Ness County Hospital

All Charges

Charge

Type

Setting

Price

SCLERODERMA ANTIBODY (SCL-70)

Facility

$368.00

Service Code	HCPCS 86235
Hospital Charge Code	8623504
Hospital Revenue Code	302
Min. Negotiated Rate	$301.76
Max. Negotiated Rate	$356.96
Rate for Payer: Cash Price	$276.00
Rate for Payer: Health Partners Plans Commercial	$349.60
Rate for Payer: UnitedHealthcare Commercial	$356.96
Rate for Payer: WPPA Commercial	$301.76

SCLERODERMA ANTIBODY (SCL-70)

Facility

$368.00

Service Code	HCPCS 86235
Hospital Charge Code	8623510
Hospital Revenue Code	302
Min. Negotiated Rate	$301.76
Max. Negotiated Rate	$356.96
Rate for Payer: Cash Price	$276.00
Rate for Payer: Health Partners Plans Commercial	$349.60
Rate for Payer: UnitedHealthcare Commercial	$356.96
Rate for Payer: WPPA Commercial	$301.76

SCOLIOSIS 6 VIEW MIN

Facility

$650.00

Service Code	HCPCS 72084
Hospital Charge Code	7208400
Hospital Revenue Code	320
Min. Negotiated Rate	$533.00
Max. Negotiated Rate	$630.50
Rate for Payer: Cash Price	$487.50
Rate for Payer: Health Partners Plans Commercial	$617.50
Rate for Payer: UnitedHealthcare Commercial	$630.50
Rate for Payer: WPPA Commercial	$533.00

SCOLIOSIS 6 VIEW MIN

Facility

$650.00

Service Code	HCPCS 72084
Hospital Charge Code	7208400
Hospital Revenue Code	320
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$630.50
Rate for Payer: BCBS Commercial	$132.93
Rate for Payer: Cash Price	$487.50
Rate for Payer: Cash Price	$487.50
Rate for Payer: Celtic Commercial/Exchange	$300.30
Rate for Payer: Health Partners Plans Commercial	$617.50
Rate for Payer: UnitedHealthcare Commercial	$630.50
Rate for Payer: WPPA Commercial	$546.00

SCOLIOSIS ENTIRE SPINE AP-LAT

Facility

$523.00

Service Code	HCPCS 72082
Hospital Charge Code	3270024
Hospital Revenue Code	320
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$507.31
Rate for Payer: BCBS Commercial	$132.93
Rate for Payer: Cash Price	$392.70
Rate for Payer: Cash Price	$392.70
Rate for Payer: Celtic Commercial/Exchange	$241.63
Rate for Payer: Health Partners Plans Commercial	$496.85
Rate for Payer: UnitedHealthcare Commercial	$507.31
Rate for Payer: WPPA Commercial	$439.32

SCOLIOSIS ENTIRE SPINE AP-LAT

Facility

$523.00

Service Code	HCPCS 72082
Hospital Charge Code	3270024
Hospital Revenue Code	320
Min. Negotiated Rate	$428.86
Max. Negotiated Rate	$507.31
Rate for Payer: Cash Price	$392.70
Rate for Payer: Health Partners Plans Commercial	$496.85
Rate for Payer: UnitedHealthcare Commercial	$507.31
Rate for Payer: WPPA Commercial	$428.86

SCOPOLAMINE 1 MG PATCH (TRANSDERM SCOP)

Facility

$64.00

Service Code	NDC 45802058001
Hospital Charge Code	2514743
Hospital Revenue Code	250
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$62.08
Rate for Payer: Cash Price	$48.15
Rate for Payer: Celtic Commercial/Exchange	$29.57
Rate for Payer: Health Partners Plans Commercial	$60.80
Rate for Payer: UnitedHealthcare Commercial	$62.08
Rate for Payer: WPPA Commercial	$53.76

SCOPOLAMINE 1 MG PATCH (TRANSDERM SCOP)

Facility

$64.00

Service Code	NDC 45802058001
Hospital Charge Code	2514743
Hospital Revenue Code	250
Min. Negotiated Rate	$52.48
Max. Negotiated Rate	$62.08
Rate for Payer: Cash Price	$48.15
Rate for Payer: Health Partners Plans Commercial	$60.80
Rate for Payer: UnitedHealthcare Commercial	$62.08
Rate for Payer: WPPA Commercial	$52.48

SECONDARY CLOSURE,SURG WOUND

Facility

$1,750.00

Service Code	HCPCS 13160
Hospital Charge Code	1316000
Hospital Revenue Code	761
Min. Negotiated Rate	$1,435.00
Max. Negotiated Rate	$1,697.50
Rate for Payer: Cash Price	$1,312.50
Rate for Payer: Health Partners Plans Commercial	$1,662.50
Rate for Payer: UnitedHealthcare Commercial	$1,697.50
Rate for Payer: WPPA Commercial	$1,435.00

SECONDARY CLOSURE,SURG WOUND

Facility

$1,750.00

Service Code	HCPCS 13160
Hospital Charge Code	1316000
Hospital Revenue Code	761
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$2,038.18
Rate for Payer: BCBS Commercial	$2,038.18
Rate for Payer: Cash Price	$1,312.50
Rate for Payer: Cash Price	$1,312.50
Rate for Payer: Celtic Commercial/Exchange	$808.50
Rate for Payer: Health Partners Plans Commercial	$1,662.50
Rate for Payer: UnitedHealthcare Commercial	$1,697.50
Rate for Payer: WPPA Commercial	$1,470.00

SEDATIVE HYPNOTICS SCREEN

Facility

$271.00

Service Code	HCPCS 80368
Hospital Charge Code	8036800
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

SEDATIVE HYPNOTICS SCREEN

Facility

$271.00

Service Code	HCPCS 80368
Hospital Charge Code	8036800
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

SEDIMENTATION RATE, AUTOMATED

Facility

$80.00

Service Code	HCPCS 85652
Hospital Charge Code	8565200
Hospital Revenue Code	305
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

SEDIMENTATION RATE, AUTOMATED

Facility

$80.00

Service Code	HCPCS 85652
Hospital Charge Code	8565200
Hospital Revenue Code	305
Min. Negotiated Rate	$12.82
Max. Negotiated Rate	$77.60
Rate for Payer: BCBS Commercial	$12.82
Rate for Payer: Cash Price	$60.00
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

SEDIMENTATION RATE,NON-AUTOMAT

Facility

$47.00

Service Code	HCPCS 85651
Hospital Charge Code	8565100
Hospital Revenue Code	305
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$45.59
Rate for Payer: BCBS Commercial	$13.24
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cash Price	$35.25
Rate for Payer: Celtic Commercial/Exchange	$21.71
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$39.48

SEDIMENTATION RATE,NON-AUTOMAT

Facility

$47.00

Service Code	HCPCS 85651
Hospital Charge Code	8565100
Hospital Revenue Code	305
Min. Negotiated Rate	$38.54
Max. Negotiated Rate	$45.59
Rate for Payer: Cash Price	$35.25
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$38.54

SEIZURES WITH MCC

Facility

$16,824.26

Service Code	MSDRG 100
Min. Negotiated Rate	$16,824.26
Max. Negotiated Rate	$16,824.26
Rate for Payer: BCBS Commercial	$16,824.26

SEIZURES WITHOUT MCC

Facility

$7,965.61

Service Code	MSDRG 101
Min. Negotiated Rate	$7,965.61
Max. Negotiated Rate	$7,965.61
Rate for Payer: BCBS Commercial	$7,965.61

SELECTIVE CATHETER PLACEMENT'

Facility

$660.00

Service Code	HCPCS 36011
Hospital Charge Code	3601100
Hospital Revenue Code	761
Min. Negotiated Rate	$304.92
Max. Negotiated Rate	$659.53
Rate for Payer: BCBS Commercial	$659.53
Rate for Payer: Cash Price	$495.00
Rate for Payer: Cash Price	$495.00
Rate for Payer: Celtic Commercial/Exchange	$304.92
Rate for Payer: Health Partners Plans Commercial	$627.00
Rate for Payer: UnitedHealthcare Commercial	$640.20
Rate for Payer: WPPA Commercial	$554.40

SELECTIVE CATHETER PLACEMENT'

Facility

$660.00

Service Code	HCPCS 36011
Hospital Charge Code	3601100
Hospital Revenue Code	761
Min. Negotiated Rate	$541.20
Max. Negotiated Rate	$640.20
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Partners Plans Commercial	$627.00
Rate for Payer: UnitedHealthcare Commercial	$640.20
Rate for Payer: WPPA Commercial	$541.20

SELFCARE/HOME MGMT TRNG,EA 15"

Facility

$119.00

Service Code	HCPCS 97535 GP
Hospital Charge Code	4201345
Hospital Revenue Code	420
Min. Negotiated Rate	$97.58
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$89.25
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$97.58

SELFCARE/HOME MGMT TRNG,EA 15"

Facility

$119.00

Service Code	HCPCS 97535 GP
Hospital Charge Code	4201345
Hospital Revenue Code	420
Min. Negotiated Rate	$34.17
Max. Negotiated Rate	$115.43
Rate for Payer: BCBS Commercial	$34.17
Rate for Payer: Cash Price	$89.25
Rate for Payer: Cash Price	$89.25
Rate for Payer: Celtic Commercial/Exchange	$54.98
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$99.96

SELF-CARE MGMT TRN, EA 15 MIN

Facility

$107.00

Service Code	HCPCS 97535 GO
Hospital Charge Code	9753500
Hospital Revenue Code	430
Min. Negotiated Rate	$34.17
Max. Negotiated Rate	$103.79
Rate for Payer: BCBS Commercial	$34.17
Rate for Payer: Cash Price	$80.25
Rate for Payer: Cash Price	$80.25
Rate for Payer: Celtic Commercial/Exchange	$49.43
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$89.88

SELF-CARE MGMT TRN, EA 15 MIN

Facility

$107.00

Service Code	HCPCS 97535 GO
Hospital Charge Code	9753500
Hospital Revenue Code	430
Min. Negotiated Rate	$87.74
Max. Negotiated Rate	$103.79
Rate for Payer: Cash Price	$80.25
Rate for Payer: Health Partners Plans Commercial	$101.65
Rate for Payer: UnitedHealthcare Commercial	$103.79
Rate for Payer: WPPA Commercial	$87.74

SELLA TURCICA

Facility

$160.00

Service Code	HCPCS 70240
Hospital Charge Code	3260016
Hospital Revenue Code	320
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$155.20
Rate for Payer: Cash Price	$120.45
Rate for Payer: Celtic Commercial/Exchange	$73.92
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$134.40

Know your out-of-pocket cost for care.

All Charges