Ness County Hospital

All Charges

Charge

Type

Setting

Price

ASPIRATION/INJ SMALL JNT/BURSA

Facility

$450.00

Service Code	HCPCS 20600
Hospital Charge Code	2060023
Hospital Revenue Code	761
Min. Negotiated Rate	$369.00
Max. Negotiated Rate	$436.50
Rate for Payer: Cash Price	$337.50
Rate for Payer: Health Partners Plans Commercial	$427.50
Rate for Payer: UnitedHealthcare Commercial	$436.50
Rate for Payer: WPPA Commercial	$369.00

ASPIRATION/INJ SMALL JNT/BURSA

Facility

$450.00

Service Code	HCPCS 20600
Hospital Charge Code	2060023
Hospital Revenue Code	761
Min. Negotiated Rate	$207.90
Max. Negotiated Rate	$436.50
Rate for Payer: BCBS Commercial	$368.99
Rate for Payer: Cash Price	$337.50
Rate for Payer: Cash Price	$337.50
Rate for Payer: Celtic Commercial/Exchange	$207.90
Rate for Payer: Health Partners Plans Commercial	$427.50
Rate for Payer: UnitedHealthcare Commercial	$436.50
Rate for Payer: WPPA Commercial	$378.00

ASPIRIN 325 MG TAB

Facility

$1.00

Service Code	NDC 46122069178
Hospital Charge Code	2508687
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
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

ASPIRIN 325 MG TAB

Facility

$1.00

Service Code	NDC 46122069178
Hospital Charge Code	2508687
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$0.75
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ASPIRIN EC 325 MG TAB

Facility

$1.00

Service Code	NDC 57896092101
Hospital Charge Code	2508810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
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

ASPIRIN EC 325 MG TAB

Facility

$1.00

Service Code	NDC 57896092101
Hospital Charge Code	2508810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ASPIR/INJ INTERMED JOINT/BURSA

Facility

$470.00

Service Code	HCPCS 20605
Hospital Charge Code	2060523
Hospital Revenue Code	761
Min. Negotiated Rate	$217.14
Max. Negotiated Rate	$455.90
Rate for Payer: BCBS Commercial	$368.99
Rate for Payer: Cash Price	$352.50
Rate for Payer: Cash Price	$352.50
Rate for Payer: Celtic Commercial/Exchange	$217.14
Rate for Payer: Health Partners Plans Commercial	$446.50
Rate for Payer: UnitedHealthcare Commercial	$455.90
Rate for Payer: WPPA Commercial	$394.80

ASPIR/INJ INTERMED JOINT/BURSA

Facility

$470.00

Service Code	HCPCS 20605
Hospital Charge Code	2060523
Hospital Revenue Code	761
Min. Negotiated Rate	$385.40
Max. Negotiated Rate	$455.90
Rate for Payer: Cash Price	$352.50
Rate for Payer: Health Partners Plans Commercial	$446.50
Rate for Payer: UnitedHealthcare Commercial	$455.90
Rate for Payer: WPPA Commercial	$385.40

Assay Interleukin-6

Facility

$75.00

Service Code	HCPCS 83529
Hospital Charge Code	8352900
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

Assay Interleukin-6

Facility

$75.00

Service Code	HCPCS 83529
Hospital Charge Code	8352900
Hospital Revenue Code	301
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
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

ASSAY OF LIPOPROTEIN (A)

Facility

$78.00

Service Code	HCPCS 83695
Hospital Charge Code	8369500
Hospital Revenue Code	301
Min. Negotiated Rate	$63.96
Max. Negotiated Rate	$75.66
Rate for Payer: Cash Price	$58.50
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$63.96

ASSAY OF LIPOPROTEIN (A)

Facility

$78.00

Service Code	HCPCS 83695
Hospital Charge Code	8369500
Hospital Revenue Code	301
Min. Negotiated Rate	$28.79
Max. Negotiated Rate	$75.66
Rate for Payer: BCBS Commercial	$28.79
Rate for Payer: Cash Price	$58.50
Rate for Payer: Cash Price	$58.50
Rate for Payer: Celtic Commercial/Exchange	$36.04
Rate for Payer: Health Partners Plans Commercial	$74.10
Rate for Payer: UnitedHealthcare Commercial	$75.66
Rate for Payer: WPPA Commercial	$65.52

ASSESSMENT OF APHASIA, PER HR

Facility

$200.00

Service Code	HCPCS 96105 GN
Hospital Charge Code	9610500
Hospital Revenue Code	444
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$194.00
Rate for Payer: BCBS Commercial	$136.68
Rate for Payer: Cash Price	$150.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Celtic Commercial/Exchange	$92.40
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$168.00

ASSESSMENT OF APHASIA, PER HR

Facility

$200.00

Service Code	HCPCS 96105 GN
Hospital Charge Code	9610500
Hospital Revenue Code	444
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$194.00
Rate for Payer: Cash Price	$150.00
Rate for Payer: Health Partners Plans Commercial	$190.00
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: WPPA Commercial	$164.00

ASSY OF CARNITINE

Facility

$293.00

Service Code	HCPCS 82379
Hospital Charge Code	8237900
Hospital Revenue Code	301
Min. Negotiated Rate	$135.37
Max. Negotiated Rate	$284.21
Rate for Payer: BCBS Commercial	$193.77
Rate for Payer: Cash Price	$219.75
Rate for Payer: Cash Price	$219.75
Rate for Payer: Celtic Commercial/Exchange	$135.37
Rate for Payer: Health Partners Plans Commercial	$278.35
Rate for Payer: UnitedHealthcare Commercial	$284.21
Rate for Payer: WPPA Commercial	$246.12

ASSY OF CARNITINE

Facility

$293.00

Service Code	HCPCS 82379
Hospital Charge Code	8237900
Hospital Revenue Code	301
Min. Negotiated Rate	$240.26
Max. Negotiated Rate	$284.21
Rate for Payer: Cash Price	$219.75
Rate for Payer: Health Partners Plans Commercial	$278.35
Rate for Payer: UnitedHealthcare Commercial	$284.21
Rate for Payer: WPPA Commercial	$240.26

ASSY OF MANGANESE, BLOOD

Facility

$65.00

Service Code	HCPCS 83785
Hospital Charge Code	8378500
Hospital Revenue Code	301
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$63.05
Rate for Payer: Cash Price	$48.75
Rate for Payer: Health Partners Plans Commercial	$61.75
Rate for Payer: UnitedHealthcare Commercial	$63.05
Rate for Payer: WPPA Commercial	$53.30

ASSY OF MANGANESE, BLOOD

Facility

$65.00

Service Code	HCPCS 83785
Hospital Charge Code	8378500
Hospital Revenue Code	301
Min. Negotiated Rate	$30.03
Max. Negotiated Rate	$67.14
Rate for Payer: BCBS Commercial	$67.14
Rate for Payer: Cash Price	$48.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Celtic Commercial/Exchange	$30.03
Rate for Payer: Health Partners Plans Commercial	$61.75
Rate for Payer: UnitedHealthcare Commercial	$63.05
Rate for Payer: WPPA Commercial	$54.60

ASSY OF SELENIUM

Facility

$156.00

Service Code	HCPCS 84255
Hospital Charge Code	8425500
Hospital Revenue Code	301
Min. Negotiated Rate	$127.92
Max. Negotiated Rate	$151.32
Rate for Payer: Cash Price	$117.00
Rate for Payer: Health Partners Plans Commercial	$148.20
Rate for Payer: UnitedHealthcare Commercial	$151.32
Rate for Payer: WPPA Commercial	$127.92

ASSY OF SELENIUM

Facility

$156.00

Service Code	HCPCS 84255
Hospital Charge Code	8425500
Hospital Revenue Code	301
Min. Negotiated Rate	$72.07
Max. Negotiated Rate	$151.32
Rate for Payer: BCBS Commercial	$80.20
Rate for Payer: Cash Price	$117.00
Rate for Payer: Cash Price	$117.00
Rate for Payer: Celtic Commercial/Exchange	$72.07
Rate for Payer: Health Partners Plans Commercial	$148.20
Rate for Payer: UnitedHealthcare Commercial	$151.32
Rate for Payer: WPPA Commercial	$131.04

ATARAX 10 MG TAB(HYDROXYZINE HCL)

Facility

$1.00

Service Code	NDC 68084025301
Hospital Charge Code	2508372
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.39
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

ATARAX 10 MG TAB(HYDROXYZINE HCL)

Facility

$1.00

Service Code	NDC 68084025301
Hospital Charge Code	2508372
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.39
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

ATARAX 25 MG TAB(HYDROXYZINE HCL)

Facility

$2.00

Service Code	NDC 68084025401
Hospital Charge Code	2500718
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$2.06
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.64

ATARAX 25 MG TAB(HYDROXYZINE HCL)

Facility

$2.00

Service Code	NDC 68084025401
Hospital Charge Code	2500718
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$2.06
Rate for Payer: Celtic Commercial/Exchange	$0.92
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.68

ATHEROSCLEROSIS WITH MCC

Facility

$9,816.25

Service Code	MSDRG 302
Min. Negotiated Rate	$9,816.25
Max. Negotiated Rate	$9,816.25
Rate for Payer: BCBS Commercial	$9,816.25

Know your out-of-pocket cost for care.

All Charges