Ness County Hospital

All Charges

Charge

Type

Setting

Price

BRIEFS LG

Facility

$13.00

Hospital Charge Code	2706513LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEFS MD

Facility

$18.00

Hospital Charge Code	2706514
Hospital Revenue Code	990
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.50
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$14.76

BRIEFS MD

Facility

$18.00

Hospital Charge Code	2706514
Hospital Revenue Code	990
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.50
Rate for Payer: Celtic Commercial/Exchange	$8.32
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$15.12

BRIEFS SM

Facility

$13.00

Hospital Charge Code	2706515
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEFS SM

Facility

$13.00

Hospital Charge Code	2706515
Hospital Revenue Code	270
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
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

BRIEFS SM

Facility

$13.00

Hospital Charge Code	2706515LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEFS SM

Facility

$13.00

Hospital Charge Code	2706515LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
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

BRIEFS XL

Facility

$13.00

Hospital Charge Code	2706516
Hospital Revenue Code	990
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
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

BRIEFS XL

Facility

$13.00

Hospital Charge Code	2706516
Hospital Revenue Code	990
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEFS XXL

Facility

$13.00

Hospital Charge Code	2706517
Hospital Revenue Code	990
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEFS XXL

Facility

$14.00

Hospital Charge Code	2706517LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.88
Rate for Payer: Celtic Commercial/Exchange	$6.47
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.76

BRIEFS XXL

Facility

$13.00

Hospital Charge Code	2706517
Hospital Revenue Code	990
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
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

BRIEFS XXL

Facility

$14.00

Hospital Charge Code	2706517LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$11.48
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.88
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.48

BRIEF XL

Facility

$13.00

Hospital Charge Code	2706516LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BRIEF XL

Facility

$13.00

Hospital Charge Code	2706516LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$10.12
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

BRONCHITIS AND ASTHMA WITH CC/MCC

Facility

$8,937.49

Service Code	MSDRG 202
Min. Negotiated Rate	$8,937.49
Max. Negotiated Rate	$8,937.49
Rate for Payer: BCBS Commercial	$8,937.49

BRONCHITIS AND ASTHMA WITHOUT CC/MCC

Facility

$6,709.00

Service Code	MSDRG 203
Min. Negotiated Rate	$6,709.00
Max. Negotiated Rate	$6,709.00
Rate for Payer: BCBS Commercial	$6,709.00

BRONCHODILATION RESPONSIVE TST

Facility

$374.00

Service Code	HCPCS 94060 59
Hospital Charge Code	9406000
Hospital Revenue Code	410
Min. Negotiated Rate	$172.79
Max. Negotiated Rate	$373.83
Rate for Payer: BCBS Commercial	$373.83
Rate for Payer: Cash Price	$280.50
Rate for Payer: Cash Price	$280.50
Rate for Payer: Celtic Commercial/Exchange	$172.79
Rate for Payer: Health Partners Plans Commercial	$355.30
Rate for Payer: UnitedHealthcare Commercial	$362.78
Rate for Payer: WPPA Commercial	$314.16

BRONCHODILATION RESPONSIVE TST

Facility

$374.00

Service Code	HCPCS 94060 59
Hospital Charge Code	9406000
Hospital Revenue Code	410
Min. Negotiated Rate	$306.68
Max. Negotiated Rate	$362.78
Rate for Payer: Cash Price	$280.50
Rate for Payer: Health Partners Plans Commercial	$355.30
Rate for Payer: UnitedHealthcare Commercial	$362.78
Rate for Payer: WPPA Commercial	$306.68

BUBBLE CONNECTOR

Facility

$5.00

Hospital Charge Code	4100330
Hospital Revenue Code	272
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Celtic Commercial/Exchange	$2.31
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.20

BUBBLE CONNECTOR

Facility

$5.00

Hospital Charge Code	4100330
Hospital Revenue Code	272
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$4.85
Rate for Payer: Cash Price	$3.75
Rate for Payer: Health Partners Plans Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$4.85
Rate for Payer: WPPA Commercial	$4.10

BUCKS TRACTION EX SMALL

Facility

$88.00

Hospital Charge Code	2701365
Hospital Revenue Code	270
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.56
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

BUCKS TRACTION EX SMALL

Facility

$88.00

Hospital Charge Code	2701365
Hospital Revenue Code	270
Min. Negotiated Rate	$72.16
Max. Negotiated Rate	$85.36
Rate for Payer: Cash Price	$66.56
Rate for Payer: Health Partners Plans Commercial	$83.60
Rate for Payer: UnitedHealthcare Commercial	$85.36
Rate for Payer: WPPA Commercial	$72.16

BUFFERIN 325 MG TABLET

Facility

$1.00

Hospital Charge Code	2501112
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

BUFFERIN 325 MG TABLET

Facility

$1.00

Hospital Charge Code	2501112
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

Know your out-of-pocket cost for care.

All Charges