Ness County Hospital

All Charges

Charge

Type

Setting

Price

CERVICAL COLLAR 2 X 23.5" LG

Facility

$25.00

Hospital Charge Code	2701187
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 23.5" LG

Facility

$25.00

Hospital Charge Code	2701187
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 3 3/4" MD

Facility

$25.00

Hospital Charge Code	2701188
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 3 3/4" MD

Facility

$25.00

Hospital Charge Code	2701188
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 3 3/4" X-LONG

Facility

$25.00

Hospital Charge Code	2701189
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 3 3/4" X-LONG

Facility

$25.00

Hospital Charge Code	2701189
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 3 X 20" LG

Facility

$25.00

Hospital Charge Code	2701190
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 3 X 20" LG

Facility

$25.00

Hospital Charge Code	2701190
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 3 X 22" XL

Facility

$25.00

Hospital Charge Code	2701191
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 3 X 22" XL

Facility

$25.00

Hospital Charge Code	2701191
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 4 X 20" LG

Facility

$25.00

Hospital Charge Code	2701192
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 4 X 20" LG

Facility

$25.00

Hospital Charge Code	2701192
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 SPINAL FUSION WITH CC

Facility

$27,103.13

Service Code	MSDRG 472
Min. Negotiated Rate	$27,103.13
Max. Negotiated Rate	$27,103.13
Rate for Payer: BCBS Commercial	$27,103.13

CERVICAL SPINAL FUSION WITH MCC

Facility

$44,552.40

Service Code	MSDRG 471
Min. Negotiated Rate	$44,552.40
Max. Negotiated Rate	$44,552.40
Rate for Payer: BCBS Commercial	$44,552.40

CERVICAL SPINAL FUSION WITHOUT CC/MCC

Facility

$22,534.91

Service Code	MSDRG 473
Min. Negotiated Rate	$22,534.91
Max. Negotiated Rate	$22,534.91
Rate for Payer: BCBS Commercial	$22,534.91

CERV-O COLLAR FIRM FOAM SM

Facility

$35.00

Hospital Charge Code	2701193
Hospital Revenue Code	272
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.25
Rate for Payer: Celtic Commercial/Exchange	$16.17
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$29.40

CERV-O COLLAR FIRM FOAM SM

Facility

$35.00

Hospital Charge Code	2701193
Hospital Revenue Code	272
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$33.95
Rate for Payer: Cash Price	$26.25
Rate for Payer: Health Partners Plans Commercial	$33.25
Rate for Payer: UnitedHealthcare Commercial	$33.95
Rate for Payer: WPPA Commercial	$28.70

CESAREAN SECTION WITHOUT STERILIZATION WITH CC

Facility

$9,755.59

Service Code	MSDRG 787
Min. Negotiated Rate	$9,755.59
Max. Negotiated Rate	$9,755.59
Rate for Payer: BCBS Commercial	$9,755.59

CESAREAN SECTION WITHOUT STERILIZATION WITH MCC

Facility

$15,012.29

Service Code	MSDRG 786
Min. Negotiated Rate	$15,012.29
Max. Negotiated Rate	$15,012.29
Rate for Payer: BCBS Commercial	$15,012.29

CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

Facility

$8,167.17

Service Code	MSDRG 788
Min. Negotiated Rate	$8,167.17
Max. Negotiated Rate	$8,167.17
Rate for Payer: BCBS Commercial	$8,167.17

CESAREAN SECTION WITH STERILIZATION WITH CC

Facility

$9,993.37

Service Code	MSDRG 784
Min. Negotiated Rate	$9,993.37
Max. Negotiated Rate	$9,993.37
Rate for Payer: BCBS Commercial	$9,993.37

CESAREAN SECTION WITH STERILIZATION WITH MCC

Facility

$16,935.38

Service Code	MSDRG 783
Min. Negotiated Rate	$16,935.38
Max. Negotiated Rate	$16,935.38
Rate for Payer: BCBS Commercial	$16,935.38

CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC

Facility

$7,703.66

Service Code	MSDRG 785
Min. Negotiated Rate	$7,703.66
Max. Negotiated Rate	$7,703.66
Rate for Payer: BCBS Commercial	$7,703.66

CETACAINE SPRAY

Facility

$267.00

Service Code	NDC 10223020103
Hospital Charge Code	2501336
Hospital Revenue Code	270
Min. Negotiated Rate	$218.94
Max. Negotiated Rate	$258.99
Rate for Payer: Cash Price	$200.25
Rate for Payer: Health Partners Plans Commercial	$253.65
Rate for Payer: UnitedHealthcare Commercial	$258.99
Rate for Payer: WPPA Commercial	$218.94

CETACAINE SPRAY

Facility

$267.00

Service Code	NDC 10223020103
Hospital Charge Code	2501336
Hospital Revenue Code	270
Min. Negotiated Rate	$123.35
Max. Negotiated Rate	$258.99
Rate for Payer: Cash Price	$200.25
Rate for Payer: Celtic Commercial/Exchange	$123.35
Rate for Payer: Health Partners Plans Commercial	$253.65
Rate for Payer: UnitedHealthcare Commercial	$258.99
Rate for Payer: WPPA Commercial	$224.28

Know your out-of-pocket cost for care.

All Charges