Ness County Hospital

All Charges

Charge

Type

Setting

Price

TRICHOMONAS VAG RNA,Q

Facility

$137.00

Service Code	HCPCS 87661
Hospital Charge Code	8766100
Hospital Revenue Code	306
Min. Negotiated Rate	$63.29
Max. Negotiated Rate	$132.89
Rate for Payer: BCBS Commercial	$95.50
Rate for Payer: Cash Price	$102.75
Rate for Payer: Cash Price	$102.75
Rate for Payer: Celtic Commercial/Exchange	$63.29
Rate for Payer: Health Partners Plans Commercial	$130.15
Rate for Payer: UnitedHealthcare Commercial	$132.89
Rate for Payer: WPPA Commercial	$115.08

TRICHOMONAS VAG RNA,Q

Facility

$137.00

Service Code	HCPCS 87661
Hospital Charge Code	8766100
Hospital Revenue Code	306
Min. Negotiated Rate	$112.34
Max. Negotiated Rate	$132.89
Rate for Payer: Cash Price	$102.75
Rate for Payer: Health Partners Plans Commercial	$130.15
Rate for Payer: UnitedHealthcare Commercial	$132.89
Rate for Payer: WPPA Commercial	$112.34

TRIGLYCERIDES

Facility

$53.00

Service Code	HCPCS 84478
Hospital Charge Code	8447800
Hospital Revenue Code	301
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$51.41
Rate for Payer: BCBS Commercial	$12.35
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

TRIGLYCERIDES

Facility

$53.00

Service Code	HCPCS 84478
Hospital Charge Code	8447800
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

TRIIODOTHYRONINE T3 FREE

Facility

$181.00

Service Code	HCPCS 84481
Hospital Charge Code	8448100
Hospital Revenue Code	301
Min. Negotiated Rate	$148.42
Max. Negotiated Rate	$175.57
Rate for Payer: Cash Price	$135.75
Rate for Payer: Health Partners Plans Commercial	$171.95
Rate for Payer: UnitedHealthcare Commercial	$175.57
Rate for Payer: WPPA Commercial	$148.42

TRIIODOTHYRONINE T3 FREE

Facility

$181.00

Service Code	HCPCS 84481
Hospital Charge Code	8448100
Hospital Revenue Code	301
Min. Negotiated Rate	$83.62
Max. Negotiated Rate	$175.57
Rate for Payer: BCBS Commercial	$84.25
Rate for Payer: Cash Price	$135.75
Rate for Payer: Cash Price	$135.75
Rate for Payer: Celtic Commercial/Exchange	$83.62
Rate for Payer: Health Partners Plans Commercial	$171.95
Rate for Payer: UnitedHealthcare Commercial	$175.57
Rate for Payer: WPPA Commercial	$152.04

TRIIODOTHYRONINE T3 REVERSE

Facility

$160.00

Service Code	HCPCS 84482
Hospital Charge Code	8448200
Hospital Revenue Code	301
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$155.20
Rate for Payer: BCBS Commercial	$82.92
Rate for Payer: Cash Price	$120.00
Rate for Payer: Cash Price	$120.00
Rate for Payer: Celtic Commercial/Exchange	$73.92
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$134.40

TRIIODOTHYRONINE T3 REVERSE

Facility

$160.00

Service Code	HCPCS 84482
Hospital Charge Code	8448200
Hospital Revenue Code	301
Min. Negotiated Rate	$131.20
Max. Negotiated Rate	$155.20
Rate for Payer: Cash Price	$120.00
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$131.20

TRIIODOTHYRONINE T3 TOTAL

Facility

$117.00

Service Code	HCPCS 84480
Hospital Charge Code	8448000
Hospital Revenue Code	301
Min. Negotiated Rate	$95.94
Max. Negotiated Rate	$113.49
Rate for Payer: Cash Price	$87.75
Rate for Payer: Health Partners Plans Commercial	$111.15
Rate for Payer: UnitedHealthcare Commercial	$113.49
Rate for Payer: WPPA Commercial	$95.94

TRIIODOTHYRONINE T3 TOTAL

Facility

$117.00

Service Code	HCPCS 84480
Hospital Charge Code	8448000
Hospital Revenue Code	301
Min. Negotiated Rate	$47.20
Max. Negotiated Rate	$113.49
Rate for Payer: BCBS Commercial	$47.20
Rate for Payer: Cash Price	$87.75
Rate for Payer: Cash Price	$87.75
Rate for Payer: Celtic Commercial/Exchange	$54.05
Rate for Payer: Health Partners Plans Commercial	$111.15
Rate for Payer: UnitedHealthcare Commercial	$113.49
Rate for Payer: WPPA Commercial	$98.28

TRIM 2-4 LESIONS

Facility

$400.00

Service Code	HCPCS 11056
Hospital Charge Code	1105623
Hospital Revenue Code	761
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$388.00
Rate for Payer: BCBS Commercial	$248.38
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Celtic Commercial/Exchange	$184.80
Rate for Payer: Health Partners Plans Commercial	$380.00
Rate for Payer: UnitedHealthcare Commercial	$388.00
Rate for Payer: WPPA Commercial	$336.00

TRIM 2-4 LESIONS

Facility

$400.00

Service Code	HCPCS 11056
Hospital Charge Code	1105623
Hospital Revenue Code	761
Min. Negotiated Rate	$328.00
Max. Negotiated Rate	$388.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Health Partners Plans Commercial	$380.00
Rate for Payer: UnitedHealthcare Commercial	$388.00
Rate for Payer: WPPA Commercial	$328.00

TRIM >4 LESIONS

Facility

$400.00

Service Code	HCPCS 11057
Hospital Charge Code	1105723
Hospital Revenue Code	761
Min. Negotiated Rate	$328.00
Max. Negotiated Rate	$388.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Health Partners Plans Commercial	$380.00
Rate for Payer: UnitedHealthcare Commercial	$388.00
Rate for Payer: WPPA Commercial	$328.00

TRIM >4 LESIONS

Facility

$400.00

Service Code	HCPCS 11057
Hospital Charge Code	1105723
Hospital Revenue Code	761
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$388.00
Rate for Payer: BCBS Commercial	$248.38
Rate for Payer: Cash Price	$300.00
Rate for Payer: Cash Price	$300.00
Rate for Payer: Celtic Commercial/Exchange	$184.80
Rate for Payer: Health Partners Plans Commercial	$380.00
Rate for Payer: UnitedHealthcare Commercial	$388.00
Rate for Payer: WPPA Commercial	$336.00

TRIMMING DYSTROPHIC NAILS

Facility

$96.00

Service Code	HCPCS G0127
Hospital Charge Code	G012723
Hospital Revenue Code	761
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$78.72

TRIMMING DYSTROPHIC NAILS

Facility

$96.00

Service Code	HCPCS G0127
Hospital Charge Code	G012723
Hospital Revenue Code	761
Min. Negotiated Rate	$44.35
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Celtic Commercial/Exchange	$44.35
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$80.64

TRIMMING NONDYSTROPHIC NAILS

Facility

$125.00

Service Code	HCPCS 11719
Hospital Charge Code	1171900
Hospital Revenue Code	761
Min. Negotiated Rate	$102.50
Max. Negotiated Rate	$121.25
Rate for Payer: Cash Price	$93.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$102.50

TRIMMING NONDYSTROPHIC NAILS

Facility

$125.00

Service Code	HCPCS 11719
Hospital Charge Code	1171900
Hospital Revenue Code	761
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$121.25
Rate for Payer: BCBS Commercial	$74.74
Rate for Payer: Cash Price	$93.75
Rate for Payer: Cash Price	$93.75
Rate for Payer: Celtic Commercial/Exchange	$57.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$105.00

TRIM NONDYSTROPHIC NAILS

Facility

$96.00

Service Code	HCPCS 11719
Hospital Charge Code	1171923
Hospital Revenue Code	761
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$78.72

TRIM NONDYSTROPHIC NAILS

Facility

$96.00

Service Code	HCPCS 11719
Hospital Charge Code	1171923
Hospital Revenue Code	761
Min. Negotiated Rate	$44.35
Max. Negotiated Rate	$93.12
Rate for Payer: BCBS Commercial	$74.74
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cash Price	$72.00
Rate for Payer: Celtic Commercial/Exchange	$44.35
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$80.64

TRIM SKIN LESION

Facility

$304.00

Service Code	HCPCS 11055
Hospital Charge Code	1105523
Hospital Revenue Code	761
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$294.88
Rate for Payer: BCBS Commercial	$248.38
Rate for Payer: Cash Price	$228.00
Rate for Payer: Cash Price	$228.00
Rate for Payer: Celtic Commercial/Exchange	$140.45
Rate for Payer: Health Partners Plans Commercial	$288.80
Rate for Payer: UnitedHealthcare Commercial	$294.88
Rate for Payer: WPPA Commercial	$255.36

TRIM SKIN LESION

Facility

$304.00

Service Code	HCPCS 11055
Hospital Charge Code	1105523
Hospital Revenue Code	761
Min. Negotiated Rate	$249.28
Max. Negotiated Rate	$294.88
Rate for Payer: Cash Price	$228.00
Rate for Payer: Health Partners Plans Commercial	$288.80
Rate for Payer: UnitedHealthcare Commercial	$294.88
Rate for Payer: WPPA Commercial	$249.28

TROPICAMIDE OPTHALMIC SOLUTION 1% - 15 ml

Facility

$222.00

Service Code	NDC 70069012101
Hospital Charge Code	2511434
Hospital Revenue Code	250
Min. Negotiated Rate	$182.04
Max. Negotiated Rate	$215.34
Rate for Payer: Cash Price	$167.18
Rate for Payer: Health Partners Plans Commercial	$210.90
Rate for Payer: UnitedHealthcare Commercial	$215.34
Rate for Payer: WPPA Commercial	$182.04

TROPICAMIDE OPTHALMIC SOLUTION 1% - 15 ml

Facility

$222.00

Service Code	NDC 70069012101
Hospital Charge Code	2511434
Hospital Revenue Code	250
Min. Negotiated Rate	$102.56
Max. Negotiated Rate	$215.34
Rate for Payer: Cash Price	$167.18
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

TROPONIN, HIGH SENSITIVE

Facility

$189.00

Service Code	HCPCS 84484
Hospital Charge Code	8448400
Hospital Revenue Code	301
Min. Negotiated Rate	$154.98
Max. Negotiated Rate	$183.33
Rate for Payer: Cash Price	$141.75
Rate for Payer: Health Partners Plans Commercial	$179.55
Rate for Payer: UnitedHealthcare Commercial	$183.33
Rate for Payer: WPPA Commercial	$154.98

Know your out-of-pocket cost for care.

All Charges