Ness County Hospital

All Charges

Charge

Type

Setting

Price

CHILDREN'S DELSYM COUGH 12-HR OS (DEXTROMETHORPAN POLISTIREX ER)

Facility

$1.00

Service Code	NDC 63824017365
Hospital Charge Code	2519429
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.16
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

CHILDRENS TYLENOL OS 160 MG/5 ML (ACETAMINOPHEN)

Facility

$1.00

Service Code	NDC 50580061401
Hospital Charge Code	2507572
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

CHILDRENS TYLENOL OS 160 MG/5 ML (ACETAMINOPHEN)

Facility

$1.00

Service Code	NDC 50580061401
Hospital Charge Code	2507572
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

CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$426,668.40

Service Code	MSDRG 018
Min. Negotiated Rate	$426,668.40
Max. Negotiated Rate	$426,668.40
Rate for Payer: BCBS Commercial	$426,668.40

CHLORAPREP 3ML

Facility

$3.00

Hospital Charge Code	2726358
Hospital Revenue Code	272
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

CHLORAPREP 3ML

Facility

$3.00

Hospital Charge Code	2726358
Hospital Revenue Code	272
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

CHLORAPREP APPLICATOR

Facility

$4.00

Hospital Charge Code	2516565
Hospital Revenue Code	270
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
Rate for Payer: Health Partners Plans Commercial	$3.80
Rate for Payer: UnitedHealthcare Commercial	$3.88
Rate for Payer: WPPA Commercial	$3.28

CHLORAPREP APPLICATOR

Facility

$4.00

Hospital Charge Code	2516565
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$3.88
Rate for Payer: Cash Price	$3.00
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

CHLORASEPTIC SORE THRAOT LOZENGES (BENZOCAINE MENTHOL)

Facility

$1.00

Service Code	NDC 78112001106
Hospital Charge Code	2501377
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

CHLORASEPTIC SORE THRAOT LOZENGES (BENZOCAINE MENTHOL)

Facility

$1.00

Service Code	NDC 78112001106
Hospital Charge Code	2501377
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

CHLORASEPTIC SORE THROAT SPRAY 6 OZ

Facility

$12.00

Service Code	NDC 46122026530
Hospital Charge Code	2501385
Hospital Revenue Code	250
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.68
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$9.84

CHLORASEPTIC SORE THROAT SPRAY 6 OZ

Facility

$12.00

Service Code	NDC 46122026530
Hospital Charge Code	2501385
Hospital Revenue Code	250
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$11.64
Rate for Payer: Cash Price	$9.68
Rate for Payer: Celtic Commercial/Exchange	$5.54
Rate for Payer: Health Partners Plans Commercial	$11.40
Rate for Payer: UnitedHealthcare Commercial	$11.64
Rate for Payer: WPPA Commercial	$10.08

CHLORIDE BLOOD

Facility

$31.00

Service Code	HCPCS 82435
Hospital Charge Code	8243500
Hospital Revenue Code	301
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$30.07
Rate for Payer: Cash Price	$23.25
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$25.42

CHLORIDE BLOOD

Facility

$31.00

Service Code	HCPCS 82435
Hospital Charge Code	8243500
Hospital Revenue Code	301
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$30.07
Rate for Payer: BCBS Commercial	$9.87
Rate for Payer: Cash Price	$23.25
Rate for Payer: Cash Price	$23.25
Rate for Payer: Celtic Commercial/Exchange	$14.32
Rate for Payer: Health Partners Plans Commercial	$29.45
Rate for Payer: UnitedHealthcare Commercial	$30.07
Rate for Payer: WPPA Commercial	$26.04

CHLORIDE; OTHER SOURCE

Facility

$34.00

Service Code	HCPCS 82438
Hospital Charge Code	8243800
Hospital Revenue Code	301
Min. Negotiated Rate	$9.11
Max. Negotiated Rate	$32.98
Rate for Payer: BCBS Commercial	$9.11
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

CHLORIDE; OTHER SOURCE

Facility

$34.00

Service Code	HCPCS 82438
Hospital Charge Code	8243800
Hospital Revenue Code	301
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

CHLORIDE URINE

Facility

$37.00

Service Code	HCPCS 82436
Hospital Charge Code	8243600
Hospital Revenue Code	301
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$35.89
Rate for Payer: BCBS Commercial	$20.82
Rate for Payer: Cash Price	$27.75
Rate for Payer: Cash Price	$27.75
Rate for Payer: Celtic Commercial/Exchange	$17.09
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$31.08

CHLORIDE URINE

Facility

$37.00

Service Code	HCPCS 82436
Hospital Charge Code	8243600
Hospital Revenue Code	301
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$35.89
Rate for Payer: Cash Price	$27.75
Rate for Payer: Health Partners Plans Commercial	$35.15
Rate for Payer: UnitedHealthcare Commercial	$35.89
Rate for Payer: WPPA Commercial	$30.34

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility

$18,032.36

Service Code	MSDRG 415
Min. Negotiated Rate	$18,032.36
Max. Negotiated Rate	$18,032.36
Rate for Payer: BCBS Commercial	$18,032.36

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility

$28,204.10

Service Code	MSDRG 414
Min. Negotiated Rate	$28,204.10
Max. Negotiated Rate	$28,204.10
Rate for Payer: BCBS Commercial	$28,204.10

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$12,623.63

Service Code	MSDRG 416
Min. Negotiated Rate	$12,623.63
Max. Negotiated Rate	$12,623.63
Rate for Payer: BCBS Commercial	$12,623.63

CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility

$20,213.95

Service Code	MSDRG 412
Min. Negotiated Rate	$20,213.95
Max. Negotiated Rate	$20,213.95
Rate for Payer: BCBS Commercial	$20,213.95

CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility

$28,207.18

Service Code	MSDRG 411
Min. Negotiated Rate	$28,207.18
Max. Negotiated Rate	$28,207.18
Rate for Payer: BCBS Commercial	$28,207.18

CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility

$15,362.61

Service Code	MSDRG 413
Min. Negotiated Rate	$15,362.61
Max. Negotiated Rate	$15,362.61
Rate for Payer: BCBS Commercial	$15,362.61

CHOLESTEROL, SERUM, TOTAL

Facility

$47.00

Service Code	HCPCS 82465
Hospital Charge Code	8246500
Hospital Revenue Code	301
Min. Negotiated Rate	$10.87
Max. Negotiated Rate	$45.59
Rate for Payer: BCBS Commercial	$10.87
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cash Price	$35.25
Rate for Payer: Celtic Commercial/Exchange	$21.71
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$39.48

Know your out-of-pocket cost for care.

All Charges