Ness County Hospital

All Charges

Charge

Type

Setting

Price

BIOPSY BONE, SUPERFICL NEEDLE

Facility

$1,500.00

Service Code	HCPCS 20220
Hospital Charge Code	2022023
Hospital Revenue Code	761
Min. Negotiated Rate	$451.47
Max. Negotiated Rate	$1,455.00
Rate for Payer: BCBS Commercial	$451.47
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/EXCISION OF LYMPH NODE

Facility

$4,000.00

Service Code	HCPCS 38500
Hospital Charge Code	3850000
Hospital Revenue Code	761
Min. Negotiated Rate	$3,280.00
Max. Negotiated Rate	$3,880.00
Rate for Payer: Cash Price	$3,000.00
Rate for Payer: Health Partners Plans Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,880.00
Rate for Payer: WPPA Commercial	$3,280.00

BIOPSY/EXCISION OF LYMPH NODE

Facility

$4,000.00

Service Code	HCPCS 38500
Hospital Charge Code	3850000
Hospital Revenue Code	761
Min. Negotiated Rate	$1,848.00
Max. Negotiated Rate	$4,786.60
Rate for Payer: Cash Price	$3,000.00
Rate for Payer: BCBS Commercial	$4,786.60
Rate for Payer: Cash Price	$3,000.00
Rate for Payer: Celtic Commercial/Exchange	$1,848.00
Rate for Payer: Health Partners Plans Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,880.00
Rate for Payer: WPPA Commercial	$3,360.00

BIOPSY FORCEP

Facility

$43.00

Hospital Charge Code	2705973
Hospital Revenue Code	270
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$41.71
Rate for Payer: Cash Price	$32.44
Rate for Payer: Health Partners Plans Commercial	$40.85
Rate for Payer: UnitedHealthcare Commercial	$41.71
Rate for Payer: WPPA Commercial	$35.26

BIOPSY FORCEP

Facility

$43.00

Hospital Charge Code	2705973
Hospital Revenue Code	270
Min. Negotiated Rate	$19.87
Max. Negotiated Rate	$41.71
Rate for Payer: Cash Price	$32.44
Rate for Payer: Celtic Commercial/Exchange	$19.87
Rate for Payer: Health Partners Plans Commercial	$40.85
Rate for Payer: UnitedHealthcare Commercial	$41.71
Rate for Payer: WPPA Commercial	$36.12

BIOPSY KIT GREEN BAG

Facility

$23.00

Hospital Charge Code	2705974
Hospital Revenue Code	272
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$18.86

BIOPSY KIT GREEN BAG

Facility

$23.00

Hospital Charge Code	2705974
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$22.31
Rate for Payer: Cash Price	$17.25
Rate for Payer: Celtic Commercial/Exchange	$10.63
Rate for Payer: Health Partners Plans Commercial	$21.85
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: WPPA Commercial	$19.32

BIOPSY/SKIN-ALL

Facility

$250.00

Service Code	HCPCS 11100
Hospital Charge Code	1110000
Hospital Revenue Code	761
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$242.50
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

BIOPSY/SKIN-ALL

Facility

$250.00

Service Code	HCPCS 11100
Hospital Charge Code	1110000
Hospital Revenue Code	761
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

BIOPSY, SOFT TISSUE NECK/THORX

Facility

$1,500.00

Service Code	HCPCS 21550
Hospital Charge Code	2155000
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, SOFT TISSUE NECK/THORX

Facility

$1,500.00

Service Code	HCPCS 21550
Hospital Charge Code	2155000
Hospital Revenue Code	761
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: BCBS Commercial	$710.03
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 VALVE

Facility

$13.00

Hospital Charge Code	2727255
Hospital Revenue Code	270
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.75
Rate for Payer: Celtic Commercial/Exchange	$6.01
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.92

BIOPSY VALVE

Facility

$13.00

Hospital Charge Code	2727255
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.75
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BITE BLOCK

Facility

$15.00

Hospital Charge Code	2700202
Hospital Revenue Code	270
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

BITE BLOCK

Facility

$15.00

Hospital Charge Code	2700202
Hospital Revenue Code	270
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$14.55
Rate for Payer: Cash Price	$11.25
Rate for Payer: Celtic Commercial/Exchange	$6.93
Rate for Payer: Health Partners Plans Commercial	$14.25
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: WPPA Commercial	$12.60

BLACKEYE ENDOSCOPE MARKER

Facility

$93.00

Hospital Charge Code	2706144
Hospital Revenue Code	272
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$76.26

BLACKEYE ENDOSCOPE MARKER

Facility

$93.00

Hospital Charge Code	2706144
Hospital Revenue Code	272
Min. Negotiated Rate	$42.97
Max. Negotiated Rate	$90.21
Rate for Payer: Cash Price	$69.75
Rate for Payer: Celtic Commercial/Exchange	$42.97
Rate for Payer: Health Partners Plans Commercial	$88.35
Rate for Payer: UnitedHealthcare Commercial	$90.21
Rate for Payer: WPPA Commercial	$78.12

BLADDER IRRIGATION,SIMPLE,LAVG

Facility

$313.00

Service Code	HCPCS 51700
Hospital Charge Code	5170000
Hospital Revenue Code	761
Min. Negotiated Rate	$144.61
Max. Negotiated Rate	$312.17
Rate for Payer: BCBS Commercial	$312.17
Rate for Payer: Cash Price	$234.75
Rate for Payer: Cash Price	$234.75
Rate for Payer: Celtic Commercial/Exchange	$144.61
Rate for Payer: Health Partners Plans Commercial	$297.35
Rate for Payer: UnitedHealthcare Commercial	$303.61
Rate for Payer: WPPA Commercial	$262.92

BLADDER IRRIGATION,SIMPLE,LAVG

Facility

$313.00

Service Code	HCPCS 51700
Hospital Charge Code	5170000
Hospital Revenue Code	761
Min. Negotiated Rate	$256.66
Max. Negotiated Rate	$303.61
Rate for Payer: Cash Price	$234.75
Rate for Payer: Health Partners Plans Commercial	$297.35
Rate for Payer: UnitedHealthcare Commercial	$303.61
Rate for Payer: WPPA Commercial	$256.66

BLADDER PADS

Facility

$12.00

Hospital Charge Code	2706700
Hospital Revenue Code	990
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

BLADDER PADS

Facility

$12.00

Hospital Charge Code	2706700LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

BLADDER PADS

Facility

$12.00

Hospital Charge Code	2706700
Hospital Revenue Code	990
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

BLADDER PADS

Facility

$12.00

Hospital Charge Code	2706700LTC
Hospital Revenue Code	270
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

BLADDER PADS ISB

Facility

$12.00

Hospital Charge Code	2706700ISB
Hospital Revenue Code	270
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

BLADDER PADS ISB

Facility

$12.00

Hospital Charge Code	2706700ISB
Hospital Revenue Code	270
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.00
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

Know your out-of-pocket cost for care.

All Charges