Ness County Hospital

All Charges

Charge

Type

Setting

Price

ARANESP 60MCG INJECT (NO DIALY

Facility

$1,389.00

Hospital Charge Code	2513737
Hospital Revenue Code	250
Min. Negotiated Rate	$641.72
Max. Negotiated Rate	$1,347.33
Rate for Payer: Cash Price	$1,041.94
Rate for Payer: Celtic Commercial/Exchange	$641.72
Rate for Payer: Health Partners Plans Commercial	$1,319.55
Rate for Payer: UnitedHealthcare Commercial	$1,347.33
Rate for Payer: WPPA Commercial	$1,166.76

ARCORAIL

Facility

$208.00

Hospital Charge Code	5710372
Hospital Revenue Code	271
Min. Negotiated Rate	$170.56
Max. Negotiated Rate	$201.76
Rate for Payer: Cash Price	$156.00
Rate for Payer: Health Partners Plans Commercial	$197.60
Rate for Payer: UnitedHealthcare Commercial	$201.76
Rate for Payer: WPPA Commercial	$170.56

ARCORAIL

Facility

$208.00

Hospital Charge Code	5710372
Hospital Revenue Code	271
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$201.76
Rate for Payer: Cash Price	$156.00
Rate for Payer: Celtic Commercial/Exchange	$96.10
Rate for Payer: Health Partners Plans Commercial	$197.60
Rate for Payer: UnitedHealthcare Commercial	$201.76
Rate for Payer: WPPA Commercial	$174.72

Arginaid (arginine-vitamin C-vitamin E) oral powder in packet

Facility

$1.00

Service Code	NDC 43900035984
Hospital Charge Code	2512408
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.98
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

Arginaid (arginine-vitamin C-vitamin E) oral powder in packet

Facility

$1.00

Service Code	NDC 43900035984
Hospital Charge Code	2512408
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.98
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ARGINAID, PER PKG

Facility

$1.00

Hospital Charge Code	7778855
Hospital Revenue Code	990
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.94
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

ARGINAID, PER PKG

Facility

$1.00

Hospital Charge Code	9998855
Hospital Revenue Code	990
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.94
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

ARGINAID, PER PKG

Facility

$1.00

Hospital Charge Code	9998855
Hospital Revenue Code	990
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.94
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ARGINAID, PER PKG

Facility

$1.00

Hospital Charge Code	7778855
Hospital Revenue Code	990
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.94
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ARICEPT 5 MG TAB (DONEPEZIL)

Facility

$26.00

Service Code	NDC 60687029211
Hospital Charge Code	2513562
Hospital Revenue Code	250
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.69
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

ARICEPT 5 MG TAB (DONEPEZIL)

Facility

$26.00

Service Code	NDC 60687029211
Hospital Charge Code	2513562
Hospital Revenue Code	250
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.69
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

ARM BOARD ADULT

Facility

$23.00

Hospital Charge Code	2700375
Hospital Revenue Code	270
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.62
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$18.86

ARM BOARD ADULT

Facility

$23.00

Hospital Charge Code	2700383
Hospital Revenue Code	270
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Celtic Commercial/Exchange	$10.63
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$19.32

ARM BOARD ADULT

Facility

$23.00

Hospital Charge Code	2700383
Hospital Revenue Code	270
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$18.86

ARM BOARD ADULT

Facility

$23.00

Hospital Charge Code	2700375
Hospital Revenue Code	270
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.62
Rate for Payer: Celtic Commercial/Exchange	$10.63
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$19.32

ARM BOARD PEDS

Facility

$21.00

Hospital Charge Code	2708449
Hospital Revenue Code	270
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

ARM BOARD PEDS

Facility

$21.00

Hospital Charge Code	2708449
Hospital Revenue Code	270
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
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

ARM/LEG SLEEVE 1 PAIR

Facility

$60.00

Hospital Charge Code	2795901
Hospital Revenue Code	272
Min. Negotiated Rate	$27.72
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$45.00
Rate for Payer: Celtic Commercial/Exchange	$27.72
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$50.40

ARM/LEG SLEEVE 1 PAIR

Facility

$60.00

Hospital Charge Code	2795901
Hospital Revenue Code	272
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$45.00
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$49.20

ARM PROTECTORS

Facility

$19.00

Hospital Charge Code	2795900
Hospital Revenue Code	272
Min. Negotiated Rate	$15.58
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.51
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.58

ARM PROTECTORS

Facility

$19.00

Hospital Charge Code	2795900
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.51
Rate for Payer: Celtic Commercial/Exchange	$8.78
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.96

ARM SLEEVE 1 PR

Facility

$50.00

Hospital Charge Code	2795898
Hospital Revenue Code	270
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.88
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

ARM SLEEVE 1 PR

Facility

$50.00

Hospital Charge Code	2795898
Hospital Revenue Code	270
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.88
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

ARM SLING ENVELOPE W/ PAD CHIL

Facility

$12.00

Hospital Charge Code	2700986
Hospital Revenue Code	272
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

ARM SLING ENVELOPE W/ PAD CHIL

Facility

$12.00

Hospital Charge Code	2700986
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

Know your out-of-pocket cost for care.

All Charges