Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

Nasal Septal Button 3 cm Diameter Silicone

Facility

$574.83

Hospital Charge Code	3256122
Hospital Revenue Code	270
Min. Negotiated Rate	$517.35
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$517.35
Rate for Payer: UnitedHealthcare Commercial	$546.09
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasogastric (NG) Tube Care

Facility

$759.00

Service Code	HCPCS 43753
Hospital Charge Code	3304685
Hospital Revenue Code	761
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$721.05
Rate for Payer: Aetna Commercial	$683.10
Rate for Payer: Humana Medicare Advantage	$318.78
Rate for Payer: UnitedHealthcare Commercial	$721.05
Rate for Payer: UnitedHealthcare Medicaid	$24.85
Rate for Payer: WPPA Medicare Advantage	$455.40

Nasogastric (NG) Tube Care

Facility

$759.00

Service Code	HCPCS 43753
Hospital Charge Code	3304685
Hospital Revenue Code	761
Min. Negotiated Rate	$683.10
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$683.10
Rate for Payer: UnitedHealthcare Commercial	$721.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

NASOPHARYNGOSCOPY, SURGICAL, WITH DILATION OF EUSTACHIAN TUBE (IE, BALLOON DILATION); BILATERAL

Facility

$9,072.08

Service Code	CPT 69706
Hospital Revenue Code	360
Min. Negotiated Rate	$541.36
Max. Negotiated Rate	$9,072.08
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$541.36
Rate for Payer: UnitedHealthcare Medicaid	$3,305.93
Rate for Payer: WPPA Medicare Advantage	$9,072.08

nebivolol 5 mg Tab [HMC]

Facility

$23.28

Service Code	NDC 00456140530
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$22.12
Rate for Payer: Aetna Commercial	$20.95
Rate for Payer: Humana Medicare Advantage	$9.78
Rate for Payer: UnitedHealthcare Commercial	$22.12
Rate for Payer: UnitedHealthcare Medicaid	$9.31
Rate for Payer: WPPA Medicare Advantage	$13.97

nebivolol 5 mg Tab [HMC]

Facility

$15.08

Service Code	NDC 00904718904
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$14.33
Rate for Payer: Aetna Commercial	$13.57
Rate for Payer: Humana Medicare Advantage	$6.33
Rate for Payer: UnitedHealthcare Commercial	$14.33
Rate for Payer: UnitedHealthcare Medicaid	$6.03
Rate for Payer: WPPA Medicare Advantage	$9.05

nebivolol 5 mg Tab [HMC]

Facility

$23.28

Service Code	NDC 00456140530
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$20.95
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$20.95
Rate for Payer: UnitedHealthcare Commercial	$22.12
Rate for Payer: WPPA Medicare Advantage	$1,200.00

nebivolol 5 mg Tab [HMC]

Facility

$19.20

Service Code	NDC 62559027630
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$18.24
Rate for Payer: Aetna Commercial	$17.28
Rate for Payer: Humana Medicare Advantage	$8.06
Rate for Payer: UnitedHealthcare Commercial	$18.24
Rate for Payer: UnitedHealthcare Medicaid	$7.68
Rate for Payer: WPPA Medicare Advantage	$11.52

nebivolol 5 mg Tab [HMC]

Facility

$15.08

Service Code	NDC 00904718904
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$13.57
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$13.57
Rate for Payer: UnitedHealthcare Commercial	$14.33
Rate for Payer: WPPA Medicare Advantage	$1,200.00

nebivolol 5 mg Tab [HMC]

Facility

$19.20

Service Code	NDC 62559027630
Hospital Charge Code	3804135
Hospital Revenue Code	250
Min. Negotiated Rate	$17.28
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$17.28
Rate for Payer: UnitedHealthcare Commercial	$18.24
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nebulizer AeroEclipse

Facility

$20.39

Hospital Charge Code	3250207
Hospital Revenue Code	270
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$18.35
Rate for Payer: UnitedHealthcare Commercial	$19.37
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nebulizer AeroEclipse

Facility

$20.39

Hospital Charge Code	3250207
Hospital Revenue Code	270
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$19.37
Rate for Payer: Aetna Commercial	$18.35
Rate for Payer: Humana Medicare Advantage	$8.56
Rate for Payer: UnitedHealthcare Commercial	$19.37
Rate for Payer: UnitedHealthcare Medicaid	$8.16
Rate for Payer: WPPA Medicare Advantage	$12.23

Nebulizer Continuous Medication HOPE Pediatric Kit

Facility

$76.00

Hospital Charge Code	3250379
Hospital Revenue Code	270
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: UnitedHealthcare Commercial	$72.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nebulizer Continuous Medication HOPE Pediatric Kit

Facility

$76.00

Hospital Charge Code	3250379
Hospital Revenue Code	270
Min. Negotiated Rate	$30.40
Max. Negotiated Rate	$72.20
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Humana Medicare Advantage	$31.92
Rate for Payer: UnitedHealthcare Commercial	$72.20
Rate for Payer: UnitedHealthcare Medicaid	$30.40
Rate for Payer: WPPA Medicare Advantage	$45.60

Nebulizer Micro Mist

Facility

$2.79

Hospital Charge Code	3251449
Hospital Revenue Code	270
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$2.51
Rate for Payer: UnitedHealthcare Commercial	$2.65
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nebulizer Micro Mist

Facility

$2.79

Hospital Charge Code	3251449
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$2.51
Rate for Payer: Humana Medicare Advantage	$1.17
Rate for Payer: UnitedHealthcare Commercial	$2.65
Rate for Payer: UnitedHealthcare Medicaid	$1.12
Rate for Payer: WPPA Medicare Advantage	$1.67

Nebulizer System Respirgard II AirLife Filtered Medication Nebulizer

Facility

$29.00

Hospital Charge Code	3251236
Hospital Revenue Code	270
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$26.10
Rate for Payer: UnitedHealthcare Commercial	$27.55
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nebulizer System Respirgard II AirLife Filtered Medication Nebulizer

Facility

$29.00

Hospital Charge Code	3251236
Hospital Revenue Code	270
Min. Negotiated Rate	$11.60
Max. Negotiated Rate	$27.55
Rate for Payer: Aetna Commercial	$26.10
Rate for Payer: Humana Medicare Advantage	$12.18
Rate for Payer: UnitedHealthcare Commercial	$27.55
Rate for Payer: UnitedHealthcare Medicaid	$11.60
Rate for Payer: WPPA Medicare Advantage	$17.40

Needle aspiration aspiration, drainage

Facility

$1,314.00

Service Code	HCPCS 10160
Hospital Charge Code	3360160
Hospital Revenue Code	761
Min. Negotiated Rate	$223.08
Max. Negotiated Rate	$1,248.30
Rate for Payer: Aetna Commercial	$1,182.60
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$947.38
Rate for Payer: Humana Medicare Advantage	$551.88
Rate for Payer: UnitedHealthcare Commercial	$1,248.30
Rate for Payer: UnitedHealthcare Medicaid	$223.08
Rate for Payer: WPPA Medicare Advantage	$788.40

Needle aspiration aspiration, drainage

Facility

$1,314.00

Service Code	HCPCS 10160
Hospital Charge Code	3360160
Hospital Revenue Code	761
Min. Negotiated Rate	$1,182.60
Max. Negotiated Rate	$1,248.30
Rate for Payer: Aetna Commercial	$1,182.60
Rate for Payer: UnitedHealthcare Commercial	$1,248.30
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Needle Bone Marrow Biopsy Original Jamshidi 11G X 4

Facility

$87.00

Hospital Charge Code	3255663
Hospital Revenue Code	270
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$78.30
Rate for Payer: UnitedHealthcare Commercial	$82.65
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Needle Bone Marrow Biopsy Original Jamshidi 11G X 4

Facility

$87.00

Hospital Charge Code	3255663
Hospital Revenue Code	270
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$82.65
Rate for Payer: Aetna Commercial	$78.30
Rate for Payer: Humana Medicare Advantage	$36.54
Rate for Payer: UnitedHealthcare Commercial	$82.65
Rate for Payer: UnitedHealthcare Medicaid	$34.80
Rate for Payer: WPPA Medicare Advantage	$52.20

Needle Bone Marrow Biopsy T-Handle Jamshidi 11G X 4

Facility

$84.00

Hospital Charge Code	3254055
Hospital Revenue Code	270
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$79.80
Rate for Payer: Aetna Commercial	$75.60
Rate for Payer: Humana Medicare Advantage	$35.28
Rate for Payer: UnitedHealthcare Commercial	$79.80
Rate for Payer: UnitedHealthcare Medicaid	$33.60
Rate for Payer: WPPA Medicare Advantage	$50.40

Needle Bone Marrow Biopsy T-Handle Jamshidi 11G X 4

Facility

$84.00

Hospital Charge Code	3254055
Hospital Revenue Code	270
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$75.60
Rate for Payer: UnitedHealthcare Commercial	$79.80
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Needle EMG Electrode Boject/Myoject DHN Natus 37mm X 27G

Facility

$116.00

Hospital Charge Code	3253874
Hospital Revenue Code	270
Min. Negotiated Rate	$104.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$104.40
Rate for Payer: UnitedHealthcare Commercial	$110.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges