Ness County Hospital

All Charges

Charge

Type

Setting

Price

SHAMPOO CAP

Facility

$11.00

Hospital Charge Code	9999050
Hospital Revenue Code	990
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

SHAVING EPIDERMAL/DERMAL LES

Facility

$184.00

Service Code	HCPCS 11302
Hospital Charge Code	1130200
Hospital Revenue Code	761
Min. Negotiated Rate	$85.01
Max. Negotiated Rate	$217.71
Rate for Payer: BCBS Commercial	$217.71
Rate for Payer: Cash Price	$138.00
Rate for Payer: Cash Price	$138.00
Rate for Payer: Celtic Commercial/Exchange	$85.01
Rate for Payer: Health Partners Plans Commercial	$174.80
Rate for Payer: UnitedHealthcare Commercial	$178.48
Rate for Payer: WPPA Commercial	$154.56

SHAVING EPIDERMAL/DERMAL LES

Facility

$184.00

Service Code	HCPCS 11302
Hospital Charge Code	1130200
Hospital Revenue Code	761
Min. Negotiated Rate	$150.88
Max. Negotiated Rate	$178.48
Rate for Payer: Cash Price	$138.00
Rate for Payer: Health Partners Plans Commercial	$174.80
Rate for Payer: UnitedHealthcare Commercial	$178.48
Rate for Payer: WPPA Commercial	$150.88

SHEEP SKIN HEEL PROTECTOR

Facility

$26.00

Hospital Charge Code	2708550
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

SHEEP SKIN HEEL PROTECTOR

Facility

$26.00

Hospital Charge Code	2708550
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC

Facility

$17,461.67

Service Code	MSDRG 511
Min. Negotiated Rate	$17,461.67
Max. Negotiated Rate	$17,461.67
Rate for Payer: BCBS Commercial	$17,461.67

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC

Facility

$18,487.33

Service Code	MSDRG 510
Min. Negotiated Rate	$18,487.33
Max. Negotiated Rate	$18,487.33
Rate for Payer: BCBS Commercial	$18,487.33

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$13,938.02

Service Code	MSDRG 512
Min. Negotiated Rate	$13,938.02
Max. Negotiated Rate	$13,938.02
Rate for Payer: BCBS Commercial	$13,938.02

SHOULDER IMMOBILIZER CHILD

Facility

$50.00

Hospital Charge Code	2701397
Hospital Revenue Code	270
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Celtic Commercial/Exchange	$23.10
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$42.00

SHOULDER IMMOBILIZER CHILD

Facility

$50.00

Hospital Charge Code	2701397
Hospital Revenue Code	270
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

SHOULDER IMMOBILIZER MD

Facility

$50.00

Hospital Charge Code	2701400
Hospital Revenue Code	270
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

SHOULDER IMMOBILIZER MD

Facility

$50.00

Hospital Charge Code	2701400
Hospital Revenue Code	270
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Celtic Commercial/Exchange	$23.10
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$42.00

Shoulder immobilizer w/ abduc

Facility

$52.00

Hospital Charge Code	2701396
Hospital Revenue Code	272
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.00
Rate for Payer: Celtic Commercial/Exchange	$24.02
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$43.68

Shoulder immobilizer w/ abduc

Facility

$52.00

Hospital Charge Code	2701396
Hospital Revenue Code	272
Min. Negotiated Rate	$42.64
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.00
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$42.64

SHOULDER IMMOBILIZER XL

Facility

$50.00

Hospital Charge Code	2701398
Hospital Revenue Code	270
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

SHOULDER IMMOBILIZER XL

Facility

$50.00

Hospital Charge Code	2701398
Hospital Revenue Code	270
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Celtic Commercial/Exchange	$23.10
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$42.00

SHOULDER LT 1V

Facility

$200.00

Service Code	HCPCS 73020 LT
Hospital Charge Code	3280023
Hospital Revenue Code	320
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$194.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$164.00

SHOULDER LT 1V

Facility

$200.00

Service Code	HCPCS 73020 LT
Hospital Charge Code	3280023
Hospital Revenue Code	320
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$194.00
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$150.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Celtic Commercial/Exchange	$92.40
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$168.00

SHOULDER LT 2V

Facility

$252.00

Service Code	HCPCS 73030 LT
Hospital Charge Code	3280025
Hospital Revenue Code	320
Min. Negotiated Rate	$116.42
Max. Negotiated Rate	$244.44
Rate for Payer: BCBS Commercial	$140.31
Rate for Payer: Cash Price	$189.00
Rate for Payer: Cash Price	$189.00
Rate for Payer: Celtic Commercial/Exchange	$116.42
Rate for Payer: Health Partners Plans Commercial	$239.40
Rate for Payer: UnitedHealthcare Commercial	$244.44
Rate for Payer: WPPA Commercial	$211.68

SHOULDER LT 2V

Facility

$252.00

Service Code	HCPCS 73030 LT
Hospital Charge Code	3280025
Hospital Revenue Code	320
Min. Negotiated Rate	$206.64
Max. Negotiated Rate	$244.44
Rate for Payer: Cash Price	$189.00
Rate for Payer: Health Partners Plans Commercial	$239.40
Rate for Payer: UnitedHealthcare Commercial	$244.44
Rate for Payer: WPPA Commercial	$206.64

SHOULDER RT 1V

Facility

$160.00

Service Code	HCPCS 73020 RT
Hospital Charge Code	3280022
Hospital Revenue Code	320
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$155.20
Rate for Payer: BCBS Commercial	$110.06
Rate for Payer: Cash Price	$120.45
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

SHOULDER RT 1V

Facility

$160.00

Service Code	HCPCS 73020 RT
Hospital Charge Code	3280022
Hospital Revenue Code	320
Min. Negotiated Rate	$131.20
Max. Negotiated Rate	$155.20
Rate for Payer: Cash Price	$120.45
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$131.20

SHOULDER RT 2V

Facility

$252.00

Service Code	HCPCS 73030 RT
Hospital Charge Code	3280024
Hospital Revenue Code	320
Min. Negotiated Rate	$206.64
Max. Negotiated Rate	$244.44
Rate for Payer: Cash Price	$189.00
Rate for Payer: Health Partners Plans Commercial	$239.40
Rate for Payer: UnitedHealthcare Commercial	$244.44
Rate for Payer: WPPA Commercial	$206.64

SHOULDER RT 2V

Facility

$252.00

Service Code	HCPCS 73030 RT
Hospital Charge Code	3280024
Hospital Revenue Code	320
Min. Negotiated Rate	$116.42
Max. Negotiated Rate	$244.44
Rate for Payer: BCBS Commercial	$140.31
Rate for Payer: Cash Price	$189.00
Rate for Payer: Cash Price	$189.00
Rate for Payer: Celtic Commercial/Exchange	$116.42
Rate for Payer: Health Partners Plans Commercial	$239.40
Rate for Payer: UnitedHealthcare Commercial	$244.44
Rate for Payer: WPPA Commercial	$211.68

SHOWER CHAIR WITH BACK

Facility

$173.00

Hospital Charge Code	5710256
Hospital Revenue Code	271
Min. Negotiated Rate	$79.93
Max. Negotiated Rate	$167.81
Rate for Payer: Cash Price	$130.31
Rate for Payer: Celtic Commercial/Exchange	$79.93
Rate for Payer: Health Partners Plans Commercial	$164.35
Rate for Payer: UnitedHealthcare Commercial	$167.81
Rate for Payer: WPPA Commercial	$145.32

Know your out-of-pocket cost for care.

All Charges