Ness County Hospital

All Charges

Charge

Type

Setting

Price

ACAPELLA

Facility

$133.00

Hospital Charge Code	4101200
Hospital Revenue Code	270
Min. Negotiated Rate	$109.06
Max. Negotiated Rate	$129.01
Rate for Payer: Cash Price	$99.75
Rate for Payer: Health Partners Plans Commercial	$126.35
Rate for Payer: UnitedHealthcare Commercial	$129.01
Rate for Payer: WPPA Commercial	$109.06

ACCUPRIL 20 MG TAB

Facility

$4.00

Hospital Charge Code	2511806
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

ACCUPRIL 20 MG TAB

Facility

$4.00

Hospital Charge Code	2511806
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

ACE BANDAGE 2"

Facility

$14.00

Hospital Charge Code	2701654
Hospital Revenue Code	270
Min. Negotiated Rate	$11.48
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.69
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.48

ACE BANDAGE 2"

Facility

$14.00

Hospital Charge Code	2701654
Hospital Revenue Code	270
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$13.58
Rate for Payer: Cash Price	$10.69
Rate for Payer: Celtic Commercial/Exchange	$6.47
Rate for Payer: Health Partners Plans Commercial	$13.30
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: WPPA Commercial	$11.76

ACE BANDAGE 3"

Facility

$16.00

Hospital Charge Code	2701657
Hospital Revenue Code	272
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.12

ACE BANDAGE 3"

Facility

$16.00

Hospital Charge Code	2701657
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Celtic Commercial/Exchange	$7.39
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.44

ACE BANDAGE 4"

Facility

$9.00

Hospital Charge Code	2701655LTC
Hospital Revenue Code	270
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

ACE BANDAGE 4"

Facility

$9.00

Hospital Charge Code	2701655LTC
Hospital Revenue Code	270
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

ACE BANDAGE 4"

Facility

$16.00

Hospital Charge Code	2701655
Hospital Revenue Code	270
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Celtic Commercial/Exchange	$7.39
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.44

ACE BANDAGE 4"

Facility

$16.00

Hospital Charge Code	2701655
Hospital Revenue Code	270
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.12

ACE BANDAGE 6"

Facility

$16.00

Hospital Charge Code	2701656
Hospital Revenue Code	270
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Celtic Commercial/Exchange	$7.39
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.44

ACE BANDAGE 6"

Facility

$16.00

Hospital Charge Code	2701656
Hospital Revenue Code	270
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.38
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.12

ACETAMINOPHEN

Facility

$206.00

Service Code	HCPCS 80329
Hospital Charge Code	8032901
Hospital Revenue Code	301
Min. Negotiated Rate	$57.86
Max. Negotiated Rate	$199.82
Rate for Payer: BCBS Commercial	$57.86
Rate for Payer: Cash Price	$154.50
Rate for Payer: Cash Price	$154.50
Rate for Payer: Celtic Commercial/Exchange	$95.17
Rate for Payer: Health Partners Plans Commercial	$195.70
Rate for Payer: UnitedHealthcare Commercial	$199.82
Rate for Payer: WPPA Commercial	$173.04

ACETAMINOPHEN

Facility

$103.00

Service Code	HCPCS 82003
Hospital Charge Code	8200300
Hospital Revenue Code	301
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

ACETAMINOPHEN

Facility

$103.00

Service Code	HCPCS 82003
Hospital Charge Code	8200300
Hospital Revenue Code	301
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$84.46

ACETAMINOPHEN

Facility

$206.00

Service Code	HCPCS 80329
Hospital Charge Code	8032901
Hospital Revenue Code	301
Min. Negotiated Rate	$168.92
Max. Negotiated Rate	$199.82
Rate for Payer: Cash Price	$154.50
Rate for Payer: Health Partners Plans Commercial	$195.70
Rate for Payer: UnitedHealthcare Commercial	$199.82
Rate for Payer: WPPA Commercial	$168.92

ACETONE OR OTHER KETONE BODIES

Facility

$20.00

Service Code	HCPCS 82009
Hospital Charge Code	8200900
Hospital Revenue Code	301
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$19.40
Rate for Payer: BCBS Commercial	$12.93
Rate for Payer: Cash Price	$15.00
Rate for Payer: Cash Price	$15.00
Rate for Payer: Celtic Commercial/Exchange	$9.24
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.80

ACETONE OR OTHER KETONE BODIES

Facility

$20.00

Service Code	HCPCS 82009
Hospital Charge Code	8200900
Hospital Revenue Code	301
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$19.40
Rate for Payer: Cash Price	$15.00
Rate for Payer: Health Partners Plans Commercial	$19.00
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: WPPA Commercial	$16.40

ACETONE OR OTHER KETONE,QUANTI

Facility

$100.00

Service Code	HCPCS 82010
Hospital Charge Code	8201000
Hospital Revenue Code	301
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

ACETONE OR OTHER KETONE,QUANTI

Facility

$100.00

Service Code	HCPCS 82010
Hospital Charge Code	8201000
Hospital Revenue Code	301
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$97.00
Rate for Payer: BCBS Commercial	$29.06
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

ACETYLCHOLINE RECEPT BIND ANTI

Facility

$81.00

Service Code	HCPCS 83519
Hospital Charge Code	8351901
Hospital Revenue Code	301
Min. Negotiated Rate	$66.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.75
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$66.42

ACETYLCHOLINE RECEPT BIND ANTI

Facility

$81.00

Service Code	HCPCS 83519
Hospital Charge Code	8351901
Hospital Revenue Code	301
Min. Negotiated Rate	$36.48
Max. Negotiated Rate	$78.57
Rate for Payer: BCBS Commercial	$36.48
Rate for Payer: Cash Price	$60.75
Rate for Payer: Cash Price	$60.75
Rate for Payer: Celtic Commercial/Exchange	$37.42
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$68.04

ACETYLCHOLINE RECEPT BLOCK ANT

Facility

$81.00

Service Code	HCPCS 83519
Hospital Charge Code	8351902
Hospital Revenue Code	301
Min. Negotiated Rate	$36.48
Max. Negotiated Rate	$78.57
Rate for Payer: BCBS Commercial	$36.48
Rate for Payer: Cash Price	$60.75
Rate for Payer: Cash Price	$60.75
Rate for Payer: Celtic Commercial/Exchange	$37.42
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$68.04

ACETYLCHOLINE RECEPT BLOCK ANT

Facility

$81.00

Service Code	HCPCS 83519
Hospital Charge Code	8351902
Hospital Revenue Code	301
Min. Negotiated Rate	$66.42
Max. Negotiated Rate	$78.57
Rate for Payer: Cash Price	$60.75
Rate for Payer: Health Partners Plans Commercial	$76.95
Rate for Payer: UnitedHealthcare Commercial	$78.57
Rate for Payer: WPPA Commercial	$66.42

Know your out-of-pocket cost for care.

All Charges