Ness County Hospital

All Charges

Charge

Type

Setting

Price

RHEUMATOID FACTOR, QUAL.

Facility

$45.00

Service Code	HCPCS 86430
Hospital Charge Code	8643000
Hospital Revenue Code	302
Min. Negotiated Rate	$20.79
Max. Negotiated Rate	$43.65
Rate for Payer: BCBS Commercial	$23.30
Rate for Payer: Cash Price	$33.75
Rate for Payer: Cash Price	$33.75
Rate for Payer: Celtic Commercial/Exchange	$20.79
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$37.80

RHEUMATOID FACTOR, QUAL.

Facility

$45.00

Service Code	HCPCS 86430
Hospital Charge Code	8643000
Hospital Revenue Code	302
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$43.65
Rate for Payer: Cash Price	$33.75
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$36.90

RHX STAPLE EXTRACTOR

Facility

$7.00

Hospital Charge Code	2720969
Hospital Revenue Code	270
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

RHX STAPLE EXTRACTOR

Facility

$7.00

Hospital Charge Code	2720969
Hospital Revenue Code	270
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.25
Rate for Payer: Celtic Commercial/Exchange	$3.23
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.88

RHYTHM ECG,1-3 LEADS,TRACING

Facility

$74.00

Service Code	HCPCS 93041
Hospital Charge Code	2700775
Hospital Revenue Code	730
Min. Negotiated Rate	$60.68
Max. Negotiated Rate	$71.78
Rate for Payer: Cash Price	$55.50
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$60.68

RHYTHM ECG,1-3 LEADS,TRACING

Facility

$74.00

Service Code	HCPCS 93041
Hospital Charge Code	2700775
Hospital Revenue Code	730
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$73.10
Rate for Payer: BCBS Commercial	$73.10
Rate for Payer: Cash Price	$55.50
Rate for Payer: Cash Price	$55.50
Rate for Payer: Celtic Commercial/Exchange	$34.19
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$62.16

RIB BELT FEMALE 6" SM

Facility

$29.00

Hospital Charge Code	2701689
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIB BELT FEMALE 6" SM

Facility

$29.00

Hospital Charge Code	2701689
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT FEMALE UNIVERSAL

Facility

$29.00

Hospital Charge Code	2701690
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIB BELT FEMALE UNIVERSAL

Facility

$29.00

Hospital Charge Code	2701690
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT MALE 6" LG

Facility

$29.00

Hospital Charge Code	2701691
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIB BELT MALE 6" LG

Facility

$29.00

Hospital Charge Code	2701691
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT MALE 6" LG

Facility

$29.00

Hospital Charge Code	2701692
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT MALE 6" LG

Facility

$29.00

Hospital Charge Code	2701692
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIB BELT MENS

Facility

$29.00

Hospital Charge Code	2701696
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT MENS

Facility

$29.00

Hospital Charge Code	2701696
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIB BELT WOMEN

Facility

$29.00

Hospital Charge Code	2701688
Hospital Revenue Code	270
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$23.78

RIB BELT WOMEN

Facility

$29.00

Hospital Charge Code	2701688
Hospital Revenue Code	270
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$28.13
Rate for Payer: Cash Price	$22.31
Rate for Payer: Celtic Commercial/Exchange	$13.40
Rate for Payer: Health Partners Plans Commercial	$27.55
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: WPPA Commercial	$24.36

RIBS BIL 3V+

Facility

$264.00

Service Code	HCPCS 71110
Hospital Charge Code	3240012
Hospital Revenue Code	320
Min. Negotiated Rate	$216.48
Max. Negotiated Rate	$256.08
Rate for Payer: Cash Price	$198.00
Rate for Payer: Health Partners Plans Commercial	$250.80
Rate for Payer: UnitedHealthcare Commercial	$256.08
Rate for Payer: WPPA Commercial	$216.48

RIBS BIL 3V+

Facility

$264.00

Service Code	HCPCS 71110
Hospital Charge Code	3240012
Hospital Revenue Code	320
Min. Negotiated Rate	$121.97
Max. Negotiated Rate	$256.08
Rate for Payer: BCBS Commercial	$134.73
Rate for Payer: Cash Price	$198.00
Rate for Payer: Cash Price	$198.00
Rate for Payer: Celtic Commercial/Exchange	$121.97
Rate for Payer: Health Partners Plans Commercial	$250.80
Rate for Payer: UnitedHealthcare Commercial	$256.08
Rate for Payer: WPPA Commercial	$221.76

RIBS BIL W CHEST

Facility

$447.00

Service Code	HCPCS 71111
Hospital Charge Code	7111100
Hospital Revenue Code	320
Min. Negotiated Rate	$206.51
Max. Negotiated Rate	$433.59
Rate for Payer: BCBS Commercial	$245.31
Rate for Payer: Cash Price	$335.25
Rate for Payer: Cash Price	$335.25
Rate for Payer: Celtic Commercial/Exchange	$206.51
Rate for Payer: Health Partners Plans Commercial	$424.65
Rate for Payer: UnitedHealthcare Commercial	$433.59
Rate for Payer: WPPA Commercial	$375.48

RIBS BIL W CHEST

Facility

$447.00

Service Code	HCPCS 71111
Hospital Charge Code	7111100
Hospital Revenue Code	320
Min. Negotiated Rate	$366.54
Max. Negotiated Rate	$433.59
Rate for Payer: Cash Price	$335.25
Rate for Payer: Health Partners Plans Commercial	$424.65
Rate for Payer: UnitedHealthcare Commercial	$433.59
Rate for Payer: WPPA Commercial	$366.54

RIBS LT 2V

Facility

$196.00

Service Code	HCPCS 71100 LT
Hospital Charge Code	7111105
Hospital Revenue Code	320
Min. Negotiated Rate	$160.72
Max. Negotiated Rate	$190.12
Rate for Payer: Cash Price	$147.68
Rate for Payer: Health Partners Plans Commercial	$186.20
Rate for Payer: UnitedHealthcare Commercial	$190.12
Rate for Payer: WPPA Commercial	$160.72

RIBS LT 2V

Facility

$196.00

Service Code	HCPCS 71100 LT
Hospital Charge Code	7111105
Hospital Revenue Code	320
Min. Negotiated Rate	$90.55
Max. Negotiated Rate	$190.12
Rate for Payer: BCBS Commercial	$133.80
Rate for Payer: Cash Price	$147.68
Rate for Payer: Cash Price	$147.68
Rate for Payer: Celtic Commercial/Exchange	$90.55
Rate for Payer: Health Partners Plans Commercial	$186.20
Rate for Payer: UnitedHealthcare Commercial	$190.12
Rate for Payer: WPPA Commercial	$164.64

RIBS LT W CHEST

Facility

$349.00

Service Code	HCPCS 71101 LT
Hospital Charge Code	7111103
Hospital Revenue Code	320
Min. Negotiated Rate	$286.18
Max. Negotiated Rate	$338.53
Rate for Payer: Cash Price	$261.75
Rate for Payer: Health Partners Plans Commercial	$331.55
Rate for Payer: UnitedHealthcare Commercial	$338.53
Rate for Payer: WPPA Commercial	$286.18

Know your out-of-pocket cost for care.

All Charges