Ness County Hospital

All Charges

Charge

Type

Setting

Price

BULLDOG ENDO VALVE

Facility

$21.00

Hospital Charge Code	2709020
Hospital Revenue Code	272
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

BULLDOG ENDO VALVE

Facility

$21.00

Hospital Charge Code	2709020
Hospital Revenue Code	272
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$15.75
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

BUMEX 1 MG/4 ML INJ. (BUMETANIDE)

Facility

$10.00

Service Code	NDC 00641600801
Hospital Charge Code	2513273
Hospital Revenue Code	250
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

BUMEX 1 MG/4 ML INJ. (BUMETANIDE)

Facility

$10.00

Service Code	NDC 00641600801
Hospital Charge Code	2513273
Hospital Revenue Code	250
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

BUMEX 1 MG TAB (BUMETANIDE)

Facility

$8.00

Service Code	NDC 60687038411
Hospital Charge Code	2509537
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.34
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.56

BUMEX 1 MG TAB (BUMETANIDE)

Facility

$8.00

Service Code	NDC 60687038411
Hospital Charge Code	2509537
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$7.76
Rate for Payer: Cash Price	$6.34
Rate for Payer: Celtic Commercial/Exchange	$3.70
Rate for Payer: Health Partners Plans Commercial	$7.60
Rate for Payer: UnitedHealthcare Commercial	$7.76
Rate for Payer: WPPA Commercial	$6.72

BUPIVACAINE 0.25 % 10 ml vial -

Facility

$13.00

Service Code	NDC 55150016710
Hospital Charge Code	2504181
Hospital Revenue Code	250
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.79
Rate for Payer: Health Partners Plans Commercial	$12.35
Rate for Payer: UnitedHealthcare Commercial	$12.61
Rate for Payer: WPPA Commercial	$10.66

BUPIVACAINE 0.25 % 10 ml vial -

Facility

$13.00

Service Code	NDC 55150016710
Hospital Charge Code	2504181
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$12.61
Rate for Payer: Cash Price	$9.79
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

BUPRENORPHINE SCREEN

Facility

$75.00

Service Code	HCPCS 80348
Hospital Charge Code	8034800
Hospital Revenue Code	300
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$23.88
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

BUPRENORPHINE SCREEN

Facility

$75.00

Service Code	HCPCS 80348
Hospital Charge Code	8034800
Hospital Revenue Code	300
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

BUPROPION & METABOLITE, SERUM

Facility

$48.00

Service Code	HCPCS G0480
Hospital Charge Code	8033800
Hospital Revenue Code	300
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$46.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: Health Partners Plans Commercial	$45.60
Rate for Payer: UnitedHealthcare Commercial	$46.56
Rate for Payer: WPPA Commercial	$39.36

BUPROPION & METABOLITE, SERUM

Facility

$48.00

Service Code	HCPCS G0480
Hospital Charge Code	8033800
Hospital Revenue Code	300
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$73.42
Rate for Payer: BCBS Commercial	$73.42
Rate for Payer: Cash Price	$36.00
Rate for Payer: Cash Price	$36.00
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

BURN DEBRIDE.SMALL W/O ANES

Facility

$368.00

Service Code	HCPCS 16020 GP
Hospital Charge Code	4200930
Hospital Revenue Code	420
Min. Negotiated Rate	$301.76
Max. Negotiated Rate	$356.96
Rate for Payer: Cash Price	$276.00
Rate for Payer: Health Partners Plans Commercial	$349.60
Rate for Payer: UnitedHealthcare Commercial	$356.96
Rate for Payer: WPPA Commercial	$301.76

BURN DEBRIDE.SMALL W/O ANES

Facility

$368.00

Service Code	HCPCS 16020 GP
Hospital Charge Code	4200930
Hospital Revenue Code	420
Min. Negotiated Rate	$170.02
Max. Negotiated Rate	$371.68
Rate for Payer: BCBS Commercial	$371.68
Rate for Payer: Cash Price	$276.00
Rate for Payer: Cash Price	$276.00
Rate for Payer: Celtic Commercial/Exchange	$170.02
Rate for Payer: Health Partners Plans Commercial	$349.60
Rate for Payer: UnitedHealthcare Commercial	$356.96
Rate for Payer: WPPA Commercial	$309.12

BUSPAR (BUSPIRONE) 5 MG TAB

Facility

$2.00

Service Code	NDC 51079098501
Hospital Charge Code	2514065
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.72
Rate for Payer: Celtic Commercial/Exchange	$0.92
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.68

BUSPAR (BUSPIRONE) 5 MG TAB

Facility

$2.00

Service Code	NDC 51079098501
Hospital Charge Code	2514065
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.94
Rate for Payer: Cash Price	$1.72
Rate for Payer: Health Partners Plans Commercial	$1.90
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: WPPA Commercial	$1.64

BUTTON FEEDING TUBE 24FR

Facility

$33.00

Hospital Charge Code	2706835
Hospital Revenue Code	270
Min. Negotiated Rate	$27.06
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.31
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.06

BUTTON FEEDING TUBE 24FR

Facility

$33.00

Hospital Charge Code	2706835
Hospital Revenue Code	270
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.31
Rate for Payer: Celtic Commercial/Exchange	$15.25
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.72

BYSTOLIC 5 MG TAB (NEBIVOLOL)

Facility

$18.00

Service Code	NDC 00456140563
Hospital Charge Code	2517969
Hospital Revenue Code	250
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.80
Rate for Payer: Health Partners Plans Commercial	$17.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: WPPA Commercial	$14.76

BYSTOLIC 5 MG TAB (NEBIVOLOL)

Facility

$18.00

Service Code	NDC 00456140563
Hospital Charge Code	2517969
Hospital Revenue Code	250
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$17.46
Rate for Payer: Cash Price	$13.80
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

CA27.29 IMMUNO TUMOR ANTI QUAN

Facility

$151.00

Service Code	HCPCS 86300
Hospital Charge Code	8630001
Hospital Revenue Code	302
Min. Negotiated Rate	$54.84
Max. Negotiated Rate	$146.47
Rate for Payer: BCBS Commercial	$54.84
Rate for Payer: Cash Price	$113.25
Rate for Payer: Cash Price	$113.25
Rate for Payer: Celtic Commercial/Exchange	$69.76
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$126.84

CA27.29 IMMUNO TUMOR ANTI QUAN

Facility

$151.00

Service Code	HCPCS 86300
Hospital Charge Code	8630001
Hospital Revenue Code	302
Min. Negotiated Rate	$123.82
Max. Negotiated Rate	$146.47
Rate for Payer: Cash Price	$113.25
Rate for Payer: Health Partners Plans Commercial	$143.45
Rate for Payer: UnitedHealthcare Commercial	$146.47
Rate for Payer: WPPA Commercial	$123.82

CALAMINE LOTION 4 OZ BOTTLE

Facility

$7.00

Service Code	NDC 00904253300
Hospital Charge Code	2501146
Hospital Revenue Code	250
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.40
Rate for Payer: Celtic Commercial/Exchange	$3.23
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.88

CALAMINE LOTION 4 OZ BOTTLE

Facility

$7.00

Service Code	NDC 00904253300
Hospital Charge Code	2501146
Hospital Revenue Code	250
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$6.79
Rate for Payer: Cash Price	$5.40
Rate for Payer: Health Partners Plans Commercial	$6.65
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: WPPA Commercial	$5.74

CALAZIME 4 OZ

Facility

$4.00

Hospital Charge Code	2700061
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.67
Rate for Payer: Celtic Commercial/Exchange	$1.85
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.36

Know your out-of-pocket cost for care.

All Charges