Scott County Hospital Inc.

All Charges

Charge

Type

Setting

Price

59820 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER ProFee

Facility

$2,978.00

Service Code	HCPCS 59820
Hospital Charge Code	3159820
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,829.10
Rate for Payer: Aetna Commercial	$2,680.20
Rate for Payer: UnitedHealthcare Commercial	$2,829.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

59820 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER ProFee

Facility

$2,978.00

Service Code	HCPCS 59820
Hospital Charge Code	3159820
Hospital Revenue Code	360
Min. Negotiated Rate	$1,012.78
Max. Negotiated Rate	$2,829.10
Rate for Payer: Aetna Commercial	$2,680.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,931.12
Rate for Payer: Humana Medicare Advantage	$1,250.76
Rate for Payer: UnitedHealthcare Commercial	$2,829.10
Rate for Payer: UnitedHealthcare Medicaid	$1,012.78
Rate for Payer: WPPA Medicare Advantage	$1,786.80

60210 Partial thyroid lobectomy, unilateral

Facility

$5,032.00

Service Code	HCPCS 60210
Hospital Charge Code	3406021
Hospital Revenue Code	360
Min. Negotiated Rate	$1,869.18
Max. Negotiated Rate	$4,780.40
Rate for Payer: Aetna Commercial	$4,528.80
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$3,629.94
Rate for Payer: Humana Medicare Advantage	$2,113.44
Rate for Payer: UnitedHealthcare Commercial	$4,780.40
Rate for Payer: UnitedHealthcare Medicaid	$1,869.18
Rate for Payer: WPPA Medicare Advantage	$3,019.20

60210 Partial thyroid lobectomy, unilateral

Facility

$5,032.00

Service Code	HCPCS 60210
Hospital Charge Code	3406021
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,780.40
Rate for Payer: Aetna Commercial	$4,528.80
Rate for Payer: UnitedHealthcare Commercial	$4,780.40
Rate for Payer: WPPA Medicare Advantage	$1,200.00

60252 THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK D CHARGE

Facility

$11,298.00

Service Code	HCPCS 60252
Hospital Charge Code	3150252
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$10,733.10
Rate for Payer: Aetna Commercial	$10,168.20
Rate for Payer: UnitedHealthcare Commercial	$10,733.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

60252 THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK D CHARGE

Facility

$11,298.00

Service Code	HCPCS 60252
Hospital Charge Code	3150252
Hospital Revenue Code	360
Min. Negotiated Rate	$1,897.10
Max. Negotiated Rate	$10,733.10
Rate for Payer: Aetna Commercial	$10,168.20
Rate for Payer: Humana Medicare Advantage	$4,745.16
Rate for Payer: UnitedHealthcare Commercial	$10,733.10
Rate for Payer: UnitedHealthcare Medicaid	$1,897.10
Rate for Payer: WPPA Medicare Advantage	$6,778.80

60500 PARATHYROIDECTOMY/EXPLORE PARATHYROID CHARGE

Facility

$14,789.00

Service Code	HCPCS 60500
Hospital Charge Code	3150500
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$14,049.55
Rate for Payer: Aetna Commercial	$13,310.10
Rate for Payer: UnitedHealthcare Commercial	$14,049.55
Rate for Payer: WPPA Medicare Advantage	$1,200.00

60500 PARATHYROIDECTOMY/EXPLORE PARATHYROID CHARGE

Facility

$14,789.00

Service Code	HCPCS 60500
Hospital Charge Code	3150500
Hospital Revenue Code	360
Min. Negotiated Rate	$1,897.10
Max. Negotiated Rate	$14,049.55
Rate for Payer: Aetna Commercial	$13,310.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$6,446.09
Rate for Payer: Humana Medicare Advantage	$6,211.38
Rate for Payer: UnitedHealthcare Commercial	$14,049.55
Rate for Payer: UnitedHealthcare Medicaid	$1,897.10
Rate for Payer: WPPA Medicare Advantage	$8,873.40

61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural

Facility

$2,207.00

Service Code	HCPCS 61782
Hospital Charge Code	3351782
Hospital Revenue Code	360
Min. Negotiated Rate	$882.80
Max. Negotiated Rate	$2,096.65
Rate for Payer: Aetna Commercial	$1,986.30
Rate for Payer: Humana Medicare Advantage	$926.94
Rate for Payer: UnitedHealthcare Commercial	$2,096.65
Rate for Payer: UnitedHealthcare Medicaid	$882.80
Rate for Payer: WPPA Medicare Advantage	$1,324.20

61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural

Facility

$2,207.00

Service Code	HCPCS 61782
Hospital Charge Code	3351782
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$2,096.65
Rate for Payer: Aetna Commercial	$1,986.30
Rate for Payer: UnitedHealthcare Commercial	$2,096.65
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62270 LUMBAR PUNCTURE

Facility

$601.00

Service Code	HCPCS 62270
Hospital Charge Code	3152270
Hospital Revenue Code	360
Min. Negotiated Rate	$540.90
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$540.90
Rate for Payer: UnitedHealthcare Commercial	$570.95
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62270 LUMBAR PUNCTURE

Facility

$601.00

Service Code	HCPCS 62270
Hospital Charge Code	3152270
Hospital Revenue Code	360
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$570.95
Rate for Payer: Aetna Commercial	$540.90
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$433.29
Rate for Payer: Humana Medicare Advantage	$252.42
Rate for Payer: UnitedHealthcare Commercial	$570.95
Rate for Payer: UnitedHealthcare Medicaid	$224.03
Rate for Payer: WPPA Medicare Advantage	$360.60

62270 Spinal puncture, lumbar, diagnostic;

Facility

$815.00

Service Code	HCPCS 62270
Hospital Charge Code	3150755
Hospital Revenue Code	360
Min. Negotiated Rate	$733.50
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$733.50
Rate for Payer: UnitedHealthcare Commercial	$774.25
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62270 Spinal puncture, lumbar, diagnostic;

Facility

$815.00

Service Code	HCPCS 62270
Hospital Charge Code	3150755
Hospital Revenue Code	360
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$774.25
Rate for Payer: Aetna Commercial	$733.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$433.29
Rate for Payer: Humana Medicare Advantage	$342.30
Rate for Payer: UnitedHealthcare Commercial	$774.25
Rate for Payer: UnitedHealthcare Medicaid	$224.03
Rate for Payer: WPPA Medicare Advantage	$489.00

62273 CRNA EPIDURAL BLOOD PATCH

Facility

$1,335.00

Service Code	HCPCS 62273
Hospital Charge Code	3152273
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,268.25
Rate for Payer: Aetna Commercial	$1,201.50
Rate for Payer: UnitedHealthcare Commercial	$1,268.25
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62273 CRNA EPIDURAL BLOOD PATCH

Facility

$1,335.00

Service Code	HCPCS 62273
Hospital Charge Code	3152273
Hospital Revenue Code	360
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$1,268.25
Rate for Payer: Aetna Commercial	$1,201.50
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$448.41
Rate for Payer: Humana Medicare Advantage	$560.70
Rate for Payer: UnitedHealthcare Commercial	$1,268.25
Rate for Payer: UnitedHealthcare Medicaid	$224.03
Rate for Payer: WPPA Medicare Advantage	$801.00

62273-Inject Epidural Blood/Clot Patch

Facility

$1,519.00

Service Code	HCPCS 62273
Hospital Charge Code	3302273
Hospital Revenue Code	450
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$1,443.05
Rate for Payer: Aetna Commercial	$1,367.10
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$448.41
Rate for Payer: Humana Medicare Advantage	$637.98
Rate for Payer: UnitedHealthcare Commercial	$1,443.05
Rate for Payer: UnitedHealthcare Medicaid	$224.03
Rate for Payer: WPPA Medicare Advantage	$911.40

62273-Inject Epidural Blood/Clot Patch

Facility

$1,519.00

Service Code	HCPCS 62273
Hospital Charge Code	3302273
Hospital Revenue Code	450
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,443.05
Rate for Payer: Aetna Commercial	$1,367.10
Rate for Payer: UnitedHealthcare Commercial	$1,443.05
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62321 EPIDURAL STEROID INJECTION CERVICAL

Facility

$1,586.00

Service Code	HCPCS 62321
Hospital Charge Code	3152321
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,506.70
Rate for Payer: Aetna Commercial	$1,427.40
Rate for Payer: UnitedHealthcare Commercial	$1,506.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62321 EPIDURAL STEROID INJECTION CERVICAL

Facility

$1,586.00

Service Code	HCPCS 62321
Hospital Charge Code	3152321
Hospital Revenue Code	360
Min. Negotiated Rate	$377.15
Max. Negotiated Rate	$1,506.70
Rate for Payer: Aetna Commercial	$1,427.40
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,141.80
Rate for Payer: Humana Medicare Advantage	$666.12
Rate for Payer: UnitedHealthcare Commercial	$1,506.70
Rate for Payer: UnitedHealthcare Medicaid	$377.15
Rate for Payer: WPPA Medicare Advantage	$951.60

62323 EPIDURAL STEROID INJECTION LUMBAR

Facility

$1,700.00

Service Code	HCPCS 62323
Hospital Charge Code	3152323
Hospital Revenue Code	360
Min. Negotiated Rate	$377.15
Max. Negotiated Rate	$1,615.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1,141.80
Rate for Payer: Humana Medicare Advantage	$714.00
Rate for Payer: UnitedHealthcare Commercial	$1,615.00
Rate for Payer: UnitedHealthcare Medicaid	$377.15
Rate for Payer: WPPA Medicare Advantage	$1,020.00

62323 EPIDURAL STEROID INJECTION LUMBAR

Facility

$1,700.00

Service Code	HCPCS 62323
Hospital Charge Code	3152323
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,615.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: UnitedHealthcare Commercial	$1,615.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62324 EPIDURAL INFUSION CERVICAL/THORACIC CHARGE

Facility

$1,164.00

Service Code	HCPCS 62324
Hospital Charge Code	3152324
Hospital Revenue Code	360
Min. Negotiated Rate	$475.10
Max. Negotiated Rate	$1,105.80
Rate for Payer: Aetna Commercial	$1,047.60
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$588.83
Rate for Payer: Humana Medicare Advantage	$488.88
Rate for Payer: UnitedHealthcare Commercial	$1,105.80
Rate for Payer: UnitedHealthcare Medicaid	$475.10
Rate for Payer: WPPA Medicare Advantage	$698.40

62324 EPIDURAL INFUSION CERVICAL/THORACIC CHARGE

Facility

$1,164.00

Service Code	HCPCS 62324
Hospital Charge Code	3152324
Hospital Revenue Code	360
Min. Negotiated Rate	$1,047.60
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$1,047.60
Rate for Payer: UnitedHealthcare Commercial	$1,105.80
Rate for Payer: WPPA Medicare Advantage	$1,200.00

62326 EPIDURAL INFUSION LUMBAR/SACRAL CHARGE

Facility

$1,368.00

Service Code	HCPCS 62326
Hospital Charge Code	3152326
Hospital Revenue Code	360
Min. Negotiated Rate	$475.10
Max. Negotiated Rate	$1,299.60
Rate for Payer: Aetna Commercial	$1,231.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$588.83
Rate for Payer: Humana Medicare Advantage	$574.56
Rate for Payer: UnitedHealthcare Commercial	$1,299.60
Rate for Payer: UnitedHealthcare Medicaid	$475.10
Rate for Payer: WPPA Medicare Advantage	$820.80

Know your out-of-pocket cost for care.

All Charges