Ness County Hospital

All Charges

Charge

Type

Setting

Price

STONE SCREEN

Facility

$5.00

Hospital Charge Code	2700946
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.31
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

STOOL, PANCREATIC ELASTASE

Facility

$75.00

Service Code	HCPCS 82656
Hospital Charge Code	8265600
Hospital Revenue Code	301
Min. Negotiated Rate	$25.51
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$25.51
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

STOOL, PANCREATIC ELASTASE

Facility

$75.00

Service Code	HCPCS 82656
Hospital Charge Code	8265600
Hospital Revenue Code	301
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

STOOL PATHOGEN PANEL

Facility

$901.00

Service Code	HCPCS 87507
Hospital Charge Code	8750700
Hospital Revenue Code	306
Min. Negotiated Rate	$738.82
Max. Negotiated Rate	$873.97
Rate for Payer: Cash Price	$675.75
Rate for Payer: Health Partners Plans Commercial	$855.95
Rate for Payer: UnitedHealthcare Commercial	$873.97
Rate for Payer: WPPA Commercial	$738.82

STOOL PATHOGEN PANEL

Facility

$901.00

Service Code	HCPCS 87507
Hospital Charge Code	8750700
Hospital Revenue Code	306
Min. Negotiated Rate	$416.26
Max. Negotiated Rate	$909.47
Rate for Payer: BCBS Commercial	$909.47
Rate for Payer: Cash Price	$675.75
Rate for Payer: Cash Price	$675.75
Rate for Payer: Celtic Commercial/Exchange	$416.26
Rate for Payer: Health Partners Plans Commercial	$855.95
Rate for Payer: UnitedHealthcare Commercial	$873.97
Rate for Payer: WPPA Commercial	$756.84

STOOL RISER WITH ARMS

Facility

$269.00

Hospital Charge Code	5710257
Hospital Revenue Code	271
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$201.94
Rate for Payer: Celtic Commercial/Exchange	$124.28
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$225.96

STOOL RISER WITH ARMS

Facility

$269.00

Hospital Charge Code	5710257
Hospital Revenue Code	271
Min. Negotiated Rate	$220.58
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$201.94
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$220.58

STOOL RISER WITHOUT ARMS

Facility

$145.00

Hospital Charge Code	5710249
Hospital Revenue Code	271
Min. Negotiated Rate	$118.90
Max. Negotiated Rate	$140.65
Rate for Payer: Cash Price	$108.75
Rate for Payer: Health Partners Plans Commercial	$137.75
Rate for Payer: UnitedHealthcare Commercial	$140.65
Rate for Payer: WPPA Commercial	$118.90

STOOL RISER WITHOUT ARMS

Facility

$145.00

Hospital Charge Code	5710249
Hospital Revenue Code	271
Min. Negotiated Rate	$66.99
Max. Negotiated Rate	$140.65
Rate for Payer: Cash Price	$108.75
Rate for Payer: Celtic Commercial/Exchange	$66.99
Rate for Payer: Health Partners Plans Commercial	$137.75
Rate for Payer: UnitedHealthcare Commercial	$140.65
Rate for Payer: WPPA Commercial	$121.80

STOP THE BLEED INTERMEDIATE

Facility

$222.00

Hospital Charge Code	2722025
Hospital Revenue Code	272
Min. Negotiated Rate	$182.04
Max. Negotiated Rate	$215.34
Rate for Payer: Cash Price	$166.50
Rate for Payer: Health Partners Plans Commercial	$210.90
Rate for Payer: UnitedHealthcare Commercial	$215.34
Rate for Payer: WPPA Commercial	$182.04

STOP THE BLEED INTERMEDIATE

Facility

$222.00

Hospital Charge Code	2722025
Hospital Revenue Code	272
Min. Negotiated Rate	$102.56
Max. Negotiated Rate	$215.34
Rate for Payer: Cash Price	$166.50
Rate for Payer: Celtic Commercial/Exchange	$102.56
Rate for Payer: Health Partners Plans Commercial	$210.90
Rate for Payer: UnitedHealthcare Commercial	$215.34
Rate for Payer: WPPA Commercial	$186.48

Strapping; ankle and/or foot

Facility

$391.00

Service Code	HCPCS 29540
Hospital Charge Code	2954000
Hospital Revenue Code	761
Min. Negotiated Rate	$320.62
Max. Negotiated Rate	$379.27
Rate for Payer: Cash Price	$293.25
Rate for Payer: Health Partners Plans Commercial	$371.45
Rate for Payer: UnitedHealthcare Commercial	$379.27
Rate for Payer: WPPA Commercial	$320.62

Strapping; ankle and/or foot

Facility

$391.00

Service Code	HCPCS 29540
Hospital Charge Code	2954000
Hospital Revenue Code	761
Min. Negotiated Rate	$180.64
Max. Negotiated Rate	$379.27
Rate for Payer: BCBS Commercial	$277.75
Rate for Payer: Cash Price	$293.25
Rate for Payer: Cash Price	$293.25
Rate for Payer: Celtic Commercial/Exchange	$180.64
Rate for Payer: Health Partners Plans Commercial	$371.45
Rate for Payer: UnitedHealthcare Commercial	$379.27
Rate for Payer: WPPA Commercial	$328.44

STRAPPING CHEST/THORAX

Facility

$296.00

Service Code	HCPCS 29200
Hospital Charge Code	2920000
Hospital Revenue Code	450
Min. Negotiated Rate	$242.72
Max. Negotiated Rate	$287.12
Rate for Payer: Cash Price	$222.00
Rate for Payer: Health Partners Plans Commercial	$281.20
Rate for Payer: UnitedHealthcare Commercial	$287.12
Rate for Payer: WPPA Commercial	$242.72

STRAPPING CHEST/THORAX

Facility

$296.00

Service Code	HCPCS 29200
Hospital Charge Code	2920000
Hospital Revenue Code	450
Min. Negotiated Rate	$136.75
Max. Negotiated Rate	$287.12
Rate for Payer: BCBS Commercial	$197.24
Rate for Payer: Cash Price	$222.00
Rate for Payer: Cash Price	$222.00
Rate for Payer: Celtic Commercial/Exchange	$136.75
Rate for Payer: Health Partners Plans Commercial	$281.20
Rate for Payer: UnitedHealthcare Commercial	$287.12
Rate for Payer: WPPA Commercial	$248.64

STRAPPING ELBOW OR WRIST

Facility

$278.00

Service Code	HCPCS 29260
Hospital Charge Code	2926000
Hospital Revenue Code	450
Min. Negotiated Rate	$227.96
Max. Negotiated Rate	$269.66
Rate for Payer: Cash Price	$208.50
Rate for Payer: Health Partners Plans Commercial	$264.10
Rate for Payer: UnitedHealthcare Commercial	$269.66
Rate for Payer: WPPA Commercial	$227.96

STRAPPING ELBOW OR WRIST

Facility

$278.00

Service Code	HCPCS 29260
Hospital Charge Code	2926000
Hospital Revenue Code	450
Min. Negotiated Rate	$128.44
Max. Negotiated Rate	$277.75
Rate for Payer: BCBS Commercial	$277.75
Rate for Payer: Cash Price	$208.50
Rate for Payer: Cash Price	$208.50
Rate for Payer: Celtic Commercial/Exchange	$128.44
Rate for Payer: Health Partners Plans Commercial	$264.10
Rate for Payer: UnitedHealthcare Commercial	$269.66
Rate for Payer: WPPA Commercial	$233.52

Strapping, hand or finger

Facility

$350.00

Service Code	HCPCS 29280
Hospital Charge Code	2928000
Hospital Revenue Code	450
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

Strapping, hand or finger

Facility

$350.00

Service Code	HCPCS 29280
Hospital Charge Code	2928000
Hospital Revenue Code	450
Min. Negotiated Rate	$161.70
Max. Negotiated Rate	$339.50
Rate for Payer: BCBS Commercial	$277.75
Rate for Payer: Cash Price	$262.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Celtic Commercial/Exchange	$161.70
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$294.00

STRAPPING OF KNEE APPLICATION

Facility

$377.00

Service Code	HCPCS 29530
Hospital Charge Code	2953000
Hospital Revenue Code	761
Min. Negotiated Rate	$309.14
Max. Negotiated Rate	$365.69
Rate for Payer: Cash Price	$282.75
Rate for Payer: Health Partners Plans Commercial	$358.15
Rate for Payer: UnitedHealthcare Commercial	$365.69
Rate for Payer: WPPA Commercial	$309.14

STRAPPING OF KNEE APPLICATION

Facility

$377.00

Service Code	HCPCS 29530
Hospital Charge Code	2953000
Hospital Revenue Code	761
Min. Negotiated Rate	$174.17
Max. Negotiated Rate	$365.69
Rate for Payer: BCBS Commercial	$277.75
Rate for Payer: Cash Price	$282.75
Rate for Payer: Cash Price	$282.75
Rate for Payer: Celtic Commercial/Exchange	$174.17
Rate for Payer: Health Partners Plans Commercial	$358.15
Rate for Payer: UnitedHealthcare Commercial	$365.69
Rate for Payer: WPPA Commercial	$316.68

Streptococcus pneumoniae antibody

Facility

$75.00

Service Code	HCPCS 86581
Hospital Charge Code	8658100
Hospital Revenue Code	302
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

Streptococcus pneumoniae antibody

Facility

$75.00

Service Code	HCPCS 86581
Hospital Charge Code	8658100
Hospital Revenue Code	302
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

SUB INFUSION, ADDTL PUMP SETUP

Facility

$132.00

Service Code	HCPCS 96371
Hospital Charge Code	9637100
Hospital Revenue Code	761
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$133.32
Rate for Payer: BCBS Commercial	$133.32
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

SUB INFUSION, ADDTL PUMP SETUP

Facility

$132.00

Service Code	HCPCS 96371
Hospital Charge Code	9637100
Hospital Revenue Code	761
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

Know your out-of-pocket cost for care.

All Charges