Madison Medical Center

All Charges

Charge

Type

Setting

Price

CULTURE - GC

Facility

$21.00

Service Code	CPT 87081
Hospital Charge Code	4287081
Hospital Revenue Code	521
Rate for Payer: Cash Price	$18.90

CULTURE - GC

Facility

$21.00

Service Code	CPT 87081
Hospital Charge Code	4287081
Hospital Revenue Code	521
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.97
Rate for Payer: Aetna Medicare Advantage	$6.63
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: Cash Price	$18.90
Rate for Payer: Cash Price	$18.90
Rate for Payer: Cash Price	$18.90
Rate for Payer: Cigna Commercial HMO & PPO	$6.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.37
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.39
Rate for Payer: Home State Health Plan Medicare Advantage	$6.63
Rate for Payer: Humana Commercial	$13.26
Rate for Payer: Humana Medicare Advantage	$6.63
Rate for Payer: UnitedHealthcare Commercial	$14.01
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

CULTURE GENITAL

Facility

$75.00

Service Code	CPT 87070
Hospital Charge Code	3017019
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

CULTURE GENITAL

Facility

$75.00

Service Code	CPT 87070
Hospital Charge Code	3017019
Hospital Revenue Code	306
Rate for Payer: Cash Price	$67.50

CULTURE GROUP B STREP

Facility

$75.00

Service Code	CPT 87081
Hospital Charge Code	3087080
Hospital Revenue Code	306
Rate for Payer: Cash Price	$67.50

CULTURE GROUP B STREP

Facility

$75.00

Service Code	CPT 87081
Hospital Charge Code	3087080
Hospital Revenue Code	306
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.97
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$6.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.39
Rate for Payer: Home State Health Plan Medicare Advantage	$6.63
Rate for Payer: Humana Commercial	$13.26
Rate for Payer: Humana Medicare Advantage	$6.63
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

CULTURE H PYLORI

Facility

$62.00

Service Code	CPT 87070
Hospital Charge Code	2280885
Hospital Revenue Code	306
Rate for Payer: Cash Price	$55.80

CULTURE H PYLORI

Facility

$62.00

Service Code	CPT 87070
Hospital Charge Code	2280885
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$44.27
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$36.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$44.27
Rate for Payer: Cash Price	$55.80
Rate for Payer: Cash Price	$55.80
Rate for Payer: Cash Price	$55.80
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.32

CULTURE MISC LOWER RESP

Facility

$61.00

Service Code	CPT 87070
Hospital Charge Code	3011100
Hospital Revenue Code	306
Rate for Payer: Cash Price	$54.90

CULTURE MISC LOWER RESP

Facility

$61.00

Service Code	CPT 87070
Hospital Charge Code	3011100
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$43.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$36.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$43.55
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96

CULTURE MISC UPPER RESP

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3013100
Hospital Revenue Code	306
Rate for Payer: Cash Price	$198.90

CULTURE MISC UPPER RESP

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3013100
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$157.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$130.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$157.79
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$79.56

CULTURE NASAL

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	309000
Hospital Revenue Code	306
Rate for Payer: Cash Price	$198.90

CULTURE NASAL

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	309000
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$157.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$130.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$157.79
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$79.56

CULTURE NEISSERIA GONORRHOEAE

Facility

$171.00

Service Code	CPT 87081
Hospital Charge Code	3087081
Hospital Revenue Code	306
Rate for Payer: Cash Price	$153.90

CULTURE NEISSERIA GONORRHOEAE

Facility

$171.00

Service Code	CPT 87081
Hospital Charge Code	3087081
Hospital Revenue Code	306
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$122.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.97
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$101.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$122.09
Rate for Payer: Cash Price	$153.90
Rate for Payer: Cash Price	$153.90
Rate for Payer: Cash Price	$153.90
Rate for Payer: Cigna Commercial HMO & PPO	$6.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.39
Rate for Payer: Home State Health Plan Medicare Advantage	$6.63
Rate for Payer: Humana Commercial	$13.26
Rate for Payer: Humana Medicare Advantage	$6.63
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.56

CULTURE (ROUTINE)

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	4287070
Hospital Revenue Code	521
Min. Negotiated Rate	$6.98
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$18.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$22.85
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6.98
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

CULTURE (ROUTINE)

Facility

$32.00

Service Code	CPT 87070
Hospital Charge Code	4287070
Hospital Revenue Code	521
Rate for Payer: Cash Price	$28.80

CULTURE SPUTUM W/GRAM STAIN

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3011000
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$157.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$130.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$157.79
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$79.56

CULTURE SPUTUM W/GRAM STAIN

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3011000
Hospital Revenue Code	306
Rate for Payer: Cash Price	$198.90

..CULTURE SPUTUM W/GRAM STAIN AEL

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3011001
Hospital Revenue Code	306
Rate for Payer: Cash Price	$198.90

..CULTURE SPUTUM W/GRAM STAIN AEL

Facility

$221.00

Service Code	CPT 87070
Hospital Charge Code	3011001
Hospital Revenue Code	306
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$157.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.76
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$130.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$157.79
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cash Price	$198.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.30
Rate for Payer: Home State Health Plan Medicare Advantage	$8.62
Rate for Payer: Humana Commercial	$17.24
Rate for Payer: Humana Medicare Advantage	$8.62
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$79.56

.CULTURE STOOL ADDT PATHOGENS

Facility

$100.00

Service Code	CPT 87046
Hospital Charge Code	3012000
Hospital Revenue Code	306
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$8.50
Rate for Payer: Aetna Medicare Advantage	$9.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$71.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cigna Commercial HMO & PPO	$9.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8.50
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9.10
Rate for Payer: Home State Health Plan Medicare Advantage	$9.44
Rate for Payer: Humana Commercial	$18.88
Rate for Payer: Humana Medicare Advantage	$9.44
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

.CULTURE STOOL ADDT PATHOGENS

Facility

$100.00

Service Code	CPT 87046
Hospital Charge Code	3012000
Hospital Revenue Code	306
Rate for Payer: Cash Price	$90.00

.CULTURE STOOL (SALMONELLA/SHIGELLA)

Facility

$55.00

Service Code	CPT 87045
Hospital Charge Code	3087899
Hospital Revenue Code	306
Rate for Payer: Cash Price	$49.50

Know your out-of-pocket cost for care.

All Charges