Ness County Hospital

All Charges

Charge

Type

Setting

Price

CELL COUNT,MISC BODY FLUIDS,

Facility

$123.00

Service Code	HCPCS 89051
Hospital Charge Code	8905100
Hospital Revenue Code	309
Min. Negotiated Rate	$41.45
Max. Negotiated Rate	$119.31
Rate for Payer: BCBS Commercial	$41.45
Rate for Payer: Cash Price	$92.25
Rate for Payer: Cash Price	$92.25
Rate for Payer: Celtic Commercial/Exchange	$56.83
Rate for Payer: Health Partners Plans Commercial	$116.85
Rate for Payer: UnitedHealthcare Commercial	$119.31
Rate for Payer: WPPA Commercial	$103.32

CELL COUNT,MISC BODY FLUIDS,

Facility

$34.00

Service Code	HCPCS 89050
Hospital Charge Code	8905000
Hospital Revenue Code	309
Min. Negotiated Rate	$27.88
Max. Negotiated Rate	$32.98
Rate for Payer: Cash Price	$25.50
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$27.88

CELL COUNT,MISC BODY FLUIDS,

Facility

$34.00

Service Code	HCPCS 89050
Hospital Charge Code	8905000
Hospital Revenue Code	309
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$32.98
Rate for Payer: BCBS Commercial	$18.90
Rate for Payer: Cash Price	$25.50
Rate for Payer: Cash Price	$25.50
Rate for Payer: Celtic Commercial/Exchange	$15.71
Rate for Payer: Health Partners Plans Commercial	$32.30
Rate for Payer: UnitedHealthcare Commercial	$32.98
Rate for Payer: WPPA Commercial	$28.56

CELLULITIS WITH MCC

Facility

$12,869.48

Service Code	MSDRG 602
Min. Negotiated Rate	$12,869.48
Max. Negotiated Rate	$12,869.48
Rate for Payer: BCBS Commercial	$12,869.48

CELLULITIS WITHOUT MCC

Facility

$8,234.03

Service Code	MSDRG 603
Min. Negotiated Rate	$8,234.03
Max. Negotiated Rate	$8,234.03
Rate for Payer: BCBS Commercial	$8,234.03

CENTRAL LINE TRAY

Facility

$19.00

Hospital Charge Code	2726355
Hospital Revenue Code	272
Min. Negotiated Rate	$15.58
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.25
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.58

CENTRAL LINE TRAY

Facility

$19.00

Hospital Charge Code	2726355
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.25
Rate for Payer: Celtic Commercial/Exchange	$8.78
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.96

CENTRAL VENOUS CATHETER

Facility

$85.00

Hospital Charge Code	2580231
Hospital Revenue Code	270
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Celtic Commercial/Exchange	$39.27
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$71.40

CENTRAL VENOUS CATHETER

Facility

$85.00

Hospital Charge Code	2580231
Hospital Revenue Code	270
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.75
Rate for Payer: Health Partners Plans Commercial	$80.75
Rate for Payer: UnitedHealthcare Commercial	$82.45
Rate for Payer: WPPA Commercial	$69.70

CENTROMERE B ANTIBODY

Facility

$368.00

Service Code	HCPCS 86235
Hospital Charge Code	8623511
Hospital Revenue Code	302
Min. Negotiated Rate	$52.26
Max. Negotiated Rate	$356.96
Rate for Payer: BCBS Commercial	$52.26
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

CENTROMERE B ANTIBODY

Facility

$368.00

Service Code	HCPCS 86235
Hospital Charge Code	8623511
Hospital Revenue Code	302
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

Cepacol Lozenge

Facility

$1.00

Service Code	NDC 63824073216
Hospital Charge Code	2501294
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

Cepacol Lozenge

Facility

$1.00

Service Code	NDC 63824073216
Hospital Charge Code	2501294
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

Cerebyx 100 mg/2ml inj.(fosphenytoin)

Facility

$95.00

Service Code	NDC 00069547102
Hospital Charge Code	2514875
Hospital Revenue Code	250
Min. Negotiated Rate	$77.90
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$71.59
Rate for Payer: Health Partners Plans Commercial	$90.25
Rate for Payer: UnitedHealthcare Commercial	$92.15
Rate for Payer: WPPA Commercial	$77.90

Cerebyx 100 mg/2ml inj.(fosphenytoin)

Facility

$95.00

Service Code	NDC 00069547102
Hospital Charge Code	2514875
Hospital Revenue Code	250
Min. Negotiated Rate	$43.89
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$71.59
Rate for Payer: Celtic Commercial/Exchange	$43.89
Rate for Payer: Health Partners Plans Commercial	$90.25
Rate for Payer: UnitedHealthcare Commercial	$92.15
Rate for Payer: WPPA Commercial	$79.80

CERULOPLASMIN

Facility

$71.00

Service Code	HCPCS 82390
Hospital Charge Code	8239000
Hospital Revenue Code	301
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$68.87
Rate for Payer: Cash Price	$53.25
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$58.22

CERULOPLASMIN

Facility

$71.00

Service Code	HCPCS 82390
Hospital Charge Code	8239000
Hospital Revenue Code	301
Min. Negotiated Rate	$32.80
Max. Negotiated Rate	$68.87
Rate for Payer: BCBS Commercial	$37.33
Rate for Payer: Cash Price	$53.25
Rate for Payer: Cash Price	$53.25
Rate for Payer: Celtic Commercial/Exchange	$32.80
Rate for Payer: Health Partners Plans Commercial	$67.45
Rate for Payer: UnitedHealthcare Commercial	$68.87
Rate for Payer: WPPA Commercial	$59.64

CERUMEN/IMPACTED ALL

Facility

$100.00

Service Code	HCPCS 69210
Hospital Charge Code	6921000
Hospital Revenue Code	761
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$543.31
Rate for Payer: BCBS Commercial	$543.31
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Celtic Commercial/Exchange	$46.20
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$84.00

CERUMEN/IMPACTED ALL

Facility

$100.00

Service Code	HCPCS 69210
Hospital Charge Code	6921000
Hospital Revenue Code	761
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$75.00
Rate for Payer: Health Partners Plans Commercial	$95.00
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: WPPA Commercial	$82.00

CERVICAL COLLAR 2 1/2 X 22 XLG

Facility

$25.00

Hospital Charge Code	2701184
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

CERVICAL COLLAR 2 1/2 X 22 XLG

Facility

$25.00

Hospital Charge Code	2701184
Hospital Revenue Code	272
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

CERVICAL COLLAR 2 X 20.5" SM

Facility

$25.00

Hospital Charge Code	2701185
Hospital Revenue Code	272
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

CERVICAL COLLAR 2 X 20.5" SM

Facility

$25.00

Hospital Charge Code	2701185
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

CERVICAL COLLAR 2 X 22.5" MD

Facility

$25.00

Hospital Charge Code	2701186
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Celtic Commercial/Exchange	$11.55
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$21.00

CERVICAL COLLAR 2 X 22.5" MD

Facility

$25.00

Hospital Charge Code	2701186
Hospital Revenue Code	272
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$24.25
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Partners Plans Commercial	$23.75
Rate for Payer: UnitedHealthcare Commercial	$24.25
Rate for Payer: WPPA Commercial	$20.50

Know your out-of-pocket cost for care.

All Charges