HCPCS 87300
Hospital Charge Code	8730001
Hospital Revenue Code	306
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

RESUSCITATOR BAG PED

Facility

$41.00

Hospital Charge Code	2722473
Hospital Revenue Code	270
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$39.77
Rate for Payer: Cash Price	$30.94
Rate for Payer: Health Partners Plans Commercial	$38.95
Rate for Payer: UnitedHealthcare Commercial	$39.77
Rate for Payer: WPPA Commercial	$33.62

RESUSCITATOR BAG PED

Facility

$41.00

Hospital Charge Code	2722473
Hospital Revenue Code	270
Min. Negotiated Rate	$18.94
Max. Negotiated Rate	$39.77
Rate for Payer: Cash Price	$30.94
Rate for Payer: Celtic Commercial/Exchange	$18.94
Rate for Payer: Health Partners Plans Commercial	$38.95
Rate for Payer: UnitedHealthcare Commercial	$39.77
Rate for Payer: WPPA Commercial	$34.44

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC

Facility

$9,381.27

Service Code	MSDRG 815
Min. Negotiated Rate	$9,381.27
Max. Negotiated Rate	$9,381.27
Rate for Payer: BCBS Commercial	$9,381.27

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC

Facility

$17,126.12

Service Code	MSDRG 814
Min. Negotiated Rate	$17,126.12
Max. Negotiated Rate	$17,126.12
Rate for Payer: BCBS Commercial	$17,126.12

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Facility

$7,475.07

Service Code	MSDRG 816
Min. Negotiated Rate	$7,475.07
Max. Negotiated Rate	$7,475.07
Rate for Payer: BCBS Commercial	$7,475.07

REVISION OF HIP OR KNEE REPLACEMENT WITH CC

Facility

$33,132.64

Service Code	MSDRG 467
Min. Negotiated Rate	$33,132.64
Max. Negotiated Rate	$33,132.64
Rate for Payer: BCBS Commercial	$33,132.64

REVISION OF HIP OR KNEE REPLACEMENT WITH MCC

Facility

$47,445.80

Service Code	MSDRG 466
Min. Negotiated Rate	$47,445.80
Max. Negotiated Rate	$47,445.80
Rate for Payer: BCBS Commercial	$47,445.80

REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC

Facility

$26,079.06

Service Code	MSDRG 468
Min. Negotiated Rate	$26,079.06
Max. Negotiated Rate	$26,079.06
Rate for Payer: BCBS Commercial	$26,079.06

RHEUMATOID FACTOR, QUAL.

Facility

$73.00

Service Code	HCPCS 86431
Hospital Charge Code	8643100
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

RHEUMATOID FACTOR, QUAL.

Facility

$73.00

Service Code	HCPCS 86431
Hospital Charge Code	8643100
Hospital Revenue Code	302
Min. Negotiated Rate	$25.74
Max. Negotiated Rate	$70.81
Rate for Payer: BCBS Commercial	$25.74
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

Know your out-of-pocket cost for care.

All Charges