Ness County Hospital

All Charges

Charge

Type

Setting

Price

TRAMADOL SCREEN

Facility

$271.00

Service Code	HCPCS 80373
Hospital Charge Code	8037300
Hospital Revenue Code	300
Min. Negotiated Rate	$222.22
Max. Negotiated Rate	$262.87
Rate for Payer: Cash Price	$203.25
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$222.22

TRAMADOL SCREEN

Facility

$271.00

Service Code	HCPCS 80373
Hospital Charge Code	8037300
Hospital Revenue Code	300
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$262.87
Rate for Payer: BCBS Commercial	$23.88
Rate for Payer: Cash Price	$203.25
Rate for Payer: Cash Price	$203.25
Rate for Payer: Celtic Commercial/Exchange	$125.20
Rate for Payer: Health Partners Plans Commercial	$257.45
Rate for Payer: UnitedHealthcare Commercial	$262.87
Rate for Payer: WPPA Commercial	$227.64

TRANEXAMIC ACID 1,000 MG/10 ML INJ. (TXA)

Facility

$74.00

Service Code	NDC 61990061102
Hospital Charge Code	2519866
Hospital Revenue Code	250
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$71.78
Rate for Payer: Cash Price	$56.14
Rate for Payer: Celtic Commercial/Exchange	$34.19
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$62.16

TRANEXAMIC ACID 1,000 MG/10 ML INJ. (TXA)

Facility

$74.00

Service Code	NDC 61990061102
Hospital Charge Code	2519866
Hospital Revenue Code	250
Min. Negotiated Rate	$60.68
Max. Negotiated Rate	$71.78
Rate for Payer: Cash Price	$56.14
Rate for Payer: Health Partners Plans Commercial	$70.30
Rate for Payer: UnitedHealthcare Commercial	$71.78
Rate for Payer: WPPA Commercial	$60.68

TRANSDERM NITRO 0.1 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$5.00

Service Code	NDC 00378910293
Hospital Charge Code	2512309
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.35
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

TRANSDERM NITRO 0.1 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$5.00

Service Code	NDC 00378910293
Hospital Charge Code	2512309
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$4.35
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

TRANSDERM NITRO 0.2 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$7.00

Service Code	NDC 68382030930
Hospital Charge Code	2507408
Hospital Revenue Code	250
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.85
Rate for Payer: Celtic Commercial/Exchange	$3.23
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.88

TRANSDERM NITRO 0.2 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$7.00

Service Code	NDC 68382030930
Hospital Charge Code	2507408
Hospital Revenue Code	250
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.85
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

TRANSDERM NITRO 0.4 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$8.00

Service Code	NDC 00378911293
Hospital Charge Code	2507416
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.56
Rate for Payer: Celtic Commercial/Exchange	$3.70
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.72

TRANSDERM NITRO 0.4 MG/HR (NITROGLYCERIN TRANSDERMAL)

Facility

$8.00

Service Code	NDC 00378911293
Hospital Charge Code	2507416
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.56
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

TRANSDERM NITRO 0.6MG/HR

Facility

$9.00

Hospital Charge Code	2512820
Hospital Revenue Code	250
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.09
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

TRANSDERM NITRO 0.6MG/HR

Facility

$9.00

Hospital Charge Code	2512820
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.09
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

TRANSFERASE ALANINE AMINO

Facility

$50.00

Service Code	HCPCS 84460
Hospital Charge Code	8446000
Hospital Revenue Code	301
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$48.50
Rate for Payer: BCBS Commercial	$11.36
Rate for Payer: Cash Price	$37.50
Rate for Payer: Cash Price	$37.50
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

TRANSFERASE ALANINE AMINO

Facility

$50.00

Service Code	HCPCS 84460
Hospital Charge Code	8446000
Hospital Revenue Code	301
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$48.50
Rate for Payer: Cash Price	$37.50
Rate for Payer: Health Partners Plans Commercial	$47.50
Rate for Payer: UnitedHealthcare Commercial	$48.50
Rate for Payer: WPPA Commercial	$41.00

TRANSFERASE ASPARTATE AMINO

Facility

$53.00

Service Code	HCPCS 84450 59
Hospital Charge Code	8445000
Hospital Revenue Code	301
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

TRANSFERASE ASPARTATE AMINO

Facility

$53.00

Service Code	HCPCS 84450 59
Hospital Charge Code	8445000
Hospital Revenue Code	301
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$51.41
Rate for Payer: BCBS Commercial	$11.11
Rate for Payer: Cash Price	$39.75
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

TRANSFERRIN

Facility

$97.00

Service Code	HCPCS 84466
Hospital Charge Code	8446600
Hospital Revenue Code	301
Min. Negotiated Rate	$44.81
Max. Negotiated Rate	$94.09
Rate for Payer: BCBS Commercial	$77.93
Rate for Payer: Cash Price	$72.75
Rate for Payer: Cash Price	$72.75
Rate for Payer: Celtic Commercial/Exchange	$44.81
Rate for Payer: Health Partners Plans Commercial	$92.15
Rate for Payer: UnitedHealthcare Commercial	$94.09
Rate for Payer: WPPA Commercial	$81.48

TRANSFERRIN

Facility

$97.00

Service Code	HCPCS 84466
Hospital Charge Code	8446600
Hospital Revenue Code	301
Min. Negotiated Rate	$79.54
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$72.75
Rate for Payer: Health Partners Plans Commercial	$92.15
Rate for Payer: UnitedHealthcare Commercial	$94.09
Rate for Payer: WPPA Commercial	$79.54

Transfusion Pathology Consult- 5-20 min

Facility

$150.00

Service Code	HCPCS 80503
Hospital Charge Code	8050300
Hospital Revenue Code	300
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$123.00

Transfusion Pathology Consult- 5-20 min

Facility

$150.00

Service Code	HCPCS 80503
Hospital Charge Code	8050300
Hospital Revenue Code	300
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$145.50
Rate for Payer: BCBS Commercial	$76.82
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Celtic Commercial/Exchange	$69.30
Rate for Payer: Health Partners Plans Commercial	$142.50
Rate for Payer: UnitedHealthcare Commercial	$145.50
Rate for Payer: WPPA Commercial	$126.00

TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$6,985.91

Service Code	MSDRG 069
Min. Negotiated Rate	$6,985.91
Max. Negotiated Rate	$6,985.91
Rate for Payer: BCBS Commercial	$6,985.91

TRANSURETHRAL PROCEDURES WITH CC

Facility

$13,876.85

Service Code	MSDRG 669
Min. Negotiated Rate	$13,876.85
Max. Negotiated Rate	$13,876.85
Rate for Payer: BCBS Commercial	$13,876.85

TRANSURETHRAL PROCEDURES WITH MCC

Facility

$20,019.25

Service Code	MSDRG 668
Min. Negotiated Rate	$20,019.25
Max. Negotiated Rate	$20,019.25
Rate for Payer: BCBS Commercial	$20,019.25

TRANSURETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$7,092.20

Service Code	MSDRG 670
Min. Negotiated Rate	$7,092.20
Max. Negotiated Rate	$7,092.20
Rate for Payer: BCBS Commercial	$7,092.20

TRANSURETHRAL PROSTATECTOMY WITH CC/MCC

Facility

$13,254.67

Service Code	MSDRG 713
Min. Negotiated Rate	$13,254.67
Max. Negotiated Rate	$13,254.67
Rate for Payer: BCBS Commercial	$13,254.67

Know your out-of-pocket cost for care.

All Charges