Ness County Hospital

All Charges

Charge

Type

Setting

Price

9 INCH SAM SPLINT

Facility

$24.00

Hospital Charge Code	2709812
Hospital Revenue Code	270
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

9 INCH SAM SPLINT

Facility

$24.00

Hospital Charge Code	2709812
Hospital Revenue Code	270
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
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

ABD 5X9

Facility

$9.00

Hospital Charge Code	2720739LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ABD 5X9

Facility

$9.00

Hospital Charge Code	2720739
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ABD 5X9

Facility

$9.00

Hospital Charge Code	2720739LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ABD 5X9

Facility

$9.00

Hospital Charge Code	2720739
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ABD 7 1/2 X 8

Facility

$9.00

Hospital Charge Code	2720737
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ABD 7 1/2 X 8

Facility

$9.00

Hospital Charge Code	2720737
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ABD 8X10

Facility

$9.00

Hospital Charge Code	2720738LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ABD 8X10

Facility

$9.00

Hospital Charge Code	2720738LTC
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ABDOMEN 1 VIEW (KUB)

Facility

$263.00

Service Code	HCPCS 74018
Hospital Charge Code	3250002
Hospital Revenue Code	320
Min. Negotiated Rate	$215.66
Max. Negotiated Rate	$255.11
Rate for Payer: Cash Price	$197.25
Rate for Payer: Health Partners Plans Commercial	$249.85
Rate for Payer: UnitedHealthcare Commercial	$255.11
Rate for Payer: WPPA Commercial	$215.66

ABDOMEN 1 VIEW (KUB)

Facility

$263.00

Service Code	HCPCS 74018
Hospital Charge Code	3250002
Hospital Revenue Code	320
Min. Negotiated Rate	$121.51
Max. Negotiated Rate	$255.11
Rate for Payer: BCBS Commercial	$134.73
Rate for Payer: Cash Price	$197.25
Rate for Payer: Cash Price	$197.25
Rate for Payer: Celtic Commercial/Exchange	$121.51
Rate for Payer: Health Partners Plans Commercial	$249.85
Rate for Payer: UnitedHealthcare Commercial	$255.11
Rate for Payer: WPPA Commercial	$220.92

ABDOMEN ACUTE COMPLETE

Facility

$347.00

Service Code	HCPCS 74022
Hospital Charge Code	3250008
Hospital Revenue Code	320
Min. Negotiated Rate	$160.31
Max. Negotiated Rate	$336.59
Rate for Payer: BCBS Commercial	$263.89
Rate for Payer: Cash Price	$260.70
Rate for Payer: Cash Price	$260.70
Rate for Payer: Celtic Commercial/Exchange	$160.31
Rate for Payer: Health Partners Plans Commercial	$329.65
Rate for Payer: UnitedHealthcare Commercial	$336.59
Rate for Payer: WPPA Commercial	$291.48

ABDOMEN ACUTE COMPLETE

Facility

$347.00

Service Code	HCPCS 74022
Hospital Charge Code	3250008
Hospital Revenue Code	320
Min. Negotiated Rate	$284.54
Max. Negotiated Rate	$336.59
Rate for Payer: Cash Price	$260.70
Rate for Payer: Health Partners Plans Commercial	$329.65
Rate for Payer: UnitedHealthcare Commercial	$336.59
Rate for Payer: WPPA Commercial	$284.54

ABDOMEN KUB AND UPRIGHT 2V

Facility

$367.00

Service Code	HCPCS 74019
Hospital Charge Code	3250006
Hospital Revenue Code	320
Min. Negotiated Rate	$300.94
Max. Negotiated Rate	$355.99
Rate for Payer: Cash Price	$275.25
Rate for Payer: Health Partners Plans Commercial	$348.65
Rate for Payer: UnitedHealthcare Commercial	$355.99
Rate for Payer: WPPA Commercial	$300.94

ABDOMEN KUB AND UPRIGHT 2V

Facility

$367.00

Service Code	HCPCS 74019
Hospital Charge Code	3250006
Hospital Revenue Code	320
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$355.99
Rate for Payer: BCBS Commercial	$132.93
Rate for Payer: Cash Price	$275.25
Rate for Payer: Cash Price	$275.25
Rate for Payer: Celtic Commercial/Exchange	$169.55
Rate for Payer: Health Partners Plans Commercial	$348.65
Rate for Payer: UnitedHealthcare Commercial	$355.99
Rate for Payer: WPPA Commercial	$308.28

ABDOMINAL PARACENTESIS W/O IMG

Facility

$827.00

Service Code	HCPCS 49082
Hospital Charge Code	4908200
Hospital Revenue Code	761
Min. Negotiated Rate	$382.07
Max. Negotiated Rate	$1,171.95
Rate for Payer: BCBS Commercial	$1,171.95
Rate for Payer: Cash Price	$620.25
Rate for Payer: Cash Price	$620.25
Rate for Payer: Celtic Commercial/Exchange	$382.07
Rate for Payer: Health Partners Plans Commercial	$785.65
Rate for Payer: UnitedHealthcare Commercial	$802.19
Rate for Payer: WPPA Commercial	$694.68

ABDOMINAL PARACENTESIS W/O IMG

Facility

$827.00

Service Code	HCPCS 49082
Hospital Charge Code	4908200
Hospital Revenue Code	761
Min. Negotiated Rate	$678.14
Max. Negotiated Rate	$802.19
Rate for Payer: Cash Price	$620.25
Rate for Payer: Health Partners Plans Commercial	$785.65
Rate for Payer: UnitedHealthcare Commercial	$802.19
Rate for Payer: WPPA Commercial	$678.14

ABDOM PARACENTESIS DX/THER W/

Facility

$1,080.00

Service Code	HCPCS 49083
Hospital Charge Code	4908300
Hospital Revenue Code	761
Min. Negotiated Rate	$498.96
Max. Negotiated Rate	$1,171.95
Rate for Payer: BCBS Commercial	$1,171.95
Rate for Payer: Cash Price	$810.00
Rate for Payer: Cash Price	$810.00
Rate for Payer: Celtic Commercial/Exchange	$498.96
Rate for Payer: Health Partners Plans Commercial	$1,026.00
Rate for Payer: UnitedHealthcare Commercial	$1,047.60
Rate for Payer: WPPA Commercial	$907.20

ABDOM PARACENTESIS DX/THER W/

Facility

$1,080.00

Service Code	HCPCS 49083
Hospital Charge Code	4908300
Hospital Revenue Code	761
Min. Negotiated Rate	$885.60
Max. Negotiated Rate	$1,047.60
Rate for Payer: Cash Price	$810.00
Rate for Payer: Health Partners Plans Commercial	$1,026.00
Rate for Payer: UnitedHealthcare Commercial	$1,047.60
Rate for Payer: WPPA Commercial	$885.60

ABD PAD

Facility

$9.00

Hospital Charge Code	2720738
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

ABD PAD

Facility

$9.00

Hospital Charge Code	2720738
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility

$6,432.18

Service Code	MSDRG 770
Min. Negotiated Rate	$6,432.18
Max. Negotiated Rate	$6,432.18
Rate for Payer: BCBS Commercial	$6,432.18

ABORTION WITHOUT D&C

Facility

$5,167.56

Service Code	MSDRG 779
Min. Negotiated Rate	$5,167.56
Max. Negotiated Rate	$5,167.56
Rate for Payer: BCBS Commercial	$5,167.56

ACAPELLA

Facility

$133.00

Hospital Charge Code	4101200
Hospital Revenue Code	270
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$99.75
Rate for Payer: Celtic Commercial/Exchange	$61.45
Rate for Payer: Health Partners Plans Commercial	$126.35
Rate for Payer: UnitedHealthcare Commercial	$129.01
Rate for Payer: WPPA Commercial	$111.72

Know your out-of-pocket cost for care.

All Charges