Ness County Hospital

All Charges

Charge

Type

Setting

Price

CT FOOT LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111147
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 FOOT RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111146
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 FOOT RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111146
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 HAND LT WO

Facility

$1,518.00

Service Code	HCPCS 73200 LT
Hospital Charge Code	7111139
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,472.46
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,138.50
Rate for Payer: Cash Price	$1,138.50
Rate for Payer: Celtic Commercial/Exchange	$701.32
Rate for Payer: Health Partners Plans Commercial	$1,442.10
Rate for Payer: UnitedHealthcare Commercial	$1,472.46
Rate for Payer: WPPA Commercial	$1,275.12

CT HAND LT WO

Facility

$1,518.00

Service Code	HCPCS 73200 LT
Hospital Charge Code	7111139
Hospital Revenue Code	350
Min. Negotiated Rate	$1,244.76
Max. Negotiated Rate	$1,472.46
Rate for Payer: Cash Price	$1,138.50
Rate for Payer: Health Partners Plans Commercial	$1,442.10
Rate for Payer: UnitedHealthcare Commercial	$1,472.46
Rate for Payer: WPPA Commercial	$1,244.76

CT HAND RT WO

Facility

$943.00

Service Code	HCPCS 73200 RT
Hospital Charge Code	7111138
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 HAND RT WO

Facility

$943.00

Service Code	HCPCS 73200 RT
Hospital Charge Code	7111138
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 HEAD WITH CONTRAST

Facility

$1,589.00

Service Code	HCPCS 70460
Hospital Charge Code	3330010
Hospital Revenue Code	350
Min. Negotiated Rate	$1,302.98
Max. Negotiated Rate	$1,541.33
Rate for Payer: Cash Price	$1,191.75
Rate for Payer: Health Partners Plans Commercial	$1,509.55
Rate for Payer: UnitedHealthcare Commercial	$1,541.33
Rate for Payer: WPPA Commercial	$1,302.98

CT HEAD WITH CONTRAST

Facility

$1,589.00

Service Code	HCPCS 70460
Hospital Charge Code	3330010
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,541.33
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,191.75
Rate for Payer: Cash Price	$1,191.75
Rate for Payer: Celtic Commercial/Exchange	$734.12
Rate for Payer: Health Partners Plans Commercial	$1,509.55
Rate for Payer: UnitedHealthcare Commercial	$1,541.33
Rate for Payer: WPPA Commercial	$1,334.76

CT HEAD W/O CONTRAST

Facility

$1,829.00

Service Code	HCPCS 70450
Hospital Charge Code	3330008
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,774.13
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,371.75
Rate for Payer: Cash Price	$1,371.75
Rate for Payer: Celtic Commercial/Exchange	$845.00
Rate for Payer: Health Partners Plans Commercial	$1,737.55
Rate for Payer: UnitedHealthcare Commercial	$1,774.13
Rate for Payer: WPPA Commercial	$1,536.36

CT HEAD W/O CONTRAST

Facility

$1,829.00

Service Code	HCPCS 70450
Hospital Charge Code	3330008
Hospital Revenue Code	350
Min. Negotiated Rate	$1,499.78
Max. Negotiated Rate	$1,774.13
Rate for Payer: Cash Price	$1,371.75
Rate for Payer: Health Partners Plans Commercial	$1,737.55
Rate for Payer: UnitedHealthcare Commercial	$1,774.13
Rate for Payer: WPPA Commercial	$1,499.78

CT HEAD W/& W/0 CONTRAST

Facility

$2,009.00

Service Code	HCPCS 70470
Hospital Charge Code	3330012
Hospital Revenue Code	350
Min. Negotiated Rate	$1,647.38
Max. Negotiated Rate	$1,948.73
Rate for Payer: Cash Price	$1,506.75
Rate for Payer: Health Partners Plans Commercial	$1,908.55
Rate for Payer: UnitedHealthcare Commercial	$1,948.73
Rate for Payer: WPPA Commercial	$1,647.38

CT HEAD W/& W/0 CONTRAST

Facility

$2,009.00

Service Code	HCPCS 70470
Hospital Charge Code	3330012
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,948.73
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,506.75
Rate for Payer: Cash Price	$1,506.75
Rate for Payer: Celtic Commercial/Exchange	$928.16
Rate for Payer: Health Partners Plans Commercial	$1,908.55
Rate for Payer: UnitedHealthcare Commercial	$1,948.73
Rate for Payer: WPPA Commercial	$1,687.56

CT HIP LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111141
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 HIP LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111141
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 HIP RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111140
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 HIP RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111140
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 KNEE LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111143
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 KNEE LT WO

Facility

$1,713.00

Service Code	HCPCS 73700 LT
Hospital Charge Code	7111143
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 KNEE RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111142
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 KNEE RT WO

Facility

$1,713.00

Service Code	HCPCS 73700 RT
Hospital Charge Code	7111142
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 LE WITH CONTRAST

Facility

$1,860.00

Service Code	HCPCS 73701
Hospital Charge Code	3330024
Hospital Revenue Code	350
Min. Negotiated Rate	$480.41
Max. Negotiated Rate	$1,804.20
Rate for Payer: BCBS Commercial	$480.41
Rate for Payer: Cash Price	$1,395.00
Rate for Payer: Cash Price	$1,395.00
Rate for Payer: Celtic Commercial/Exchange	$859.32
Rate for Payer: Health Partners Plans Commercial	$1,767.00
Rate for Payer: UnitedHealthcare Commercial	$1,804.20
Rate for Payer: WPPA Commercial	$1,562.40

CT LE WITH CONTRAST

Facility

$1,860.00

Service Code	HCPCS 73701
Hospital Charge Code	3330024
Hospital Revenue Code	350
Min. Negotiated Rate	$1,525.20
Max. Negotiated Rate	$1,804.20
Rate for Payer: Cash Price	$1,395.00
Rate for Payer: Health Partners Plans Commercial	$1,767.00
Rate for Payer: UnitedHealthcare Commercial	$1,804.20
Rate for Payer: WPPA Commercial	$1,525.20

CT LE W/O CONTRAST

Facility

$1,713.00

Service Code	HCPCS 73700
Hospital Charge Code	3330026
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 LE W/O CONTRAST

Facility

$1,713.00

Service Code	HCPCS 73700
Hospital Charge Code	3330026
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

Know your out-of-pocket cost for care.

All Charges