Ness County Hospital

All Charges

Charge

Type

Setting

Price

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$89,103.90

Service Code	MSDRG 216
Min. Negotiated Rate	$89,103.90
Max. Negotiated Rate	$89,103.90
Rate for Payer: BCBS Commercial	$89,103.90

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$44,617.01

Service Code	MSDRG 218
Min. Negotiated Rate	$44,617.01
Max. Negotiated Rate	$44,617.01
Rate for Payer: BCBS Commercial	$44,617.01

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC

Facility

$48,661.44

Service Code	MSDRG 220
Min. Negotiated Rate	$48,661.44
Max. Negotiated Rate	$48,661.44
Rate for Payer: BCBS Commercial	$48,661.44

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC

Facility

$71,515.30

Service Code	MSDRG 219
Min. Negotiated Rate	$71,515.30
Max. Negotiated Rate	$71,515.30
Rate for Payer: BCBS Commercial	$71,515.30

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC

Facility

$44,355.97

Service Code	MSDRG 221
Min. Negotiated Rate	$44,355.97
Max. Negotiated Rate	$44,355.97
Rate for Payer: BCBS Commercial	$44,355.97

CARDIO IQ APOE GENOTYPE

Facility

$300.00

Service Code	HCPCS 81401
Hospital Charge Code	8140100
Hospital Revenue Code	300
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$291.00
Rate for Payer: BCBS Commercial	$284.34
Rate for Payer: Cash Price	$225.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Celtic Commercial/Exchange	$138.60
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$252.00

CARDIO IQ APOE GENOTYPE

Facility

$300.00

Service Code	HCPCS 81401
Hospital Charge Code	8140100
Hospital Revenue Code	300
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$291.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$246.00

CARDIOLIPIN ANTIB EA LG CLASS

Facility

$182.00

Service Code	HCPCS 86147
Hospital Charge Code	8614700
Hospital Revenue Code	302
Min. Negotiated Rate	$149.24
Max. Negotiated Rate	$176.54
Rate for Payer: Cash Price	$136.50
Rate for Payer: Health Partners Plans Commercial	$172.90
Rate for Payer: UnitedHealthcare Commercial	$176.54
Rate for Payer: WPPA Commercial	$149.24

CARDIOLIPIN ANTIB EA LG CLASS

Facility

$182.00

Service Code	HCPCS 86147
Hospital Charge Code	8614700
Hospital Revenue Code	302
Min. Negotiated Rate	$78.41
Max. Negotiated Rate	$176.54
Rate for Payer: BCBS Commercial	$78.41
Rate for Payer: Cash Price	$136.50
Rate for Payer: Cash Price	$136.50
Rate for Payer: Celtic Commercial/Exchange	$84.08
Rate for Payer: Health Partners Plans Commercial	$172.90
Rate for Payer: UnitedHealthcare Commercial	$176.54
Rate for Payer: WPPA Commercial	$152.88

CARDIOLIPIN ANTIBODIES IGG,IGM

Facility

$138.00

Service Code	HCPCS 86147
Hospital Charge Code	8888911
Hospital Revenue Code	302
Min. Negotiated Rate	$113.16
Max. Negotiated Rate	$133.86
Rate for Payer: Cash Price	$103.50
Rate for Payer: Health Partners Plans Commercial	$131.10
Rate for Payer: UnitedHealthcare Commercial	$133.86
Rate for Payer: WPPA Commercial	$113.16

CARDIOLIPIN ANTIBODIES IGG,IGM

Facility

$138.00

Service Code	HCPCS 86147
Hospital Charge Code	8888911
Hospital Revenue Code	302
Min. Negotiated Rate	$63.76
Max. Negotiated Rate	$133.86
Rate for Payer: BCBS Commercial	$78.41
Rate for Payer: Cash Price	$103.50
Rate for Payer: Cash Price	$103.50
Rate for Payer: Celtic Commercial/Exchange	$63.76
Rate for Payer: Health Partners Plans Commercial	$131.10
Rate for Payer: UnitedHealthcare Commercial	$133.86
Rate for Payer: WPPA Commercial	$115.92

CARDIOPULMONARY RESUSCITATION

Facility

$741.00

Service Code	HCPCS 92950
Hospital Charge Code	9295000
Hospital Revenue Code	450
Min. Negotiated Rate	$309.49
Max. Negotiated Rate	$718.77
Rate for Payer: BCBS Commercial	$309.49
Rate for Payer: Cash Price	$555.75
Rate for Payer: Cash Price	$555.75
Rate for Payer: Celtic Commercial/Exchange	$342.34
Rate for Payer: Health Partners Plans Commercial	$703.95
Rate for Payer: UnitedHealthcare Commercial	$718.77
Rate for Payer: WPPA Commercial	$622.44

CARDIOPULMONARY RESUSCITATION

Facility

$741.00

Service Code	HCPCS 92950
Hospital Charge Code	9295000
Hospital Revenue Code	450
Min. Negotiated Rate	$607.62
Max. Negotiated Rate	$718.77
Rate for Payer: Cash Price	$555.75
Rate for Payer: Health Partners Plans Commercial	$703.95
Rate for Payer: UnitedHealthcare Commercial	$718.77
Rate for Payer: WPPA Commercial	$607.62

CARDIOVERSION ELECTIV EXTERNAL

Facility

$834.00

Service Code	HCPCS 92960
Hospital Charge Code	9296000
Hospital Revenue Code	450
Min. Negotiated Rate	$683.88
Max. Negotiated Rate	$808.98
Rate for Payer: Cash Price	$625.50
Rate for Payer: Health Partners Plans Commercial	$792.30
Rate for Payer: UnitedHealthcare Commercial	$808.98
Rate for Payer: WPPA Commercial	$683.88

CARDIOVERSION ELECTIV EXTERNAL

Facility

$834.00

Service Code	HCPCS 92960
Hospital Charge Code	9296000
Hospital Revenue Code	450
Min. Negotiated Rate	$385.31
Max. Negotiated Rate	$808.98
Rate for Payer: BCBS Commercial	$481.93
Rate for Payer: Cash Price	$625.50
Rate for Payer: Cash Price	$625.50
Rate for Payer: Celtic Commercial/Exchange	$385.31
Rate for Payer: Health Partners Plans Commercial	$792.30
Rate for Payer: UnitedHealthcare Commercial	$808.98
Rate for Payer: WPPA Commercial	$700.56

CARDIZEM 100 MG IV ADVANTAGE (DILTIAZEM HCL)

Facility

$96.00

Service Code	NDC 00409435013
Hospital Charge Code	2518322
Hospital Revenue Code	250
Min. Negotiated Rate	$44.35
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Celtic Commercial/Exchange	$44.35
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$80.64

CARDIZEM 100 MG IV ADVANTAGE (DILTIAZEM HCL)

Facility

$96.00

Service Code	NDC 00409435013
Hospital Charge Code	2518322
Hospital Revenue Code	250
Min. Negotiated Rate	$78.72
Max. Negotiated Rate	$93.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Health Partners Plans Commercial	$91.20
Rate for Payer: UnitedHealthcare Commercial	$93.12
Rate for Payer: WPPA Commercial	$78.72

CARDIZEM 30MG TAB (DILTIAZEM)

Facility

$3.00

Service Code	NDC 60687056201
Hospital Charge Code	2501237
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.25
Rate for Payer: Celtic Commercial/Exchange	$1.39
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.52

CARDIZEM 30MG TAB (DILTIAZEM)

Facility

$3.00

Service Code	NDC 60687056201
Hospital Charge Code	2501237
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.25
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.46

CARDIZEM 50MG/10ML INJ. -for IV PUSH ONLY- (DILTIAZEM HCL)

Facility

$86.00

Service Code	NDC 25021031910
Hospital Charge Code	2511707
Hospital Revenue Code	250
Min. Negotiated Rate	$70.52
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$65.03
Rate for Payer: Health Partners Plans Commercial	$81.70
Rate for Payer: UnitedHealthcare Commercial	$83.42
Rate for Payer: WPPA Commercial	$70.52

CARDIZEM 50MG/10ML INJ. -for IV PUSH ONLY- (DILTIAZEM HCL)

Facility

$86.00

Service Code	NDC 25021031910
Hospital Charge Code	2511707
Hospital Revenue Code	250
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$65.03
Rate for Payer: Celtic Commercial/Exchange	$39.73
Rate for Payer: Health Partners Plans Commercial	$81.70
Rate for Payer: UnitedHealthcare Commercial	$83.42
Rate for Payer: WPPA Commercial	$72.24

CARDIZEM CD/ER 120 MG CAP (DILTIAZEM HCL)

Facility

$4.00

Service Code	NDC 60687019501
Hospital Charge Code	2513026
Hospital Revenue Code	250
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.08
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

CARDIZEM CD/ER 120 MG CAP (DILTIAZEM HCL)

Facility

$4.00

Service Code	NDC 60687019501
Hospital Charge Code	2513026
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.08
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

CARDIZEM CD/ER 180 MG CAP (DILTIAZEM HCL)

Facility

$5.00

Service Code	NDC 60687020601
Hospital Charge Code	2511731
Hospital Revenue Code	250
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

CARDIZEM CD/ER 180 MG CAP (DILTIAZEM HCL)

Facility

$5.00

Service Code	NDC 60687020601
Hospital Charge Code	2511731
Hospital Revenue Code	250
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

Know your out-of-pocket cost for care.

All Charges