Ness County Hospital

All Charges

Charge

Type

Setting

Price

D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC

Facility

$16,098.00

Service Code	MSDRG 744
Min. Negotiated Rate	$16,098.00
Max. Negotiated Rate	$16,098.00
Rate for Payer: BCBS Commercial	$16,098.00

D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC

Facility

$10,384.34

Service Code	MSDRG 745
Min. Negotiated Rate	$10,384.34
Max. Negotiated Rate	$10,384.34
Rate for Payer: BCBS Commercial	$10,384.34

DEBRD SQ MSL,BONE 1ST 20SQCM

Facility

$1,806.00

Service Code	HCPCS 11044
Hospital Charge Code	1104423
Hospital Revenue Code	761
Min. Negotiated Rate	$834.37
Max. Negotiated Rate	$1,805.43
Rate for Payer: BCBS Commercial	$1,805.43
Rate for Payer: Cash Price	$1,354.50
Rate for Payer: Cash Price	$1,354.50
Rate for Payer: Celtic Commercial/Exchange	$834.37
Rate for Payer: Health Partners Plans Commercial	$1,715.70
Rate for Payer: UnitedHealthcare Commercial	$1,751.82
Rate for Payer: WPPA Commercial	$1,517.04

DEBRD SQ MSL,BONE 1ST 20SQCM

Facility

$1,806.00

Service Code	HCPCS 11044
Hospital Charge Code	1104423
Hospital Revenue Code	761
Min. Negotiated Rate	$1,480.92
Max. Negotiated Rate	$1,751.82
Rate for Payer: Cash Price	$1,354.50
Rate for Payer: Health Partners Plans Commercial	$1,715.70
Rate for Payer: UnitedHealthcare Commercial	$1,751.82
Rate for Payer: WPPA Commercial	$1,480.92

Debrd sq msl, bone 1st 20 sqcm (HMC)

Facility

$640.00

Service Code	HCPCS 11044
Hospital Charge Code	1104400
Hospital Revenue Code	761
Min. Negotiated Rate	$295.68
Max. Negotiated Rate	$1,805.43
Rate for Payer: BCBS Commercial	$1,805.43
Rate for Payer: Cash Price	$480.00
Rate for Payer: Cash Price	$480.00
Rate for Payer: Celtic Commercial/Exchange	$295.68
Rate for Payer: Health Partners Plans Commercial	$608.00
Rate for Payer: UnitedHealthcare Commercial	$620.80
Rate for Payer: WPPA Commercial	$537.60

Debrd sq msl, bone 1st 20 sqcm (HMC)

Facility

$640.00

Service Code	HCPCS 11044
Hospital Charge Code	1104400
Hospital Revenue Code	761
Min. Negotiated Rate	$524.80
Max. Negotiated Rate	$620.80
Rate for Payer: Cash Price	$480.00
Rate for Payer: Health Partners Plans Commercial	$608.00
Rate for Payer: UnitedHealthcare Commercial	$620.80
Rate for Payer: WPPA Commercial	$524.80

DEBRD SQ MSL,BONE EA ADTL 20SQ

Facility

$500.00

Service Code	HCPCS 11047
Hospital Charge Code	1104723
Hospital Revenue Code	761
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$485.00
Rate for Payer: BCBS Commercial	$278.76
Rate for Payer: Cash Price	$375.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Celtic Commercial/Exchange	$231.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$420.00

DEBRD SQ MSL,BONE EA ADTL 20SQ

Facility

$500.00

Service Code	HCPCS 11047
Hospital Charge Code	1104723
Hospital Revenue Code	761
Min. Negotiated Rate	$410.00
Max. Negotiated Rate	$485.00
Rate for Payer: Cash Price	$375.00
Rate for Payer: Health Partners Plans Commercial	$475.00
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: WPPA Commercial	$410.00

DEBRID/DRES PRTL THNS BURN LG

Facility

$550.00

Service Code	HCPCS 16030
Hospital Charge Code	1603023
Hospital Revenue Code	761
Min. Negotiated Rate	$451.00
Max. Negotiated Rate	$533.50
Rate for Payer: Cash Price	$412.50
Rate for Payer: Health Partners Plans Commercial	$522.50
Rate for Payer: UnitedHealthcare Commercial	$533.50
Rate for Payer: WPPA Commercial	$451.00

DEBRID/DRES PRTL THNS BURN LG

Facility

$550.00

Service Code	HCPCS 16030
Hospital Charge Code	1603023
Hospital Revenue Code	761
Min. Negotiated Rate	$254.10
Max. Negotiated Rate	$533.50
Rate for Payer: BCBS Commercial	$371.68
Rate for Payer: Cash Price	$412.50
Rate for Payer: Cash Price	$412.50
Rate for Payer: Celtic Commercial/Exchange	$254.10
Rate for Payer: Health Partners Plans Commercial	$522.50
Rate for Payer: UnitedHealthcare Commercial	$533.50
Rate for Payer: WPPA Commercial	$462.00

DEBRID/DRESS PRTL THNS BRN MED

Facility

$480.00

Service Code	HCPCS 16025
Hospital Charge Code	1602523
Hospital Revenue Code	761
Min. Negotiated Rate	$221.76
Max. Negotiated Rate	$465.60
Rate for Payer: BCBS Commercial	$371.68
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Celtic Commercial/Exchange	$221.76
Rate for Payer: Health Partners Plans Commercial	$456.00
Rate for Payer: UnitedHealthcare Commercial	$465.60
Rate for Payer: WPPA Commercial	$403.20

DEBRID/DRESS PRTL THNS BRN MED

Facility

$480.00

Service Code	HCPCS 16025
Hospital Charge Code	1602523
Hospital Revenue Code	761
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$465.60
Rate for Payer: Cash Price	$360.00
Rate for Payer: Health Partners Plans Commercial	$456.00
Rate for Payer: UnitedHealthcare Commercial	$465.60
Rate for Payer: WPPA Commercial	$393.60

DEBRIDE/DRESS PARTL THCKNSBURN

Facility

$480.00

Service Code	HCPCS 16020
Hospital Charge Code	1602023
Hospital Revenue Code	761
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$465.60
Rate for Payer: Cash Price	$360.00
Rate for Payer: Health Partners Plans Commercial	$456.00
Rate for Payer: UnitedHealthcare Commercial	$465.60
Rate for Payer: WPPA Commercial	$393.60

DEBRIDE/DRESS PARTL THCKNSBURN

Facility

$480.00

Service Code	HCPCS 16020
Hospital Charge Code	1602023
Hospital Revenue Code	761
Min. Negotiated Rate	$221.76
Max. Negotiated Rate	$465.60
Rate for Payer: BCBS Commercial	$371.68
Rate for Payer: Cash Price	$360.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Celtic Commercial/Exchange	$221.76
Rate for Payer: Health Partners Plans Commercial	$456.00
Rate for Payer: UnitedHealthcare Commercial	$465.60
Rate for Payer: WPPA Commercial	$403.20

DEBRIDEMENT OF NAIL/ANY METHOD

Facility

$285.00

Service Code	HCPCS 11721
Hospital Charge Code	1172100
Hospital Revenue Code	761
Min. Negotiated Rate	$69.46
Max. Negotiated Rate	$276.45
Rate for Payer: BCBS Commercial	$69.46
Rate for Payer: Cash Price	$213.75
Rate for Payer: Cash Price	$213.75
Rate for Payer: Celtic Commercial/Exchange	$131.67
Rate for Payer: Health Partners Plans Commercial	$270.75
Rate for Payer: UnitedHealthcare Commercial	$276.45
Rate for Payer: WPPA Commercial	$239.40

DEBRIDEMENT OF NAIL/ANY METHOD

Facility

$125.00

Service Code	HCPCS 11720
Hospital Charge Code	1172000
Hospital Revenue Code	761
Min. Negotiated Rate	$102.50
Max. Negotiated Rate	$121.25
Rate for Payer: Cash Price	$93.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$102.50

DEBRIDEMENT OF NAIL/ANY METHOD

Facility

$125.00

Service Code	HCPCS 11720
Hospital Charge Code	1172000
Hospital Revenue Code	761
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$121.25
Rate for Payer: BCBS Commercial	$69.46
Rate for Payer: Cash Price	$93.75
Rate for Payer: Cash Price	$93.75
Rate for Payer: Celtic Commercial/Exchange	$57.75
Rate for Payer: Health Partners Plans Commercial	$118.75
Rate for Payer: UnitedHealthcare Commercial	$121.25
Rate for Payer: WPPA Commercial	$105.00

DEBRIDEMENT OF NAIL/ANY METHOD

Facility

$285.00

Service Code	HCPCS 11721
Hospital Charge Code	1172100
Hospital Revenue Code	761
Min. Negotiated Rate	$233.70
Max. Negotiated Rate	$276.45
Rate for Payer: Cash Price	$213.75
Rate for Payer: Health Partners Plans Commercial	$270.75
Rate for Payer: UnitedHealthcare Commercial	$276.45
Rate for Payer: WPPA Commercial	$233.70

DEBRIDEMENT PROC ON SKIN

Facility

$300.00

Service Code	HCPCS 11045
Hospital Charge Code	1104500
Hospital Revenue Code	761
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$291.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$246.00

DEBRIDEMENT PROC ON SKIN

Facility

$300.00

Service Code	HCPCS 11045
Hospital Charge Code	1104500
Hospital Revenue Code	761
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$291.00
Rate for Payer: BCBS Commercial	$278.76
Rate for Payer: Cash Price	$225.00
Rate for Payer: Cash Price	$225.00
Rate for Payer: Celtic Commercial/Exchange	$138.60
Rate for Payer: Health Partners Plans Commercial	$285.00
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: WPPA Commercial	$252.00

DEBRIDEMENT W/OPEN FX SKIN/TIS

Facility

$654.00

Service Code	HCPCS 11042
Hospital Charge Code	1104200
Hospital Revenue Code	761
Min. Negotiated Rate	$302.15
Max. Negotiated Rate	$634.38
Rate for Payer: BCBS Commercial	$451.17
Rate for Payer: Cash Price	$490.50
Rate for Payer: Cash Price	$490.50
Rate for Payer: Celtic Commercial/Exchange	$302.15
Rate for Payer: Health Partners Plans Commercial	$621.30
Rate for Payer: UnitedHealthcare Commercial	$634.38
Rate for Payer: WPPA Commercial	$549.36

DEBRIDEMENT W/OPEN FX SKIN/TIS

Facility

$654.00

Service Code	HCPCS 11042
Hospital Charge Code	1104200
Hospital Revenue Code	761
Min. Negotiated Rate	$536.28
Max. Negotiated Rate	$634.38
Rate for Payer: Cash Price	$490.50
Rate for Payer: Health Partners Plans Commercial	$621.30
Rate for Payer: UnitedHealthcare Commercial	$634.38
Rate for Payer: WPPA Commercial	$536.28

DEBRIDE NAILS 1-5

Facility

$250.00

Service Code	HCPCS 11720
Hospital Charge Code	1172023
Hospital Revenue Code	761
Min. Negotiated Rate	$205.00
Max. Negotiated Rate	$242.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$205.00

DEBRIDE NAILS 1-5

Facility

$250.00

Service Code	HCPCS 11720
Hospital Charge Code	1172023
Hospital Revenue Code	761
Min. Negotiated Rate	$69.46
Max. Negotiated Rate	$242.50
Rate for Payer: BCBS Commercial	$69.46
Rate for Payer: Cash Price	$187.50
Rate for Payer: Cash Price	$187.50
Rate for Payer: Celtic Commercial/Exchange	$115.50
Rate for Payer: Health Partners Plans Commercial	$237.50
Rate for Payer: UnitedHealthcare Commercial	$242.50
Rate for Payer: WPPA Commercial	$210.00

DEBRIDE OF EXTENSIV ECZEMATOUS

Facility

$581.00

Service Code	HCPCS 11000
Hospital Charge Code	1100000
Hospital Revenue Code	761
Min. Negotiated Rate	$268.42
Max. Negotiated Rate	$563.57
Rate for Payer: BCBS Commercial	$278.76
Rate for Payer: Cash Price	$435.75
Rate for Payer: Cash Price	$435.75
Rate for Payer: Celtic Commercial/Exchange	$268.42
Rate for Payer: Health Partners Plans Commercial	$551.95
Rate for Payer: UnitedHealthcare Commercial	$563.57
Rate for Payer: WPPA Commercial	$488.04

Know your out-of-pocket cost for care.

All Charges