Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

46604 Anoscopy; with dilation (eg, balloon, guide wire, bougie)

Facility

$1,503.00

Service Code	HCPCS 46604
Hospital Charge Code	3156604
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,427.85
Rate for Payer: Aetna Commercial	$1,352.70
Rate for Payer: UnitedHealthcare Commercial	$1,427.85
Rate for Payer: WPPA Medicare Advantage	$1,200.00

46604 Anoscopy; with dilation (eg, balloon, guide wire, bougie)

Facility

$1,503.00

Service Code	HCPCS 46604
Hospital Charge Code	3156604
Hospital Revenue Code	360
Min. Negotiated Rate	$382.28
Max. Negotiated Rate	$1,427.85
Rate for Payer: Aetna Commercial	$1,352.70
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$808.00
Rate for Payer: Humana Medicare Advantage	$631.26
Rate for Payer: UnitedHealthcare Commercial	$1,427.85
Rate for Payer: UnitedHealthcare Medicaid	$382.28
Rate for Payer: WPPA Medicare Advantage	$901.80

46606 Anoscopy; with biopsy, single or multiple

Facility

$1,350.00

Service Code	HCPCS 46606
Hospital Charge Code	3156606
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,282.50
Rate for Payer: Aetna Commercial	$1,215.00
Rate for Payer: UnitedHealthcare Commercial	$1,282.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

46606 Anoscopy; with biopsy, single or multiple

Facility

$1,350.00

Service Code	HCPCS 46606
Hospital Charge Code	3156606
Hospital Revenue Code	360
Min. Negotiated Rate	$382.28
Max. Negotiated Rate	$1,282.50
Rate for Payer: Aetna Commercial	$1,215.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$808.00
Rate for Payer: Humana Medicare Advantage	$567.00
Rate for Payer: UnitedHealthcare Commercial	$1,282.50
Rate for Payer: UnitedHealthcare Medicaid	$382.28
Rate for Payer: WPPA Medicare Advantage	$810.00

46922 EXCISION OF ANAL LESION(S)

Facility

$2,988.00

Service Code	HCPCS 46922
Hospital Charge Code	3156922
Hospital Revenue Code	360
Min. Negotiated Rate	$909.58
Max. Negotiated Rate	$2,838.60
Rate for Payer: Aetna Commercial	$2,689.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,845.27
Rate for Payer: Humana Medicare Advantage	$1,254.96
Rate for Payer: UnitedHealthcare Commercial	$2,838.60
Rate for Payer: UnitedHealthcare Medicaid	$909.58
Rate for Payer: WPPA Medicare Advantage	$1,792.80

46922 EXCISION OF ANAL LESION(S)

Facility

$2,988.00

Service Code	HCPCS 46922
Hospital Charge Code	3156922
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,838.60
Rate for Payer: Aetna Commercial	$2,689.20
Rate for Payer: UnitedHealthcare Commercial	$2,838.60
Rate for Payer: WPPA Medicare Advantage	$1,200.00

46945 Hemorrhoidectomy, SINGLE internal, by ligation other than rubber band;

Facility

$2,778.00

Service Code	HCPCS 46945
Hospital Charge Code	3156945
Hospital Revenue Code	360
Min. Negotiated Rate	$909.58
Max. Negotiated Rate	$2,639.10
Rate for Payer: Aetna Commercial	$2,500.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,479.65
Rate for Payer: Humana Medicare Advantage	$1,166.76
Rate for Payer: UnitedHealthcare Commercial	$2,639.10
Rate for Payer: UnitedHealthcare Medicaid	$909.58
Rate for Payer: WPPA Medicare Advantage	$1,666.80

46945 Hemorrhoidectomy, SINGLE internal, by ligation other than rubber band;

Facility

$2,778.00

Service Code	HCPCS 46945
Hospital Charge Code	3156945
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,639.10
Rate for Payer: Aetna Commercial	$2,500.20
Rate for Payer: UnitedHealthcare Commercial	$2,639.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

46946 LIGATION OF HEMORRHOIDS

Facility

$5,398.00

Service Code	HCPCS 46946
Hospital Charge Code	3150323
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$5,128.10
Rate for Payer: Aetna Commercial	$4,858.20
Rate for Payer: UnitedHealthcare Commercial	$5,128.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

46946 LIGATION OF HEMORRHOIDS

Facility

$5,398.00

Service Code	HCPCS 46946
Hospital Charge Code	3150323
Hospital Revenue Code	360
Min. Negotiated Rate	$909.58
Max. Negotiated Rate	$5,128.10
Rate for Payer: Aetna Commercial	$4,858.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$3,501.67
Rate for Payer: Humana Medicare Advantage	$2,267.16
Rate for Payer: UnitedHealthcare Commercial	$5,128.10
Rate for Payer: UnitedHealthcare Medicaid	$909.58
Rate for Payer: WPPA Medicare Advantage	$3,238.80

46999 Unlisted procedure, anus

Facility

$791.00

Service Code	HCPCS 46999
Hospital Charge Code	3154699
Hospital Revenue Code	360
Min. Negotiated Rate	$329.05
Max. Negotiated Rate	$751.45
Rate for Payer: Aetna Commercial	$711.90
Rate for Payer: Humana Medicare Advantage	$332.22
Rate for Payer: UnitedHealthcare Commercial	$751.45
Rate for Payer: UnitedHealthcare Medicaid	$329.05
Rate for Payer: WPPA Medicare Advantage	$474.60

46999 Unlisted procedure, anus

Facility

$791.00

Service Code	HCPCS 46999
Hospital Charge Code	3154699
Hospital Revenue Code	360
Min. Negotiated Rate	$711.90
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$711.90
Rate for Payer: UnitedHealthcare Commercial	$751.45
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47000-Biopsy of liver, needle; percutaneous

Facility

$4,050.00

Service Code	HCPCS 47000
Hospital Charge Code	3297000
Hospital Revenue Code	761
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,847.50
Rate for Payer: Aetna Commercial	$3,645.00
Rate for Payer: UnitedHealthcare Commercial	$3,847.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47000-Biopsy of liver, needle; percutaneous

Facility

$4,050.00

Service Code	HCPCS 47000
Hospital Charge Code	3297000
Hospital Revenue Code	761
Min. Negotiated Rate	$525.22
Max. Negotiated Rate	$3,847.50
Rate for Payer: Aetna Commercial	$3,645.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$988.79
Rate for Payer: Humana Medicare Advantage	$1,701.00
Rate for Payer: UnitedHealthcare Commercial	$3,847.50
Rate for Payer: UnitedHealthcare Medicaid	$525.22
Rate for Payer: WPPA Medicare Advantage	$2,430.00

47000 - BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS

Facility

$4,050.00

Service Code	HCPCS 47000
Hospital Charge Code	3740640
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$3,847.50
Rate for Payer: Aetna Commercial	$3,645.00
Rate for Payer: UnitedHealthcare Commercial	$3,847.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47000 - BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS

Facility

$4,050.00

Service Code	HCPCS 47000
Hospital Charge Code	3740640
Hospital Revenue Code	360
Min. Negotiated Rate	$525.22
Max. Negotiated Rate	$3,847.50
Rate for Payer: Aetna Commercial	$3,645.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$988.79
Rate for Payer: Humana Medicare Advantage	$1,701.00
Rate for Payer: UnitedHealthcare Commercial	$3,847.50
Rate for Payer: UnitedHealthcare Medicaid	$525.22
Rate for Payer: WPPA Medicare Advantage	$2,430.00

47001 Biopsy of liver, needle

Facility

$885.00

Service Code	HCPCS 47001
Hospital Charge Code	3154700
Hospital Revenue Code	360
Min. Negotiated Rate	$796.50
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$796.50
Rate for Payer: UnitedHealthcare Commercial	$840.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47001 Biopsy of liver, needle

Facility

$885.00

Service Code	HCPCS 47001
Hospital Charge Code	3154700
Hospital Revenue Code	360
Min. Negotiated Rate	$223.60
Max. Negotiated Rate	$840.75
Rate for Payer: Aetna Commercial	$796.50
Rate for Payer: Humana Medicare Advantage	$371.70
Rate for Payer: UnitedHealthcare Commercial	$840.75
Rate for Payer: UnitedHealthcare Medicaid	$223.60
Rate for Payer: WPPA Medicare Advantage	$531.00

47100 Biopsy of liver, wedge

Facility

$4,215.00

Service Code	HCPCS 47100
Hospital Charge Code	3157100
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,004.25
Rate for Payer: Aetna Commercial	$3,793.50
Rate for Payer: UnitedHealthcare Commercial	$4,004.25
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47100 Biopsy of liver, wedge

Facility

$4,215.00

Service Code	HCPCS 47100
Hospital Charge Code	3157100
Hospital Revenue Code	360
Min. Negotiated Rate	$223.60
Max. Negotiated Rate	$4,004.25
Rate for Payer: Aetna Commercial	$3,793.50
Rate for Payer: Humana Medicare Advantage	$1,770.30
Rate for Payer: UnitedHealthcare Commercial	$4,004.25
Rate for Payer: UnitedHealthcare Medicaid	$223.60
Rate for Payer: WPPA Medicare Advantage	$2,529.00

47563 LAP CHOLE W/CHOLANGIOGRM

Facility

$9,729.00

Service Code	HCPCS 47563
Hospital Charge Code	3150342
Hospital Revenue Code	360
Min. Negotiated Rate	$1,869.18
Max. Negotiated Rate	$9,242.55
Rate for Payer: Aetna Commercial	$8,756.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$6,871.99
Rate for Payer: Humana Medicare Advantage	$4,086.18
Rate for Payer: UnitedHealthcare Commercial	$9,242.55
Rate for Payer: UnitedHealthcare Medicaid	$1,869.18
Rate for Payer: WPPA Medicare Advantage	$5,837.40

47563 LAP CHOLE W/CHOLANGIOGRM

Facility

$9,729.00

Service Code	HCPCS 47563
Hospital Charge Code	3150342
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$9,242.55
Rate for Payer: Aetna Commercial	$8,756.10
Rate for Payer: UnitedHealthcare Commercial	$9,242.55
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47600 Cholecystectomy

Facility

$9,525.00

Service Code	HCPCS 47600
Hospital Charge Code	3157600
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$9,048.75
Rate for Payer: Aetna Commercial	$8,572.50
Rate for Payer: UnitedHealthcare Commercial	$9,048.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

47600 Cholecystectomy

Facility

$9,525.00

Service Code	HCPCS 47600
Hospital Charge Code	3157600
Hospital Revenue Code	360
Min. Negotiated Rate	$1,040.00
Max. Negotiated Rate	$9,048.75
Rate for Payer: Aetna Commercial	$8,572.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$6,871.99
Rate for Payer: Humana Medicare Advantage	$4,000.50
Rate for Payer: UnitedHealthcare Commercial	$9,048.75
Rate for Payer: UnitedHealthcare Medicaid	$1,040.00
Rate for Payer: WPPA Medicare Advantage	$5,715.00

49000 EXPLORATION OF ABDOMEN

Facility

$5,114.00

Service Code	HCPCS 49000
Hospital Charge Code	3150310
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,858.30
Rate for Payer: Aetna Commercial	$4,602.60
Rate for Payer: UnitedHealthcare Commercial	$4,858.30
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Know your out-of-pocket cost for care.

All Charges