Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

11470 Exc skin/subq tissue for hidradenitis, perianal/perineal/umbilical; w/ simple or interm repair

Facility

$4,072.00

Service Code	HCPCS 11470
Hospital Charge Code	3351470
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,868.40
Rate for Payer: Aetna Commercial	$3,664.80
Rate for Payer: UnitedHealthcare Commercial	$3,868.40
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11600 Excision, malignant lesion including margins, trunk, arms, or legs; < 0.5cm

Facility

$1,086.00

Service Code	HCPCS 11600
Hospital Charge Code	3351600
Hospital Revenue Code	761
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11600 Excision, malignant lesion including margins, trunk, arms, or legs; < 0.5cm

Facility

$1,086.00

Service Code	HCPCS 11600
Hospital Charge Code	3351600
Hospital Revenue Code	761
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,031.70
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$456.12
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$651.60

11601 Excision Malignant Lesion (trunk, arms, or legs) 0.6-1.0CM

Facility

$1,086.00

Service Code	HCPCS 11601
Hospital Charge Code	3151601
Hospital Revenue Code	360
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11601 Excision Malignant Lesion (trunk, arms, or legs) 0.6-1.0CM

Facility

$1,086.00

Service Code	HCPCS 11601
Hospital Charge Code	3151601
Hospital Revenue Code	360
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,031.70
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$456.12
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$651.60

11601 EXC TR-EXT MLG MARG 0.6-1 CM

Facility

$1,086.00

Service Code	HCPCS 11601
Hospital Charge Code	3351601
Hospital Revenue Code	761
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11601 EXC TR-EXT MLG MARG 0.6-1 CM

Facility

$1,086.00

Service Code	HCPCS 11601
Hospital Charge Code	3351601
Hospital Revenue Code	761
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,031.70
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$456.12
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$651.60

11602 EXC TR-EXT MAL+MARG 1.1-2 CM

Facility

$606.00

Service Code	HCPCS 11602
Hospital Charge Code	3150218
Hospital Revenue Code	360
Min. Negotiated Rate	$254.52
Max. Negotiated Rate	$575.70
Rate for Payer: Aetna Commercial	$545.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$451.17
Rate for Payer: Humana Medicare Advantage	$254.52
Rate for Payer: UnitedHealthcare Commercial	$575.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$363.60

11602 EXC TR-EXT MAL+MARG 1.1-2 CM

Facility

$606.00

Service Code	HCPCS 11602
Hospital Charge Code	3150218
Hospital Revenue Code	360
Min. Negotiated Rate	$545.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$545.40
Rate for Payer: UnitedHealthcare Commercial	$575.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11602 EXC TR-EXT MLG MARG 1.1-2 CM

Facility

$606.00

Service Code	HCPCS 11602
Hospital Charge Code	3351602
Hospital Revenue Code	761
Min. Negotiated Rate	$545.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$545.40
Rate for Payer: UnitedHealthcare Commercial	$575.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11602 EXC TR-EXT MLG MARG 1.1-2 CM

Facility

$606.00

Service Code	HCPCS 11602
Hospital Charge Code	3351602
Hospital Revenue Code	761
Min. Negotiated Rate	$254.52
Max. Negotiated Rate	$575.70
Rate for Payer: Aetna Commercial	$545.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$451.17
Rate for Payer: Humana Medicare Advantage	$254.52
Rate for Payer: UnitedHealthcare Commercial	$575.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$363.60

11603 EXC TR-EXT MAL+MARG 2.1-3 CM

Facility

$1,086.00

Service Code	HCPCS 11603
Hospital Charge Code	3361603
Hospital Revenue Code	360
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,031.70
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$456.12
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$651.60

11603 EXC TR-EXT MAL+MARG 2.1-3 CM

Facility

$1,086.00

Service Code	HCPCS 11603
Hospital Charge Code	3361603
Hospital Revenue Code	360
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11603 EXC TR-EXT MLG MARG 2.1-3 CM

Facility

$1,086.00

Service Code	HCPCS 11603
Hospital Charge Code	3351603
Hospital Revenue Code	761
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,031.70
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$456.12
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$651.60

11603 EXC TR-EXT MLG MARG 2.1-3 CM

Facility

$1,086.00

Service Code	HCPCS 11603
Hospital Charge Code	3351603
Hospital Revenue Code	761
Min. Negotiated Rate	$977.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$977.40
Rate for Payer: UnitedHealthcare Commercial	$1,031.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11604 EXC TR-EXT MAL+MARG 3.1-4 CM

Facility

$1,278.00

Service Code	HCPCS 11604
Hospital Charge Code	3150219
Hospital Revenue Code	360
Min. Negotiated Rate	$1,150.20
Max. Negotiated Rate	$1,214.10
Rate for Payer: Aetna Commercial	$1,150.20
Rate for Payer: UnitedHealthcare Commercial	$1,214.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11604 EXC TR-EXT MAL+MARG 3.1-4 CM

Facility

$1,278.00

Service Code	HCPCS 11604
Hospital Charge Code	3150219
Hospital Revenue Code	360
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,214.10
Rate for Payer: Aetna Commercial	$1,150.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$536.76
Rate for Payer: UnitedHealthcare Commercial	$1,214.10
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$766.80

11604 EXC TR-EXT MLG MARG 3.1-4 CM

Facility

$1,217.00

Service Code	HCPCS 11604
Hospital Charge Code	3351604
Hospital Revenue Code	761
Min. Negotiated Rate	$1,095.30
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$1,095.30
Rate for Payer: UnitedHealthcare Commercial	$1,156.15
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11604 EXC TR-EXT MLG MARG 3.1-4 CM

Facility

$1,217.00

Service Code	HCPCS 11604
Hospital Charge Code	3351604
Hospital Revenue Code	761
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,156.15
Rate for Payer: Aetna Commercial	$1,095.30
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$783.57
Rate for Payer: Humana Medicare Advantage	$511.14
Rate for Payer: UnitedHealthcare Commercial	$1,156.15
Rate for Payer: UnitedHealthcare Medicaid	$343.20
Rate for Payer: WPPA Medicare Advantage	$730.20

11606 Excision, malignant lesion including margins, trunk, arms, or legs; >4.0cm

Facility

$3,534.00

Service Code	HCPCS 11606
Hospital Charge Code	3351606
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,357.30
Rate for Payer: Aetna Commercial	$3,180.60
Rate for Payer: UnitedHealthcare Commercial	$3,357.30
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11606 Excision, malignant lesion including margins, trunk, arms, or legs; >4.0cm

Facility

$3,534.00

Service Code	HCPCS 11606
Hospital Charge Code	3351606
Hospital Revenue Code	761
Min. Negotiated Rate	$525.22
Max. Negotiated Rate	$3,357.30
Rate for Payer: Aetna Commercial	$3,180.60
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,998.79
Rate for Payer: Humana Medicare Advantage	$1,484.28
Rate for Payer: UnitedHealthcare Commercial	$3,357.30
Rate for Payer: UnitedHealthcare Medicaid	$525.22
Rate for Payer: WPPA Medicare Advantage	$2,120.40

11606 EXC TR-EXT MAL+MARG >4 CM

Facility

$3,366.00

Service Code	HCPCS 11606
Hospital Charge Code	3150221
Hospital Revenue Code	360
Min. Negotiated Rate	$525.22
Max. Negotiated Rate	$3,197.70
Rate for Payer: Aetna Commercial	$3,029.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,998.79
Rate for Payer: Humana Medicare Advantage	$1,413.72
Rate for Payer: UnitedHealthcare Commercial	$3,197.70
Rate for Payer: UnitedHealthcare Medicaid	$525.22
Rate for Payer: WPPA Medicare Advantage	$2,019.60

11606 EXC TR-EXT MAL+MARG >4 CM

Facility

$3,366.00

Service Code	HCPCS 11606
Hospital Charge Code	3150221
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,197.70
Rate for Payer: Aetna Commercial	$3,029.40
Rate for Payer: UnitedHealthcare Commercial	$3,197.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; < 0.5 cm

Facility

$2,502.00

Service Code	HCPCS 11620
Hospital Charge Code	3151620
Hospital Revenue Code	360
Min. Negotiated Rate	$1,000.80
Max. Negotiated Rate	$2,376.90
Rate for Payer: Aetna Commercial	$2,251.80
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,805.43
Rate for Payer: Humana Medicare Advantage	$1,050.84
Rate for Payer: UnitedHealthcare Commercial	$2,376.90
Rate for Payer: UnitedHealthcare Medicaid	$1,000.80
Rate for Payer: WPPA Medicare Advantage	$1,501.20

11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; < 0.5 cm

Facility

$2,502.00

Service Code	HCPCS 11620
Hospital Charge Code	3151620
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,376.90
Rate for Payer: Aetna Commercial	$2,251.80
Rate for Payer: UnitedHealthcare Commercial	$2,376.90
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges