Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

32551-Insertion Chest Tube

Facility

$4,317.00

Service Code	HCPCS 32551
Hospital Charge Code	3302551
Hospital Revenue Code	450
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,101.15
Rate for Payer: Aetna Commercial	$3,885.30
Rate for Payer: UnitedHealthcare Commercial	$4,101.15
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32551 Insertion of Chest Tube Bilat Charges

Facility

$1,072.00

Service Code	HCPCS 32551
Hospital Charge Code	3152551
Hospital Revenue Code	360
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$1,018.40
Rate for Payer: Aetna Commercial	$964.80
Rate for Payer: Humana Medicare Advantage	$450.24
Rate for Payer: UnitedHealthcare Commercial	$1,018.40
Rate for Payer: UnitedHealthcare Medicaid	$224.00
Rate for Payer: WPPA Medicare Advantage	$643.20

32551 Insertion of Chest Tube Bilat Charges

Facility

$1,072.00

Service Code	HCPCS 32551
Hospital Charge Code	3152551
Hospital Revenue Code	360
Min. Negotiated Rate	$964.80
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$964.80
Rate for Payer: UnitedHealthcare Commercial	$1,018.40
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee

Facility

$1,072.00

Service Code	HCPCS 32551
Hospital Charge Code	3302551
Hospital Revenue Code	450
Min. Negotiated Rate	$964.80
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$964.80
Rate for Payer: UnitedHealthcare Commercial	$1,018.40
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32551 TUBE THORACOSTOMY INCLUDES WATER SEAL TechFee

Facility

$1,072.00

Service Code	HCPCS 32551
Hospital Charge Code	3302551
Hospital Revenue Code	450
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$1,018.40
Rate for Payer: Aetna Commercial	$964.80
Rate for Payer: Humana Medicare Advantage	$450.24
Rate for Payer: UnitedHealthcare Commercial	$1,018.40
Rate for Payer: UnitedHealthcare Medicaid	$224.00
Rate for Payer: WPPA Medicare Advantage	$643.20

32554 Aspirate Pleura w/o Imaging

Facility

$1,463.00

Service Code	HCPCS 32554
Hospital Charge Code	3292554
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,389.85
Rate for Payer: Aetna Commercial	$1,316.70
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$742.35
Rate for Payer: Humana Medicare Advantage	$614.46
Rate for Payer: UnitedHealthcare Commercial	$1,389.85
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$877.80

32554 Aspirate Pleura w/o Imaging

Facility

$1,463.00

Service Code	HCPCS 32554
Hospital Charge Code	3292554
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,389.85
Rate for Payer: Aetna Commercial	$1,316.70
Rate for Payer: UnitedHealthcare Commercial	$1,389.85
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance

Facility

$1,029.00

Service Code	HCPCS 32554
Hospital Charge Code	3292554
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$977.55
Rate for Payer: Aetna Commercial	$926.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$742.35
Rate for Payer: Humana Medicare Advantage	$432.18
Rate for Payer: UnitedHealthcare Commercial	$977.55
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$617.40

32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance

Facility

$1,029.00

Service Code	HCPCS 32554
Hospital Charge Code	3292554
Hospital Revenue Code	761
Min. Negotiated Rate	$926.10
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$926.10
Rate for Payer: UnitedHealthcare Commercial	$977.55
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32555 EXC OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$862.54
Rate for Payer: Humana Medicare Advantage	$713.58
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$1,019.40

32555 EXC OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32555 THORACENTESIS; ASPIRATION PLEURA WITH IMAGING

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32555 THORACENTESIS; ASPIRATION PLEURA WITH IMAGING

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$862.54
Rate for Payer: Humana Medicare Advantage	$713.58
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$1,019.40

32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance

Facility

$1,699.00

Service Code	HCPCS 32555
Hospital Charge Code	3352555
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,614.05
Rate for Payer: Aetna Commercial	$1,529.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$862.54
Rate for Payer: Humana Medicare Advantage	$713.58
Rate for Payer: UnitedHealthcare Commercial	$1,614.05
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$1,019.40

32556 Pleural drainage, percutaneous, w/o imaging guidance

Facility

$1,145.00

Service Code	HCPCS 32556
Hospital Charge Code	3152556
Hospital Revenue Code	360
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,087.75
Rate for Payer: Aetna Commercial	$1,030.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$742.35
Rate for Payer: Humana Medicare Advantage	$480.90
Rate for Payer: UnitedHealthcare Commercial	$1,087.75
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$687.00

32556 Pleural drainage, percutaneous, w/o imaging guidance

Facility

$1,145.00

Service Code	HCPCS 32556
Hospital Charge Code	3152556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,030.50
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$1,030.50
Rate for Payer: UnitedHealthcare Commercial	$1,087.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32557 Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance

Facility

$1,395.00

Service Code	HCPCS 32557
Hospital Charge Code	3355572
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,325.25
Rate for Payer: Aetna Commercial	$1,255.50
Rate for Payer: UnitedHealthcare Commercial	$1,325.25
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32557 Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance

Facility

$1,395.00

Service Code	HCPCS 32557
Hospital Charge Code	3355572
Hospital Revenue Code	761
Min. Negotiated Rate	$278.77
Max. Negotiated Rate	$1,325.25
Rate for Payer: Aetna Commercial	$1,255.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$862.54
Rate for Payer: Humana Medicare Advantage	$585.90
Rate for Payer: UnitedHealthcare Commercial	$1,325.25
Rate for Payer: UnitedHealthcare Medicaid	$278.77
Rate for Payer: WPPA Medicare Advantage	$837.00

32651 THORACOSCOPY, SURGICAL W/VIDEO

Facility

$3,204.00

Service Code	HCPCS 32651
Hospital Charge Code	3152651
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,043.80
Rate for Payer: Aetna Commercial	$2,883.60
Rate for Payer: UnitedHealthcare Commercial	$3,043.80
Rate for Payer: WPPA Medicare Advantage	$1,200.00

32651 THORACOSCOPY, SURGICAL W/VIDEO

Facility

$3,204.00

Service Code	HCPCS 32651
Hospital Charge Code	3152651
Hospital Revenue Code	360
Min. Negotiated Rate	$1,281.60
Max. Negotiated Rate	$3,043.80
Rate for Payer: Aetna Commercial	$2,883.60
Rate for Payer: Humana Medicare Advantage	$1,345.68
Rate for Payer: UnitedHealthcare Commercial	$3,043.80
Rate for Payer: UnitedHealthcare Medicaid	$1,281.60
Rate for Payer: WPPA Medicare Advantage	$1,922.40

3.5MM CORT LOCK SCR 12MM NS

Facility

$364.50

Hospital Charge Code	3258142
Hospital Revenue Code	270
Min. Negotiated Rate	$328.05
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$328.05
Rate for Payer: UnitedHealthcare Commercial	$346.27
Rate for Payer: WPPA Medicare Advantage	$1,200.00

3.5MM CORT LOCK SCR 12MM NS

Facility

$364.50

Hospital Charge Code	3258142
Hospital Revenue Code	270
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$346.27
Rate for Payer: Aetna Commercial	$328.05
Rate for Payer: Humana Medicare Advantage	$153.09
Rate for Payer: UnitedHealthcare Commercial	$346.27
Rate for Payer: UnitedHealthcare Medicaid	$145.80
Rate for Payer: WPPA Medicare Advantage	$218.70

3.5MM CORT LOCK SCR 14MM NS

Facility

$364.50

Hospital Charge Code	3258143
Hospital Revenue Code	270
Min. Negotiated Rate	$328.05
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$328.05
Rate for Payer: UnitedHealthcare Commercial	$346.27
Rate for Payer: WPPA Medicare Advantage	$1,200.00

3.5MM CORT LOCK SCR 14MM NS

Facility

$364.50

Hospital Charge Code	3258143
Hospital Revenue Code	270
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$346.27
Rate for Payer: Aetna Commercial	$328.05
Rate for Payer: Humana Medicare Advantage	$153.09
Rate for Payer: UnitedHealthcare Commercial	$346.27
Rate for Payer: UnitedHealthcare Medicaid	$145.80
Rate for Payer: WPPA Medicare Advantage	$218.70

Know your out-of-pocket cost for care.

All Charges