Ness County Hospital

All Charges

Charge

Type

Setting

Price

BILAT DIAGNOSTIC MAMMO W CAD

Facility

$342.00

Service Code	HCPCS 77066
Hospital Charge Code	7706600
Hospital Revenue Code	401
Min. Negotiated Rate	$123.22
Max. Negotiated Rate	$331.74
Rate for Payer: BCBS Commercial	$123.22
Rate for Payer: Cash Price	$256.50
Rate for Payer: Cash Price	$256.50
Rate for Payer: Celtic Commercial/Exchange	$158.00
Rate for Payer: Health Partners Plans Commercial	$324.90
Rate for Payer: UnitedHealthcare Commercial	$331.74
Rate for Payer: WPPA Commercial	$287.28

BILAT DIAGNOSTIC MAMMO W CAD

Facility

$342.00

Service Code	HCPCS 77066
Hospital Charge Code	7706600
Hospital Revenue Code	401
Min. Negotiated Rate	$280.44
Max. Negotiated Rate	$331.74
Rate for Payer: Cash Price	$256.50
Rate for Payer: Health Partners Plans Commercial	$324.90
Rate for Payer: UnitedHealthcare Commercial	$331.74
Rate for Payer: WPPA Commercial	$280.44

BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC

Facility

$54,502.23

Service Code	MSDRG 461
Min. Negotiated Rate	$54,502.23
Max. Negotiated Rate	$54,502.23
Rate for Payer: BCBS Commercial	$54,502.23

BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC

Facility

$32,228.24

Service Code	MSDRG 462
Min. Negotiated Rate	$32,228.24
Max. Negotiated Rate	$32,228.24
Rate for Payer: BCBS Commercial	$32,228.24

BILAT SCREENING MAMMO W CAD

Facility

$294.00

Service Code	HCPCS 77067
Hospital Charge Code	7706700
Hospital Revenue Code	403
Min. Negotiated Rate	$241.08
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$220.50
Rate for Payer: Health Partners Plans Commercial	$279.30
Rate for Payer: UnitedHealthcare Commercial	$285.18
Rate for Payer: WPPA Commercial	$241.08

BILAT SCREENING MAMMO W CAD

Facility

$294.00

Service Code	HCPCS 77067
Hospital Charge Code	7706700
Hospital Revenue Code	403
Min. Negotiated Rate	$135.83
Max. Negotiated Rate	$285.18
Rate for Payer: BCBS Commercial	$161.00
Rate for Payer: Cash Price	$220.50
Rate for Payer: Cash Price	$220.50
Rate for Payer: Celtic Commercial/Exchange	$135.83
Rate for Payer: Health Partners Plans Commercial	$279.30
Rate for Payer: UnitedHealthcare Commercial	$285.18
Rate for Payer: WPPA Commercial	$246.96

BILE BAG

Facility

$28.00

Hospital Charge Code	2720324
Hospital Revenue Code	272
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.00
Rate for Payer: Celtic Commercial/Exchange	$12.94
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$23.52

BILE BAG

Facility

$28.00

Hospital Charge Code	2720324
Hospital Revenue Code	272
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$27.16
Rate for Payer: Cash Price	$21.00
Rate for Payer: Health Partners Plans Commercial	$26.60
Rate for Payer: UnitedHealthcare Commercial	$27.16
Rate for Payer: WPPA Commercial	$22.96

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$20,791.29

Service Code	MSDRG 409
Min. Negotiated Rate	$20,791.29
Max. Negotiated Rate	$20,791.29
Rate for Payer: BCBS Commercial	$20,791.29

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$33,308.88

Service Code	MSDRG 408
Min. Negotiated Rate	$33,308.88
Max. Negotiated Rate	$33,308.88
Rate for Payer: BCBS Commercial	$33,308.88

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$16,371.23

Service Code	MSDRG 410
Min. Negotiated Rate	$16,371.23
Max. Negotiated Rate	$16,371.23
Rate for Payer: BCBS Commercial	$16,371.23

BILIRUBIN DIRECT

Facility

$54.00

Service Code	HCPCS 82248
Hospital Charge Code	8224800
Hospital Revenue Code	302
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$52.38
Rate for Payer: BCBS Commercial	$20.18
Rate for Payer: Cash Price	$40.50
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

BILIRUBIN DIRECT

Facility

$54.00

Service Code	HCPCS 82248
Hospital Charge Code	8224800
Hospital Revenue Code	302
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

BILIRUBIN-TOTAL

Facility

$60.00

Service Code	HCPCS 82247
Hospital Charge Code	8224700
Hospital Revenue Code	301
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$45.00
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$49.20

BILIRUBIN-TOTAL

Facility

$60.00

Service Code	HCPCS 82247
Hospital Charge Code	8224700
Hospital Revenue Code	301
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$58.20
Rate for Payer: BCBS Commercial	$21.30
Rate for Payer: Cash Price	$45.00
Rate for Payer: Cash Price	$45.00
Rate for Payer: Celtic Commercial/Exchange	$27.72
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$50.40

BIOFLO CANNULA

Facility

$9.00

Hospital Charge Code	2720323
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

BIOFLO CANNULA

Facility

$9.00

Hospital Charge Code	2720323
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

BIOPATCH

Facility

$22.00

Hospital Charge Code	2708699
Hospital Revenue Code	270
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$21.34
Rate for Payer: Cash Price	$16.50
Rate for Payer: Celtic Commercial/Exchange	$10.16
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.48

BIOPATCH

Facility

$22.00

Hospital Charge Code	2708699
Hospital Revenue Code	270
Min. Negotiated Rate	$18.04
Max. Negotiated Rate	$21.34
Rate for Payer: Cash Price	$16.50
Rate for Payer: Health Partners Plans Commercial	$20.90
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: WPPA Commercial	$18.04

BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$20,932.00

Service Code	MSDRG 478
Min. Negotiated Rate	$20,932.00
Max. Negotiated Rate	$20,932.00
Rate for Payer: BCBS Commercial	$20,932.00

BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$25,345.93

Service Code	MSDRG 477
Min. Negotiated Rate	$25,345.93
Max. Negotiated Rate	$25,345.93
Rate for Payer: BCBS Commercial	$25,345.93

BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$16,060.22

Service Code	MSDRG 479
Min. Negotiated Rate	$16,060.22
Max. Negotiated Rate	$16,060.22
Rate for Payer: BCBS Commercial	$16,060.22

BIOPSY BONE DEEP, NEEDLE

Facility

$1,500.00

Service Code	HCPCS 20225
Hospital Charge Code	2022523
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: BCBS Commercial	$895.87
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Celtic Commercial/Exchange	$693.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,260.00

BIOPSY BONE DEEP, NEEDLE

Facility

$1,500.00

Service Code	HCPCS 20225
Hospital Charge Code	2022523
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

BIOPSY BONE, SUPERFICL NEEDLE

Facility

$1,500.00

Service Code	HCPCS 20220
Hospital Charge Code	2022023
Hospital Revenue Code	761
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Cash Price	$1,125.00
Rate for Payer: Health Partners Plans Commercial	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,455.00
Rate for Payer: WPPA Commercial	$1,230.00

Know your out-of-pocket cost for care.

All Charges