Ness County Hospital

All Charges

Charge

Type

Setting

Price

CTA LOWER EXT runoff

Facility

$1,664.00

Service Code	HCPCS 73706
Hospital Charge Code	7370600
Hospital Revenue Code	350
Min. Negotiated Rate	$222.53
Max. Negotiated Rate	$1,614.08
Rate for Payer: BCBS Commercial	$222.53
Rate for Payer: Cash Price	$1,248.00
Rate for Payer: Cash Price	$1,248.00
Rate for Payer: Celtic Commercial/Exchange	$768.77
Rate for Payer: Health Partners Plans Commercial	$1,580.80
Rate for Payer: UnitedHealthcare Commercial	$1,614.08
Rate for Payer: WPPA Commercial	$1,397.76

CTA LOWER EXT runoff

Facility

$1,664.00

Service Code	HCPCS 73706
Hospital Charge Code	7370600
Hospital Revenue Code	350
Min. Negotiated Rate	$1,364.48
Max. Negotiated Rate	$1,614.08
Rate for Payer: Cash Price	$1,248.00
Rate for Payer: Health Partners Plans Commercial	$1,580.80
Rate for Payer: UnitedHealthcare Commercial	$1,614.08
Rate for Payer: WPPA Commercial	$1,364.48

CTA NECK (CAROTID) W OR W/O

Facility

$2,611.00

Service Code	HCPCS 70498
Hospital Charge Code	7049800
Hospital Revenue Code	350
Min. Negotiated Rate	$1,159.64
Max. Negotiated Rate	$2,532.67
Rate for Payer: BCBS Commercial	$1,159.64
Rate for Payer: Cash Price	$1,958.25
Rate for Payer: Cash Price	$1,958.25
Rate for Payer: Celtic Commercial/Exchange	$1,206.28
Rate for Payer: Health Partners Plans Commercial	$2,480.45
Rate for Payer: UnitedHealthcare Commercial	$2,532.67
Rate for Payer: WPPA Commercial	$2,193.24

CTA NECK (CAROTID) W OR W/O

Facility

$2,611.00

Service Code	HCPCS 70498
Hospital Charge Code	7049800
Hospital Revenue Code	350
Min. Negotiated Rate	$2,141.02
Max. Negotiated Rate	$2,532.67
Rate for Payer: Cash Price	$1,958.25
Rate for Payer: Health Partners Plans Commercial	$2,480.45
Rate for Payer: UnitedHealthcare Commercial	$2,532.67
Rate for Payer: WPPA Commercial	$2,141.02

CT ANKLE LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111145
Hospital Revenue Code	350
Min. Negotiated Rate	$1,404.66
Max. Negotiated Rate	$1,661.61
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Health Partners Plans Commercial	$1,627.35
Rate for Payer: UnitedHealthcare Commercial	$1,661.61
Rate for Payer: WPPA Commercial	$1,404.66

CT ANKLE LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111145
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,661.61
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Celtic Commercial/Exchange	$791.41
Rate for Payer: Health Partners Plans Commercial	$1,627.35
Rate for Payer: UnitedHealthcare Commercial	$1,661.61
Rate for Payer: WPPA Commercial	$1,438.92

CT ANKLE RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111144
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,661.61
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Celtic Commercial/Exchange	$791.41
Rate for Payer: Health Partners Plans Commercial	$1,627.35
Rate for Payer: UnitedHealthcare Commercial	$1,661.61
Rate for Payer: WPPA Commercial	$1,438.92

CT ANKLE RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111144
Hospital Revenue Code	350
Min. Negotiated Rate	$1,404.66
Max. Negotiated Rate	$1,661.61
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Health Partners Plans Commercial	$1,627.35
Rate for Payer: UnitedHealthcare Commercial	$1,661.61
Rate for Payer: WPPA Commercial	$1,404.66

CTA PELVIS W 0R W/O CONTRAST

Facility

$1,456.00

Service Code	HCPCS 72191
Hospital Charge Code	7219100
Hospital Revenue Code	350
Min. Negotiated Rate	$222.53
Max. Negotiated Rate	$1,412.32
Rate for Payer: BCBS Commercial	$222.53
Rate for Payer: Cash Price	$1,092.00
Rate for Payer: Cash Price	$1,092.00
Rate for Payer: Celtic Commercial/Exchange	$672.67
Rate for Payer: Health Partners Plans Commercial	$1,383.20
Rate for Payer: UnitedHealthcare Commercial	$1,412.32
Rate for Payer: WPPA Commercial	$1,223.04

CTA PELVIS W 0R W/O CONTRAST

Facility

$1,456.00

Service Code	HCPCS 72191
Hospital Charge Code	7219100
Hospital Revenue Code	350
Min. Negotiated Rate	$1,193.92
Max. Negotiated Rate	$1,412.32
Rate for Payer: Cash Price	$1,092.00
Rate for Payer: Health Partners Plans Commercial	$1,383.20
Rate for Payer: UnitedHealthcare Commercial	$1,412.32
Rate for Payer: WPPA Commercial	$1,193.92

CT CHEST WITH CONTRAST

Facility

$1,970.00

Service Code	HCPCS 71260
Hospital Charge Code	3330020
Hospital Revenue Code	350
Min. Negotiated Rate	$1,615.40
Max. Negotiated Rate	$1,910.90
Rate for Payer: Cash Price	$1,477.50
Rate for Payer: Health Partners Plans Commercial	$1,871.50
Rate for Payer: UnitedHealthcare Commercial	$1,910.90
Rate for Payer: WPPA Commercial	$1,615.40

CT CHEST WITH CONTRAST

Facility

$1,970.00

Service Code	HCPCS 71260
Hospital Charge Code	3330020
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,910.90
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,477.50
Rate for Payer: Cash Price	$1,477.50
Rate for Payer: Celtic Commercial/Exchange	$910.14
Rate for Payer: Health Partners Plans Commercial	$1,871.50
Rate for Payer: UnitedHealthcare Commercial	$1,910.90
Rate for Payer: WPPA Commercial	$1,654.80

CT CHEST W/O CONTRAST

Facility

$1,707.00

Service Code	HCPCS 71250
Hospital Charge Code	3330018
Hospital Revenue Code	350
Min. Negotiated Rate	$1,399.74
Max. Negotiated Rate	$1,655.79
Rate for Payer: Cash Price	$1,280.25
Rate for Payer: Health Partners Plans Commercial	$1,621.65
Rate for Payer: UnitedHealthcare Commercial	$1,655.79
Rate for Payer: WPPA Commercial	$1,399.74

CT CHEST W/O CONTRAST

Facility

$1,707.00

Service Code	HCPCS 71250
Hospital Charge Code	3330018
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,655.79
Rate for Payer: UnitedHealthcare Commercial	$1,655.79
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,280.25
Rate for Payer: Cash Price	$1,280.25
Rate for Payer: Celtic Commercial/Exchange	$788.63
Rate for Payer: Health Partners Plans Commercial	$1,621.65
Rate for Payer: WPPA Commercial	$1,433.88

CT CHEST WO/W CONTRAST

Facility

$2,083.00

Service Code	HCPCS 71270
Hospital Charge Code	3330016
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$2,020.51
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,562.25
Rate for Payer: Cash Price	$1,562.25
Rate for Payer: Celtic Commercial/Exchange	$962.35
Rate for Payer: Health Partners Plans Commercial	$1,978.85
Rate for Payer: UnitedHealthcare Commercial	$2,020.51
Rate for Payer: WPPA Commercial	$1,749.72

CT CHEST WO/W CONTRAST

Facility

$2,083.00

Service Code	HCPCS 71270
Hospital Charge Code	3330016
Hospital Revenue Code	350
Min. Negotiated Rate	$1,708.06
Max. Negotiated Rate	$2,020.51
Rate for Payer: Cash Price	$1,562.25
Rate for Payer: Health Partners Plans Commercial	$1,978.85
Rate for Payer: UnitedHealthcare Commercial	$2,020.51
Rate for Payer: WPPA Commercial	$1,708.06

CT CLAVE EXTENSION SET

Facility

$61.00

Hospital Charge Code	2516680
Hospital Revenue Code	270
Min. Negotiated Rate	$28.18
Max. Negotiated Rate	$59.17
Rate for Payer: Cash Price	$46.20
Rate for Payer: Celtic Commercial/Exchange	$28.18
Rate for Payer: Health Partners Plans Commercial	$57.95
Rate for Payer: UnitedHealthcare Commercial	$59.17
Rate for Payer: WPPA Commercial	$51.24

CT CLAVE EXTENSION SET

Facility

$61.00

Hospital Charge Code	2516680
Hospital Revenue Code	270
Min. Negotiated Rate	$50.02
Max. Negotiated Rate	$59.17
Rate for Payer: Cash Price	$46.20
Rate for Payer: Health Partners Plans Commercial	$57.95
Rate for Payer: UnitedHealthcare Commercial	$59.17
Rate for Payer: WPPA Commercial	$50.02

CT C-SPINE W/O CONTRAST

Facility

$1,754.00

Service Code	HCPCS 72125
Hospital Charge Code	3330014
Hospital Revenue Code	350
Min. Negotiated Rate	$1,438.28
Max. Negotiated Rate	$1,701.38
Rate for Payer: Cash Price	$1,315.50
Rate for Payer: Health Partners Plans Commercial	$1,666.30
Rate for Payer: UnitedHealthcare Commercial	$1,701.38
Rate for Payer: WPPA Commercial	$1,438.28

CT C-SPINE W/O CONTRAST

Facility

$1,754.00

Service Code	HCPCS 72125
Hospital Charge Code	3330014
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,701.38
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,315.50
Rate for Payer: Cash Price	$1,315.50
Rate for Payer: Celtic Commercial/Exchange	$810.35
Rate for Payer: Health Partners Plans Commercial	$1,666.30
Rate for Payer: UnitedHealthcare Commercial	$1,701.38
Rate for Payer: WPPA Commercial	$1,473.36

CT ELBOW LT WO

Facility

$943.00

Service Code	HCPCS 73200 LT
Hospital Charge Code	7111135
Hospital Revenue Code	350
Min. Negotiated Rate	$773.26
Max. Negotiated Rate	$914.71
Rate for Payer: Cash Price	$707.25
Rate for Payer: Health Partners Plans Commercial	$895.85
Rate for Payer: UnitedHealthcare Commercial	$914.71
Rate for Payer: WPPA Commercial	$773.26

CT ELBOW LT WO

Facility

$943.00

Service Code	HCPCS 73200 LT
Hospital Charge Code	7111135
Hospital Revenue Code	350
Min. Negotiated Rate	$435.67
Max. Negotiated Rate	$914.71
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$707.25
Rate for Payer: Cash Price	$707.25
Rate for Payer: Celtic Commercial/Exchange	$435.67
Rate for Payer: Health Partners Plans Commercial	$895.85
Rate for Payer: UnitedHealthcare Commercial	$914.71
Rate for Payer: WPPA Commercial	$792.12

CT ELBOW RT WO

Facility

$943.00

Service Code	HCPCS 73200 RT
Hospital Charge Code	7111134
Hospital Revenue Code	350
Min. Negotiated Rate	$773.26
Max. Negotiated Rate	$914.71
Rate for Payer: Cash Price	$707.25
Rate for Payer: Health Partners Plans Commercial	$895.85
Rate for Payer: UnitedHealthcare Commercial	$914.71
Rate for Payer: WPPA Commercial	$773.26

CT ELBOW RT WO

Facility

$943.00

Service Code	HCPCS 73200 RT
Hospital Charge Code	7111134
Hospital Revenue Code	350
Min. Negotiated Rate	$435.67
Max. Negotiated Rate	$914.71
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$707.25
Rate for Payer: Cash Price	$707.25
Rate for Payer: Celtic Commercial/Exchange	$435.67
Rate for Payer: Health Partners Plans Commercial	$895.85
Rate for Payer: UnitedHealthcare Commercial	$914.71
Rate for Payer: WPPA Commercial	$792.12

CT FOOT LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111147
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,661.61
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Cash Price	$1,284.75
Rate for Payer: Celtic Commercial/Exchange	$791.41
Rate for Payer: Health Partners Plans Commercial	$1,627.35
Rate for Payer: UnitedHealthcare Commercial	$1,661.61
Rate for Payer: WPPA Commercial	$1,438.92

Know your out-of-pocket cost for care.

All Charges