Ness County Hospital

All Charges

Charge

Type

Setting

Price

ZITHROMAX 500 MG INJ. (AZITHROMYCIN)

Facility

$97.00

Service Code	NDC 70860010010
Hospital Charge Code	2514172
Hospital Revenue Code	250
Min. Negotiated Rate	$44.81
Max. Negotiated Rate	$94.09
Rate for Payer: Cash Price	$73.12
Rate for Payer: Celtic Commercial/Exchange	$44.81
Rate for Payer: Health Partners Plans Commercial	$92.15
Rate for Payer: UnitedHealthcare Commercial	$94.09
Rate for Payer: WPPA Commercial	$81.48

ZITHROMAX 500 MG IV ADV (AZITHROMYCIN)

Facility

$56.00

Service Code	NDC 00409014421
Hospital Charge Code	2518249
Hospital Revenue Code	250
Min. Negotiated Rate	$25.87
Max. Negotiated Rate	$54.32
Rate for Payer: Cash Price	$42.68
Rate for Payer: Celtic Commercial/Exchange	$25.87
Rate for Payer: Health Partners Plans Commercial	$53.20
Rate for Payer: UnitedHealthcare Commercial	$54.32
Rate for Payer: WPPA Commercial	$47.04

ZITHROMAX 500 MG IV ADV (AZITHROMYCIN)

Facility

$56.00

Service Code	NDC 00409014421
Hospital Charge Code	2518249
Hospital Revenue Code	250
Min. Negotiated Rate	$45.92
Max. Negotiated Rate	$54.32
Rate for Payer: Cash Price	$42.68
Rate for Payer: Health Partners Plans Commercial	$53.20
Rate for Payer: UnitedHealthcare Commercial	$54.32
Rate for Payer: WPPA Commercial	$45.92

ZITHROMAX SUSPENSION 100 MG /5 ML - 15 ML (AZITHROMYCIN SUSPENSION)

Facility

$110.00

Service Code	NDC 00093202723
Hospital Charge Code	2514016
Hospital Revenue Code	250
Min. Negotiated Rate	$90.20
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$83.02
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$90.20

ZITHROMAX SUSPENSION 100 MG /5 ML - 15 ML (AZITHROMYCIN SUSPENSION)

Facility

$110.00

Service Code	NDC 00093202723
Hospital Charge Code	2514016
Hospital Revenue Code	250
Min. Negotiated Rate	$50.82
Max. Negotiated Rate	$106.70
Rate for Payer: Cash Price	$83.02
Rate for Payer: Celtic Commercial/Exchange	$50.82
Rate for Payer: Health Partners Plans Commercial	$104.50
Rate for Payer: UnitedHealthcare Commercial	$106.70
Rate for Payer: WPPA Commercial	$92.40

ZITHROMAX SUSPENSION 200 MG/5 ML - 30 ML (AZITHROMYCIN SUSPENSION)

Facility

$116.00

Service Code	NDC 00093202623
Hospital Charge Code	2514008
Hospital Revenue Code	250
Min. Negotiated Rate	$95.12
Max. Negotiated Rate	$112.52
Rate for Payer: Cash Price	$87.30
Rate for Payer: Health Partners Plans Commercial	$110.20
Rate for Payer: UnitedHealthcare Commercial	$112.52
Rate for Payer: WPPA Commercial	$95.12

ZITHROMAX SUSPENSION 200 MG/5 ML - 30 ML (AZITHROMYCIN SUSPENSION)

Facility

$116.00

Service Code	NDC 00093202623
Hospital Charge Code	2514008
Hospital Revenue Code	250
Min. Negotiated Rate	$53.59
Max. Negotiated Rate	$112.52
Rate for Payer: Cash Price	$87.30
Rate for Payer: Celtic Commercial/Exchange	$53.59
Rate for Payer: Health Partners Plans Commercial	$110.20
Rate for Payer: UnitedHealthcare Commercial	$112.52
Rate for Payer: WPPA Commercial	$97.44

ZOCOR 10 MG TAB (SIMVASTATIN)

Facility

$9.00

Service Code	NDC 68084051101
Hospital Charge Code	2512895
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.05
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

ZOCOR 10 MG TAB (SIMVASTATIN)

Facility

$9.00

Service Code	NDC 68084051101
Hospital Charge Code	2512895
Hospital Revenue Code	250
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$7.05
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ZOFRAN 4 MG/2 ML INJ. (ONDANSETRON HCL)

Facility

$80.00

Service Code	NDC 00641608025
Hospital Charge Code	2511301
Hospital Revenue Code	250
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.11
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

ZOFRAN 4 MG/2 ML INJ. (ONDANSETRON HCL)

Facility

$80.00

Service Code	NDC 00641608025
Hospital Charge Code	2511301
Hospital Revenue Code	250
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.11
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

ZOFRAN 4 MG/5ML ORAL SOLUTION

Facility

$124.00

Hospital Charge Code	2518835
Hospital Revenue Code	250
Min. Negotiated Rate	$101.68
Max. Negotiated Rate	$120.28
Rate for Payer: Cash Price	$93.52
Rate for Payer: Health Partners Plans Commercial	$117.80
Rate for Payer: UnitedHealthcare Commercial	$120.28
Rate for Payer: WPPA Commercial	$101.68

ZOFRAN 4 MG/5ML ORAL SOLUTION

Facility

$124.00

Hospital Charge Code	2518835
Hospital Revenue Code	250
Min. Negotiated Rate	$57.29
Max. Negotiated Rate	$120.28
Rate for Payer: Cash Price	$93.52
Rate for Payer: Celtic Commercial/Exchange	$57.29
Rate for Payer: Health Partners Plans Commercial	$117.80
Rate for Payer: UnitedHealthcare Commercial	$120.28
Rate for Payer: WPPA Commercial	$104.16

ZOFRAN 4 MG ODT TAB (ONDANSETRON)

Facility

$99.00

Service Code	NDC 68001024617
Hospital Charge Code	2519304
Hospital Revenue Code	250
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.85
Rate for Payer: Celtic Commercial/Exchange	$45.74
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$83.16

ZOFRAN 4 MG ODT TAB (ONDANSETRON)

Facility

$99.00

Service Code	NDC 68001024617
Hospital Charge Code	2519304
Hospital Revenue Code	250
Min. Negotiated Rate	$81.18
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.85
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$81.18

ZOLOFT 25 MG TAB (SERTRALINE)

Facility

$1.00

Service Code	NDC 60687023101
Hospital Charge Code	2518595
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.01
Rate for Payer: Celtic Commercial/Exchange	$0.46
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.84

ZOLOFT 25 MG TAB (SERTRALINE)

Facility

$1.00

Service Code	NDC 60687023101
Hospital Charge Code	2518595
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.01
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

Zometa 4 mg/5 ml (zoledronic acid)

Facility

$3,224.00

Service Code	NDC 00078038725
Hospital Charge Code	2517183
Hospital Revenue Code	250
Min. Negotiated Rate	$2,643.68
Max. Negotiated Rate	$3,127.28
Rate for Payer: Cash Price	$2,418.19
Rate for Payer: Health Partners Plans Commercial	$3,062.80
Rate for Payer: UnitedHealthcare Commercial	$3,127.28
Rate for Payer: WPPA Commercial	$2,643.68

Zometa 4 mg/5 ml (zoledronic acid)

Facility

$3,224.00

Service Code	NDC 00078038725
Hospital Charge Code	2517183
Hospital Revenue Code	250
Min. Negotiated Rate	$1,489.49
Max. Negotiated Rate	$3,127.28
Rate for Payer: Cash Price	$2,418.19
Rate for Payer: Celtic Commercial/Exchange	$1,489.49
Rate for Payer: Health Partners Plans Commercial	$3,062.80
Rate for Payer: UnitedHealthcare Commercial	$3,127.28
Rate for Payer: WPPA Commercial	$2,708.16

ZONISAMIDE

Facility

$75.00

Service Code	HCPCS 80203
Hospital Charge Code	8020300
Hospital Revenue Code	301
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$36.08
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

ZONISAMIDE

Facility

$75.00

Service Code	HCPCS 80203
Hospital Charge Code	8020300
Hospital Revenue Code	301
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

Zosyn 2.25 GM IV(piperacillin-tazobactam)

Facility

$45.00

Service Code	NDC 44567080110
Hospital Charge Code	2515187
Hospital Revenue Code	250
Min. Negotiated Rate	$20.79
Max. Negotiated Rate	$43.65
Rate for Payer: Cash Price	$34.42
Rate for Payer: Celtic Commercial/Exchange	$20.79
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$37.80

Zosyn 2.25 GM IV(piperacillin-tazobactam)

Facility

$45.00

Service Code	NDC 44567080110
Hospital Charge Code	2515187
Hospital Revenue Code	250
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$43.65
Rate for Payer: Cash Price	$34.42
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$36.90

ZOSYN 3.375 GM IV

Facility

$69.00

Hospital Charge Code	2514719
Hospital Revenue Code	250
Min. Negotiated Rate	$31.88
Max. Negotiated Rate	$66.93
Rate for Payer: Cash Price	$52.24
Rate for Payer: Celtic Commercial/Exchange	$31.88
Rate for Payer: Health Partners Plans Commercial	$65.55
Rate for Payer: UnitedHealthcare Commercial	$66.93
Rate for Payer: WPPA Commercial	$57.96

ZOSYN 3.375 GM IV

Facility

$69.00

Hospital Charge Code	2514719
Hospital Revenue Code	250
Min. Negotiated Rate	$56.58
Max. Negotiated Rate	$66.93
Rate for Payer: Cash Price	$52.24
Rate for Payer: Health Partners Plans Commercial	$65.55
Rate for Payer: UnitedHealthcare Commercial	$66.93
Rate for Payer: WPPA Commercial	$56.58

Know your out-of-pocket cost for care.

All Charges