Ness County Hospital

All Charges

Charge

Type

Setting

Price

COLACE 50 MG/5 ML ORAL LIQUID (DOCUSATE SODIUM)

Facility

$1.00

Service Code	NDC 00536130485
Hospital Charge Code	2519791
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
Rate for Payer: Health Partners Plans Commercial	$0.95
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: WPPA Commercial	$0.82

COLACE 50 MG/5 ML ORAL LIQUID (DOCUSATE SODIUM)

Facility

$1.00

Service Code	NDC 00536130485
Hospital Charge Code	2519791
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.97
Rate for Payer: Cash Price	$1.20
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

COLCHICINE 0.6 MG TAB (COLCRYS)

Facility

$33.00

Service Code	NDC 60687038921
Hospital Charge Code	2501591
Hospital Revenue Code	250
Min. Negotiated Rate	$27.06
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.09
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.06

COLCHICINE 0.6 MG TAB (COLCRYS)

Facility

$33.00

Service Code	NDC 60687038921
Hospital Charge Code	2501591
Hospital Revenue Code	250
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$32.01
Rate for Payer: Cash Price	$25.09
Rate for Payer: Celtic Commercial/Exchange	$15.25
Rate for Payer: Health Partners Plans Commercial	$31.35
Rate for Payer: UnitedHealthcare Commercial	$32.01
Rate for Payer: WPPA Commercial	$27.72

COLD AGGLUTININ SCREEN

Facility

$75.00

Service Code	HCPCS 86156
Hospital Charge Code	8615600
Hospital Revenue Code	302
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$39.99
Rate for Payer: Cash Price	$56.25
Rate for Payer: Cash Price	$56.25
Rate for Payer: Celtic Commercial/Exchange	$34.65
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$63.00

COLD AGGLUTININ SCREEN

Facility

$75.00

Service Code	HCPCS 86156
Hospital Charge Code	8615600
Hospital Revenue Code	302
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$72.75
Rate for Payer: Cash Price	$56.25
Rate for Payer: Health Partners Plans Commercial	$71.25
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: WPPA Commercial	$61.50

COLD AGGLUTININ TITER

Facility

$54.00

Service Code	HCPCS 86157
Hospital Charge Code	8615700
Hospital Revenue Code	302
Min. Negotiated Rate	$44.28
Max. Negotiated Rate	$52.38
Rate for Payer: Cash Price	$40.50
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$44.28

COLD AGGLUTININ TITER

Facility

$54.00

Service Code	HCPCS 86157
Hospital Charge Code	8615700
Hospital Revenue Code	302
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$52.38
Rate for Payer: BCBS Commercial	$30.88
Rate for Payer: Cash Price	$40.50
Rate for Payer: Cash Price	$40.50
Rate for Payer: Celtic Commercial/Exchange	$24.95
Rate for Payer: Health Partners Plans Commercial	$51.30
Rate for Payer: UnitedHealthcare Commercial	$52.38
Rate for Payer: WPPA Commercial	$45.36

COLLAGEN CROSS LINKS, ANY METH

Facility

$143.00

Service Code	HCPCS 82523
Hospital Charge Code	8252300
Hospital Revenue Code	301
Min. Negotiated Rate	$117.26
Max. Negotiated Rate	$138.71
Rate for Payer: Cash Price	$107.25
Rate for Payer: Health Partners Plans Commercial	$135.85
Rate for Payer: UnitedHealthcare Commercial	$138.71
Rate for Payer: WPPA Commercial	$117.26

COLLAGEN CROSS LINKS, ANY METH

Facility

$143.00

Service Code	HCPCS 82523
Hospital Charge Code	8252300
Hospital Revenue Code	301
Min. Negotiated Rate	$62.35
Max. Negotiated Rate	$138.71
Rate for Payer: BCBS Commercial	$62.35
Rate for Payer: Cash Price	$107.25
Rate for Payer: Cash Price	$107.25
Rate for Payer: Celtic Commercial/Exchange	$66.07
Rate for Payer: Health Partners Plans Commercial	$135.85
Rate for Payer: UnitedHealthcare Commercial	$138.71
Rate for Payer: WPPA Commercial	$120.12

COLL BLD SPEC COMPLETE INPLANT

Facility

$130.00

Service Code	HCPCS 36591
Hospital Charge Code	3659100
Hospital Revenue Code	309
Min. Negotiated Rate	$106.60
Max. Negotiated Rate	$126.10
Rate for Payer: Cash Price	$97.50
Rate for Payer: Health Partners Plans Commercial	$123.50
Rate for Payer: UnitedHealthcare Commercial	$126.10
Rate for Payer: WPPA Commercial	$106.60

COLL BLD SPEC COMPLETE INPLANT

Facility

$130.00

Service Code	HCPCS 36591
Hospital Charge Code	3659100
Hospital Revenue Code	309
Min. Negotiated Rate	$60.06
Max. Negotiated Rate	$126.68
Rate for Payer: BCBS Commercial	$126.68
Rate for Payer: Cash Price	$97.50
Rate for Payer: Cash Price	$97.50
Rate for Payer: Celtic Commercial/Exchange	$60.06
Rate for Payer: Health Partners Plans Commercial	$123.50
Rate for Payer: UnitedHealthcare Commercial	$126.10
Rate for Payer: WPPA Commercial	$109.20

COLLECTION OF CAP. BLD SPECIMN

Facility

$24.00

Service Code	HCPCS 36416
Hospital Charge Code	3641600
Hospital Revenue Code	309
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$23.28
Rate for Payer: BCBS Commercial	$4.42
Rate for Payer: Cash Price	$18.00
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

COLLECTION OF CAP. BLD SPECIMN

Facility

$24.00

Service Code	HCPCS 36416
Hospital Charge Code	3641600
Hospital Revenue Code	309
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

COLONOSCOPY, FLEX,DIAGNOSITC

Facility

$1,986.00

Service Code	HCPCS 45378
Hospital Charge Code	4537800
Hospital Revenue Code	761
Min. Negotiated Rate	$1,628.52
Max. Negotiated Rate	$1,926.42
Rate for Payer: Cash Price	$1,489.50
Rate for Payer: Health Partners Plans Commercial	$1,886.70
Rate for Payer: UnitedHealthcare Commercial	$1,926.42
Rate for Payer: WPPA Commercial	$1,628.52

COLONOSCOPY, FLEX,DIAGNOSITC

Facility

$1,986.00

Service Code	HCPCS 45378
Hospital Charge Code	4537800
Hospital Revenue Code	761
Min. Negotiated Rate	$917.53
Max. Negotiated Rate	$1,926.42
Rate for Payer: BCBS Commercial	$1,321.08
Rate for Payer: Cash Price	$1,489.50
Rate for Payer: Cash Price	$1,489.50
Rate for Payer: Celtic Commercial/Exchange	$917.53
Rate for Payer: Health Partners Plans Commercial	$1,886.70
Rate for Payer: UnitedHealthcare Commercial	$1,926.42
Rate for Payer: WPPA Commercial	$1,668.24

COLONOSCOPY,W/CONTROL OF BLEED

Facility

$1,083.00

Service Code	HCPCS 45382
Hospital Charge Code	4538200
Hospital Revenue Code	761
Min. Negotiated Rate	$500.35
Max. Negotiated Rate	$1,473.85
Rate for Payer: BCBS Commercial	$1,473.85
Rate for Payer: Cash Price	$812.25
Rate for Payer: Cash Price	$812.25
Rate for Payer: Celtic Commercial/Exchange	$500.35
Rate for Payer: Health Partners Plans Commercial	$1,028.85
Rate for Payer: UnitedHealthcare Commercial	$1,050.51
Rate for Payer: WPPA Commercial	$909.72

COLONOSCOPY,W/CONTROL OF BLEED

Facility

$1,083.00

Service Code	HCPCS 45382
Hospital Charge Code	4538200
Hospital Revenue Code	761
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$1,050.51
Rate for Payer: Cash Price	$812.25
Rate for Payer: Health Partners Plans Commercial	$1,028.85
Rate for Payer: UnitedHealthcare Commercial	$1,050.51
Rate for Payer: WPPA Commercial	$888.06

COLONSCOPY,FLEX W/SUBMUC INJ

Facility

$1,083.00

Service Code	HCPCS 45381
Hospital Charge Code	4538100
Hospital Revenue Code	761
Min. Negotiated Rate	$500.35
Max. Negotiated Rate	$1,473.85
Rate for Payer: BCBS Commercial	$1,473.85
Rate for Payer: Cash Price	$812.25
Rate for Payer: Cash Price	$812.25
Rate for Payer: Celtic Commercial/Exchange	$500.35
Rate for Payer: Health Partners Plans Commercial	$1,028.85
Rate for Payer: UnitedHealthcare Commercial	$1,050.51
Rate for Payer: WPPA Commercial	$909.72

COLONSCOPY,FLEX W/SUBMUC INJ

Facility

$1,083.00

Service Code	HCPCS 45381
Hospital Charge Code	4538100
Hospital Revenue Code	761
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$1,050.51
Rate for Payer: Cash Price	$812.25
Rate for Payer: Health Partners Plans Commercial	$1,028.85
Rate for Payer: UnitedHealthcare Commercial	$1,050.51
Rate for Payer: WPPA Commercial	$888.06

COLOR COBAN 1" OR 2"

Facility

$9.00

Hospital Charge Code	2722600
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.38

COLOR COBAN 1" OR 2"

Facility

$9.00

Hospital Charge Code	2722600
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$8.73
Rate for Payer: Cash Price	$6.75
Rate for Payer: Celtic Commercial/Exchange	$4.16
Rate for Payer: Health Partners Plans Commercial	$8.55
Rate for Payer: UnitedHealthcare Commercial	$8.73
Rate for Payer: WPPA Commercial	$7.56

COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK

Facility

$1,139.64

Service Code	CPT G0105
Hospital Revenue Code	750
Min. Negotiated Rate	$1,139.64
Max. Negotiated Rate	$1,139.64
Rate for Payer: BCBS Commercial	$1,139.64

COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK

Facility

$1,139.64

Service Code	CPT G0121
Hospital Revenue Code	750
Min. Negotiated Rate	$1,139.64
Max. Negotiated Rate	$1,139.64
Rate for Payer: BCBS Commercial	$1,139.64

COLOWRAP

Facility

$450.00

Hospital Charge Code	2708778
Hospital Revenue Code	270
Min. Negotiated Rate	$207.90
Max. Negotiated Rate	$436.50
Rate for Payer: Cash Price	$337.50
Rate for Payer: Celtic Commercial/Exchange	$207.90
Rate for Payer: Health Partners Plans Commercial	$427.50
Rate for Payer: UnitedHealthcare Commercial	$436.50
Rate for Payer: WPPA Commercial	$378.00

Know your out-of-pocket cost for care.

All Charges