Ness County Hospital

All Charges

Charge

Type

Setting

Price

CREATININE OTHER SOURCE

Facility

$59.00

Service Code	HCPCS 82570
Hospital Charge Code	8257000
Hospital Revenue Code	301
Min. Negotiated Rate	$21.53
Max. Negotiated Rate	$57.23
Rate for Payer: BCBS Commercial	$21.53
Rate for Payer: Cash Price	$44.25
Rate for Payer: Cash Price	$44.25
Rate for Payer: Celtic Commercial/Exchange	$27.26
Rate for Payer: Health Partners Plans Commercial	$56.05
Rate for Payer: UnitedHealthcare Commercial	$57.23
Rate for Payer: WPPA Commercial	$49.56

CREATININE OTHER SOURCE

Facility

$59.00

Service Code	HCPCS 82570
Hospital Charge Code	8257000
Hospital Revenue Code	301
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$57.23
Rate for Payer: Cash Price	$44.25
Rate for Payer: Health Partners Plans Commercial	$56.05
Rate for Payer: UnitedHealthcare Commercial	$57.23
Rate for Payer: WPPA Commercial	$48.38

CRESTOR 5 MG TAB (ROSUVASTATIN)

Facility

$21.00

Service Code	NDC 50228011690
Hospital Charge Code	2519775
Hospital Revenue Code	250
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.05
Rate for Payer: Celtic Commercial/Exchange	$9.70
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.64

CRESTOR 5 MG TAB (ROSUVASTATIN)

Facility

$21.00

Service Code	NDC 50228011690
Hospital Charge Code	2519775
Hospital Revenue Code	250
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$16.05
Rate for Payer: Health Partners Plans Commercial	$19.95
Rate for Payer: UnitedHealthcare Commercial	$20.37
Rate for Payer: WPPA Commercial	$17.22

CROFAB RATTLESNAKE (CROTALIDAE POLYVALENT IMMUNE FAB)

Facility

$11,512.00

Service Code	NDC 50633011012
Hospital Charge Code	2500486
Hospital Revenue Code	250
Min. Negotiated Rate	$5,318.54
Max. Negotiated Rate	$11,166.64
Rate for Payer: Cash Price	$8,634.64
Rate for Payer: Celtic Commercial/Exchange	$5,318.54
Rate for Payer: Health Partners Plans Commercial	$10,936.40
Rate for Payer: UnitedHealthcare Commercial	$11,166.64
Rate for Payer: WPPA Commercial	$9,670.08

CROFAB RATTLESNAKE (CROTALIDAE POLYVALENT IMMUNE FAB)

Facility

$11,512.00

Service Code	NDC 50633011012
Hospital Charge Code	2500486
Hospital Revenue Code	250
Min. Negotiated Rate	$9,439.84
Max. Negotiated Rate	$11,166.64
Rate for Payer: Cash Price	$8,634.64
Rate for Payer: Health Partners Plans Commercial	$10,936.40
Rate for Payer: UnitedHealthcare Commercial	$11,166.64
Rate for Payer: WPPA Commercial	$9,439.84

CRUTCHES

Facility

$80.00

Hospital Charge Code	2910008
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

CRUTCHES

Facility

$80.00

Hospital Charge Code	2910008
Hospital Revenue Code	270
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

CRUTCHES PEDIATRIC 1 PR

Facility

$38.00

Hospital Charge Code	2910006
Hospital Revenue Code	270
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$28.50
Rate for Payer: Health Partners Plans Commercial	$36.10
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Commercial	$31.16

CRUTCHES PEDIATRIC 1 PR

Facility

$38.00

Hospital Charge Code	2910006
Hospital Revenue Code	270
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$36.86
Rate for Payer: Cash Price	$28.50
Rate for Payer: Celtic Commercial/Exchange	$17.56
Rate for Payer: Health Partners Plans Commercial	$36.10
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Commercial	$31.92

CRUTCHES TALL ADULT 1PR

Facility

$80.00

Hospital Charge Code	2910009
Hospital Revenue Code	270
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

CRUTCHES TALL ADULT 1PR

Facility

$80.00

Hospital Charge Code	2910009
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

CRUTCHES YOUTH 1PR

Facility

$80.00

Hospital Charge Code	2910007
Hospital Revenue Code	270
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$65.60

CRUTCHES YOUTH 1PR

Facility

$80.00

Hospital Charge Code	2910007
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$77.60
Rate for Payer: Cash Price	$60.00
Rate for Payer: Celtic Commercial/Exchange	$36.96
Rate for Payer: Health Partners Plans Commercial	$76.00
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: WPPA Commercial	$67.20

CRYOGLOBULIN,QUAL.OR SEMIQUANT

Facility

$31.00

Service Code	HCPCS 82595
Hospital Charge Code	8259500
Hospital Revenue Code	301
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$30.07
Rate for Payer: BCBS Commercial	$18.75
Rate for Payer: Cash Price	$23.25
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

CRYOGLOBULIN,QUAL.OR SEMIQUANT

Facility

$31.00

Service Code	HCPCS 82595
Hospital Charge Code	8259500
Hospital Revenue Code	301
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

CRYPTOCOCCAL ANTIG,LATEX SCRN

Facility

$60.00

Service Code	HCPCS 86403
Hospital Charge Code	8640302
Hospital Revenue Code	302
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$58.20
Rate for Payer: Cash Price	$45.00
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$49.20

CRYPTOCOCCAL ANTIG,LATEX SCRN

Facility

$60.00

Service Code	HCPCS 86403
Hospital Charge Code	8640302
Hospital Revenue Code	302
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$58.20
Rate for Payer: BCBS Commercial	$21.88
Rate for Payer: Cash Price	$45.00
Rate for Payer: Cash Price	$45.00
Rate for Payer: Celtic Commercial/Exchange	$27.72
Rate for Payer: Health Partners Plans Commercial	$57.00
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: WPPA Commercial	$50.40

CRYSTAL ID,LIGHT MICRO,W/ORW/O

Facility

$132.00

Service Code	HCPCS 89060
Hospital Charge Code	8906000
Hospital Revenue Code	309
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$128.04
Rate for Payer: Cash Price	$99.00
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$108.24

CRYSTAL ID,LIGHT MICRO,W/ORW/O

Facility

$132.00

Service Code	HCPCS 89060
Hospital Charge Code	8906000
Hospital Revenue Code	309
Min. Negotiated Rate	$60.98
Max. Negotiated Rate	$128.04
Rate for Payer: BCBS Commercial	$73.47
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: Celtic Commercial/Exchange	$60.98
Rate for Payer: Health Partners Plans Commercial	$125.40
Rate for Payer: UnitedHealthcare Commercial	$128.04
Rate for Payer: WPPA Commercial	$110.88

C-SPINE 3 VIEWS OR LESS

Facility

$305.00

Service Code	HCPCS 72040
Hospital Charge Code	7204000
Hospital Revenue Code	320
Min. Negotiated Rate	$140.91
Max. Negotiated Rate	$295.85
Rate for Payer: BCBS Commercial	$159.82
Rate for Payer: Cash Price	$228.75
Rate for Payer: Cash Price	$228.75
Rate for Payer: Celtic Commercial/Exchange	$140.91
Rate for Payer: Health Partners Plans Commercial	$289.75
Rate for Payer: UnitedHealthcare Commercial	$295.85
Rate for Payer: WPPA Commercial	$256.20

C-SPINE 3 VIEWS OR LESS

Facility

$305.00

Service Code	HCPCS 72040
Hospital Charge Code	7204000
Hospital Revenue Code	320
Min. Negotiated Rate	$250.10
Max. Negotiated Rate	$295.85
Rate for Payer: Cash Price	$228.75
Rate for Payer: Health Partners Plans Commercial	$289.75
Rate for Payer: UnitedHealthcare Commercial	$295.85
Rate for Payer: WPPA Commercial	$250.10

C-SPINE, 4 OR 5 VIEWS

Facility

$302.00

Service Code	HCPCS 72050
Hospital Charge Code	7205000
Hospital Revenue Code	320
Min. Negotiated Rate	$139.52
Max. Negotiated Rate	$292.94
Rate for Payer: BCBS Commercial	$230.44
Rate for Payer: Cash Price	$226.88
Rate for Payer: Cash Price	$226.88
Rate for Payer: Celtic Commercial/Exchange	$139.52
Rate for Payer: Health Partners Plans Commercial	$286.90
Rate for Payer: UnitedHealthcare Commercial	$292.94
Rate for Payer: WPPA Commercial	$253.68

C-SPINE, 4 OR 5 VIEWS

Facility

$302.00

Service Code	HCPCS 72050
Hospital Charge Code	7205000
Hospital Revenue Code	320
Min. Negotiated Rate	$247.64
Max. Negotiated Rate	$292.94
Rate for Payer: Cash Price	$226.88
Rate for Payer: Health Partners Plans Commercial	$286.90
Rate for Payer: UnitedHealthcare Commercial	$292.94
Rate for Payer: WPPA Commercial	$247.64

C-SPINE COMPLETE 6 OR MORE

Facility

$350.00

Service Code	HCPCS 72052
Hospital Charge Code	7205200
Hospital Revenue Code	320
Min. Negotiated Rate	$287.00
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$262.50
Rate for Payer: Health Partners Plans Commercial	$332.50
Rate for Payer: UnitedHealthcare Commercial	$339.50
Rate for Payer: WPPA Commercial	$287.00

Know your out-of-pocket cost for care.

All Charges