Ness County Hospital

All Charges

Charge

Type

Setting

Price

STOCKING TED THIGH LG SHORT

Facility

$30.00

Hospital Charge Code	2700167
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH MD LONG

Facility

$30.00

Hospital Charge Code	2700168
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH MD LONG

Facility

$30.00

Hospital Charge Code	2700168
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH MD REG

Facility

$30.00

Hospital Charge Code	2700169
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH MD REG

Facility

$30.00

Hospital Charge Code	2700169
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH MD SHORT

Facility

$30.00

Hospital Charge Code	2700170
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH MD SHORT

Facility

$30.00

Hospital Charge Code	2700170
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH SM LONG

Facility

$30.00

Hospital Charge Code	2700171
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH SM LONG

Facility

$30.00

Hospital Charge Code	2700171
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH SM REG

Facility

$30.00

Hospital Charge Code	2700172
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH SM REG

Facility

$30.00

Hospital Charge Code	2700172
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH SM SHORT

Facility

$30.00

Hospital Charge Code	2700173
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH SM SHORT

Facility

$30.00

Hospital Charge Code	2700173
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH XL LONG

Facility

$30.00

Hospital Charge Code	2700174
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH XL LONG

Facility

$30.00

Hospital Charge Code	2700174
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH XL REG

Facility

$30.00

Hospital Charge Code	2700175
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH XL REG

Facility

$30.00

Hospital Charge Code	2700176
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH XL REG

Facility

$30.00

Hospital Charge Code	2700175
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH XL REG

Facility

$30.00

Hospital Charge Code	2700176
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOCKING TED THIGH XL SHORT

Facility

$30.00

Hospital Charge Code	2700178
Hospital Revenue Code	270
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Celtic Commercial/Exchange	$13.86
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$25.20

STOCKING TED THIGH XL SHORT

Facility

$30.00

Hospital Charge Code	2700178
Hospital Revenue Code	270
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$29.10
Rate for Payer: Cash Price	$22.50
Rate for Payer: Health Partners Plans Commercial	$28.50
Rate for Payer: UnitedHealthcare Commercial	$29.10
Rate for Payer: WPPA Commercial	$24.60

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC

Facility

$26,822.59

Service Code	MSDRG 327
Min. Negotiated Rate	$26,822.59
Max. Negotiated Rate	$26,822.59
Rate for Payer: BCBS Commercial	$26,822.59

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC

Facility

$47,184.86

Service Code	MSDRG 326
Min. Negotiated Rate	$47,184.86
Max. Negotiated Rate	$47,184.86
Rate for Payer: BCBS Commercial	$47,184.86

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC

Facility

$14,794.59

Service Code	MSDRG 328
Min. Negotiated Rate	$14,794.59
Max. Negotiated Rate	$14,794.59
Rate for Payer: BCBS Commercial	$14,794.59

STONE SCREEN

Facility

$5.00

Hospital Charge Code	2700946
Hospital Revenue Code	270
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

Know your out-of-pocket cost for care.

All Charges