Ness County Hospital

All Charges

Charge

Type

Setting

Price

SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$10,645.76

Service Code	MSDRG 578
Min. Negotiated Rate	$10,645.76
Max. Negotiated Rate	$10,645.76
Rate for Payer: BCBS Commercial	$10,645.76

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$21,270.53

Service Code	MSDRG 574
Min. Negotiated Rate	$21,270.53
Max. Negotiated Rate	$21,270.53
Rate for Payer: BCBS Commercial	$21,270.53

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$29,986.45

Service Code	MSDRG 573
Min. Negotiated Rate	$29,986.45
Max. Negotiated Rate	$29,986.45
Rate for Payer: BCBS Commercial	$29,986.45

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$12,072.53

Service Code	MSDRG 575
Min. Negotiated Rate	$12,072.53
Max. Negotiated Rate	$12,072.53
Rate for Payer: BCBS Commercial	$12,072.53

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC

Facility

$16,610.51

Service Code	MSDRG 623
Min. Negotiated Rate	$16,610.51
Max. Negotiated Rate	$16,610.51
Rate for Payer: BCBS Commercial	$16,610.51

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC

Facility

$32,412.11

Service Code	MSDRG 622
Min. Negotiated Rate	$32,412.11
Max. Negotiated Rate	$32,412.11
Rate for Payer: BCBS Commercial	$32,412.11

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC

Facility

$9,291.40

Service Code	MSDRG 624
Min. Negotiated Rate	$9,291.40
Max. Negotiated Rate	$9,291.40
Rate for Payer: BCBS Commercial	$9,291.40

SKIN GRAFTS FOR INJURIES WITH CC/MCC

Facility

$33,417.22

Service Code	MSDRG 904
Min. Negotiated Rate	$33,417.22
Max. Negotiated Rate	$33,417.22
Rate for Payer: BCBS Commercial	$33,417.22

SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC

Facility

$11,126.78

Service Code	MSDRG 905
Min. Negotiated Rate	$11,126.78
Max. Negotiated Rate	$11,126.78
Rate for Payer: BCBS Commercial	$11,126.78

SKIN PREP WIPES

Facility

$1.00

Hospital Charge Code	2513620
Hospital Revenue Code	270
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

SKIN PREP WIPES

Facility

$1.00

Hospital Charge Code	2513620
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

SKIN REPAIR CREAM 32OZ

Facility

$22.00

Hospital Charge Code	2700055
Hospital Revenue Code	270
Min. Negotiated Rate	$18.04
Max. Negotiated Rate	$21.34
Rate for Payer: Cash Price	$16.95
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.04

SKIN REPAIR CREAM 32OZ

Facility

$22.00

Hospital Charge Code	2700055
Hospital Revenue Code	270
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$21.34
Rate for Payer: Cash Price	$16.95
Rate for Payer: Celtic Commercial/Exchange	$10.16
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.48

SKIN REPAIR CREAM 4 OZ

Facility

$3.00

Hospital Charge Code	2700057
Hospital Revenue Code	270
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.79
Rate for Payer: Celtic Commercial/Exchange	$1.39
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.52

SKIN REPAIR CREAM 4 OZ

Facility

$3.00

Hospital Charge Code	2700057
Hospital Revenue Code	270
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.79
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.46

SKIN STAPLE EXTRACTOR

Facility

$20.00

Hospital Charge Code	2720969LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.19
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

SKIN STAPLE EXTRACTOR

Facility

$20.00

Hospital Charge Code	2720969LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.19
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

SKIN ULCERS WITH CC

Facility

$10,226.89

Service Code	MSDRG 593
Min. Negotiated Rate	$10,226.89
Max. Negotiated Rate	$10,226.89
Rate for Payer: BCBS Commercial	$10,226.89

SKIN ULCERS WITH MCC

Facility

$11,524.96

Service Code	MSDRG 592
Min. Negotiated Rate	$11,524.96
Max. Negotiated Rate	$11,524.96
Rate for Payer: BCBS Commercial	$11,524.96

SKIN ULCERS WITHOUT CC/MCC

Facility

$5,852.00

Service Code	MSDRG 594
Min. Negotiated Rate	$5,852.00
Max. Negotiated Rate	$5,852.00
Rate for Payer: BCBS Commercial	$5,852.00

SKLD NURSE VISIT-ASSESS-OASIS

Facility

$120.00

Service Code	HCPCS T1023
Hospital Charge Code	5712571
Hospital Revenue Code	551
Min. Negotiated Rate	$55.44
Max. Negotiated Rate	$116.40
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

SKLD NURSE VISIT-ASSESS-OASIS

Facility

$120.00

Service Code	HCPCS T1023
Hospital Charge Code	5712571
Hospital Revenue Code	551
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

SKN SBGRFT,FC/NK/HF/G 25 SQCM

Facility

$2,930.00

Service Code	HCPCS 15275
Hospital Charge Code	1527523
Hospital Revenue Code	761
Min. Negotiated Rate	$2,402.60
Max. Negotiated Rate	$2,842.10
Rate for Payer: Cash Price	$2,197.50
Rate for Payer: Health Partners Plans Commercial	$2,783.50
Rate for Payer: UnitedHealthcare Commercial	$2,842.10
Rate for Payer: WPPA Commercial	$2,402.60

SKN SBGRFT,FC/NK/HF/G 25 SQCM

Facility

$2,930.00

Service Code	HCPCS 15275
Hospital Charge Code	1527523
Hospital Revenue Code	761
Min. Negotiated Rate	$1,353.66
Max. Negotiated Rate	$4,483.39
Rate for Payer: BCBS Commercial	$4,483.39
Rate for Payer: Cash Price	$2,197.50
Rate for Payer: Cash Price	$2,197.50
Rate for Payer: Celtic Commercial/Exchange	$1,353.66
Rate for Payer: Health Partners Plans Commercial	$2,783.50
Rate for Payer: UnitedHealthcare Commercial	$2,842.10
Rate for Payer: WPPA Commercial	$2,461.20

SKULL 4 VIEW MINIMUM

Facility

$410.00

Service Code	HCPCS 70260
Hospital Charge Code	3260004
Hospital Revenue Code	320
Min. Negotiated Rate	$189.42
Max. Negotiated Rate	$397.70
Rate for Payer: BCBS Commercial	$210.93
Rate for Payer: Cash Price	$307.50
Rate for Payer: Cash Price	$307.50
Rate for Payer: Celtic Commercial/Exchange	$189.42
Rate for Payer: Health Partners Plans Commercial	$389.50
Rate for Payer: UnitedHealthcare Commercial	$397.70
Rate for Payer: WPPA Commercial	$344.40

Know your out-of-pocket cost for care.

All Charges