Ness County Hospital

All Charges

Charge

Type

Setting

Price

CLAVICLE STRAP

Facility

$39.00

Hospital Charge Code	2701209
Hospital Revenue Code	270
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.62
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

CLAVICLE STRAP W/ VELCRO SM/MD

Facility

$39.00

Hospital Charge Code	2701210
Hospital Revenue Code	272
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.62
Rate for Payer: Health Partners Plans Commercial	$37.05
Rate for Payer: UnitedHealthcare Commercial	$37.83
Rate for Payer: WPPA Commercial	$31.98

CLAVICLE STRAP W/ VELCRO SM/MD

Facility

$39.00

Hospital Charge Code	2701210
Hospital Revenue Code	272
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$29.62
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

CLAYER CLOSURE FACE2.5<

Facility

$380.00

Service Code	HCPCS 12051
Hospital Charge Code	1205100
Hospital Revenue Code	450
Min. Negotiated Rate	$175.56
Max. Negotiated Rate	$715.08
Rate for Payer: BCBS Commercial	$715.08
Rate for Payer: Cash Price	$285.00
Rate for Payer: Cash Price	$285.00
Rate for Payer: Celtic Commercial/Exchange	$175.56
Rate for Payer: Health Partners Plans Commercial	$361.00
Rate for Payer: UnitedHealthcare Commercial	$368.60
Rate for Payer: WPPA Commercial	$319.20

CLAYER CLOSURE FACE2.5<

Facility

$380.00

Service Code	HCPCS 12051
Hospital Charge Code	1205100
Hospital Revenue Code	450
Min. Negotiated Rate	$311.60
Max. Negotiated Rate	$368.60
Rate for Payer: Cash Price	$285.00
Rate for Payer: Health Partners Plans Commercial	$361.00
Rate for Payer: UnitedHealthcare Commercial	$368.60
Rate for Payer: WPPA Commercial	$311.60

CLEANSING LOTION

Facility

$19.00

Hospital Charge Code	2700065
Hospital Revenue Code	270
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.64
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

CLEANSING LOTION

Facility

$19.00

Hospital Charge Code	2700065
Hospital Revenue Code	270
Min. Negotiated Rate	$15.58
Max. Negotiated Rate	$18.43
Rate for Payer: Cash Price	$14.64
Rate for Payer: Health Partners Plans Commercial	$18.05
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: WPPA Commercial	$15.58

CLEANSING LOTION 8 OZ SPRAY

Facility

$6.00

Hospital Charge Code	2700063
Hospital Revenue Code	270
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$4.51
Rate for Payer: Celtic Commercial/Exchange	$2.77
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$5.04

CLEANSING LOTION 8 OZ SPRAY

Facility

$6.00

Hospital Charge Code	2700063
Hospital Revenue Code	270
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$5.82
Rate for Payer: Cash Price	$4.51
Rate for Payer: Health Partners Plans Commercial	$5.70
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: WPPA Commercial	$4.92

CLEOCIN (CLINDAMYCIN)300MG INJ

Facility

$24.00

Hospital Charge Code	2513711
Hospital Revenue Code	250
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Celtic Commercial/Exchange	$11.09
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$20.16

CLEOCIN (CLINDAMYCIN)300MG INJ

Facility

$24.00

Hospital Charge Code	2513711
Hospital Revenue Code	250
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$23.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: Health Partners Plans Commercial	$22.80
Rate for Payer: UnitedHealthcare Commercial	$23.28
Rate for Payer: WPPA Commercial	$19.68

CLINDAMYCIN 150 MG CAP (CLEOCIN)

Facility

$3.00

Service Code	NDC 68084024301
Hospital Charge Code	2514479
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.70
Rate for Payer: Health Partners Plans Commercial	$2.85
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: WPPA Commercial	$2.46

CLINDAMYCIN 150 MG CAP (CLEOCIN)

Facility

$3.00

Service Code	NDC 68084024301
Hospital Charge Code	2514479
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$2.91
Rate for Payer: Cash Price	$2.70
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

CLINDAMYCIN 300 MG PREMIX (CLEOCIN) IV

Facility

$31.00

Service Code	NDC 00338341050
Hospital Charge Code	2518264
Hospital Revenue Code	250
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$30.07
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

CLINDAMYCIN 300 MG PREMIX (CLEOCIN) IV

Facility

$31.00

Service Code	NDC 00338341050
Hospital Charge Code	2518264
Hospital Revenue Code	250
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

CLINDAMYCIN 600 MG PREMIX (CLEOCIN) IV

Facility

$62.00

Service Code	NDC 00338361250
Hospital Charge Code	2519841
Hospital Revenue Code	250
Min. Negotiated Rate	$50.84
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$47.10
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$50.84

CLINDAMYCIN 600 MG PREMIX (CLEOCIN) IV

Facility

$62.00

Service Code	NDC 00338361250
Hospital Charge Code	2519841
Hospital Revenue Code	250
Min. Negotiated Rate	$28.64
Max. Negotiated Rate	$60.14
Rate for Payer: Cash Price	$47.10
Rate for Payer: Celtic Commercial/Exchange	$28.64
Rate for Payer: Health Partners Plans Commercial	$58.90
Rate for Payer: UnitedHealthcare Commercial	$60.14
Rate for Payer: WPPA Commercial	$52.08

CLINIMIX E 5/20 2 L BAG

Facility

$417.00

Hospital Charge Code	2520000
Hospital Revenue Code	250
Min. Negotiated Rate	$192.65
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$313.14
Rate for Payer: Celtic Commercial/Exchange	$192.65
Rate for Payer: Health Partners Plans Commercial	$396.15
Rate for Payer: UnitedHealthcare Commercial	$404.49
Rate for Payer: WPPA Commercial	$350.28

CLINIMIX E 5/20 2 L BAG

Facility

$417.00

Hospital Charge Code	2520000
Hospital Revenue Code	250
Min. Negotiated Rate	$341.94
Max. Negotiated Rate	$404.49
Rate for Payer: Cash Price	$313.14
Rate for Payer: Health Partners Plans Commercial	$396.15
Rate for Payer: UnitedHealthcare Commercial	$404.49
Rate for Payer: WPPA Commercial	$341.94

CLIN PATH CONSULT;LIMITED W/O

Facility

$100.00

Service Code	HCPCS 80500
Hospital Charge Code	8050000
Hospital Revenue Code	300
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$97.00
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

CLIN PATH CONSULT;LIMITED W/O

Facility

$100.00

Service Code	HCPCS 80500
Hospital Charge Code	8050000
Hospital Revenue Code	300
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

CLIPPER BLADE

Facility

$11.00

Hospital Charge Code	2705498
Hospital Revenue Code	270
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
Rate for Payer: Health Partners Plans Commercial	$10.45
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: WPPA Commercial	$9.02

CLIPPER BLADE

Facility

$11.00

Hospital Charge Code	2705498
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$10.67
Rate for Payer: Cash Price	$8.25
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

CLONAZEPAM

Facility

$146.00

Service Code	HCPCS 80346
Hospital Charge Code	8034600
Hospital Revenue Code	300
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$141.62
Rate for Payer: BCBS Commercial	$54.75
Rate for Payer: Cash Price	$109.50
Rate for Payer: Cash Price	$109.50
Rate for Payer: Celtic Commercial/Exchange	$67.45
Rate for Payer: Health Partners Plans Commercial	$138.70
Rate for Payer: UnitedHealthcare Commercial	$141.62
Rate for Payer: WPPA Commercial	$122.64

CLONAZEPAM

Facility

$146.00

Service Code	HCPCS 80346
Hospital Charge Code	8034600
Hospital Revenue Code	300
Min. Negotiated Rate	$119.72
Max. Negotiated Rate	$141.62
Rate for Payer: Cash Price	$109.50
Rate for Payer: Health Partners Plans Commercial	$138.70
Rate for Payer: UnitedHealthcare Commercial	$141.62
Rate for Payer: WPPA Commercial	$119.72

Know your out-of-pocket cost for care.

All Charges