Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC

Facility

$8,800.29

Service Code	MSDRG 357
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,800.29
Rate for Payer: UnitedHealthcare Medicaid	$8,800.29
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC

Facility

$16,615.71

Service Code	MSDRG 356
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$16,615.71
Rate for Payer: UnitedHealthcare Medicaid	$16,615.71
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$5,273.82

Service Code	MSDRG 358
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,273.82
Rate for Payer: UnitedHealthcare Medicaid	$5,273.82
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DISORDERS OF NERVOUS SYSTEM WITH CC

Facility

$6,290.46

Service Code	MSDRG 092
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$6,290.46
Rate for Payer: UnitedHealthcare Medicaid	$6,290.46
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC

Facility

$8,673.21

Service Code	MSDRG 091
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,673.21
Rate for Payer: UnitedHealthcare Medicaid	$8,673.21
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$3,590.01

Service Code	MSDRG 093
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,590.01
Rate for Payer: UnitedHealthcare Medicaid	$3,590.01
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT

Facility

$4,225.41

Service Code	MSDRG 124
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,225.41
Rate for Payer: UnitedHealthcare Medicaid	$4,225.41
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER DISORDERS OF THE EYE WITHOUT MCC

Facility

$2,446.29

Service Code	MSDRG 125
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,446.29
Rate for Payer: UnitedHealthcare Medicaid	$2,446.29
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$2,668.68

Service Code	MSDRG 155
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,668.68
Rate for Payer: UnitedHealthcare Medicaid	$2,668.68
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$4,543.11

Service Code	MSDRG 154
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,543.11
Rate for Payer: UnitedHealthcare Medicaid	$4,543.11
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$2,001.51

Service Code	MSDRG 156
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,001.51
Rate for Payer: UnitedHealthcare Medicaid	$2,001.51
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$3,240.54

Service Code	MSDRG 144
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,240.54
Rate for Payer: UnitedHealthcare Medicaid	$3,240.54
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$7,021.17

Service Code	MSDRG 143
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$7,021.17
Rate for Payer: UnitedHealthcare Medicaid	$7,021.17
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$2,255.67

Service Code	MSDRG 145
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,255.67
Rate for Payer: UnitedHealthcare Medicaid	$2,255.67
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$8,260.20

Service Code	MSDRG 629
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,260.20
Rate for Payer: UnitedHealthcare Medicaid	$8,260.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$13,311.63

Service Code	MSDRG 628
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$13,311.63
Rate for Payer: UnitedHealthcare Medicaid	$13,311.63
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$5,210.28

Service Code	MSDRG 630
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,210.28
Rate for Payer: UnitedHealthcare Medicaid	$5,210.28
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$15,980.31

Service Code	MSDRG 319
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$15,980.31
Rate for Payer: UnitedHealthcare Medicaid	$15,980.31
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$8,609.67

Service Code	MSDRG 320
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,609.67
Rate for Payer: UnitedHealthcare Medicaid	$8,609.67
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$3,939.48

Service Code	MSDRG 951
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,939.48
Rate for Payer: UnitedHealthcare Medicaid	$3,939.48
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$8,609.67

Service Code	MSDRG 749
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,609.67
Rate for Payer: UnitedHealthcare Medicaid	$8,609.67
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$4,956.12

Service Code	MSDRG 750
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,956.12
Rate for Payer: UnitedHealthcare Medicaid	$4,956.12
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$35,677.71

Service Code	MSDRG 215
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$35,677.71
Rate for Payer: UnitedHealthcare Medicaid	$35,677.71
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$7,052.94

Service Code	MSDRG 424
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$7,052.94
Rate for Payer: UnitedHealthcare Medicaid	$7,052.94
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$13,375.17

Service Code	MSDRG 423
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$13,375.17
Rate for Payer: UnitedHealthcare Medicaid	$13,375.17
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges