Madison Medical Center

All Charges

Charge

Type

Setting

Price

CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$71,830.42

Service Code	MSDRG 323
Min. Negotiated Rate	$35,915.21
Max. Negotiated Rate	$71,830.42
Rate for Payer: Aetna Medicare Advantage	$35,915.21
Rate for Payer: Cigna Commercial HMO & PPO	$35,915.21
Rate for Payer: Home State Health Plan Medicare Advantage	$35,915.21
Rate for Payer: Humana Commercial	$71,830.42
Rate for Payer: Humana Medicare Advantage	$35,915.21

CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$53,176.12

Service Code	MSDRG 324
Min. Negotiated Rate	$26,588.06
Max. Negotiated Rate	$53,176.12
Rate for Payer: Aetna Medicare Advantage	$26,588.06
Rate for Payer: Cigna Commercial HMO & PPO	$26,588.06
Rate for Payer: Home State Health Plan Medicare Advantage	$26,588.06
Rate for Payer: Humana Commercial	$53,176.12
Rate for Payer: Humana Medicare Advantage	$26,588.06

CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE

Facility

$54,115.84

Service Code	MSDRG 325
Min. Negotiated Rate	$27,057.92
Max. Negotiated Rate	$54,115.84
Rate for Payer: Aetna Medicare Advantage	$27,057.92
Rate for Payer: Cigna Commercial HMO & PPO	$27,057.92
Rate for Payer: Home State Health Plan Medicare Advantage	$27,057.92
Rate for Payer: Humana Commercial	$54,115.84
Rate for Payer: Humana Medicare Advantage	$27,057.92

CORTICAL SCREW

Facility

$89.00

Hospital Charge Code	283326
Hospital Revenue Code	271
Rate for Payer: Cash Price	$80.10

CORTICAL SCREW

Facility

$89.00

Hospital Charge Code	283326
Hospital Revenue Code	271
Min. Negotiated Rate	$32.04
Max. Negotiated Rate	$63.55
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: UnitedHealthcare Commercial	$59.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.04

CORTISOL #1 BASE

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223288
Hospital Revenue Code	301
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$32.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

CORTISOL #1 BASE

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223288
Hospital Revenue Code	301
Rate for Payer: Cash Price	$19.80

CORTISOL #2

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223289
Hospital Revenue Code	301
Rate for Payer: Cash Price	$19.80

CORTISOL #2

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223289
Hospital Revenue Code	301
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$32.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

CORTISOL #3

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223290
Hospital Revenue Code	301
Rate for Payer: Cash Price	$19.80

CORTISOL #3

Facility

$22.00

Service Code	CPT 82533
Hospital Charge Code	223290
Hospital Revenue Code	301
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$32.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cash Price	$19.80
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

CORTISOL AM

Facility

$36.00

Service Code	CPT 82533
Hospital Charge Code	2282536
Hospital Revenue Code	301
Rate for Payer: Cash Price	$32.40

CORTISOL AM

Facility

$36.00

Service Code	CPT 82533
Hospital Charge Code	2282536
Hospital Revenue Code	301
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$32.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$25.70
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.96

CORTISOL FREE 24HR URINE

Facility

$141.00

Service Code	CPT 82530
Hospital Charge Code	223287
Hospital Revenue Code	301
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$100.67
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.04
Rate for Payer: Aetna Medicare Advantage	$16.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$83.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$100.67
Rate for Payer: Cash Price	$126.90
Rate for Payer: Cash Price	$126.90
Rate for Payer: Cash Price	$126.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.09
Rate for Payer: Home State Health Plan Medicare Advantage	$16.71
Rate for Payer: Humana Commercial	$33.42
Rate for Payer: Humana Medicare Advantage	$16.71
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$50.76

CORTISOL FREE 24HR URINE

Facility

$141.00

Service Code	CPT 82530
Hospital Charge Code	223287
Hospital Revenue Code	301
Rate for Payer: Cash Price	$126.90

CORTISOL FREE SERUM

Facility

$321.00

Service Code	CPT 84449
Hospital Charge Code	223286
Hospital Revenue Code	301
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$229.19
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.20
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$190.03
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$229.19
Rate for Payer: Cash Price	$288.90
Rate for Payer: Cash Price	$288.90
Rate for Payer: Cash Price	$288.90
Rate for Payer: Cigna Commercial HMO & PPO	$18.00
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.33
Rate for Payer: Home State Health Plan Medicare Advantage	$18.00
Rate for Payer: Humana Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$18.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$115.56

CORTISOL FREE SERUM

Facility

$321.00

Service Code	CPT 84449
Hospital Charge Code	223286
Hospital Revenue Code	301
Rate for Payer: Cash Price	$288.90

CORTISOL FREE UR

Facility

$121.00

Service Code	CPT 84449
Hospital Charge Code	2282530
Hospital Revenue Code	301
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$86.39
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.20
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$71.63
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$86.39
Rate for Payer: Cash Price	$108.90
Rate for Payer: Cash Price	$108.90
Rate for Payer: Cash Price	$108.90
Rate for Payer: Cigna Commercial HMO & PPO	$18.00
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.33
Rate for Payer: Home State Health Plan Medicare Advantage	$18.00
Rate for Payer: Humana Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$18.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$43.56

CORTISOL FREE UR

Facility

$121.00

Service Code	CPT 84449
Hospital Charge Code	2282530
Hospital Revenue Code	301
Rate for Payer: Cash Price	$108.90

CORTISOL SALIVA

Facility

$108.00

Service Code	CPT 82530
Hospital Charge Code	2282531
Hospital Revenue Code	301
Rate for Payer: Cash Price	$97.20

CORTISOL SALIVA

Facility

$108.00

Service Code	CPT 82530
Hospital Charge Code	2282531
Hospital Revenue Code	301
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$77.11
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.04
Rate for Payer: Aetna Medicare Advantage	$16.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$63.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$77.11
Rate for Payer: Cash Price	$97.20
Rate for Payer: Cash Price	$97.20
Rate for Payer: Cash Price	$97.20
Rate for Payer: Cigna Commercial HMO & PPO	$16.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.09
Rate for Payer: Home State Health Plan Medicare Advantage	$16.71
Rate for Payer: Humana Commercial	$33.42
Rate for Payer: Humana Medicare Advantage	$16.71
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.88

CORTISOL SALIVARY

Facility

$124.00

Service Code	CPT 82533
Hospital Charge Code	2282533
Hospital Revenue Code	301
Min. Negotiated Rate	$14.67
Max. Negotiated Rate	$88.54
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$73.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$88.54
Rate for Payer: Cash Price	$111.60
Rate for Payer: Cash Price	$111.60
Rate for Payer: Cash Price	$111.60
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.64

CORTISOL SALIVARY

Facility

$124.00

Service Code	CPT 82533
Hospital Charge Code	2282533
Hospital Revenue Code	301
Rate for Payer: Cash Price	$111.60

CORTISOL TOTAL

Facility

$36.00

Service Code	CPT 82533
Hospital Charge Code	223285
Hospital Revenue Code	301
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$32.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.67
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$25.70
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cash Price	$32.40
Rate for Payer: Cigna Commercial HMO & PPO	$16.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.70
Rate for Payer: Home State Health Plan Medicare Advantage	$16.30
Rate for Payer: Humana Commercial	$32.60
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.96

CORTISOL TOTAL

Facility

$36.00

Service Code	CPT 82533
Hospital Charge Code	223285
Hospital Revenue Code	301
Rate for Payer: Cash Price	$32.40

Know your out-of-pocket cost for care.

All Charges