Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

44143 PARTIAL REMOVAL OF COLON

Facility

$8,199.00

Service Code	HCPCS 44143
Hospital Charge Code	3154143
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$7,789.05
Rate for Payer: Aetna Commercial	$7,379.10
Rate for Payer: UnitedHealthcare Commercial	$7,789.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44143 PARTIAL REMOVAL OF COLON

Facility

$8,199.00

Service Code	HCPCS 44143
Hospital Charge Code	3154143
Hospital Revenue Code	360
Min. Negotiated Rate	$3,279.60
Max. Negotiated Rate	$7,789.05
Rate for Payer: Aetna Commercial	$7,379.10
Rate for Payer: Humana Medicare Advantage	$3,443.58
Rate for Payer: UnitedHealthcare Commercial	$7,789.05
Rate for Payer: UnitedHealthcare Medicaid	$3,279.60
Rate for Payer: WPPA Medicare Advantage	$4,919.40

44144 Partial removal of colon

Facility

$9,403.00

Service Code	HCPCS 44144
Hospital Charge Code	3154144
Hospital Revenue Code	360
Min. Negotiated Rate	$3,761.20
Max. Negotiated Rate	$8,932.85
Rate for Payer: Aetna Commercial	$8,462.70
Rate for Payer: Humana Medicare Advantage	$3,949.26
Rate for Payer: UnitedHealthcare Commercial	$8,932.85
Rate for Payer: UnitedHealthcare Medicaid	$3,761.20
Rate for Payer: WPPA Medicare Advantage	$5,641.80

44144 Partial removal of colon

Facility

$9,403.00

Service Code	HCPCS 44144
Hospital Charge Code	3154144
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$8,932.85
Rate for Payer: Aetna Commercial	$8,462.70
Rate for Payer: UnitedHealthcare Commercial	$8,932.85
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44146 Colectomy, partial

Facility

$6,258.00

Service Code	HCPCS 44146
Hospital Charge Code	3154146
Hospital Revenue Code	360
Min. Negotiated Rate	$2,503.20
Max. Negotiated Rate	$5,945.10
Rate for Payer: Aetna Commercial	$5,632.20
Rate for Payer: Humana Medicare Advantage	$2,628.36
Rate for Payer: UnitedHealthcare Commercial	$5,945.10
Rate for Payer: UnitedHealthcare Medicaid	$2,503.20
Rate for Payer: WPPA Medicare Advantage	$3,754.80

44146 Colectomy, partial

Facility

$6,258.00

Service Code	HCPCS 44146
Hospital Charge Code	3154146
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,945.10
Rate for Payer: Aetna Commercial	$5,632.20
Rate for Payer: UnitedHealthcare Commercial	$5,945.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44160 COLECTOMY PART W/REM [HGHO]

Facility

$7,082.00

Service Code	HCPCS 44160
Hospital Charge Code	3154160
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$6,727.90
Rate for Payer: Aetna Commercial	$6,373.80
Rate for Payer: UnitedHealthcare Commercial	$6,727.90
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44160 COLECTOMY PART W/REM [HGHO]

Facility

$7,082.00

Service Code	HCPCS 44160
Hospital Charge Code	3154160
Hospital Revenue Code	360
Min. Negotiated Rate	$2,832.80
Max. Negotiated Rate	$6,727.90
Rate for Payer: Aetna Commercial	$6,373.80
Rate for Payer: Humana Medicare Advantage	$2,974.44
Rate for Payer: UnitedHealthcare Commercial	$6,727.90
Rate for Payer: UnitedHealthcare Medicaid	$2,832.80
Rate for Payer: WPPA Medicare Advantage	$4,249.20

44180 LAP ENTEROLYSIS [HGHO]

Facility

$6,641.00

Service Code	HCPCS 44180
Hospital Charge Code	3364180
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$6,308.95
Rate for Payer: Aetna Commercial	$5,976.90
Rate for Payer: UnitedHealthcare Commercial	$6,308.95
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44180 LAP ENTEROLYSIS [HGHO]

Facility

$6,641.00

Service Code	HCPCS 44180
Hospital Charge Code	3364180
Hospital Revenue Code	360
Min. Negotiated Rate	$1,646.85
Max. Negotiated Rate	$6,308.95
Rate for Payer: Aetna Commercial	$5,976.90
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$4,791.44
Rate for Payer: Humana Medicare Advantage	$2,789.22
Rate for Payer: UnitedHealthcare Commercial	$6,308.95
Rate for Payer: UnitedHealthcare Medicaid	$1,646.85
Rate for Payer: WPPA Medicare Advantage	$3,984.60

44186 Laparoscopy, surgical

Facility

$7,970.00

Service Code	HCPCS 44186
Hospital Charge Code	3154186
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$7,571.50
Rate for Payer: Aetna Commercial	$7,173.00
Rate for Payer: UnitedHealthcare Commercial	$7,571.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44186 Laparoscopy, surgical

Facility

$7,970.00

Service Code	HCPCS 44186
Hospital Charge Code	3154186
Hospital Revenue Code	360
Min. Negotiated Rate	$1,646.85
Max. Negotiated Rate	$7,571.50
Rate for Payer: Aetna Commercial	$7,173.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$4,291.49
Rate for Payer: Humana Medicare Advantage	$3,347.40
Rate for Payer: UnitedHealthcare Commercial	$7,571.50
Rate for Payer: UnitedHealthcare Medicaid	$1,646.85
Rate for Payer: WPPA Medicare Advantage	$4,782.00

44204 LAPARO PARTIAL COLECTOMY

Facility

$5,948.00

Service Code	HCPCS 44204
Hospital Charge Code	3154204
Hospital Revenue Code	360
Min. Negotiated Rate	$2,379.20
Max. Negotiated Rate	$5,650.60
Rate for Payer: Aetna Commercial	$5,353.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$4,291.49
Rate for Payer: Humana Medicare Advantage	$2,498.16
Rate for Payer: UnitedHealthcare Commercial	$5,650.60
Rate for Payer: UnitedHealthcare Medicaid	$2,379.20
Rate for Payer: WPPA Medicare Advantage	$3,568.80

44204 LAPARO PARTIAL COLECTOMY

Facility

$5,948.00

Service Code	HCPCS 44204
Hospital Charge Code	3154204
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,650.60
Rate for Payer: Aetna Commercial	$5,353.20
Rate for Payer: UnitedHealthcare Commercial	$5,650.60
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44207 Laparoscopy, surgical

Facility

$5,948.00

Service Code	HCPCS 44207
Hospital Charge Code	3364207
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,650.60
Rate for Payer: Aetna Commercial	$5,353.20
Rate for Payer: UnitedHealthcare Commercial	$5,650.60
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44207 Laparoscopy, surgical

Facility

$5,948.00

Service Code	HCPCS 44207
Hospital Charge Code	3364207
Hospital Revenue Code	360
Min. Negotiated Rate	$2,379.20
Max. Negotiated Rate	$5,650.60
Rate for Payer: Aetna Commercial	$5,353.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$4,291.49
Rate for Payer: Humana Medicare Advantage	$2,498.16
Rate for Payer: UnitedHealthcare Commercial	$5,650.60
Rate for Payer: UnitedHealthcare Medicaid	$2,379.20
Rate for Payer: WPPA Medicare Advantage	$3,568.80

44213-Laparoscopy,surgical,mobilization(take-down) of splenic flexure performed in conjunction with

Facility

$3,203.00

Service Code	HCPCS 44213
Hospital Charge Code	3164213
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,042.85
Rate for Payer: Aetna Commercial	$2,882.70
Rate for Payer: UnitedHealthcare Commercial	$3,042.85
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44213-Laparoscopy,surgical,mobilization(take-down) of splenic flexure performed in conjunction with

Facility

$3,203.00

Service Code	HCPCS 44213
Hospital Charge Code	3164213
Hospital Revenue Code	360
Min. Negotiated Rate	$1,281.20
Max. Negotiated Rate	$3,042.85
Rate for Payer: Aetna Commercial	$2,882.70
Rate for Payer: Humana Medicare Advantage	$1,345.26
Rate for Payer: UnitedHealthcare Commercial	$3,042.85
Rate for Payer: UnitedHealthcare Medicaid	$1,281.20
Rate for Payer: WPPA Medicare Advantage	$1,921.80

44300 Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression)

Facility

$3,856.00

Service Code	HCPCS 44300
Hospital Charge Code	3154300
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,663.20
Rate for Payer: Aetna Commercial	$3,470.40
Rate for Payer: UnitedHealthcare Commercial	$3,663.20
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44300 Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression)

Facility

$3,856.00

Service Code	HCPCS 44300
Hospital Charge Code	3154300
Hospital Revenue Code	360
Min. Negotiated Rate	$312.00
Max. Negotiated Rate	$3,663.20
Rate for Payer: Aetna Commercial	$3,470.40
Rate for Payer: Humana Medicare Advantage	$1,619.52
Rate for Payer: UnitedHealthcare Commercial	$3,663.20
Rate for Payer: UnitedHealthcare Medicaid	$312.00
Rate for Payer: WPPA Medicare Advantage	$2,313.60

44310 Ileostomy or jejunostomy, non-tube

Facility

$4,481.00

Service Code	HCPCS 44310
Hospital Charge Code	3154310
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,256.95
Rate for Payer: Aetna Commercial	$4,032.90
Rate for Payer: UnitedHealthcare Commercial	$4,256.95
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44310 Ileostomy or jejunostomy, non-tube

Facility

$4,481.00

Service Code	HCPCS 44310
Hospital Charge Code	3154310
Hospital Revenue Code	360
Min. Negotiated Rate	$1,792.40
Max. Negotiated Rate	$4,256.95
Rate for Payer: Aetna Commercial	$4,032.90
Rate for Payer: Humana Medicare Advantage	$1,882.02
Rate for Payer: UnitedHealthcare Commercial	$4,256.95
Rate for Payer: UnitedHealthcare Medicaid	$1,792.40
Rate for Payer: WPPA Medicare Advantage	$2,688.60

44360 Small intestinal endoscopy; diagnostic

Facility

$1,780.00

Service Code	HCPCS 44360
Hospital Charge Code	3154360
Hospital Revenue Code	360
Min. Negotiated Rate	$616.42
Max. Negotiated Rate	$1,691.00
Rate for Payer: Aetna Commercial	$1,602.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,006.97
Rate for Payer: Humana Medicare Advantage	$747.60
Rate for Payer: UnitedHealthcare Commercial	$1,691.00
Rate for Payer: UnitedHealthcare Medicaid	$616.42
Rate for Payer: WPPA Medicare Advantage	$1,068.00

44360 Small intestinal endoscopy; diagnostic

Facility

$1,780.00

Service Code	HCPCS 44360
Hospital Charge Code	3154360
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,691.00
Rate for Payer: Aetna Commercial	$1,602.00
Rate for Payer: UnitedHealthcare Commercial	$1,691.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

44373 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileu

Facility

$1,631.00

Service Code	HCPCS 44373
Hospital Charge Code	3154373
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,549.45
Rate for Payer: Aetna Commercial	$1,467.90
Rate for Payer: UnitedHealthcare Commercial	$1,549.45
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges