Ness County Hospital

All Charges

Charge

Type

Setting

Price

BANDAGE EZE-BAND 4" S-CLOSE

Facility

$9.00

Hospital Charge Code	2725059
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

BANDAGE EZE-BAND 4" S-CLOSE

Facility

$9.00

Hospital Charge Code	2725059
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

BANDAGE EZE-BAND 6:

Facility

$9.00

Hospital Charge Code	2725059LTC
Hospital Revenue Code	270
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

BANDAGE EZE-BAND 6:

Facility

$9.00

Hospital Charge Code	2725059LTC
Hospital Revenue Code	270
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

BARIATRIC BLADER PADS

Facility

$130.00

Hospital Charge Code	2706701
Hospital Revenue Code	272
Min. Negotiated Rate	$106.60
Max. Negotiated Rate	$126.10
Rate for Payer: Cash Price	$97.50
Rate for Payer: Health Partners Plans Commercial	$123.50
Rate for Payer: UnitedHealthcare Commercial	$126.10
Rate for Payer: WPPA Commercial	$106.60

BARIATRIC BLADER PADS

Facility

$130.00

Hospital Charge Code	2706701
Hospital Revenue Code	272
Min. Negotiated Rate	$60.06
Max. Negotiated Rate	$126.10
Rate for Payer: Cash Price	$97.50
Rate for Payer: Celtic Commercial/Exchange	$60.06
Rate for Payer: Health Partners Plans Commercial	$123.50
Rate for Payer: UnitedHealthcare Commercial	$126.10
Rate for Payer: WPPA Commercial	$109.20

BARIATRIC GEL CUSHION 24"

Facility

$748.00

Hospital Charge Code	2700443
Hospital Revenue Code	272
Min. Negotiated Rate	$613.36
Max. Negotiated Rate	$725.56
Rate for Payer: Cash Price	$561.00
Rate for Payer: Health Partners Plans Commercial	$710.60
Rate for Payer: UnitedHealthcare Commercial	$725.56
Rate for Payer: WPPA Commercial	$613.36

BARIATRIC GEL CUSHION 24"

Facility

$748.00

Hospital Charge Code	2700443
Hospital Revenue Code	272
Min. Negotiated Rate	$345.58
Max. Negotiated Rate	$725.56
Rate for Payer: Cash Price	$561.00
Rate for Payer: Celtic Commercial/Exchange	$345.58
Rate for Payer: Health Partners Plans Commercial	$710.60
Rate for Payer: UnitedHealthcare Commercial	$725.56
Rate for Payer: WPPA Commercial	$628.32

BARTONELLA SPEC ANTIBOD IGGIGM

Facility

$176.00

Service Code	HCPCS 86611
Hospital Charge Code	8888899
Hospital Revenue Code	302
Min. Negotiated Rate	$19.23
Max. Negotiated Rate	$170.72
Rate for Payer: BCBS Commercial	$19.23
Rate for Payer: Cash Price	$132.00
Rate for Payer: Cash Price	$132.00
Rate for Payer: Celtic Commercial/Exchange	$81.31
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$147.84

BARTONELLA SPEC ANTIBOD IGGIGM

Facility

$176.00

Service Code	HCPCS 86611
Hospital Charge Code	8888899
Hospital Revenue Code	302
Min. Negotiated Rate	$144.32
Max. Negotiated Rate	$170.72
Rate for Payer: Cash Price	$132.00
Rate for Payer: Health Partners Plans Commercial	$167.20
Rate for Payer: UnitedHealthcare Commercial	$170.72
Rate for Payer: WPPA Commercial	$144.32

BASEBALL SPLINT

Facility

$10.00

Hospital Charge Code	2701548
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

BASEBALL SPLINT

Facility

$10.00

Hospital Charge Code	2701548
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

BASIC METABOLIC

Facility

$117.00

Service Code	HCPCS 80048
Hospital Charge Code	8004800
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$113.49
Rate for Payer: BCBS Commercial	$19.65
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

BASIC METABOLIC

Facility

$117.00

Service Code	HCPCS 80048
Hospital Charge Code	8004800
Hospital Revenue Code	301
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

BAYER ASPIRIN EC 81 MG

Facility

$1.00

Service Code	NDC 00904679430
Hospital Charge Code	2514289
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

BAYER ASPIRIN EC 81 MG

Facility

$1.00

Service Code	NDC 00904679430
Hospital Charge Code	2514289
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

BB-INVEST TRANSFSN REACTION

Facility

$161.00

Service Code	HCPCS 86078
Hospital Charge Code	8607800
Hospital Revenue Code	302
Min. Negotiated Rate	$132.02
Max. Negotiated Rate	$156.17
Rate for Payer: Cash Price	$120.75
Rate for Payer: Health Partners Plans Commercial	$152.95
Rate for Payer: UnitedHealthcare Commercial	$156.17
Rate for Payer: WPPA Commercial	$132.02

BB-INVEST TRANSFSN REACTION

Facility

$161.00

Service Code	HCPCS 86078
Hospital Charge Code	8607800
Hospital Revenue Code	302
Min. Negotiated Rate	$74.38
Max. Negotiated Rate	$156.17
Rate for Payer: BCBS Commercial	$102.16
Rate for Payer: Cash Price	$120.75
Rate for Payer: Cash Price	$120.75
Rate for Payer: Celtic Commercial/Exchange	$74.38
Rate for Payer: Health Partners Plans Commercial	$152.95
Rate for Payer: UnitedHealthcare Commercial	$156.17
Rate for Payer: WPPA Commercial	$135.24

B CELL, TOTAL COUNT

Facility

$600.00

Service Code	HCPCS 86355
Hospital Charge Code	8635500
Hospital Revenue Code	302
Min. Negotiated Rate	$492.00
Max. Negotiated Rate	$582.00
Rate for Payer: Cash Price	$450.00
Rate for Payer: Health Partners Plans Commercial	$570.00
Rate for Payer: UnitedHealthcare Commercial	$582.00
Rate for Payer: WPPA Commercial	$492.00

B CELL, TOTAL COUNT

Facility

$600.00

Service Code	HCPCS 86355
Hospital Charge Code	8635500
Hospital Revenue Code	302
Min. Negotiated Rate	$80.93
Max. Negotiated Rate	$582.00
Rate for Payer: BCBS Commercial	$80.93
Rate for Payer: Cash Price	$450.00
Rate for Payer: Cash Price	$450.00
Rate for Payer: Celtic Commercial/Exchange	$277.20
Rate for Payer: Health Partners Plans Commercial	$570.00
Rate for Payer: UnitedHealthcare Commercial	$582.00
Rate for Payer: WPPA Commercial	$504.00

BCR/ABL1, MAJOR BREAKPOINT

Facility

$250.00

Service Code	HCPCS 81206
Hospital Charge Code	8120600
Hospital Revenue Code	300
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$242.50
Rate for Payer: BCBS Commercial	$193.89
Rate for Payer: Cash Price	$187.50
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

BCR/ABL1, MAJOR BREAKPOINT

Facility

$250.00

Service Code	HCPCS 81206
Hospital Charge Code	8120600
Hospital Revenue Code	300
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

BCR/ABL1 MINOR BREAKPOINT

Facility

$275.00

Service Code	HCPCS 81207
Hospital Charge Code	8120700
Hospital Revenue Code	300
Min. Negotiated Rate	$225.50
Max. Negotiated Rate	$266.75
Rate for Payer: Cash Price	$206.25
Rate for Payer: Health Partners Plans Commercial	$261.25
Rate for Payer: UnitedHealthcare Commercial	$266.75
Rate for Payer: WPPA Commercial	$225.50

BCR/ABL1 MINOR BREAKPOINT

Facility

$275.00

Service Code	HCPCS 81207
Hospital Charge Code	8120700
Hospital Revenue Code	300
Min. Negotiated Rate	$127.05
Max. Negotiated Rate	$266.75
Rate for Payer: BCBS Commercial	$197.71
Rate for Payer: Cash Price	$206.25
Rate for Payer: Cash Price	$206.25
Rate for Payer: Celtic Commercial/Exchange	$127.05
Rate for Payer: Health Partners Plans Commercial	$261.25
Rate for Payer: UnitedHealthcare Commercial	$266.75
Rate for Payer: WPPA Commercial	$231.00

BD ANGIOCATH

Facility

$103.00

Hospital Charge Code	2727455
Hospital Revenue Code	270
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

Know your out-of-pocket cost for care.

All Charges