Madison Medical Center

All Charges

Charge

Type

Setting

Price

DRESSING, EXUDERM 4 X 4

Facility

$15.00

Hospital Charge Code	284844
Hospital Revenue Code	272
Rate for Payer: Cash Price	$13.50

DRESSING, EXUDERM 4 X 4

Facility

$15.00

Hospital Charge Code	284844
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$10.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.88
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.71
Rate for Payer: Cash Price	$13.50
Rate for Payer: UnitedHealthcare Commercial	$10.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.40

DRESSING, NON ADHERANT OPTIFOAM

Facility

$28.00

Hospital Charge Code	284016
Hospital Revenue Code	271
Rate for Payer: Cash Price	$25.20

DRESSING, NON ADHERANT OPTIFOAM

Facility

$28.00

Hospital Charge Code	284016
Hospital Revenue Code	271
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

DRESSING, OPTIFOAM 4 X 4

Facility

$24.00

Hospital Charge Code	284845
Hospital Revenue Code	272
Rate for Payer: Cash Price	$21.60

DRESSING, OPTIFOAM 4 X 4

Facility

$24.00

Hospital Charge Code	284845
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$17.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.14
Rate for Payer: Cash Price	$21.60
Rate for Payer: UnitedHealthcare Commercial	$16.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.64

DRESSING, OWENS

Facility

$28.00

Hospital Charge Code	284837
Hospital Revenue Code	271
Rate for Payer: Cash Price	$25.20

DRESSING, OWENS

Facility

$28.00

Hospital Charge Code	284837
Hospital Revenue Code	271
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

DRESSING PAK

Facility

$75.00

Hospital Charge Code	2819441
Hospital Revenue Code	271
Rate for Payer: Cash Price	$67.50

DRESSING PAK

Facility

$75.00

Hospital Charge Code	2819441
Hospital Revenue Code	271
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$53.55
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: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

DRESSING STICK

Facility

$56.00

Hospital Charge Code	5350004
Hospital Revenue Code	271
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$39.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$33.15
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.98
Rate for Payer: Cash Price	$50.40
Rate for Payer: UnitedHealthcare Commercial	$37.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.16

DRESSING STICK

Facility

$20.00

Hospital Charge Code	5349012
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.00

DRESSING STICK

Facility

$20.00

Hospital Charge Code	5349012
Hospital Revenue Code	271
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$14.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: UnitedHealthcare Commercial	$13.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20

DRESSING STICK

Facility

$56.00

Hospital Charge Code	5350004
Hospital Revenue Code	271
Rate for Payer: Cash Price	$50.40

DRESSING TRAU-MEDIC

Facility

$40.00

Hospital Charge Code	284840
Hospital Revenue Code	271
Rate for Payer: Cash Price	$36.00

DRESSING TRAU-MEDIC

Facility

$40.00

Hospital Charge Code	284840
Hospital Revenue Code	271
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$28.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$28.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: UnitedHealthcare Commercial	$26.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.40

DRESSING TRAY-SUPP

Facility

$40.00

Hospital Charge Code	284014
Hospital Revenue Code	271
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$28.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$28.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: UnitedHealthcare Commercial	$26.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.40

DRESSING TRAY-SUPP

Facility

$40.00

Hospital Charge Code	284014
Hospital Revenue Code	271
Rate for Payer: Cash Price	$36.00

DRES WOUND SWEEN CREAM

Facility

$35.00

Hospital Charge Code	284841
Hospital Revenue Code	271
Rate for Payer: Cash Price	$31.50

DRES WOUND SWEEN CREAM

Facility

$35.00

Hospital Charge Code	284841
Hospital Revenue Code	271
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$24.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$20.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$24.99
Rate for Payer: Cash Price	$31.50
Rate for Payer: UnitedHealthcare Commercial	$23.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60

DRILL BIT

Facility

$643.00

Hospital Charge Code	127776
Hospital Revenue Code	271
Rate for Payer: Cash Price	$578.70

DRILL BIT

Facility

$698.00

Hospital Charge Code	123316
Hospital Revenue Code	271
Rate for Payer: Cash Price	$628.20

DRILL BIT

Facility

$643.00

Hospital Charge Code	127776
Hospital Revenue Code	271
Min. Negotiated Rate	$231.48
Max. Negotiated Rate	$459.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$380.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$459.10
Rate for Payer: Cash Price	$578.70
Rate for Payer: UnitedHealthcare Commercial	$428.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$231.48

DRILL BIT

Facility

$698.00

Hospital Charge Code	123316
Hospital Revenue Code	271
Min. Negotiated Rate	$251.28
Max. Negotiated Rate	$498.37
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$413.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$498.37
Rate for Payer: Cash Price	$628.20
Rate for Payer: UnitedHealthcare Commercial	$465.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$251.28

DRILL BIT 2.0MMX135MM AO DIA SCALED

Facility

$924.00

Hospital Charge Code	123423
Hospital Revenue Code	271
Min. Negotiated Rate	$332.64
Max. Negotiated Rate	$659.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$547.01
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$659.74
Rate for Payer: Cash Price	$831.60
Rate for Payer: UnitedHealthcare Commercial	$616.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.64

Know your out-of-pocket cost for care.

All Charges