Ness County Hospital

All Charges

Charge

Type

Setting

Price

CLONIDINE 0.1 MG/DAY TRANSDERMAL PATCH (CATAPRES)

Facility

$99.00

Service Code	NDC 00591350804
Hospital Charge Code	2517225
Hospital Revenue Code	250
Min. Negotiated Rate	$45.74
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.62
Rate for Payer: Celtic Commercial/Exchange	$45.74
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$83.16

CLONIDINE 0.1 MG/DAY TRANSDERMAL PATCH (CATAPRES)

Facility

$99.00

Service Code	NDC 00591350804
Hospital Charge Code	2517225
Hospital Revenue Code	250
Min. Negotiated Rate	$81.18
Max. Negotiated Rate	$96.03
Rate for Payer: Cash Price	$74.62
Rate for Payer: Health Partners Plans Commercial	$94.05
Rate for Payer: UnitedHealthcare Commercial	$96.03
Rate for Payer: WPPA Commercial	$81.18

CLOSED TIBIAL SHAFT FRACTURE

Facility

$323.00

Service Code	HCPCS 27750
Hospital Charge Code	2775000
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TIBIAL SHAFT FRACTURE

Facility

$323.00

Service Code	HCPCS 27750
Hospital Charge Code	2775000
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREAT CARPAL SCAPHOID

Facility

$323.00

Service Code	HCPCS 25622
Hospital Charge Code	2562200
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREAT CARPAL SCAPHOID

Facility

$323.00

Service Code	HCPCS 25622
Hospital Charge Code	2562200
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREAT ELBOW WITH MANIP

Facility

$1,530.00

Service Code	HCPCS 24655
Hospital Charge Code	2465500
Hospital Revenue Code	450
Min. Negotiated Rate	$706.86
Max. Negotiated Rate	$1,484.10
Rate for Payer: BCBS Commercial	$1,117.06
Rate for Payer: Cash Price	$1,147.50
Rate for Payer: Cash Price	$1,147.50
Rate for Payer: Celtic Commercial/Exchange	$706.86
Rate for Payer: Health Partners Plans Commercial	$1,453.50
Rate for Payer: UnitedHealthcare Commercial	$1,484.10
Rate for Payer: WPPA Commercial	$1,285.20

CLOSED TREAT ELBOW WITH MANIP

Facility

$1,530.00

Service Code	HCPCS 24655
Hospital Charge Code	2465500
Hospital Revenue Code	450
Min. Negotiated Rate	$1,254.60
Max. Negotiated Rate	$1,484.10
Rate for Payer: Cash Price	$1,147.50
Rate for Payer: Health Partners Plans Commercial	$1,453.50
Rate for Payer: UnitedHealthcare Commercial	$1,484.10
Rate for Payer: WPPA Commercial	$1,254.60

CLOSED TREAT FMORAL FRACTURE

Facility

$323.00

Service Code	HCPCS 27508
Hospital Charge Code	2750800
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREAT FMORAL FRACTURE

Facility

$323.00

Service Code	HCPCS 27508
Hospital Charge Code	2750800
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREAT FRACTURE OF ORBIT

Facility

$1,290.00

Service Code	HCPCS 21400
Hospital Charge Code	2140000
Hospital Revenue Code	450
Min. Negotiated Rate	$595.98
Max. Negotiated Rate	$1,251.30
Rate for Payer: Cash Price	$967.50
Rate for Payer: Celtic Commercial/Exchange	$595.98
Rate for Payer: Health Partners Plans Commercial	$1,225.50
Rate for Payer: UnitedHealthcare Commercial	$1,251.30
Rate for Payer: WPPA Commercial	$1,083.60

CLOSED TREAT FRACTURE OF ORBIT

Facility

$1,290.00

Service Code	HCPCS 21400
Hospital Charge Code	2140000
Hospital Revenue Code	450
Min. Negotiated Rate	$1,057.80
Max. Negotiated Rate	$1,251.30
Rate for Payer: Cash Price	$967.50
Rate for Payer: Health Partners Plans Commercial	$1,225.50
Rate for Payer: UnitedHealthcare Commercial	$1,251.30
Rate for Payer: WPPA Commercial	$1,057.80

CLOSED TREAT/HIP DISLOCATION

Facility

$323.00

Service Code	HCPCS 27250
Hospital Charge Code	2725000
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$541.36
Rate for Payer: BCBS Commercial	$541.36
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREAT/HIP DISLOCATION

Facility

$323.00

Service Code	HCPCS 27250
Hospital Charge Code	2725000
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREAT MEDIAL MALLEOLUS

Facility

$323.00

Service Code	HCPCS 27760
Hospital Charge Code	2776000
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREAT MEDIAL MALLEOLUS

Facility

$323.00

Service Code	HCPCS 27760
Hospital Charge Code	2776000
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREATMENT CALCANEAL

Facility

$323.00

Service Code	HCPCS 28400
Hospital Charge Code	2840000
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREATMENT CALCANEAL

Facility

$323.00

Service Code	HCPCS 28400
Hospital Charge Code	2840000
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREATMENT/FRACTURE TOE

Facility

$323.00

Service Code	HCPCS 28495
Hospital Charge Code	2849500
Hospital Revenue Code	450
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$1,617.01
Rate for Payer: BCBS Commercial	$1,617.01
Rate for Payer: Cash Price	$242.25
Rate for Payer: Cash Price	$242.25
Rate for Payer: Celtic Commercial/Exchange	$149.23
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$271.32

CLOSED TREATMENT/FRACTURE TOE

Facility

$323.00

Service Code	HCPCS 28495
Hospital Charge Code	2849500
Hospital Revenue Code	450
Min. Negotiated Rate	$264.86
Max. Negotiated Rate	$313.31
Rate for Payer: Cash Price	$242.25
Rate for Payer: Health Partners Plans Commercial	$306.85
Rate for Payer: UnitedHealthcare Commercial	$313.31
Rate for Payer: WPPA Commercial	$264.86

CLOSED TREATMENT METATRSAL FX

Facility

$227.00

Service Code	HCPCS 28470
Hospital Charge Code	2847000
Hospital Revenue Code	450
Min. Negotiated Rate	$104.87
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$170.25
Rate for Payer: Cash Price	$170.25
Rate for Payer: Celtic Commercial/Exchange	$104.87
Rate for Payer: Health Partners Plans Commercial	$215.65
Rate for Payer: UnitedHealthcare Commercial	$220.19
Rate for Payer: WPPA Commercial	$190.68

CLOSED TREATMENT METATRSAL FX

Facility

$227.00

Service Code	HCPCS 28470
Hospital Charge Code	2847000
Hospital Revenue Code	450
Min. Negotiated Rate	$186.14
Max. Negotiated Rate	$220.19
Rate for Payer: Cash Price	$170.25
Rate for Payer: Health Partners Plans Commercial	$215.65
Rate for Payer: UnitedHealthcare Commercial	$220.19
Rate for Payer: WPPA Commercial	$186.14

Closed treatment of femoral shaft fx w/manipulation

Facility

$500.00

Service Code	HCPCS 27502
Hospital Charge Code	2750200
Hospital Revenue Code	450
Min. Negotiated Rate	$410.00
Max. Negotiated Rate	$485.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$410.00

Closed treatment of femoral shaft fx w/manipulation

Facility

$500.00

Service Code	HCPCS 27502
Hospital Charge Code	2750200
Hospital Revenue Code	450
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$375.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Celtic Commercial/Exchange	$231.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$420.00

CLOSED TREATMENT OF FRACTURE

Facility

$413.00

Service Code	HCPCS 28510
Hospital Charge Code	2851000
Hospital Revenue Code	450
Min. Negotiated Rate	$190.81
Max. Negotiated Rate	$432.28
Rate for Payer: BCBS Commercial	$432.28
Rate for Payer: Cash Price	$309.75
Rate for Payer: Cash Price	$309.75
Rate for Payer: Celtic Commercial/Exchange	$190.81
Rate for Payer: Health Partners Plans Commercial	$392.35
Rate for Payer: UnitedHealthcare Commercial	$400.61
Rate for Payer: WPPA Commercial	$346.92

Know your out-of-pocket cost for care.

All Charges