Ness County Hospital

All Charges

Charge

Type

Setting

Price

URINAL MALE W/ TRANS LID 1QT

Facility

$5.00

Hospital Charge Code	2707949
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

URINAL MALE W/ TRANS LID 1QT

Facility

$5.00

Hospital Charge Code	2707949
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

URINALYSIS,AUTOMATED W/MICRO

Facility

$62.00

Service Code	HCPCS 81001
Hospital Charge Code	8100100
Hospital Revenue Code	307
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$46.50
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

URINALYSIS,AUTOMATED W/MICRO

Facility

$62.00

Service Code	HCPCS 81001
Hospital Charge Code	8100100
Hospital Revenue Code	307
Min. Negotiated Rate	$9.72
Max. Negotiated Rate	$60.14
Rate for Payer: BCBS Commercial	$9.72
Rate for Payer: Cash Price	$46.50
Rate for Payer: Cash Price	$46.50
Rate for Payer: Celtic Commercial/Exchange	$28.64
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$52.08

URINALYSIS,AUTOMATED W/O MICRO

Facility

$44.00

Service Code	HCPCS 81003
Hospital Charge Code	8100300
Hospital Revenue Code	307
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$42.68
Rate for Payer: BCBS Commercial	$9.20
Rate for Payer: Cash Price	$33.00
Rate for Payer: Cash Price	$33.00
Rate for Payer: Celtic Commercial/Exchange	$20.33
Rate for Payer: Health Partners Plans Commercial	$41.80
Rate for Payer: UnitedHealthcare Commercial	$42.68
Rate for Payer: WPPA Commercial	$36.96

URINALYSIS,AUTOMATED W/O MICRO

Facility

$44.00

Service Code	HCPCS 81003
Hospital Charge Code	8100300
Hospital Revenue Code	307
Min. Negotiated Rate	$36.08
Max. Negotiated Rate	$42.68
Rate for Payer: Cash Price	$33.00
Rate for Payer: Health Partners Plans Commercial	$41.80
Rate for Payer: UnitedHealthcare Commercial	$42.68
Rate for Payer: WPPA Commercial	$36.08

URINARY DRAIN BAG

Facility

$24.00

Hospital Charge Code	2720217
Hospital Revenue Code	272
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$19.68

URINARY DRAIN BAG

Facility

$24.00

Hospital Charge Code	2720217LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Celtic Commercial/Exchange	$11.09
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$20.16

URINARY DRAIN BAG

Facility

$24.00

Hospital Charge Code	2720217LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$19.68

URINARY DRAIN BAG

Facility

$24.00

Hospital Charge Code	2720217
Hospital Revenue Code	272
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Celtic Commercial/Exchange	$11.09
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$20.16

URINARY LEG BAG KIT

Facility

$37.00

Hospital Charge Code	2720280
Hospital Revenue Code	272
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$28.31
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$30.34

URINARY LEG BAG KIT

Facility

$37.00

Hospital Charge Code	2720280
Hospital Revenue Code	272
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$28.31
Rate for Payer: Celtic Commercial/Exchange	$17.09
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$31.08

URINARY STONES WITH MCC

Facility

$11,974.42

Service Code	MSDRG 693
Min. Negotiated Rate	$11,974.42
Max. Negotiated Rate	$11,974.42
Rate for Payer: BCBS Commercial	$11,974.42

URINARY STONES WITHOUT MCC

Facility

$7,857.04

Service Code	MSDRG 694
Min. Negotiated Rate	$7,857.04
Max. Negotiated Rate	$7,857.04
Rate for Payer: BCBS Commercial	$7,857.04

URINE COLLECTOR U-BAG NEWBORN

Facility

$5.00

Hospital Charge Code	2707948
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

URINE COLLECTOR U-BAG NEWBORN

Facility

$5.00

Hospital Charge Code	2707948
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

URINE METER

Facility

$46.00

Hospital Charge Code	2720241
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$44.62
Rate for Payer: Cash Price	$34.50
Rate for Payer: Celtic Commercial/Exchange	$21.25
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$38.64

URINE METER

Facility

$46.00

Hospital Charge Code	2720241
Hospital Revenue Code	272
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$44.62
Rate for Payer: Cash Price	$34.50
Rate for Payer: Health Partners Plans Commercial	$43.70
Rate for Payer: UnitedHealthcare Commercial	$44.62
Rate for Payer: WPPA Commercial	$37.72

URINE SULFATE (ACID) LEVEL

Facility

$36.00

Service Code	HCPCS 84392
Hospital Charge Code	8439200
Hospital Revenue Code	301
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$34.92
Rate for Payer: BCBS Commercial	$10.26
Rate for Payer: Cash Price	$27.00
Rate for Payer: Cash Price	$27.00
Rate for Payer: Celtic Commercial/Exchange	$16.63
Rate for Payer: Health Partners Plans Commercial	$34.20
Rate for Payer: UnitedHealthcare Commercial	$34.92
Rate for Payer: WPPA Commercial	$30.24

URINE SULFATE (ACID) LEVEL

Facility

$36.00

Service Code	HCPCS 84392
Hospital Charge Code	8439200
Hospital Revenue Code	301
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$34.92
Rate for Payer: Cash Price	$27.00
Rate for Payer: Health Partners Plans Commercial	$34.20
Rate for Payer: UnitedHealthcare Commercial	$34.92
Rate for Payer: WPPA Commercial	$29.52

URO-JET 5 ML SYRINGE (LIDOCAINE HCL JELLY 2%)

Facility

$28.00

Service Code	NDC 76329301205
Hospital Charge Code	2514149
Hospital Revenue Code	270
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.67
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$22.96

URO-JET 5 ML SYRINGE (LIDOCAINE HCL JELLY 2%)

Facility

$28.00

Service Code	NDC 76329301205
Hospital Charge Code	2514149
Hospital Revenue Code	270
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.67
Rate for Payer: Celtic Commercial/Exchange	$12.94
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$23.52

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC

Facility

$15,404.91

Service Code	MSDRG 742
Min. Negotiated Rate	$15,404.91
Max. Negotiated Rate	$15,404.91
Rate for Payer: BCBS Commercial	$15,404.91

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC

Facility

$10,492.93

Service Code	MSDRG 743
Min. Negotiated Rate	$10,492.93
Max. Negotiated Rate	$10,492.93
Rate for Payer: BCBS Commercial	$10,492.93

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC

Facility

$15,990.11

Service Code	MSDRG 740
Min. Negotiated Rate	$15,990.11
Max. Negotiated Rate	$15,990.11
Rate for Payer: BCBS Commercial	$15,990.11

Know your out-of-pocket cost for care.

All Charges