Ness County Hospital

All Charges

Charge

Type

Setting

Price

CULT,FUNGI,ISOLATN W/PRSUMP ID

Facility

$54.00

Service Code	HCPCS 87101
Hospital Charge Code	8710100
Hospital Revenue Code	306
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$52.38
Rate for Payer: BCBS Commercial	$24.15
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

CULT FUNGI ISO W/PRSMP ID,BLD

Facility

$67.00

Service Code	HCPCS 87103
Hospital Charge Code	8710300
Hospital Revenue Code	306
Min. Negotiated Rate	$54.94
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.25
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$54.94

CULT FUNGI ISO W/PRSMP ID,BLD

Facility

$67.00

Service Code	HCPCS 87103
Hospital Charge Code	8710300
Hospital Revenue Code	306
Min. Negotiated Rate	$30.95
Max. Negotiated Rate	$64.99
Rate for Payer: BCBS Commercial	$35.68
Rate for Payer: Cash Price	$50.25
Rate for Payer: Cash Price	$50.25
Rate for Payer: Celtic Commercial/Exchange	$30.95
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$56.28

CULT,TUBERCLE/ACID FAST BACILL

Facility

$89.00

Service Code	HCPCS 87116
Hospital Charge Code	8711600
Hospital Revenue Code	306
Min. Negotiated Rate	$72.98
Max. Negotiated Rate	$86.33
Rate for Payer: Cash Price	$66.75
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$72.98

CULT,TUBERCLE/ACID FAST BACILL

Facility

$89.00

Service Code	HCPCS 87116
Hospital Charge Code	8711600
Hospital Revenue Code	306
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$86.33
Rate for Payer: BCBS Commercial	$47.89
Rate for Payer: Cash Price	$66.75
Rate for Payer: Cash Price	$66.75
Rate for Payer: Celtic Commercial/Exchange	$41.12
Rate for Payer: Health Partners Plans Commercial	$84.55
Rate for Payer: UnitedHealthcare Commercial	$86.33
Rate for Payer: WPPA Commercial	$74.76

CULTURE,BACT ANY OTHER SOURCE

Facility

$104.00

Service Code	HCPCS 87070
Hospital Charge Code	8707000
Hospital Revenue Code	306
Min. Negotiated Rate	$85.28
Max. Negotiated Rate	$100.88
Rate for Payer: Cash Price	$78.00
Rate for Payer: Health Partners Plans Commercial	$98.80
Rate for Payer: UnitedHealthcare Commercial	$100.88
Rate for Payer: WPPA Commercial	$85.28

CULTURE,BACT ANY OTHER SOURCE

Facility

$104.00

Service Code	HCPCS 87070
Hospital Charge Code	8707000
Hospital Revenue Code	306
Min. Negotiated Rate	$31.88
Max. Negotiated Rate	$100.88
Rate for Payer: BCBS Commercial	$31.88
Rate for Payer: Cash Price	$78.00
Rate for Payer: Cash Price	$78.00
Rate for Payer: Celtic Commercial/Exchange	$48.05
Rate for Payer: Health Partners Plans Commercial	$98.80
Rate for Payer: UnitedHealthcare Commercial	$100.88
Rate for Payer: WPPA Commercial	$87.36

CULTURE,BACT BLD,AEROBIC W/ISO

Facility

$138.00

Service Code	HCPCS 87040
Hospital Charge Code	8704001
Hospital Revenue Code	306
Min. Negotiated Rate	$38.41
Max. Negotiated Rate	$133.86
Rate for Payer: BCBS Commercial	$38.41
Rate for Payer: Cash Price	$103.50
Rate for Payer: Cash Price	$103.50
Rate for Payer: Celtic Commercial/Exchange	$63.76
Rate for Payer: Health Partners Plans Commercial	$131.10
Rate for Payer: UnitedHealthcare Commercial	$133.86
Rate for Payer: WPPA Commercial	$115.92

CULTURE,BACT BLD,AEROBIC W/ISO

Facility

$164.00

Service Code	HCPCS 87040
Hospital Charge Code	8704000
Hospital Revenue Code	306
Min. Negotiated Rate	$38.41
Max. Negotiated Rate	$159.08
Rate for Payer: BCBS Commercial	$38.41
Rate for Payer: Cash Price	$123.00
Rate for Payer: Cash Price	$123.00
Rate for Payer: Celtic Commercial/Exchange	$75.77
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$137.76

CULTURE,BACT BLD,AEROBIC W/ISO

Facility

$138.00

Service Code	HCPCS 87040
Hospital Charge Code	8704001
Hospital Revenue Code	306
Min. Negotiated Rate	$113.16
Max. Negotiated Rate	$133.86
Rate for Payer: Cash Price	$103.50
Rate for Payer: Health Partners Plans Commercial	$131.10
Rate for Payer: UnitedHealthcare Commercial	$133.86
Rate for Payer: WPPA Commercial	$113.16

CULTURE,BACT BLD,AEROBIC W/ISO

Facility

$164.00

Service Code	HCPCS 87040
Hospital Charge Code	8704000
Hospital Revenue Code	306
Min. Negotiated Rate	$134.48
Max. Negotiated Rate	$159.08
Rate for Payer: Cash Price	$123.00
Rate for Payer: Health Partners Plans Commercial	$155.80
Rate for Payer: UnitedHealthcare Commercial	$159.08
Rate for Payer: WPPA Commercial	$134.48

CULTURE,BACT STOOL,AEROB,ADDTL

Facility

$67.00

Service Code	HCPCS 87046
Hospital Charge Code	8704600
Hospital Revenue Code	306
Min. Negotiated Rate	$54.94
Max. Negotiated Rate	$64.99
Rate for Payer: Cash Price	$50.25
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$54.94

CULTURE,BACT STOOL,AEROB,ADDTL

Facility

$67.00

Service Code	HCPCS 87046
Hospital Charge Code	8704600
Hospital Revenue Code	306
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$64.99
Rate for Payer: BCBS Commercial	$29.62
Rate for Payer: Cash Price	$50.25
Rate for Payer: Cash Price	$50.25
Rate for Payer: Celtic Commercial/Exchange	$30.95
Rate for Payer: Health Partners Plans Commercial	$63.65
Rate for Payer: UnitedHealthcare Commercial	$64.99
Rate for Payer: WPPA Commercial	$56.28

CULTURE,BACT,STOOL,AEROBIC W/

Facility

$103.00

Service Code	HCPCS 87045
Hospital Charge Code	8704500
Hospital Revenue Code	306
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$99.91
Rate for Payer: BCBS Commercial	$29.62
Rate for Payer: Cash Price	$77.25
Rate for Payer: Cash Price	$77.25
Rate for Payer: Celtic Commercial/Exchange	$47.59
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$86.52

CULTURE,BACT,STOOL,AEROBIC W/

Facility

$103.00

Service Code	HCPCS 87045
Hospital Charge Code	8704500
Hospital Revenue Code	306
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$99.91
Rate for Payer: Cash Price	$77.25
Rate for Payer: Health Partners Plans Commercial	$97.85
Rate for Payer: UnitedHealthcare Commercial	$99.91
Rate for Payer: WPPA Commercial	$84.46

CULTURE, CHLAMYDIA,ANY SOURCE

Facility

$141.00

Service Code	HCPCS 87110
Hospital Charge Code	8711000
Hospital Revenue Code	306
Min. Negotiated Rate	$65.14
Max. Negotiated Rate	$136.77
Rate for Payer: BCBS Commercial	$76.04
Rate for Payer: Cash Price	$105.75
Rate for Payer: Cash Price	$105.75
Rate for Payer: Celtic Commercial/Exchange	$65.14
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$118.44

CULTURE, CHLAMYDIA,ANY SOURCE

Facility

$141.00

Service Code	HCPCS 87110
Hospital Charge Code	8711000
Hospital Revenue Code	306
Min. Negotiated Rate	$115.62
Max. Negotiated Rate	$136.77
Rate for Payer: Cash Price	$105.75
Rate for Payer: Health Partners Plans Commercial	$133.95
Rate for Payer: UnitedHealthcare Commercial	$136.77
Rate for Payer: WPPA Commercial	$115.62

CULTURE,PRESUMP,PATHOGENIC ORG

Facility

$94.00

Service Code	HCPCS 87081
Hospital Charge Code	8708100
Hospital Revenue Code	306
Min. Negotiated Rate	$77.08
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$70.50
Rate for Payer: Health Partners Plans Commercial	$89.30
Rate for Payer: UnitedHealthcare Commercial	$91.18
Rate for Payer: WPPA Commercial	$77.08

CULTURE,PRESUMP,PATHOGENIC ORG

Facility

$94.00

Service Code	HCPCS 87081
Hospital Charge Code	8708100
Hospital Revenue Code	306
Min. Negotiated Rate	$23.96
Max. Negotiated Rate	$91.18
Rate for Payer: BCBS Commercial	$23.96
Rate for Payer: Cash Price	$70.50
Rate for Payer: Cash Price	$70.50
Rate for Payer: Celtic Commercial/Exchange	$43.43
Rate for Payer: Health Partners Plans Commercial	$89.30
Rate for Payer: UnitedHealthcare Commercial	$91.18
Rate for Payer: WPPA Commercial	$78.96

CULTURE TYPING;ID BY NUCLEIC

Facility

$75.00

Service Code	HCPCS 87149
Hospital Charge Code	8714900
Hospital Revenue Code	306
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

CULTURE TYPING;ID BY NUCLEIC

Facility

$75.00

Service Code	HCPCS 87149
Hospital Charge Code	8714900
Hospital Revenue Code	306
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$72.75
Rate for Payer: BCBS Commercial	$43.03
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

CULTURE,TYPING IMMUNO METHOD

Facility

$47.00

Service Code	HCPCS 87140
Hospital Charge Code	8714000
Hospital Revenue Code	306
Min. Negotiated Rate	$21.71
Max. Negotiated Rate	$45.59
Rate for Payer: BCBS Commercial	$25.79
Rate for Payer: Cash Price	$35.25
Rate for Payer: Cash Price	$35.25
Rate for Payer: Celtic Commercial/Exchange	$21.71
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$39.48

CULTURE,TYPING IMMUNO METHOD

Facility

$47.00

Service Code	HCPCS 87140
Hospital Charge Code	8714000
Hospital Revenue Code	306
Min. Negotiated Rate	$38.54
Max. Negotiated Rate	$45.59
Rate for Payer: Cash Price	$35.25
Rate for Payer: Health Partners Plans Commercial	$44.65
Rate for Payer: UnitedHealthcare Commercial	$45.59
Rate for Payer: WPPA Commercial	$38.54

CULTURE,TYPING,IMMUNO METHOD

Facility

$45.00

Service Code	HCPCS 87147
Hospital Charge Code	8714700
Hospital Revenue Code	306
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$43.65
Rate for Payer: Cash Price	$33.75
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$36.90

CULTURE,TYPING,IMMUNO METHOD

Facility

$45.00

Service Code	HCPCS 87147
Hospital Charge Code	8714700
Hospital Revenue Code	306
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$43.65
Rate for Payer: BCBS Commercial	$18.45
Rate for Payer: Cash Price	$33.75
Rate for Payer: Cash Price	$33.75
Rate for Payer: Celtic Commercial/Exchange	$20.79
Rate for Payer: Health Partners Plans Commercial	$42.75
Rate for Payer: UnitedHealthcare Commercial	$43.65
Rate for Payer: WPPA Commercial	$37.80

Know your out-of-pocket cost for care.

All Charges