Ness County Hospital

All Charges

Charge

Type

Setting

Price

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

CALCANEUS LT

Facility

$160.00

Service Code	HCPCS 73650 LT
Hospital Charge Code	3290009
Hospital Revenue Code	320
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$155.20
Rate for Payer: BCBS Commercial	$114.29
Rate for Payer: Cash Price	$120.45
Rate for Payer: Cash Price	$120.45
Rate for Payer: Celtic Commercial/Exchange	$73.92
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$134.40

CALCANEUS LT

Facility

$160.00

Service Code	HCPCS 73650 LT
Hospital Charge Code	3290009
Hospital Revenue Code	320
Min. Negotiated Rate	$131.20
Max. Negotiated Rate	$155.20
Rate for Payer: Cash Price	$120.45
Rate for Payer: Health Partners Plans Commercial	$152.00
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: WPPA Commercial	$131.20

CALCANEUS RT

Facility

$208.00

Service Code	HCPCS 73650 RT
Hospital Charge Code	3290008
Hospital Revenue Code	320
Min. Negotiated Rate	$170.56
Max. Negotiated Rate	$201.76
Rate for Payer: Cash Price	$156.00
Rate for Payer: Health Partners Plans Commercial	$197.60
Rate for Payer: UnitedHealthcare Commercial	$201.76
Rate for Payer: WPPA Commercial	$170.56

CALCANEUS RT

Facility

$208.00

Service Code	HCPCS 73650 RT
Hospital Charge Code	3290008
Hospital Revenue Code	320
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$201.76
Rate for Payer: BCBS Commercial	$114.29
Rate for Payer: Cash Price	$156.00
Rate for Payer: Cash Price	$156.00
Rate for Payer: Celtic Commercial/Exchange	$96.10
Rate for Payer: Health Partners Plans Commercial	$197.60
Rate for Payer: UnitedHealthcare Commercial	$201.76
Rate for Payer: WPPA Commercial	$174.72

CALCIFEDIOL (25-OH VITAMIN D-3

Facility

$384.00

Service Code	HCPCS 82306
Hospital Charge Code	8230600
Hospital Revenue Code	301
Min. Negotiated Rate	$177.41
Max. Negotiated Rate	$372.48
Rate for Payer: BCBS Commercial	$218.43
Rate for Payer: Cash Price	$288.00
Rate for Payer: Cash Price	$288.00
Rate for Payer: Celtic Commercial/Exchange	$177.41
Rate for Payer: Health Partners Plans Commercial	$364.80
Rate for Payer: UnitedHealthcare Commercial	$372.48
Rate for Payer: WPPA Commercial	$322.56

CALCIFEDIOL (25-OH VITAMIN D-3

Facility

$384.00

Service Code	HCPCS 82306
Hospital Charge Code	8230600
Hospital Revenue Code	301
Min. Negotiated Rate	$314.88
Max. Negotiated Rate	$372.48
Rate for Payer: Cash Price	$288.00
Rate for Payer: Health Partners Plans Commercial	$364.80
Rate for Payer: UnitedHealthcare Commercial	$372.48
Rate for Payer: WPPA Commercial	$314.88

CALCITONIN

Facility

$190.00

Service Code	HCPCS 82308
Hospital Charge Code	8230800
Hospital Revenue Code	301
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$184.30
Rate for Payer: BCBS Commercial	$102.28
Rate for Payer: Cash Price	$142.50
Rate for Payer: Cash Price	$142.50
Rate for Payer: Celtic Commercial/Exchange	$87.78
Rate for Payer: Health Partners Plans Commercial	$180.50
Rate for Payer: UnitedHealthcare Commercial	$184.30
Rate for Payer: WPPA Commercial	$159.60

CALCITONIN

Facility

$190.00

Service Code	HCPCS 82308
Hospital Charge Code	8230800
Hospital Revenue Code	301
Min. Negotiated Rate	$155.80
Max. Negotiated Rate	$184.30
Rate for Payer: Cash Price	$142.50
Rate for Payer: Health Partners Plans Commercial	$180.50
Rate for Payer: UnitedHealthcare Commercial	$184.30
Rate for Payer: WPPA Commercial	$155.80

CALCITONIN STIM PANEL

Facility

$364.00

Service Code	HCPCS 80410
Hospital Charge Code	8041000
Hospital Revenue Code	301
Min. Negotiated Rate	$298.48
Max. Negotiated Rate	$353.08
Rate for Payer: Cash Price	$273.00
Rate for Payer: Health Partners Plans Commercial	$345.80
Rate for Payer: UnitedHealthcare Commercial	$353.08
Rate for Payer: WPPA Commercial	$298.48

CALCITONIN STIM PANEL

Facility

$364.00

Service Code	HCPCS 80410
Hospital Charge Code	8041000
Hospital Revenue Code	301
Min. Negotiated Rate	$168.17
Max. Negotiated Rate	$353.08
Rate for Payer: BCBS Commercial	$344.36
Rate for Payer: Cash Price	$273.00
Rate for Payer: Cash Price	$273.00
Rate for Payer: Celtic Commercial/Exchange	$168.17
Rate for Payer: Health Partners Plans Commercial	$345.80
Rate for Payer: UnitedHealthcare Commercial	$353.08
Rate for Payer: WPPA Commercial	$305.76

CALCIUM ALGINATE 3 3/4 X 3 3/4

Facility

$11.00

Hospital Charge Code	2725049
Hospital Revenue Code	272
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

CALCIUM ALGINATE 3 3/4 X 3 3/4

Facility

$11.00

Hospital Charge Code	2725049
Hospital Revenue Code	272
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

CALCIUM ALGINATE WITH SILVER

Facility

$27.00

Hospital Charge Code	2725045
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

CALCIUM ALGINATE WITH SILVER

Facility

$27.00

Hospital Charge Code	2725045
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

CALCIUM ALGINATE WITH SILVER LTC

Facility

$27.00

Hospital Charge Code	2725047LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

CALCIUM ALGINATE WITH SILVER LTC

Facility

$27.00

Hospital Charge Code	2725047LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

CALCIUM ALGINATE W SILVER LTC

Facility

$27.00

Hospital Charge Code	2725045LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$22.14
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.14

CALCIUM ALGINATE W SILVER LTC

Facility

$27.00

Hospital Charge Code	2725045LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$26.19
Rate for Payer: Cash Price	$20.25
Rate for Payer: Celtic Commercial/Exchange	$12.47
Rate for Payer: Health Partners Plans Commercial	$25.65
Rate for Payer: UnitedHealthcare Commercial	$26.19
Rate for Payer: WPPA Commercial	$22.68

CALCIUM CHLORIDE INJ 1GM

Facility

$33.00

Service Code	NDC 00409163110
Hospital Charge Code	2501161
Hospital Revenue Code	250
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

CALCIUM CHLORIDE INJ 1GM

Facility

$33.00

Service Code	NDC 00409163110
Hospital Charge Code	2501161
Hospital Revenue Code	250
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

CALCIUM GLUCONATE 1,000 MG/10 ML INJ.

Facility

$40.00

Service Code	NDC 63323036019
Hospital Charge Code	2501179
Hospital Revenue Code	250
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.08
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$32.80

CALCIUM GLUCONATE 1,000 MG/10 ML INJ.

Facility

$40.00

Service Code	NDC 63323036019
Hospital Charge Code	2501179
Hospital Revenue Code	250
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$38.80
Rate for Payer: Cash Price	$30.08
Rate for Payer: Celtic Commercial/Exchange	$18.48
Rate for Payer: Health Partners Plans Commercial	$38.00
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: WPPA Commercial	$33.60

CALCIUM TOTAL

Facility

$63.00

Service Code	HCPCS 82310
Hospital Charge Code	8231000
Hospital Revenue Code	301
Min. Negotiated Rate	$11.06
Max. Negotiated Rate	$61.11
Rate for Payer: BCBS Commercial	$11.06
Rate for Payer: Cash Price	$47.44
Rate for Payer: Cash Price	$47.44
Rate for Payer: Celtic Commercial/Exchange	$29.11
Rate for Payer: Health Partners Plans Commercial	$59.85
Rate for Payer: UnitedHealthcare Commercial	$61.11
Rate for Payer: WPPA Commercial	$52.92

CALCIUM TOTAL

Facility

$63.00

Service Code	HCPCS 82310
Hospital Charge Code	8231000
Hospital Revenue Code	301
Min. Negotiated Rate	$51.66
Max. Negotiated Rate	$61.11
Rate for Payer: Cash Price	$47.44
Rate for Payer: Health Partners Plans Commercial	$59.85
Rate for Payer: UnitedHealthcare Commercial	$61.11
Rate for Payer: WPPA Commercial	$51.66

Know your out-of-pocket cost for care.

All Charges