Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$4,829.04

Service Code	MSDRG 425
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,829.04
Rate for Payer: UnitedHealthcare Medicaid	$4,829.04
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$4,098.33

Service Code	MSDRG 868
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,098.33
Rate for Payer: UnitedHealthcare Medicaid	$4,098.33
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$8,323.74

Service Code	MSDRG 867
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,323.74
Rate for Payer: UnitedHealthcare Medicaid	$8,323.74
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$2,891.07

Service Code	MSDRG 869
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,891.07
Rate for Payer: UnitedHealthcare Medicaid	$2,891.07
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$5,305.59

Service Code	MSDRG 922
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,305.59
Rate for Payer: UnitedHealthcare Medicaid	$5,305.59
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$3,081.69

Service Code	MSDRG 923
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,081.69
Rate for Payer: UnitedHealthcare Medicaid	$3,081.69
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$4,320.72

Service Code	MSDRG 699
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,320.72
Rate for Payer: UnitedHealthcare Medicaid	$4,320.72
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$5,559.75

Service Code	MSDRG 698
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,559.75
Rate for Payer: UnitedHealthcare Medicaid	$5,559.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC

Facility

$2,922.84

Service Code	MSDRG 700
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,922.84
Rate for Payer: UnitedHealthcare Medicaid	$2,922.84
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$10,071.09

Service Code	MSDRG 674
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$10,071.09
Rate for Payer: UnitedHealthcare Medicaid	$10,071.09
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$12,104.37

Service Code	MSDRG 673
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$12,104.37
Rate for Payer: UnitedHealthcare Medicaid	$12,104.37
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC

Facility

$5,527.98

Service Code	MSDRG 675
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,527.98
Rate for Payer: UnitedHealthcare Medicaid	$5,527.98
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$13,025.70

Service Code	MSDRG 271
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$13,025.70
Rate for Payer: UnitedHealthcare Medicaid	$13,025.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$18,903.15

Service Code	MSDRG 270
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$18,903.15
Rate for Payer: UnitedHealthcare Medicaid	$18,903.15
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$9,149.76

Service Code	MSDRG 272
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$9,149.76
Rate for Payer: UnitedHealthcare Medicaid	$9,149.76
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$3,399.39

Service Code	MSDRG 729
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,399.39
Rate for Payer: UnitedHealthcare Medicaid	$3,399.39
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$2,160.36

Service Code	MSDRG 730
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,160.36
Rate for Payer: UnitedHealthcare Medicaid	$2,160.36
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC

Facility

$6,639.93

Service Code	MSDRG 717
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$6,639.93
Rate for Payer: UnitedHealthcare Medicaid	$6,639.93
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC

Facility

$4,701.96

Service Code	MSDRG 718
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,701.96
Rate for Payer: UnitedHealthcare Medicaid	$4,701.96
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC

Facility

$7,847.19

Service Code	MSDRG 715
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$7,847.19
Rate for Payer: UnitedHealthcare Medicaid	$7,847.19
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Facility

$5,146.74

Service Code	MSDRG 716
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,146.74
Rate for Payer: UnitedHealthcare Medicaid	$5,146.74
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MENTAL DISORDER DIAGNOSES

Facility

$2,096.82

Service Code	MSDRG 887
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,096.82
Rate for Payer: UnitedHealthcare Medicaid	$2,096.82
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$4,892.58

Service Code	MSDRG 964
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,892.58
Rate for Payer: UnitedHealthcare Medicaid	$4,892.58
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$8,736.75

Service Code	MSDRG 963
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,736.75
Rate for Payer: UnitedHealthcare Medicaid	$8,736.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$3,018.15

Service Code	MSDRG 965
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,018.15
Rate for Payer: UnitedHealthcare Medicaid	$3,018.15
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges