Ness County Hospital

All Charges

Charge

Type

Setting

Price

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

CLOSED TREATMENT RADIAL SHAFT

Facility

$323.00

Service Code	HCPCS 25500
Hospital Charge Code	2550000
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 TREATMENT RADIAL SHAFT

Facility

$323.00

Service Code	HCPCS 25500
Hospital Charge Code	2550000
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 NASAL BONE FRACTU

Facility

$215.00

Service Code	HCPCS 21310
Hospital Charge Code	2131000
Hospital Revenue Code	450
Min. Negotiated Rate	$176.30
Max. Negotiated Rate	$208.55
Rate for Payer: Cash Price	$161.25
Rate for Payer: Health Partners Plans Commercial	$204.25
Rate for Payer: UnitedHealthcare Commercial	$208.55
Rate for Payer: WPPA Commercial	$176.30

CLOSED TREAT NASAL BONE FRACTU

Facility

$215.00

Service Code	HCPCS 21310
Hospital Charge Code	2131000
Hospital Revenue Code	450
Min. Negotiated Rate	$99.33
Max. Negotiated Rate	$208.55
Rate for Payer: Cash Price	$161.25
Rate for Payer: Celtic Commercial/Exchange	$99.33
Rate for Payer: Health Partners Plans Commercial	$204.25
Rate for Payer: UnitedHealthcare Commercial	$208.55
Rate for Payer: WPPA Commercial	$180.60

CLOSED TREAT NASAL BONE FRACTU

Facility

$2,150.00

Service Code	HCPCS 21315
Hospital Charge Code	2131500
Hospital Revenue Code	450
Min. Negotiated Rate	$1,763.00
Max. Negotiated Rate	$2,085.50
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Health Partners Plans Commercial	$2,042.50
Rate for Payer: UnitedHealthcare Commercial	$2,085.50
Rate for Payer: WPPA Commercial	$1,763.00

CLOSED TREAT NASAL BONE FRACTU

Facility

$2,150.00

Service Code	HCPCS 21315
Hospital Charge Code	2131500
Hospital Revenue Code	450
Min. Negotiated Rate	$993.30
Max. Negotiated Rate	$2,085.50
Rate for Payer: BCBS Commercial	$1,955.36
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Cash Price	$1,612.50
Rate for Payer: Celtic Commercial/Exchange	$993.30
Rate for Payer: Health Partners Plans Commercial	$2,042.50
Rate for Payer: UnitedHealthcare Commercial	$2,085.50
Rate for Payer: WPPA Commercial	$1,806.00

CLOSED TREAT/PEL RING FX W/O M

Facility

$323.00

Service Code	HCPCS 27197
Hospital Charge Code	2719300
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 TREAT/PEL RING FX W/O M

Facility

$323.00

Service Code	HCPCS 27197
Hospital Charge Code	2719300
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 TR FRAC WT DISTAL TIBIA

Facility

$323.00

Service Code	HCPCS 27824
Hospital Charge Code	2782400
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 TR FRAC WT DISTAL TIBIA

Facility

$323.00

Service Code	HCPCS 27824
Hospital Charge Code	2782400
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 TX COCCYGEAL FRACTURE

Facility

$269.00

Service Code	HCPCS 27200
Hospital Charge Code	2720000
Hospital Revenue Code	450
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$201.75
Rate for Payer: Celtic Commercial/Exchange	$124.28
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$225.96

CLOSED TX COCCYGEAL FRACTURE

Facility

$269.00

Service Code	HCPCS 27200
Hospital Charge Code	2720000
Hospital Revenue Code	450
Min. Negotiated Rate	$220.58
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$201.75
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$220.58

CLOSED TX DISLOCATION THUMB W/

Facility

$430.00

Service Code	HCPCS 26641
Hospital Charge Code	2664100
Hospital Revenue Code	450
Min. Negotiated Rate	$352.60
Max. Negotiated Rate	$417.10
Rate for Payer: Cash Price	$322.50
Rate for Payer: Health Partners Plans Commercial	$408.50
Rate for Payer: UnitedHealthcare Commercial	$417.10
Rate for Payer: WPPA Commercial	$352.60

CLOSED TX DISLOCATION THUMB W/

Facility

$430.00

Service Code	HCPCS 26641
Hospital Charge Code	2664100
Hospital Revenue Code	450
Min. Negotiated Rate	$198.66
Max. Negotiated Rate	$809.01
Rate for Payer: BCBS Commercial	$809.01
Rate for Payer: Cash Price	$322.50
Rate for Payer: Cash Price	$322.50
Rate for Payer: Celtic Commercial/Exchange	$198.66
Rate for Payer: Health Partners Plans Commercial	$408.50
Rate for Payer: UnitedHealthcare Commercial	$417.10
Rate for Payer: WPPA Commercial	$361.20

CLOSED TX FEMORAL FX W/O MANIP

Facility

$1,530.00

Service Code	HCPCS 27238
Hospital Charge Code	2723800
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 TX FEMORAL FX W/O MANIP

Facility

$1,530.00

Service Code	HCPCS 27238
Hospital Charge Code	2723800
Hospital Revenue Code	450
Min. Negotiated Rate	$706.86
Max. Negotiated Rate	$1,484.10
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 TX FEMORAL FX,W/O MANIP

Facility

$323.00

Service Code	HCPCS 27230
Hospital Charge Code	2723000
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 TX FEMORAL FX,W/O MANIP

Facility

$323.00

Service Code	HCPCS 27230
Hospital Charge Code	2723000
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 TX FX GRT TOE,PHALANX

Facility

$323.00

Service Code	HCPCS 28490
Hospital Charge Code	2849000
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 TX FX GRT TOE,PHALANX

Facility

$323.00

Service Code	HCPCS 28490
Hospital Charge Code	2849000
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 TX HUMERAL CONDYLAR FX

Facility

$296.00

Service Code	HCPCS 24576
Hospital Charge Code	2457600
Hospital Revenue Code	450
Min. Negotiated Rate	$136.75
Max. Negotiated Rate	$1,454.40
Rate for Payer: BCBS Commercial	$1,454.40
Rate for Payer: Cash Price	$222.00
Rate for Payer: Cash Price	$222.00
Rate for Payer: Celtic Commercial/Exchange	$136.75
Rate for Payer: Health Partners Plans Commercial	$281.20
Rate for Payer: UnitedHealthcare Commercial	$287.12
Rate for Payer: WPPA Commercial	$248.64

CLOSED TX HUMERAL CONDYLAR FX

Facility

$296.00

Service Code	HCPCS 24576
Hospital Charge Code	2457600
Hospital Revenue Code	450
Min. Negotiated Rate	$242.72
Max. Negotiated Rate	$287.12
Rate for Payer: Cash Price	$222.00
Rate for Payer: Health Partners Plans Commercial	$281.20
Rate for Payer: UnitedHealthcare Commercial	$287.12
Rate for Payer: WPPA Commercial	$242.72

CLOSED TX,METACARPAL DISLOCATN

Facility

$269.00

Service Code	HCPCS 26700
Hospital Charge Code	2670000
Hospital Revenue Code	450
Min. Negotiated Rate	$220.58
Max. Negotiated Rate	$260.93
Rate for Payer: Cash Price	$201.75
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$220.58

CLOSED TX,METACARPAL DISLOCATN

Facility

$269.00

Service Code	HCPCS 26700
Hospital Charge Code	2670000
Hospital Revenue Code	450
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$809.01
Rate for Payer: BCBS Commercial	$809.01
Rate for Payer: Cash Price	$201.75
Rate for Payer: Cash Price	$201.75
Rate for Payer: Celtic Commercial/Exchange	$124.28
Rate for Payer: Health Partners Plans Commercial	$255.55
Rate for Payer: UnitedHealthcare Commercial	$260.93
Rate for Payer: WPPA Commercial	$225.96

Know your out-of-pocket cost for care.

All Charges