Ness County Hospital

All Charges

Charge

Type

Setting

Price

BLAD INSTILL ANTICARCINOGENIC

Facility

$626.00

Service Code	HCPCS 51720
Hospital Charge Code	5172000
Hospital Revenue Code	450
Min. Negotiated Rate	$289.21
Max. Negotiated Rate	$834.34
Rate for Payer: BCBS Commercial	$834.34
Rate for Payer: Cash Price	$469.50
Rate for Payer: Cash Price	$469.50
Rate for Payer: Celtic Commercial/Exchange	$289.21
Rate for Payer: Health Partners Plans Commercial	$594.70
Rate for Payer: UnitedHealthcare Commercial	$607.22
Rate for Payer: WPPA Commercial	$525.84

BLAD INSTILL ANTICARCINOGENIC

Facility

$626.00

Service Code	HCPCS 51720
Hospital Charge Code	5172000
Hospital Revenue Code	450
Min. Negotiated Rate	$513.32
Max. Negotiated Rate	$607.22
Rate for Payer: Cash Price	$469.50
Rate for Payer: Health Partners Plans Commercial	$594.70
Rate for Payer: UnitedHealthcare Commercial	$607.22
Rate for Payer: WPPA Commercial	$513.32

BLEEDING TIME

Facility

$24.00

Service Code	HCPCS 85002
Hospital Charge Code	8500200
Hospital Revenue Code	305
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$19.68

BLEEDING TIME

Facility

$24.00

Service Code	HCPCS 85002
Hospital Charge Code	8500200
Hospital Revenue Code	305
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
Rate for Payer: BCBS Commercial	$13.23
Rate for Payer: Cash Price	$18.00
Rate for Payer: Cash Price	$18.00
Rate for Payer: Celtic Commercial/Exchange	$11.09
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$20.16

BLOOD ADMINISTRATION

Facility

$959.00

Service Code	HCPCS 36430
Hospital Charge Code	3643000
Hospital Revenue Code	391
Min. Negotiated Rate	$786.38
Max. Negotiated Rate	$930.23
Rate for Payer: Cash Price	$719.25
Rate for Payer: Health Partners Plans Commercial	$911.05
Rate for Payer: UnitedHealthcare Commercial	$930.23
Rate for Payer: WPPA Commercial	$786.38

BLOOD ADMINISTRATION

Facility

$959.00

Service Code	HCPCS 36430
Hospital Charge Code	3643000
Hospital Revenue Code	391
Min. Negotiated Rate	$443.06
Max. Negotiated Rate	$930.23
Rate for Payer: BCBS Commercial	$515.69
Rate for Payer: Cash Price	$719.25
Rate for Payer: Cash Price	$719.25
Rate for Payer: Celtic Commercial/Exchange	$443.06
Rate for Payer: Health Partners Plans Commercial	$911.05
Rate for Payer: UnitedHealthcare Commercial	$930.23
Rate for Payer: WPPA Commercial	$805.56

BLOOD CLOT INHIBITOR ANTIGEN

Facility

$52.00

Service Code	HCPCS 85302
Hospital Charge Code	8530200
Hospital Revenue Code	305
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$50.44
Rate for Payer: BCBS Commercial	$30.62
Rate for Payer: Cash Price	$39.00
Rate for Payer: Cash Price	$39.00
Rate for Payer: Celtic Commercial/Exchange	$24.02
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$43.68

BLOOD CLOT INHIBITOR ANTIGEN

Facility

$52.00

Service Code	HCPCS 85302
Hospital Charge Code	8530200
Hospital Revenue Code	305
Min. Negotiated Rate	$42.64
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.00
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$42.64

BLOOD CLOT INHIBITOR ASSY

Facility

$52.00

Service Code	HCPCS 85305
Hospital Charge Code	8530500
Hospital Revenue Code	305
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$50.44
Rate for Payer: BCBS Commercial	$30.27
Rate for Payer: Cash Price	$39.00
Rate for Payer: Cash Price	$39.00
Rate for Payer: Celtic Commercial/Exchange	$24.02
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$43.68

BLOOD CLOT INHIBITOR ASSY

Facility

$52.00

Service Code	HCPCS 85305
Hospital Charge Code	8530500
Hospital Revenue Code	305
Min. Negotiated Rate	$42.64
Max. Negotiated Rate	$50.44
Rate for Payer: Cash Price	$39.00
Rate for Payer: Health Partners Plans Commercial	$49.40
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: WPPA Commercial	$42.64

BLOOD COUNT,AUTO DIFF WBC COUN

Facility

$39.00

Service Code	HCPCS 85004
Hospital Charge Code	8500400
Hospital Revenue Code	305
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

BLOOD COUNT,AUTO DIFF WBC COUN

Facility

$39.00

Service Code	HCPCS 85004
Hospital Charge Code	8500400
Hospital Revenue Code	305
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$37.83
Rate for Payer: BCBS Commercial	$13.90
Rate for Payer: Cash Price	$29.25
Rate for Payer: Cash Price	$29.25
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

BLOOD COUNT COMPETE,AUTOMATED

Facility

$62.00

Service Code	HCPCS 85027
Hospital Charge Code	8502700
Hospital Revenue Code	305
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$60.14
Rate for Payer: BCBS Commercial	$13.90
Rate for Payer: Cash Price	$46.50
Rate for Payer: Cash Price	$46.50
Rate for Payer: Celtic Commercial/Exchange	$28.64
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$52.08

BLOOD COUNT COMPETE,AUTOMATED

Facility

$62.00

Service Code	HCPCS 85027
Hospital Charge Code	8502700
Hospital Revenue Code	305
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$46.50
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

BLOOD COUNT COMPLETE,AUTOMATED

Facility

$88.00

Service Code	HCPCS 85025
Hospital Charge Code	8502500
Hospital Revenue Code	305
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

BLOOD COUNT COMPLETE,AUTOMATED

Facility

$88.00

Service Code	HCPCS 85025
Hospital Charge Code	8502500
Hospital Revenue Code	305
Min. Negotiated Rate	$13.36
Max. Negotiated Rate	$85.36
Rate for Payer: BCBS Commercial	$13.36
Rate for Payer: Cash Price	$66.00
Rate for Payer: Cash Price	$66.00
Rate for Payer: Celtic Commercial/Exchange	$40.66
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$73.92

BLOOD COUNT HEMATROCRIT (HCT)

Facility

$37.00

Service Code	HCPCS 85014
Hospital Charge Code	8501400
Hospital Revenue Code	305
Min. Negotiated Rate	$8.91
Max. Negotiated Rate	$35.89
Rate for Payer: BCBS Commercial	$8.91
Rate for Payer: Cash Price	$27.75
Rate for Payer: Cash Price	$27.75
Rate for Payer: Celtic Commercial/Exchange	$17.09
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$31.08

BLOOD COUNT HEMATROCRIT (HCT)

Facility

$37.00

Service Code	HCPCS 85014
Hospital Charge Code	8501400
Hospital Revenue Code	305
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$27.75
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$30.34

BLOOD COUNT HEMOGLOBIN (HGB)

Facility

$37.00

Service Code	HCPCS 85018
Hospital Charge Code	8501800
Hospital Revenue Code	305
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$35.89
Rate for Payer: BCBS Commercial	$9.75
Rate for Payer: Cash Price	$27.75
Rate for Payer: Cash Price	$27.75
Rate for Payer: Celtic Commercial/Exchange	$17.09
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$31.08

BLOOD COUNT HEMOGLOBIN (HGB)

Facility

$37.00

Service Code	HCPCS 85018
Hospital Charge Code	8501800
Hospital Revenue Code	305
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$27.75
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$30.34

BLOOD COUNT LEUKOCYTE, AUTOMAT

Facility

$49.00

Service Code	HCPCS 85048
Hospital Charge Code	8504800
Hospital Revenue Code	305
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$47.53
Rate for Payer: Cash Price	$36.75
Rate for Payer: Health Partners Plans Commercial	$46.55
Rate for Payer: UnitedHealthcare Commercial	$47.53
Rate for Payer: WPPA Commercial	$40.18

BLOOD COUNT LEUKOCYTE, AUTOMAT

Facility

$49.00

Service Code	HCPCS 85048
Hospital Charge Code	8504800
Hospital Revenue Code	305
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$47.53
Rate for Payer: BCBS Commercial	$9.63
Rate for Payer: Cash Price	$36.75
Rate for Payer: Cash Price	$36.75
Rate for Payer: Celtic Commercial/Exchange	$22.64
Rate for Payer: Health Partners Plans Commercial	$46.55
Rate for Payer: UnitedHealthcare Commercial	$47.53
Rate for Payer: WPPA Commercial	$41.16

BLOOD COUNT MICRO EXAM W/MAN

Facility

$43.00

Service Code	HCPCS 85007
Hospital Charge Code	8500700
Hospital Revenue Code	305
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$41.71
Rate for Payer: BCBS Commercial	$7.53
Rate for Payer: Cash Price	$32.25
Rate for Payer: Cash Price	$32.25
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

BLOOD COUNT MICRO EXAM W/MAN

Facility

$43.00

Service Code	HCPCS 85007
Hospital Charge Code	8500700
Hospital Revenue Code	305
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$41.71
Rate for Payer: Cash Price	$32.25
Rate for Payer: Health Partners Plans Commercial	$40.85
Rate for Payer: UnitedHealthcare Commercial	$41.71
Rate for Payer: WPPA Commercial	$35.26

BLOOD COUNT,MICRO EXAM W/O MAN

Facility

$64.00

Service Code	HCPCS 85008
Hospital Charge Code	8500800
Hospital Revenue Code	305
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$64.48
Rate for Payer: BCBS Commercial	$64.48
Rate for Payer: Cash Price	$48.00
Rate for Payer: Cash Price	$48.00
Rate for Payer: Celtic Commercial/Exchange	$29.57
Rate for Payer: Health Partners Plans Commercial	$60.80
Rate for Payer: UnitedHealthcare Commercial	$62.08
Rate for Payer: WPPA Commercial	$53.76

Know your out-of-pocket cost for care.

All Charges