Ness County Hospital

All Charges

Charge

Type

Setting

Price

5X5 BORDER GAUZE

Facility

$15.00

Hospital Charge Code	2725611
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.30

6-0 ETHILON 660G

Facility

$11.00

Hospital Charge Code	2722555
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

6-0 ETHILON 660G

Facility

$11.00

Hospital Charge Code	2722555
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

635 CHROMIC 4-0 SUTURE

Facility

$48.00

Hospital Charge Code	2722536
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

635 CHROMIC 4-0 SUTURE

Facility

$48.00

Hospital Charge Code	2722536
Hospital Revenue Code	270
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

636G CHROMIC 3-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721314
Hospital Revenue Code	270
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

636G CHROMIC 3-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721314
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

683G PERMAHAND SILK 4-0 SUTURE

Facility

$10.00

Hospital Charge Code	2726778
Hospital Revenue Code	272
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

683G PERMAHAND SILK 4-0 SUTURE

Facility

$10.00

Hospital Charge Code	2726778
Hospital Revenue Code	272
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

684G SILK 3-0 SUTURE

Facility

$10.00

Hospital Charge Code	2721520
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

684G SILK 3-0 SUTURE

Facility

$10.00

Hospital Charge Code	2721520
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

687G CHROMIC 5-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721363
Hospital Revenue Code	270
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

687G CHROMIC 5-0 SUTURE

Facility

$48.00

Hospital Charge Code	2721363
Hospital Revenue Code	270
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.38
Rate for Payer: Celtic Commercial/Exchange	$22.18
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$40.32

8665G PROLENE 3-0 SUTURE

Facility

$20.00

Hospital Charge Code	2722544
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

8665G PROLENE 3-0 SUTURE

Facility

$20.00

Hospital Charge Code	2722544
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

8681G PROLENE 5-O SUTURE

Facility

$35.00

Hospital Charge Code	2722460
Hospital Revenue Code	270
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.44
Rate for Payer: Celtic Commercial/Exchange	$16.17
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$29.40

8681G PROLENE 5-O SUTURE

Facility

$35.00

Hospital Charge Code	2722460
Hospital Revenue Code	270
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.44
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$28.70

8683G PROLENE 4-0 SUTURE

Facility

$20.00

Hospital Charge Code	2721421
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

8683G PROLENE 4-0 SUTURE

Facility

$20.00

Hospital Charge Code	2721421
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

8684G PROLENE 3-0 SUTURE

Facility

$20.00

Hospital Charge Code	2721389
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

8684G PROLENE 3-0 SUTURE

Facility

$20.00

Hospital Charge Code	2721389
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

8695G PROLENE 6-0 SUTURE

Facility

$26.00

Hospital Charge Code	2721447
Hospital Revenue Code	270
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.32

8695G PROLENE 6-0 SUTURE

Facility

$26.00

Hospital Charge Code	2721447
Hospital Revenue Code	270
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$25.22
Rate for Payer: Cash Price	$19.50
Rate for Payer: Celtic Commercial/Exchange	$12.01
Rate for Payer: Health Partners Plans Commercial	$24.70
Rate for Payer: UnitedHealthcare Commercial	$25.22
Rate for Payer: WPPA Commercial	$21.84

8698G PROLENE 5-0 SUTURE

Facility

$35.00

Hospital Charge Code	2721439
Hospital Revenue Code	270
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.44
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$28.70

8698G PROLENE 5-0 SUTURE

Facility

$35.00

Hospital Charge Code	2721439
Hospital Revenue Code	270
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.44
Rate for Payer: Celtic Commercial/Exchange	$16.17
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$29.40

Know your out-of-pocket cost for care.

All Charges