Madison Medical Center

All Charges

Charge

Type

Setting

Price

CELLULITIS AND OTHER SKIN INFECTIONS

Facility

$15,153.53

Service Code	APR-DRG 3833
Min. Negotiated Rate	$15,153.53
Max. Negotiated Rate	$15,153.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,153.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,153.53
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,153.53
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,153.53

CELLULITIS WITH MCC

Facility

$25,889.66

Service Code	MSDRG 602
Min. Negotiated Rate	$12,944.83
Max. Negotiated Rate	$25,889.66
Rate for Payer: Aetna Medicare Advantage	$12,944.83
Rate for Payer: Cigna Commercial HMO & PPO	$12,944.83
Rate for Payer: Home State Health Plan Medicare Advantage	$12,944.83
Rate for Payer: Humana Commercial	$25,889.66
Rate for Payer: Humana Medicare Advantage	$12,944.83

CELLULITIS WITHOUT MCC

Facility

$17,273.54

Service Code	MSDRG 603
Min. Negotiated Rate	$8,636.77
Max. Negotiated Rate	$17,273.54
Rate for Payer: Aetna Medicare Advantage	$8,636.77
Rate for Payer: Cigna Commercial HMO & PPO	$8,636.77
Rate for Payer: Home State Health Plan Medicare Advantage	$8,636.77
Rate for Payer: Humana Commercial	$17,273.54
Rate for Payer: Humana Medicare Advantage	$8,636.77

CENTRAL DRESSING KIT

Facility

$142.00

Hospital Charge Code	283029
Hospital Revenue Code	271
Rate for Payer: Cash Price	$127.80

CENTRAL DRESSING KIT

Facility

$142.00

Hospital Charge Code	283029
Hospital Revenue Code	271
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$101.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$84.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$101.39
Rate for Payer: Cash Price	$127.80
Rate for Payer: UnitedHealthcare Commercial	$94.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.12

CENTRAL LINE DRESSING KIT

Facility

$67.00

Hospital Charge Code	2812870
Hospital Revenue Code	271
Rate for Payer: Cash Price	$60.30

CENTRAL LINE DRESSING KIT

Facility

$67.00

Hospital Charge Code	2812870
Hospital Revenue Code	271
Min. Negotiated Rate	$24.12
Max. Negotiated Rate	$47.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$39.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$47.84
Rate for Payer: Cash Price	$60.30
Rate for Payer: UnitedHealthcare Commercial	$44.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

CENTRAL VENOUS CATH-PERCUTANEOUS >2YRS

Professional

Both

$1,509.00

Service Code	CPT 36556
Hospital Charge Code	1836489
Hospital Revenue Code	981
Min. Negotiated Rate	$75.54
Max. Negotiated Rate	$528.15
Rate for Payer: Aetna Commercial/Medicare Advantage	$75.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$177.44
Rate for Payer: Cash Price	$1,358.10
Rate for Payer: Cash Price	$1,358.10
Rate for Payer: Cigna Commercial HMO & PPO	$75.54
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$177.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$195.18
Rate for Payer: Home State Health Plan Medicare Advantage	$75.54
Rate for Payer: Optum Medicare Advantage	$528.15
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$177.44

CENTRASIL

Facility

$174.00

Hospital Charge Code	283175
Hospital Revenue Code	271
Rate for Payer: Cash Price	$156.60

CENTRASIL

Facility

$174.00

Hospital Charge Code	283175
Hospital Revenue Code	271
Min. Negotiated Rate	$62.64
Max. Negotiated Rate	$124.24
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$103.01
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$124.24
Rate for Payer: Cash Price	$156.60
Rate for Payer: UnitedHealthcare Commercial	$116.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.64

CENTROMERE B AB

Facility

$125.00

Service Code	CPT 86038
Hospital Charge Code	22862561
Hospital Revenue Code	302
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$89.25
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.88
Rate for Payer: Aetna Medicare Advantage	$12.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$74.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$89.25
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cash Price	$112.50
Rate for Payer: Cigna Commercial HMO & PPO	$12.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.64
Rate for Payer: Home State Health Plan Medicare Advantage	$12.09
Rate for Payer: Humana Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$12.09
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$45.00

CENTROMERE B AB

Facility

$125.00

Service Code	CPT 86038
Hospital Charge Code	22862561
Hospital Revenue Code	302
Rate for Payer: Cash Price	$112.50

CEPHALEXIN 500MG CAP EMP

Facility

$28.00

Service Code	NDC 93314701
Hospital Charge Code	2621909
Hospital Revenue Code	250
Rate for Payer: Cash Price	$25.20

CEPHALEXIN 500MG CAP EMP

Facility

$28.00

Service Code	NDC 93314701
Hospital Charge Code	2621909
Hospital Revenue Code	250
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$19.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$16.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$19.99
Rate for Payer: Cash Price	$25.20
Rate for Payer: UnitedHealthcare Commercial	$18.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.08

CEPHALEXIN (KEFLEX) 250MG CAP

Facility

$21.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2654455
Hospital Revenue Code	250
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$14.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$12.43
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.99
Rate for Payer: Cash Price	$18.90
Rate for Payer: UnitedHealthcare Commercial	$14.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.56

CEPHALEXIN (KEFLEX) 250MG CAP

Facility

$21.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2654455
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

CEPHALEXIN (KEFLEX) 500MG CAP

Facility

$28.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2654460
Hospital Revenue Code	250
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$19.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$16.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$19.99
Rate for Payer: Cash Price	$25.20
Rate for Payer: UnitedHealthcare Commercial	$18.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.08

CEPHALEXIN (KEFLEX) 500MG CAP

Facility

$28.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2654460
Hospital Revenue Code	250
Rate for Payer: Cash Price	$25.20

CEPHALEX (KEFLEX) 250MG/5ML SUSP 100ML

Facility

$94.00

Service Code	NDC 332417736
Hospital Charge Code	2654450
Hospital Revenue Code	250
Rate for Payer: Cash Price	$84.60

CEPHALEX (KEFLEX) 250MG/5ML SUSP 100ML

Facility

$94.00

Service Code	NDC 332417736
Hospital Charge Code	2654450
Hospital Revenue Code	250
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$67.12
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$55.65
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$67.12
Rate for Payer: Cash Price	$84.60
Rate for Payer: UnitedHealthcare Commercial	$62.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.84

CEPHAZOLIN IVBP

Facility

$153.00

Hospital Charge Code	2058086
Hospital Revenue Code	370
Min. Negotiated Rate	$55.08
Max. Negotiated Rate	$109.24
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$90.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$109.24
Rate for Payer: Cash Price	$137.70
Rate for Payer: UnitedHealthcare Commercial	$102.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.08

CEPHAZOLIN IVBP

Facility

$153.00

Hospital Charge Code	2058086
Hospital Revenue Code	370
Rate for Payer: Cash Price	$137.70

CERULOPLASMIN

Facility

$89.00

Service Code	CPT 82390
Hospital Charge Code	2282390
Hospital Revenue Code	301
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$63.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$9.67
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$52.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$63.55
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cigna Commercial HMO & PPO	$10.74
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10.35
Rate for Payer: Home State Health Plan Medicare Advantage	$10.74
Rate for Payer: Humana Commercial	$21.48
Rate for Payer: Humana Medicare Advantage	$10.74
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.04

CERULOPLASMIN

Facility

$89.00

Service Code	CPT 82390
Hospital Charge Code	2282390
Hospital Revenue Code	301
Rate for Payer: Cash Price	$80.10

CERUMEN

Professional

Both

$263.00

Service Code	CPT 69210
Hospital Charge Code	1869210
Hospital Revenue Code	981
Min. Negotiated Rate	$26.30
Max. Negotiated Rate	$92.05
Rate for Payer: Aetna Commercial/Medicare Advantage	$26.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$35.64
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cigna Commercial HMO & PPO	$26.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$35.64
Rate for Payer: Home State Health Plan Medicaid Managed Care	$39.20
Rate for Payer: Home State Health Plan Medicare Advantage	$26.30
Rate for Payer: Optum Medicare Advantage	$92.05
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$35.64

Know your out-of-pocket cost for care.

All Charges