Ness County Hospital

All Charges

Charge

Type

Setting

Price

SODIUM SERUM

Facility

$32.00

Service Code	HCPCS 84295
Hospital Charge Code	8429500
Hospital Revenue Code	301
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$31.04
Rate for Payer: BCBS Commercial	$10.33
Rate for Payer: Cash Price	$24.00
Rate for Payer: Cash Price	$24.00
Rate for Payer: Celtic Commercial/Exchange	$14.78
Rate for Payer: Health Partners Plans Commercial	$30.40
Rate for Payer: UnitedHealthcare Commercial	$31.04
Rate for Payer: WPPA Commercial	$26.88

SODIUM, URINE

Facility

$46.00

Service Code	HCPCS 84300
Hospital Charge Code	8430000
Hospital Revenue Code	301
Min. Negotiated Rate	$19.53
Max. Negotiated Rate	$44.62
Rate for Payer: BCBS Commercial	$19.53
Rate for Payer: Cash Price	$34.50
Rate for Payer: Cash Price	$34.50
Rate for Payer: Celtic Commercial/Exchange	$21.25
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$38.64

SODIUM, URINE

Facility

$46.00

Service Code	HCPCS 84300
Hospital Charge Code	8430000
Hospital Revenue Code	301
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$44.62
Rate for Payer: Cash Price	$34.50
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$37.72

SOFT PVC AIRWAY KIT 20-36FR

Facility

$85.00

Hospital Charge Code	2707254
Hospital Revenue Code	270
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Celtic Commercial/Exchange	$39.27
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$71.40

SOFT PVC AIRWAY KIT 20-36FR

Facility

$85.00

Hospital Charge Code	2707254
Hospital Revenue Code	270
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$69.70

SOFT TISSUE NECK

Facility

$255.00

Service Code	HCPCS 70360
Hospital Charge Code	3260028
Hospital Revenue Code	320
Min. Negotiated Rate	$117.81
Max. Negotiated Rate	$247.35
Rate for Payer: BCBS Commercial	$129.16
Rate for Payer: Cash Price	$191.25
Rate for Payer: Cash Price	$191.25
Rate for Payer: Celtic Commercial/Exchange	$117.81
Rate for Payer: Health Partners Plans Commercial	$242.25
Rate for Payer: UnitedHealthcare Commercial	$247.35
Rate for Payer: WPPA Commercial	$214.20

SOFT TISSUE NECK

Facility

$255.00

Service Code	HCPCS 70360
Hospital Charge Code	3260028
Hospital Revenue Code	320
Min. Negotiated Rate	$209.10
Max. Negotiated Rate	$247.35
Rate for Payer: Cash Price	$191.25
Rate for Payer: Health Partners Plans Commercial	$242.25
Rate for Payer: UnitedHealthcare Commercial	$247.35
Rate for Payer: WPPA Commercial	$209.10

SOFT TISSUE PROCEDURES WITH CC

Facility

$15,568.52

Service Code	MSDRG 501
Min. Negotiated Rate	$15,568.52
Max. Negotiated Rate	$15,568.52
Rate for Payer: BCBS Commercial	$15,568.52

SOFT TISSUE PROCEDURES WITH MCC

Facility

$28,308.43

Service Code	MSDRG 500
Min. Negotiated Rate	$28,308.43
Max. Negotiated Rate	$28,308.43
Rate for Payer: BCBS Commercial	$28,308.43

SOFT TISSUE PROCEDURES WITHOUT CC/MCC

Facility

$11,950.21

Service Code	MSDRG 502
Min. Negotiated Rate	$11,950.21
Max. Negotiated Rate	$11,950.21
Rate for Payer: BCBS Commercial	$11,950.21

SOLU-CORTEF 100 MG/2 ML INJ. (HYDROCORTISONE SODIUM SUCCINATE)

Facility

$66.00

Service Code	NDC 00009001103
Hospital Charge Code	2506764
Hospital Revenue Code	250
Min. Negotiated Rate	$54.12
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$49.97
Rate for Payer: Health Partners Plans Commercial	$62.70
Rate for Payer: UnitedHealthcare Commercial	$64.02
Rate for Payer: WPPA Commercial	$54.12

SOLU-CORTEF 100 MG/2 ML INJ. (HYDROCORTISONE SODIUM SUCCINATE)

Facility

$66.00

Service Code	NDC 00009001103
Hospital Charge Code	2506764
Hospital Revenue Code	250
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$64.02
Rate for Payer: Cash Price	$49.97
Rate for Payer: Celtic Commercial/Exchange	$30.49
Rate for Payer: Health Partners Plans Commercial	$62.70
Rate for Payer: UnitedHealthcare Commercial	$64.02
Rate for Payer: WPPA Commercial	$55.44

SOLU-CORTEF 250 MG/2 ML INJ. (HYDROCORTISONE SODIUM SUCCINATE)

Facility

$123.00

Service Code	NDC 00009001305
Hospital Charge Code	2506483
Hospital Revenue Code	250
Min. Negotiated Rate	$56.83
Max. Negotiated Rate	$119.31
Rate for Payer: Cash Price	$92.45
Rate for Payer: Celtic Commercial/Exchange	$56.83
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$103.32

SOLU-CORTEF 250 MG/2 ML INJ. (HYDROCORTISONE SODIUM SUCCINATE)

Facility

$123.00

Service Code	NDC 00009001305
Hospital Charge Code	2506483
Hospital Revenue Code	250
Min. Negotiated Rate	$100.86
Max. Negotiated Rate	$119.31
Rate for Payer: Cash Price	$92.45
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$100.86

SOLU CORTEF 500MG INJ

Facility

$205.00

Hospital Charge Code	2506491
Hospital Revenue Code	250
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$198.85
Rate for Payer: Cash Price	$154.12
Rate for Payer: Health Partners Plans Commercial	$194.75
Rate for Payer: UnitedHealthcare Commercial	$198.85
Rate for Payer: WPPA Commercial	$168.10

SOLU CORTEF 500MG INJ

Facility

$205.00

Hospital Charge Code	2506491
Hospital Revenue Code	250
Min. Negotiated Rate	$94.71
Max. Negotiated Rate	$198.85
Rate for Payer: Cash Price	$154.12
Rate for Payer: Celtic Commercial/Exchange	$94.71
Rate for Payer: Health Partners Plans Commercial	$194.75
Rate for Payer: UnitedHealthcare Commercial	$198.85
Rate for Payer: WPPA Commercial	$172.20

SOLU-MEDROL 125 MG/2 ML INJ. (METHYLPREDNISOLONE SODIUM)

Facility

$53.00

Service Code	NDC 00009004727
Hospital Charge Code	2506517
Hospital Revenue Code	250
Min. Negotiated Rate	$24.49
Max. Negotiated Rate	$51.41
Rate for Payer: Cash Price	$39.75
Rate for Payer: Celtic Commercial/Exchange	$24.49
Rate for Payer: Health Partners Plans Commercial	$50.35
Rate for Payer: UnitedHealthcare Commercial	$51.41
Rate for Payer: WPPA Commercial	$44.52

SOLU-MEDROL 125 MG/2 ML INJ. (METHYLPREDNISOLONE SODIUM)

Facility

$53.00

Service Code	NDC 00009004727
Hospital Charge Code	2506517
Hospital Revenue Code	250
Min. Negotiated Rate	$43.46
Max. Negotiated Rate	$51.41
Rate for Payer: Cash Price	$39.75
Rate for Payer: Health Partners Plans Commercial	$50.35
Rate for Payer: UnitedHealthcare Commercial	$51.41
Rate for Payer: WPPA Commercial	$43.46

SOLU-MEDROL 40 MG/ML INJ. (METHYLPREDNISOLONE SODIUM)

Facility

$21.00

Service Code	NDC 00009003930
Hospital Charge Code	2513042
Hospital Revenue Code	250
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.35
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

SOLU-MEDROL 40 MG/ML INJ. (METHYLPREDNISOLONE SODIUM)

Facility

$21.00

Service Code	NDC 00009003930
Hospital Charge Code	2513042
Hospital Revenue Code	250
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.35
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

SOMATOMEDIN

Facility

$224.00

Service Code	HCPCS 84305
Hospital Charge Code	8430500
Hospital Revenue Code	301
Min. Negotiated Rate	$183.68
Max. Negotiated Rate	$217.28
Rate for Payer: Cash Price	$168.00
Rate for Payer: Health Partners Plans Commercial	$212.80
Rate for Payer: UnitedHealthcare Commercial	$217.28
Rate for Payer: WPPA Commercial	$183.68

SOMATOMEDIN

Facility

$224.00

Service Code	HCPCS 84305
Hospital Charge Code	8430500
Hospital Revenue Code	301
Min. Negotiated Rate	$103.49
Max. Negotiated Rate	$217.28
Rate for Payer: BCBS Commercial	$120.74
Rate for Payer: Cash Price	$168.00
Rate for Payer: Cash Price	$168.00
Rate for Payer: Celtic Commercial/Exchange	$103.49
Rate for Payer: Health Partners Plans Commercial	$212.80
Rate for Payer: UnitedHealthcare Commercial	$217.28
Rate for Payer: WPPA Commercial	$188.16

SONO AAA SCREENING

Facility

$448.00

Service Code	HCPCS 76706
Hospital Charge Code	3320017
Hospital Revenue Code	402
Min. Negotiated Rate	$151.50
Max. Negotiated Rate	$434.56
Rate for Payer: BCBS Commercial	$151.50
Rate for Payer: Cash Price	$336.00
Rate for Payer: Cash Price	$336.00
Rate for Payer: Celtic Commercial/Exchange	$206.98
Rate for Payer: Health Partners Plans Commercial	$425.60
Rate for Payer: UnitedHealthcare Commercial	$434.56
Rate for Payer: WPPA Commercial	$376.32

SONO AAA SCREENING

Facility

$448.00

Service Code	HCPCS 76706
Hospital Charge Code	3320017
Hospital Revenue Code	402
Min. Negotiated Rate	$367.36
Max. Negotiated Rate	$434.56
Rate for Payer: Cash Price	$336.00
Rate for Payer: Health Partners Plans Commercial	$425.60
Rate for Payer: UnitedHealthcare Commercial	$434.56
Rate for Payer: WPPA Commercial	$367.36

SONO ABDOMEN COMPLETE

Facility

$632.00

Service Code	HCPCS 76700
Hospital Charge Code	3320004
Hospital Revenue Code	402
Min. Negotiated Rate	$518.24
Max. Negotiated Rate	$613.04
Rate for Payer: Cash Price	$474.00
Rate for Payer: Health Partners Plans Commercial	$600.40
Rate for Payer: UnitedHealthcare Commercial	$613.04
Rate for Payer: WPPA Commercial	$518.24

Know your out-of-pocket cost for care.

All Charges