Ness County Hospital

All Charges

Charge

Type

Setting

Price

ARTERIAL EXTREM STUDY 3+LEVELS

Facility

$700.00

Service Code	HCPCS 93923
Hospital Charge Code	3320041
Hospital Revenue Code	921
Min. Negotiated Rate	$574.00
Max. Negotiated Rate	$679.00
Rate for Payer: Cash Price	$525.00
Rate for Payer: Health Partners Plans Commercial	$665.00
Rate for Payer: UnitedHealthcare Commercial	$679.00
Rate for Payer: WPPA Commercial	$574.00

ARTERIAL PUNCTURE

Facility

$117.00

Service Code	HCPCS 36600
Hospital Charge Code	3660000
Hospital Revenue Code	921
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

ARTERIAL PUNCTURE

Facility

$117.00

Service Code	HCPCS 36600
Hospital Charge Code	3660000
Hospital Revenue Code	921
Min. Negotiated Rate	$54.05
Max. Negotiated Rate	$113.49
Rate for Payer: BCBS Commercial	$67.67
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

ARTHRITIS SURVEY-SNGL VIEW,2OR

Facility

$180.00

Service Code	HCPCS 77077
Hospital Charge Code	7707700
Hospital Revenue Code	320
Min. Negotiated Rate	$83.16
Max. Negotiated Rate	$174.60
Rate for Payer: BCBS Commercial	$132.93
Rate for Payer: Cash Price	$135.00
Rate for Payer: Cash Price	$135.00
Rate for Payer: Celtic Commercial/Exchange	$83.16
Rate for Payer: Health Partners Plans Commercial	$171.00
Rate for Payer: UnitedHealthcare Commercial	$174.60
Rate for Payer: WPPA Commercial	$151.20

ARTHRITIS SURVEY-SNGL VIEW,2OR

Facility

$180.00

Service Code	HCPCS 77077
Hospital Charge Code	7707700
Hospital Revenue Code	320
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$174.60
Rate for Payer: Cash Price	$135.00
Rate for Payer: Health Partners Plans Commercial	$171.00
Rate for Payer: UnitedHealthcare Commercial	$174.60
Rate for Payer: WPPA Commercial	$147.60

ARTHROCENTESIS, ASP &/OR INJ

Facility

$325.00

Service Code	HCPCS 20605
Hospital Charge Code	2060500
Hospital Revenue Code	761
Min. Negotiated Rate	$266.50
Max. Negotiated Rate	$315.25
Rate for Payer: Cash Price	$243.75
Rate for Payer: Health Partners Plans Commercial	$308.75
Rate for Payer: UnitedHealthcare Commercial	$315.25
Rate for Payer: WPPA Commercial	$266.50

ARTHROCENTESIS, ASP &/OR INJ

Facility

$325.00

Service Code	HCPCS 20605
Hospital Charge Code	2060500
Hospital Revenue Code	761
Min. Negotiated Rate	$150.15
Max. Negotiated Rate	$368.99
Rate for Payer: BCBS Commercial	$368.99
Rate for Payer: Cash Price	$243.75
Rate for Payer: Cash Price	$243.75
Rate for Payer: Celtic Commercial/Exchange	$150.15
Rate for Payer: Health Partners Plans Commercial	$308.75
Rate for Payer: UnitedHealthcare Commercial	$315.25
Rate for Payer: WPPA Commercial	$273.00

ARTHROCENTESIS,ASP&/OR INJ

Facility

$400.00

Service Code	HCPCS 20600
Hospital Charge Code	2060000
Hospital Revenue Code	761
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$388.00
Rate for Payer: BCBS Commercial	$368.99
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

ARTHROCENTESIS,ASP&/OR INJ

Facility

$400.00

Service Code	HCPCS 20600
Hospital Charge Code	2060000
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

ARTHROCENTESIS, ASPR &/OR INJ.

Facility

$550.00

Service Code	HCPCS 20610
Hospital Charge Code	2061000
Hospital Revenue Code	761
Min. Negotiated Rate	$451.00
Max. Negotiated Rate	$533.50
Rate for Payer: Cash Price	$412.50
Rate for Payer: Health Partners Plans Commercial	$522.50
Rate for Payer: UnitedHealthcare Commercial	$533.50
Rate for Payer: WPPA Commercial	$451.00

ARTHROCENTESIS, ASPR &/OR INJ.

Facility

$550.00

Service Code	HCPCS 20610
Hospital Charge Code	2061000
Hospital Revenue Code	761
Min. Negotiated Rate	$254.10
Max. Negotiated Rate	$533.50
Rate for Payer: BCBS Commercial	$368.99
Rate for Payer: Cash Price	$412.50
Rate for Payer: Cash Price	$412.50
Rate for Payer: Celtic Commercial/Exchange	$254.10
Rate for Payer: Health Partners Plans Commercial	$522.50
Rate for Payer: UnitedHealthcare Commercial	$533.50
Rate for Payer: WPPA Commercial	$462.00

ARTHROTOMY W/EXPLOR,DRAIN,RMOV

Facility

$3,110.00

Service Code	HCPCS 26075
Hospital Charge Code	2607500
Hospital Revenue Code	450
Min. Negotiated Rate	$1,436.82
Max. Negotiated Rate	$3,016.70
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$2,332.50
Rate for Payer: Cash Price	$2,332.50
Rate for Payer: Celtic Commercial/Exchange	$1,436.82
Rate for Payer: Health Partners Plans Commercial	$2,954.50
Rate for Payer: UnitedHealthcare Commercial	$3,016.70
Rate for Payer: WPPA Commercial	$2,612.40

ARTHROTOMY W/EXPLOR,DRAIN,RMOV

Facility

$3,110.00

Service Code	HCPCS 26075
Hospital Charge Code	2607500
Hospital Revenue Code	450
Min. Negotiated Rate	$2,550.20
Max. Negotiated Rate	$3,016.70
Rate for Payer: Cash Price	$2,332.50
Rate for Payer: Health Partners Plans Commercial	$2,954.50
Rate for Payer: UnitedHealthcare Commercial	$3,016.70
Rate for Payer: WPPA Commercial	$2,550.20

ARTHROT W/EXPL DRN/REMV FB CM

Facility

$2,150.00

Service Code	HCPCS 26070
Hospital Charge Code	2607000
Hospital Revenue Code	450
Min. Negotiated Rate	$993.30
Max. Negotiated Rate	$2,085.50
Rate for Payer: BCBS Commercial	$2,000.51
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Celtic Commercial/Exchange	$993.30
Rate for Payer: Health Partners Plans Commercial	$2,042.50
Rate for Payer: UnitedHealthcare Commercial	$2,085.50
Rate for Payer: WPPA Commercial	$1,806.00

ARTHROT W/EXPL DRN/REMV FB CM

Facility

$2,150.00

Service Code	HCPCS 26070
Hospital Charge Code	2607000
Hospital Revenue Code	450
Min. Negotiated Rate	$1,763.00
Max. Negotiated Rate	$2,085.50
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Health Partners Plans Commercial	$2,042.50
Rate for Payer: UnitedHealthcare Commercial	$2,085.50
Rate for Payer: WPPA Commercial	$1,763.00

ASA SUPPOSITORY 300MG(5GR)

Facility

$4.00

Hospital Charge Code	2500031
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.41
Rate for Payer: Celtic Commercial/Exchange	$1.85
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.36

ASA SUPPOSITORY 300MG(5GR)

Facility

$4.00

Hospital Charge Code	2500031
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.41
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

ASCA (IGG, IGA)

Facility

$250.00

Hospital Charge Code	8888956
Hospital Revenue Code	302
Min. Negotiated Rate	$205.00
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$205.00

ASCA (IGG, IGA)

Facility

$250.00

Hospital Charge Code	8888956
Hospital Revenue Code	302
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Celtic Commercial/Exchange	$115.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$210.00

ASEPTO SYRINGE DISPOSABLE

Facility

$10.00

Hospital Charge Code	2700276
Hospital Revenue Code	270
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.50
Rate for Payer: Celtic Commercial/Exchange	$4.62
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.40

ASEPTO SYRINGE DISPOSABLE

Facility

$10.00

Hospital Charge Code	2700276
Hospital Revenue Code	270
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$9.70
Rate for Payer: Cash Price	$7.50
Rate for Payer: Health Partners Plans Commercial	$9.50
Rate for Payer: UnitedHealthcare Commercial	$9.70
Rate for Payer: WPPA Commercial	$8.20

ASPIRATE PLEURA W/IMAGING

Facility

$1,214.00

Service Code	HCPCS 32555
Hospital Charge Code	3255500
Hospital Revenue Code	761
Min. Negotiated Rate	$560.87
Max. Negotiated Rate	$1,177.58
Rate for Payer: BCBS Commercial	$862.54
Rate for Payer: Cash Price	$910.50
Rate for Payer: Cash Price	$910.50
Rate for Payer: Celtic Commercial/Exchange	$560.87
Rate for Payer: Health Partners Plans Commercial	$1,153.30
Rate for Payer: UnitedHealthcare Commercial	$1,177.58
Rate for Payer: WPPA Commercial	$1,019.76

ASPIRATE PLEURA W/IMAGING

Facility

$1,214.00

Service Code	HCPCS 32555
Hospital Charge Code	3255500
Hospital Revenue Code	761
Min. Negotiated Rate	$995.48
Max. Negotiated Rate	$1,177.58
Rate for Payer: Cash Price	$910.50
Rate for Payer: Health Partners Plans Commercial	$1,153.30
Rate for Payer: UnitedHealthcare Commercial	$1,177.58
Rate for Payer: WPPA Commercial	$995.48

ASPIRATE PLEURA W/O IMAGING

Facility

$950.00

Service Code	HCPCS 32554
Hospital Charge Code	3255400
Hospital Revenue Code	761
Min. Negotiated Rate	$438.90
Max. Negotiated Rate	$921.50
Rate for Payer: BCBS Commercial	$742.35
Rate for Payer: Cash Price	$712.50
Rate for Payer: Cash Price	$712.50
Rate for Payer: Celtic Commercial/Exchange	$438.90
Rate for Payer: Health Partners Plans Commercial	$902.50
Rate for Payer: UnitedHealthcare Commercial	$921.50
Rate for Payer: WPPA Commercial	$798.00

ASPIRATE PLEURA W/O IMAGING

Facility

$950.00

Service Code	HCPCS 32554
Hospital Charge Code	3255400
Hospital Revenue Code	761
Min. Negotiated Rate	$779.00
Max. Negotiated Rate	$921.50
Rate for Payer: Cash Price	$712.50
Rate for Payer: Health Partners Plans Commercial	$902.50
Rate for Payer: UnitedHealthcare Commercial	$921.50
Rate for Payer: WPPA Commercial	$779.00

Know your out-of-pocket cost for care.

All Charges