Ness County Hospital

All Charges

Charge

Type

Setting

Price

TROPONIN, HIGH SENSITIVE

Facility

$189.00

Service Code	HCPCS 84484
Hospital Charge Code	8448400
Hospital Revenue Code	301
Min. Negotiated Rate	$68.59
Max. Negotiated Rate	$183.33
Rate for Payer: BCBS Commercial	$68.59
Rate for Payer: Cash Price	$141.75
Rate for Payer: Cash Price	$141.75
Rate for Payer: Celtic Commercial/Exchange	$87.32
Rate for Payer: Health Partners Plans Commercial	$179.55
Rate for Payer: UnitedHealthcare Commercial	$183.33
Rate for Payer: WPPA Commercial	$158.76

TRUFORM MEN'S SOCK FIRM

Facility

$39.00

Hospital Charge Code	2704200
Hospital Revenue Code	270
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.62
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

TRUFORM MEN'S SOCK FIRM

Facility

$39.00

Hospital Charge Code	2704200
Hospital Revenue Code	270
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.62
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

TSH RECEPTOR BINDING ANTIBODY

Facility

$159.00

Service Code	HCPCS 83520
Hospital Charge Code	8352004
Hospital Revenue Code	301
Min. Negotiated Rate	$36.48
Max. Negotiated Rate	$154.23
Rate for Payer: BCBS Commercial	$36.48
Rate for Payer: Cash Price	$119.25
Rate for Payer: Cash Price	$119.25
Rate for Payer: Celtic Commercial/Exchange	$73.46
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$133.56

TSH RECEPTOR BINDING ANTIBODY

Facility

$159.00

Service Code	HCPCS 83520
Hospital Charge Code	8352004
Hospital Revenue Code	301
Min. Negotiated Rate	$130.38
Max. Negotiated Rate	$154.23
Rate for Payer: Cash Price	$119.25
Rate for Payer: Health Partners Plans Commercial	$151.05
Rate for Payer: UnitedHealthcare Commercial	$154.23
Rate for Payer: WPPA Commercial	$130.38

T-SPINE 2 VIEW

Facility

$288.00

Service Code	HCPCS 72070
Hospital Charge Code	3270008
Hospital Revenue Code	320
Min. Negotiated Rate	$236.16
Max. Negotiated Rate	$279.36
Rate for Payer: Cash Price	$216.00
Rate for Payer: Health Partners Plans Commercial	$273.60
Rate for Payer: UnitedHealthcare Commercial	$279.36
Rate for Payer: WPPA Commercial	$236.16

T-SPINE 2 VIEW

Facility

$288.00

Service Code	HCPCS 72070
Hospital Charge Code	3270008
Hospital Revenue Code	320
Min. Negotiated Rate	$133.06
Max. Negotiated Rate	$279.36
Rate for Payer: BCBS Commercial	$133.80
Rate for Payer: Cash Price	$216.00
Rate for Payer: Cash Price	$216.00
Rate for Payer: Celtic Commercial/Exchange	$133.06
Rate for Payer: Health Partners Plans Commercial	$273.60
Rate for Payer: UnitedHealthcare Commercial	$279.36
Rate for Payer: WPPA Commercial	$241.92

T-SPINE 3 VIEWS

Facility

$394.00

Service Code	HCPCS 72072
Hospital Charge Code	3270018
Hospital Revenue Code	320
Min. Negotiated Rate	$323.08
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$295.50
Rate for Payer: Health Partners Plans Commercial	$374.30
Rate for Payer: UnitedHealthcare Commercial	$382.18
Rate for Payer: WPPA Commercial	$323.08

T-SPINE 3 VIEWS

Facility

$394.00

Service Code	HCPCS 72072
Hospital Charge Code	3270018
Hospital Revenue Code	320
Min. Negotiated Rate	$182.03
Max. Negotiated Rate	$382.18
Rate for Payer: BCBS Commercial	$201.64
Rate for Payer: Cash Price	$295.50
Rate for Payer: Cash Price	$295.50
Rate for Payer: Celtic Commercial/Exchange	$182.03
Rate for Payer: Health Partners Plans Commercial	$374.30
Rate for Payer: UnitedHealthcare Commercial	$382.18
Rate for Payer: WPPA Commercial	$330.96

T-SPINE 4 VIEWS MINIMUM

Facility

$237.00

Service Code	HCPCS 72074
Hospital Charge Code	3270009
Hospital Revenue Code	320
Min. Negotiated Rate	$194.34
Max. Negotiated Rate	$229.89
Rate for Payer: Cash Price	$178.20
Rate for Payer: Health Partners Plans Commercial	$225.15
Rate for Payer: UnitedHealthcare Commercial	$229.89
Rate for Payer: WPPA Commercial	$194.34

T-SPINE 4 VIEWS MINIMUM

Facility

$237.00

Service Code	HCPCS 72074
Hospital Charge Code	3270009
Hospital Revenue Code	320
Min. Negotiated Rate	$109.49
Max. Negotiated Rate	$229.89
Rate for Payer: BCBS Commercial	$169.11
Rate for Payer: Cash Price	$178.20
Rate for Payer: Cash Price	$178.20
Rate for Payer: Celtic Commercial/Exchange	$109.49
Rate for Payer: Health Partners Plans Commercial	$225.15
Rate for Payer: UnitedHealthcare Commercial	$229.89
Rate for Payer: WPPA Commercial	$199.08

TTG IGA

Facility

$135.00

Service Code	HCPCS 86364
Hospital Charge Code	8636400
Hospital Revenue Code	302
Min. Negotiated Rate	$110.70
Max. Negotiated Rate	$130.95
Rate for Payer: Cash Price	$101.25
Rate for Payer: Health Partners Plans Commercial	$128.25
Rate for Payer: UnitedHealthcare Commercial	$130.95
Rate for Payer: WPPA Commercial	$110.70

TTG IGA

Facility

$135.00

Service Code	HCPCS 86364
Hospital Charge Code	8636400
Hospital Revenue Code	302
Min. Negotiated Rate	$21.62
Max. Negotiated Rate	$130.95
Rate for Payer: BCBS Commercial	$21.62
Rate for Payer: Cash Price	$101.25
Rate for Payer: Cash Price	$101.25
Rate for Payer: Celtic Commercial/Exchange	$62.37
Rate for Payer: Health Partners Plans Commercial	$128.25
Rate for Payer: UnitedHealthcare Commercial	$130.95
Rate for Payer: WPPA Commercial	$113.40

TUBE ATTACHMENT DEVICE

Facility

$9.00

Hospital Charge Code	2700546
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
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

TUBE ATTACHMENT DEVICE

Facility

$9.00

Hospital Charge Code	2700546
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

TUBE GASTRO-ENTERIC

Facility

$573.00

Hospital Charge Code	2700701
Hospital Revenue Code	270
Min. Negotiated Rate	$264.73
Max. Negotiated Rate	$555.81
Rate for Payer: Cash Price	$429.75
Rate for Payer: Celtic Commercial/Exchange	$264.73
Rate for Payer: Health Partners Plans Commercial	$544.35
Rate for Payer: UnitedHealthcare Commercial	$555.81
Rate for Payer: WPPA Commercial	$481.32

TUBE GASTRO-ENTERIC

Facility

$573.00

Hospital Charge Code	2700701
Hospital Revenue Code	270
Min. Negotiated Rate	$469.86
Max. Negotiated Rate	$555.81
Rate for Payer: Cash Price	$429.75
Rate for Payer: Health Partners Plans Commercial	$544.35
Rate for Payer: UnitedHealthcare Commercial	$555.81
Rate for Payer: WPPA Commercial	$469.86

TUB GRAB BAR

Facility

$169.00

Hospital Charge Code	5710298
Hospital Revenue Code	271
Min. Negotiated Rate	$78.08
Max. Negotiated Rate	$163.93
Rate for Payer: Cash Price	$127.12
Rate for Payer: Celtic Commercial/Exchange	$78.08
Rate for Payer: Health Partners Plans Commercial	$160.55
Rate for Payer: UnitedHealthcare Commercial	$163.93
Rate for Payer: WPPA Commercial	$141.96

TUB GRAB BAR

Facility

$169.00

Hospital Charge Code	5710298
Hospital Revenue Code	271
Min. Negotiated Rate	$138.58
Max. Negotiated Rate	$163.93
Rate for Payer: Cash Price	$127.12
Rate for Payer: Health Partners Plans Commercial	$160.55
Rate for Payer: UnitedHealthcare Commercial	$163.93
Rate for Payer: WPPA Commercial	$138.58

TUBI GRIP

Facility

$103.00

Hospital Charge Code	2708989
Hospital Revenue Code	270
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.96
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

TUBI GRIP

Facility

$103.00

Hospital Charge Code	2708989
Hospital Revenue Code	270
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.96
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$84.46

TUBING HUMIDIFIER ADAPTER 15"

Facility

$5.00

Hospital Charge Code	2700702
Hospital Revenue Code	270
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

TUBING HUMIDIFIER ADAPTER 15"

Facility

$5.00

Hospital Charge Code	2700702
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
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

TUBING HUMIDIFIER LTC

Facility

$5.00

Hospital Charge Code	2700702LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
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

TUBING HUMIDIFIER LTC

Facility

$5.00

Hospital Charge Code	2700702LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
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