Ness County Hospital

All Charges

Charge

Type

Setting

Price

CHOLESTEROL, SERUM, TOTAL

Facility

$47.00

Service Code	HCPCS 82465
Hospital Charge Code	8246500
Hospital Revenue Code	301
Min. Negotiated Rate	$38.54
Max. Negotiated Rate	$45.59
Rate for Payer: Cash Price	$35.25
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$38.54

CHOLINESTERASE RBC

Facility

$73.00

Service Code	HCPCS 82482
Hospital Charge Code	8248200
Hospital Revenue Code	301
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$70.81
Rate for Payer: BCBS Commercial	$38.59
Rate for Payer: Cash Price	$54.75
Rate for Payer: Cash Price	$54.75
Rate for Payer: Celtic Commercial/Exchange	$33.73
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$61.32

CHOLINESTERASE RBC

Facility

$73.00

Service Code	HCPCS 82482
Hospital Charge Code	8248200
Hospital Revenue Code	301
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$70.81
Rate for Payer: Cash Price	$54.75
Rate for Payer: Health Partners Plans Commercial	$69.35
Rate for Payer: UnitedHealthcare Commercial	$70.81
Rate for Payer: WPPA Commercial	$59.86

CHROMO ANALY ADDTL KARYOTYPES

Facility

$308.00

Service Code	HCPCS 88280
Hospital Charge Code	8828000
Hospital Revenue Code	311
Min. Negotiated Rate	$252.56
Max. Negotiated Rate	$298.76
Rate for Payer: Cash Price	$231.00
Rate for Payer: Health Partners Plans Commercial	$292.60
Rate for Payer: UnitedHealthcare Commercial	$298.76
Rate for Payer: WPPA Commercial	$252.56

CHROMO ANALY ADDTL KARYOTYPES

Facility

$308.00

Service Code	HCPCS 88280
Hospital Charge Code	8828000
Hospital Revenue Code	311
Min. Negotiated Rate	$142.30
Max. Negotiated Rate	$298.76
Rate for Payer: BCBS Commercial	$209.65
Rate for Payer: Cash Price	$231.00
Rate for Payer: Cash Price	$231.00
Rate for Payer: Celtic Commercial/Exchange	$142.30
Rate for Payer: Health Partners Plans Commercial	$292.60
Rate for Payer: UnitedHealthcare Commercial	$298.76
Rate for Payer: WPPA Commercial	$258.72

CHROMO ANALY COUNT 15-20 CELLS

Facility

$770.00

Service Code	HCPCS 88262
Hospital Charge Code	8826200
Hospital Revenue Code	311
Min. Negotiated Rate	$631.40
Max. Negotiated Rate	$746.90
Rate for Payer: Cash Price	$577.50
Rate for Payer: Health Partners Plans Commercial	$731.50
Rate for Payer: UnitedHealthcare Commercial	$746.90
Rate for Payer: WPPA Commercial	$631.40

CHROMO ANALY COUNT 15-20 CELLS

Facility

$770.00

Service Code	HCPCS 88262
Hospital Charge Code	8826200
Hospital Revenue Code	311
Min. Negotiated Rate	$355.74
Max. Negotiated Rate	$746.90
Rate for Payer: BCBS Commercial	$524.54
Rate for Payer: Cash Price	$577.50
Rate for Payer: Cash Price	$577.50
Rate for Payer: Celtic Commercial/Exchange	$355.74
Rate for Payer: Health Partners Plans Commercial	$731.50
Rate for Payer: UnitedHealthcare Commercial	$746.90
Rate for Payer: WPPA Commercial	$646.80

CHROMOGRANIN A

Facility

$95.00

Service Code	HCPCS 86316
Hospital Charge Code	8631601
Hospital Revenue Code	302
Min. Negotiated Rate	$43.89
Max. Negotiated Rate	$92.15
Rate for Payer: BCBS Commercial	$54.49
Rate for Payer: Cash Price	$71.25
Rate for Payer: Cash Price	$71.25
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

CHROMOGRANIN A

Facility

$95.00

Service Code	HCPCS 86316
Hospital Charge Code	8631601
Hospital Revenue Code	302
Min. Negotiated Rate	$77.90
Max. Negotiated Rate	$92.15
Rate for Payer: Cash Price	$71.25
Rate for Payer: Health Partners Plans Commercial	$90.25
Rate for Payer: UnitedHealthcare Commercial	$92.15
Rate for Payer: WPPA Commercial	$77.90

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC

Facility

$8,608.96

Service Code	MSDRG 191
Min. Negotiated Rate	$8,608.96
Max. Negotiated Rate	$8,608.96
Rate for Payer: BCBS Commercial	$8,608.96

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC

Facility

$11,491.77

Service Code	MSDRG 190
Min. Negotiated Rate	$11,491.77
Max. Negotiated Rate	$11,491.77
Rate for Payer: BCBS Commercial	$11,491.77

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC

Facility

$7,223.86

Service Code	MSDRG 192
Min. Negotiated Rate	$7,223.86
Max. Negotiated Rate	$7,223.86
Rate for Payer: BCBS Commercial	$7,223.86

CIALIS 2.5 MG TAB (TADALAFIL)

Facility

$39.00

Service Code	NDC 27241011103
Hospital Charge Code	2518751
Hospital Revenue Code	250
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

CIALIS 2.5 MG TAB (TADALAFIL)

Facility

$39.00

Service Code	NDC 27241011103
Hospital Charge Code	2518751
Hospital Revenue Code	250
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.25
Rate for Payer: Celtic Commercial/Exchange	$18.02
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$32.76

Cimzia (certolizumab pegol) 200 mg/ml subQ syringe kit

Facility

$10,206.00

Service Code	NDC 50474071079
Hospital Charge Code	2512341
Hospital Revenue Code	250
Min. Negotiated Rate	$8,368.92
Max. Negotiated Rate	$9,899.82
Rate for Payer: Cash Price	$7,654.91
Rate for Payer: Health Partners Plans Commercial	$9,695.70
Rate for Payer: UnitedHealthcare Commercial	$9,899.82
Rate for Payer: WPPA Commercial	$8,368.92

Cimzia (certolizumab pegol) 200 mg/ml subQ syringe kit

Facility

$10,206.00

Service Code	NDC 50474071079
Hospital Charge Code	2512341
Hospital Revenue Code	250
Min. Negotiated Rate	$4,715.17
Max. Negotiated Rate	$9,899.82
Rate for Payer: Cash Price	$7,654.91
Rate for Payer: Celtic Commercial/Exchange	$4,715.17
Rate for Payer: Health Partners Plans Commercial	$9,695.70
Rate for Payer: UnitedHealthcare Commercial	$9,899.82
Rate for Payer: WPPA Commercial	$8,573.04

Cimzia (certolizumab pegol) 200mg/ml subQ syringe kit

Facility

$10,206.00

Service Code	NDC 50474071079
Hospital Charge Code	2512341
Hospital Revenue Code	250
Min. Negotiated Rate	$4,715.17
Max. Negotiated Rate	$9,899.82
Rate for Payer: Cash Price	$7,654.91
Rate for Payer: Celtic Commercial/Exchange	$4,715.17
Rate for Payer: Health Partners Plans Commercial	$9,695.70
Rate for Payer: UnitedHealthcare Commercial	$9,899.82
Rate for Payer: WPPA Commercial	$8,573.04

Cimzia (certolizumab pegol) 200mg/ml subQ syringe kit

Facility

$10,206.00

Service Code	NDC 50474071079
Hospital Charge Code	2512341
Hospital Revenue Code	250
Min. Negotiated Rate	$8,368.92
Max. Negotiated Rate	$9,899.82
Rate for Payer: Cash Price	$7,654.91
Rate for Payer: Health Partners Plans Commercial	$9,695.70
Rate for Payer: UnitedHealthcare Commercial	$9,899.82
Rate for Payer: WPPA Commercial	$8,368.92

CIPRO 200 MG PREMIX (CIPROFLOXACIN) IV

Facility

$11.00

Service Code	NDC 25021019282
Hospital Charge Code	2518397
Hospital Revenue Code	250
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.77
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

CIPRO 200 MG PREMIX (CIPROFLOXACIN) IV

Facility

$11.00

Service Code	NDC 25021019282
Hospital Charge Code	2518397
Hospital Revenue Code	250
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.77
Rate for Payer: Celtic Commercial/Exchange	$5.08
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.24

CIPRO 250 MG TAB (CIPROFLOXACIN)

Facility

$16.00

Service Code	NDC 65862007601
Hospital Charge Code	2510824
Hospital Revenue Code	250
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.30
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

CIPRO 250 MG TAB (CIPROFLOXACIN)

Facility

$16.00

Service Code	NDC 65862007601
Hospital Charge Code	2510824
Hospital Revenue Code	250
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$15.52
Rate for Payer: Cash Price	$12.30
Rate for Payer: Health Partners Plans Commercial	$15.20
Rate for Payer: UnitedHealthcare Commercial	$15.52
Rate for Payer: WPPA Commercial	$13.12

CIPRO 400 MG PREMIX (CIPROFLOXACIN) IV

Facility

$86.00

Service Code	NDC 25021019287
Hospital Charge Code	2517027
Hospital Revenue Code	250
Min. Negotiated Rate	$70.52
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$64.88
Rate for Payer: Health Partners Plans Commercial	$81.70
Rate for Payer: UnitedHealthcare Commercial	$83.42
Rate for Payer: WPPA Commercial	$70.52

CIPRO 400 MG PREMIX (CIPROFLOXACIN) IV

Facility

$86.00

Service Code	NDC 25021019287
Hospital Charge Code	2517027
Hospital Revenue Code	250
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$83.42
Rate for Payer: Cash Price	$64.88
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

CIPRO HC OTIC DROPS (CIPROFLOXACIN + HYDROCORTISONE)

Facility

$1,137.00

Service Code	NDC 00065853110
Hospital Charge Code	2509313
Hospital Revenue Code	250
Min. Negotiated Rate	$932.34
Max. Negotiated Rate	$1,102.89
Rate for Payer: Cash Price	$852.82
Rate for Payer: Health Partners Plans Commercial	$1,080.15
Rate for Payer: UnitedHealthcare Commercial	$1,102.89
Rate for Payer: WPPA Commercial	$932.34

Know your out-of-pocket cost for care.

All Charges