Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

11730-Avulsion Nail Plate Single

Facility

$910.00

Service Code	HCPCS 11730
Hospital Charge Code	3300186
Hospital Revenue Code	450
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11730-Avulsion Nail Plate Single

Facility

$910.00

Service Code	HCPCS 11730
Hospital Charge Code	3300186
Hospital Revenue Code	450
Min. Negotiated Rate	$217.71
Max. Negotiated Rate	$864.50
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$217.71
Rate for Payer: Humana Medicare Advantage	$382.20
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: UnitedHealthcare Medicaid	$260.00
Rate for Payer: WPPA Medicare Advantage	$546.00

11730 AVULSION OF NAIL PLATE PARTIAL/COMP CHARGE

Facility

$301.00

Service Code	HCPCS 11730
Hospital Charge Code	3151730
Hospital Revenue Code	360
Min. Negotiated Rate	$270.90
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$270.90
Rate for Payer: UnitedHealthcare Commercial	$285.95
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11730 AVULSION OF NAIL PLATE PARTIAL/COMP CHARGE

Facility

$301.00

Service Code	HCPCS 11730
Hospital Charge Code	3151730
Hospital Revenue Code	360
Min. Negotiated Rate	$126.42
Max. Negotiated Rate	$285.95
Rate for Payer: Aetna Commercial	$270.90
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$217.71
Rate for Payer: Humana Medicare Advantage	$126.42
Rate for Payer: UnitedHealthcare Commercial	$285.95
Rate for Payer: UnitedHealthcare Medicaid	$260.00
Rate for Payer: WPPA Medicare Advantage	$180.60

11730 Avulsion of nail plate, partial or complete, simple; single

Facility

$186.00

Service Code	HCPCS 11730
Hospital Charge Code	3291730
Hospital Revenue Code	761
Min. Negotiated Rate	$78.12
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$167.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$217.71
Rate for Payer: Humana Medicare Advantage	$78.12
Rate for Payer: UnitedHealthcare Commercial	$176.70
Rate for Payer: UnitedHealthcare Medicaid	$260.00
Rate for Payer: WPPA Medicare Advantage	$111.60

11730 Avulsion of nail plate, partial or complete, simple; single

Facility

$186.00

Service Code	HCPCS 11730
Hospital Charge Code	3291730
Hospital Revenue Code	761
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$167.40
Rate for Payer: UnitedHealthcare Commercial	$176.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate

Facility

$186.00

Service Code	HCPCS 11732
Hospital Charge Code	3291732
Hospital Revenue Code	761
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$176.70
Rate for Payer: Aetna Commercial	$167.40
Rate for Payer: Humana Medicare Advantage	$78.12
Rate for Payer: UnitedHealthcare Commercial	$176.70
Rate for Payer: UnitedHealthcare Medicaid	$19.61
Rate for Payer: WPPA Medicare Advantage	$111.60

11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate

Facility

$186.00

Service Code	HCPCS 11732
Hospital Charge Code	3291732
Hospital Revenue Code	761
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$167.40
Rate for Payer: UnitedHealthcare Commercial	$176.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11740-Evacuation Subungual Hematoma

Facility

$736.00

Service Code	HCPCS 11740
Hospital Charge Code	3301740
Hospital Revenue Code	450
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$699.20
Rate for Payer: Aetna Commercial	$662.40
Rate for Payer: Humana Medicare Advantage	$309.12
Rate for Payer: UnitedHealthcare Commercial	$699.20
Rate for Payer: UnitedHealthcare Medicaid	$260.00
Rate for Payer: WPPA Medicare Advantage	$441.60

11740-Evacuation Subungual Hematoma

Facility

$736.00

Service Code	HCPCS 11740
Hospital Charge Code	3301740
Hospital Revenue Code	450
Min. Negotiated Rate	$662.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$662.40
Rate for Payer: UnitedHealthcare Commercial	$699.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11740 EVACUATION SUBUNGUAL HEMATOMA TechFee

Facility

$736.00

Service Code	HCPCS 11740
Hospital Charge Code	3301740
Hospital Revenue Code	450
Min. Negotiated Rate	$662.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$662.40
Rate for Payer: UnitedHealthcare Commercial	$699.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11740 EVACUATION SUBUNGUAL HEMATOMA TechFee

Facility

$736.00

Service Code	HCPCS 11740
Hospital Charge Code	3301740
Hospital Revenue Code	450
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$699.20
Rate for Payer: Aetna Commercial	$662.40
Rate for Payer: Humana Medicare Advantage	$309.12
Rate for Payer: UnitedHealthcare Commercial	$699.20
Rate for Payer: UnitedHealthcare Medicaid	$260.00
Rate for Payer: WPPA Medicare Advantage	$441.60

11750 Excision of nail and nail matrix, partial or complete, for permanent removal

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3290195
Hospital Revenue Code	761
Min. Negotiated Rate	$286.00
Max. Negotiated Rate	$864.50
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$451.17
Rate for Payer: Humana Medicare Advantage	$382.20
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: UnitedHealthcare Medicaid	$286.00
Rate for Payer: WPPA Medicare Advantage	$546.00

11750 Excision of nail and nail matrix, partial or complete, for permanent removal

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3290195
Hospital Revenue Code	761
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11750 REMOVAL NAIL BED CHARGE

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3151750
Hospital Revenue Code	360
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11750 REMOVAL NAIL BED CHARGE

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3151750
Hospital Revenue Code	360
Min. Negotiated Rate	$286.00
Max. Negotiated Rate	$864.50
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$451.17
Rate for Payer: Humana Medicare Advantage	$382.20
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: UnitedHealthcare Medicaid	$286.00
Rate for Payer: WPPA Medicare Advantage	$546.00

11750 REMOVAL OF NAIL BED

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3300187
Hospital Revenue Code	450
Min. Negotiated Rate	$286.00
Max. Negotiated Rate	$864.50
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$451.17
Rate for Payer: Humana Medicare Advantage	$382.20
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: UnitedHealthcare Medicaid	$286.00
Rate for Payer: WPPA Medicare Advantage	$546.00

11750 REMOVAL OF NAIL BED

Facility

$910.00

Service Code	HCPCS 11750
Hospital Charge Code	3300187
Hospital Revenue Code	450
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: UnitedHealthcare Commercial	$864.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11755 Biopsy of nail unit

Facility

$715.00

Service Code	HCPCS 11755
Hospital Charge Code	3351755
Hospital Revenue Code	761
Min. Negotiated Rate	$643.50
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$643.50
Rate for Payer: UnitedHealthcare Commercial	$679.25
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11755 Biopsy of nail unit

Facility

$715.00

Service Code	HCPCS 11755
Hospital Charge Code	3351755
Hospital Revenue Code	761
Min. Negotiated Rate	$227.92
Max. Negotiated Rate	$679.25
Rate for Payer: Aetna Commercial	$643.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$371.68
Rate for Payer: Humana Medicare Advantage	$300.30
Rate for Payer: UnitedHealthcare Commercial	$679.25
Rate for Payer: UnitedHealthcare Medicaid	$227.92
Rate for Payer: WPPA Medicare Advantage	$429.00

11760-Repair of Nail Bed

Facility

$773.00

Service Code	HCPCS 11760
Hospital Charge Code	3300188
Hospital Revenue Code	450
Min. Negotiated Rate	$695.70
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$695.70
Rate for Payer: UnitedHealthcare Commercial	$734.35
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11760-Repair of Nail Bed

Facility

$773.00

Service Code	HCPCS 11760
Hospital Charge Code	3300188
Hospital Revenue Code	450
Min. Negotiated Rate	$286.00
Max. Negotiated Rate	$734.35
Rate for Payer: Aetna Commercial	$695.70
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$371.68
Rate for Payer: Humana Medicare Advantage	$324.66
Rate for Payer: UnitedHealthcare Commercial	$734.35
Rate for Payer: UnitedHealthcare Medicaid	$286.00
Rate for Payer: WPPA Medicare Advantage	$463.80

11770 REMOVE PILONIDAL CYST SIMPLE

Facility

$2,760.00

Service Code	HCPCS 11770
Hospital Charge Code	3151770
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,622.00
Rate for Payer: Aetna Commercial	$2,484.00
Rate for Payer: UnitedHealthcare Commercial	$2,622.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

11770 REMOVE PILONIDAL CYST SIMPLE

Facility

$2,760.00

Service Code	HCPCS 11770
Hospital Charge Code	3151770
Hospital Revenue Code	360
Min. Negotiated Rate	$920.50
Max. Negotiated Rate	$2,622.00
Rate for Payer: Aetna Commercial	$2,484.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,714.98
Rate for Payer: Humana Medicare Advantage	$1,159.20
Rate for Payer: UnitedHealthcare Commercial	$2,622.00
Rate for Payer: UnitedHealthcare Medicaid	$920.50
Rate for Payer: WPPA Medicare Advantage	$1,656.00

11771 REMOVE PILONIDAL CYST EXTEN

Facility

$5,426.00

Service Code	HCPCS 11771
Hospital Charge Code	3151771
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,154.70
Rate for Payer: Aetna Commercial	$4,883.40
Rate for Payer: UnitedHealthcare Commercial	$5,154.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges