Ness County Hospital

All Charges

Charge

Type

Setting

Price

VANCOMYCIN 250 MG CAP

Facility

$173.00

Hospital Charge Code	2519445
Hospital Revenue Code	250
Min. Negotiated Rate	$141.86
Max. Negotiated Rate	$167.81
Rate for Payer: Cash Price	$129.86
Rate for Payer: Health Partners Plans Commercial	$164.35
Rate for Payer: UnitedHealthcare Commercial	$167.81
Rate for Payer: WPPA Commercial	$141.86

VANCOMYCIN 250 MG CAP

Facility

$173.00

Hospital Charge Code	2519445
Hospital Revenue Code	250
Min. Negotiated Rate	$79.93
Max. Negotiated Rate	$167.81
Rate for Payer: Cash Price	$129.86
Rate for Payer: Celtic Commercial/Exchange	$79.93
Rate for Payer: Health Partners Plans Commercial	$164.35
Rate for Payer: UnitedHealthcare Commercial	$167.81
Rate for Payer: WPPA Commercial	$145.32

VANCOMYCIN 500 MG/100 ML - PREMIX

Facility

$54.00

Service Code	NDC 70594004101
Hospital Charge Code	2519593
Hospital Revenue Code	250
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

VANCOMYCIN 500 MG/100 ML - PREMIX

Facility

$54.00

Service Code	NDC 70594004101
Hospital Charge Code	2519593
Hospital Revenue Code	250
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

VANCOMYCIN 750 MG/150 ML - PREMIX

Facility

$81.00

Service Code	NDC 70594005601
Hospital Charge Code	2519874
Hospital Revenue Code	250
Min. Negotiated Rate	$66.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.75
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$66.42

VANCOMYCIN 750 MG/150 ML - PREMIX

Facility

$81.00

Service Code	NDC 70594005601
Hospital Charge Code	2519874
Hospital Revenue Code	250
Min. Negotiated Rate	$37.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.75
Rate for Payer: Celtic Commercial/Exchange	$37.42
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$68.04

VANCOMYCIN 750 MG ADV

Facility

$5.00

Hospital Charge Code	2517910
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.96
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

VANCOMYCIN 750 MG ADV

Facility

$5.00

Hospital Charge Code	2517910
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.96
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

VANCOMYCIN HCL 125 MG CAP

Facility

$93.00

Service Code	NDC 00121086720
Hospital Charge Code	2519940
Hospital Revenue Code	250
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$70.46
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

VANCOMYCIN HCL 125 MG CAP

Facility

$93.00

Service Code	NDC 00121086720
Hospital Charge Code	2519940
Hospital Revenue Code	250
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$70.46
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

VANILLYLMANDELIC ACID VMA,URIN

Facility

$113.00

Service Code	HCPCS 84585
Hospital Charge Code	8458500
Hospital Revenue Code	301
Min. Negotiated Rate	$92.66
Max. Negotiated Rate	$109.61
Rate for Payer: Cash Price	$84.75
Rate for Payer: Health Partners Plans Commercial	$107.35
Rate for Payer: UnitedHealthcare Commercial	$109.61
Rate for Payer: WPPA Commercial	$92.66

VANILLYLMANDELIC ACID VMA,URIN

Facility

$113.00

Service Code	HCPCS 84585
Hospital Charge Code	8458500
Hospital Revenue Code	301
Min. Negotiated Rate	$52.21
Max. Negotiated Rate	$109.61
Rate for Payer: BCBS Commercial	$60.95
Rate for Payer: Cash Price	$84.75
Rate for Payer: Cash Price	$84.75
Rate for Payer: Celtic Commercial/Exchange	$52.21
Rate for Payer: Health Partners Plans Commercial	$107.35
Rate for Payer: UnitedHealthcare Commercial	$109.61
Rate for Payer: WPPA Commercial	$94.92

VASELINE GAUZE DRESSING 1/2X72

Facility

$23.00

Hospital Charge Code	2726245
Hospital Revenue Code	272
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

VASELINE GAUZE DRESSING 1/2X72

Facility

$23.00

Hospital Charge Code	2726245
Hospital Revenue Code	272
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

VASELINE GAUZE DRESSING 1 X 36

Facility

$9.00

Hospital Charge Code	2720894
Hospital Revenue Code	272
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

VASELINE GAUZE DRESSING 1 X 36

Facility

$9.00

Hospital Charge Code	2720894
Hospital Revenue Code	272
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

Vashe

Facility

$27.00

Hospital Charge Code	2725062
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

Vashe

Facility

$27.00

Hospital Charge Code	2725062
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

VA SKLD &/OR MEDBOX EA 15 MIN

Facility

$31.00

Service Code	HCPCS G0299
Hospital Charge Code	5710926
Hospital Revenue Code	550
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.44
Rate for Payer: Celtic Commercial/Exchange	$14.32
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$26.04

VA SKLD &/OR MEDBOX EA 15 MIN

Facility

$31.00

Service Code	HCPCS G0299
Hospital Charge Code	5710926
Hospital Revenue Code	550
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.44
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$25.42

Vasoactive Intestinal Peptide (VIP)

Facility

$119.00

Service Code	HCPCS 84586
Hospital Charge Code	8458600
Hospital Revenue Code	301
Min. Negotiated Rate	$54.98
Max. Negotiated Rate	$115.43
Rate for Payer: BCBS Commercial	$94.08
Rate for Payer: Cash Price	$89.25
Rate for Payer: Cash Price	$89.25
Rate for Payer: Celtic Commercial/Exchange	$54.98
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$99.96

Vasoactive Intestinal Peptide (VIP)

Facility

$119.00

Service Code	HCPCS 84586
Hospital Charge Code	8458600
Hospital Revenue Code	301
Min. Negotiated Rate	$97.58
Max. Negotiated Rate	$115.43
Rate for Payer: Cash Price	$89.25
Rate for Payer: Health Partners Plans Commercial	$113.05
Rate for Payer: UnitedHealthcare Commercial	$115.43
Rate for Payer: WPPA Commercial	$97.58

VASOPRESSIN 20U/ML INJ

Facility

$40.00

Hospital Charge Code	2512531
Hospital Revenue Code	250
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.60
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$32.80

VASOPRESSIN 20U/ML INJ

Facility

$40.00

Hospital Charge Code	2512531
Hospital Revenue Code	250
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.60
Rate for Payer: Celtic Commercial/Exchange	$18.48
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$33.60

VASOPRESSIN (ANTIDIURETIC HORM

Facility

$226.00

Service Code	HCPCS 84588
Hospital Charge Code	8458800
Hospital Revenue Code	301
Min. Negotiated Rate	$104.41
Max. Negotiated Rate	$219.22
Rate for Payer: BCBS Commercial	$128.50
Rate for Payer: Cash Price	$169.50
Rate for Payer: Cash Price	$169.50
Rate for Payer: Celtic Commercial/Exchange	$104.41
Rate for Payer: Health Partners Plans Commercial	$214.70
Rate for Payer: UnitedHealthcare Commercial	$219.22
Rate for Payer: WPPA Commercial	$189.84

Know your out-of-pocket cost for care.

All Charges