Madison Medical Center

All Charges

Charge

Type

Setting

Price

ELECTIVE HIP JOINT REPLACEMENT

Facility

$14,692.46

Service Code	APR-DRG 3241
Min. Negotiated Rate	$14,692.46
Max. Negotiated Rate	$14,692.46
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,692.46
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,692.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,692.46
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,692.46

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$21,217.71

Service Code	APR-DRG 3263
Min. Negotiated Rate	$21,217.71
Max. Negotiated Rate	$21,217.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$21,217.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21,217.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21,217.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21,217.71

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$15,796.33

Service Code	APR-DRG 3261
Min. Negotiated Rate	$15,796.33
Max. Negotiated Rate	$15,796.33
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,796.33
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,796.33
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,796.33
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,796.33

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$15,796.33

Service Code	APR-DRG 3262
Min. Negotiated Rate	$15,796.33
Max. Negotiated Rate	$15,796.33
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,796.33
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,796.33
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,796.33
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,796.33

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$35,875.04

Service Code	APR-DRG 3264
Min. Negotiated Rate	$35,875.04
Max. Negotiated Rate	$35,875.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$35,875.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$35,875.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$35,875.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$35,875.04

ELECTROCARDIOGRAM

Facility

$498.00

Service Code	CPT 93005
Hospital Charge Code	4500240
Hospital Revenue Code	730
Min. Negotiated Rate	$53.18
Max. Negotiated Rate	$355.57
Rate for Payer: Aetna Better Health Medicaid/QHP	$53.18
Rate for Payer: Aetna Medicare Advantage	$60.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$294.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$355.57
Rate for Payer: Cash Price	$448.20
Rate for Payer: Cash Price	$448.20
Rate for Payer: Cash Price	$448.20
Rate for Payer: Cigna Commercial HMO & PPO	$60.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$53.18
Rate for Payer: Home State Health Plan Medicaid Managed Care	$56.90
Rate for Payer: Home State Health Plan Medicare Advantage	$60.27
Rate for Payer: Humana Commercial	$120.54
Rate for Payer: Humana Medicare Advantage	$60.27
Rate for Payer: UnitedHealthcare Commercial	$332.17
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$53.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$179.28

ELECTROCARDIOGRAM

Facility

$498.00

Service Code	CPT 93005
Hospital Charge Code	4500240
Hospital Revenue Code	730
Rate for Payer: Cash Price	$448.20

ELECTROCARDIOGRAM W/INTERPRETATION &REPO

Facility

$223.00

Service Code	CPT 93000
Hospital Charge Code	4493000
Hospital Revenue Code	521
Min. Negotiated Rate	$132.02
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$132.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$159.22
Rate for Payer: Cash Price	$200.70
Rate for Payer: Cash Price	$200.70
Rate for Payer: UnitedHealthcare Commercial	$148.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ELECTROCARDIOGRAM W/INTERPRETATION &REPO

Facility

$223.00

Service Code	CPT 93000
Hospital Charge Code	4493000
Hospital Revenue Code	521
Rate for Payer: Cash Price	$200.70

ELECTRODES, EKG PEDIATRIC

Facility

$21.00

Hospital Charge Code	285208
Hospital Revenue Code	271
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

ELECTRODES, EKG PEDIATRIC

Facility

$21.00

Hospital Charge Code	285208
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.90

ELECTRODES-NEONATAL

Facility

$21.00

Hospital Charge Code	285209
Hospital Revenue Code	271
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

ELECTRODES-NEONATAL

Facility

$21.00

Hospital Charge Code	285209
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.90

ELECTROLYTE PROFILE

Facility

$178.00

Service Code	CPT 80051
Hospital Charge Code	225125
Hospital Revenue Code	301
Rate for Payer: Cash Price	$160.20

ELECTROLYTE PROFILE

Facility

$178.00

Service Code	CPT 80051
Hospital Charge Code	225125
Hospital Revenue Code	301
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$127.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$6.31
Rate for Payer: Aetna Medicare Advantage	$7.01
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$105.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$127.09
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cigna Commercial HMO & PPO	$7.01
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6.31
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.75
Rate for Payer: Home State Health Plan Medicare Advantage	$7.01
Rate for Payer: Humana Commercial	$14.02
Rate for Payer: Humana Medicare Advantage	$7.01
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.08

ELECTRONIC ANALYSIS NEUROSTIM COMPLEX SP

Professional

Both

$350.00

Service Code	CPT 95972
Hospital Charge Code	4195972
Hospital Revenue Code	975
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial/Medicare Advantage	$34.18
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$63.63
Rate for Payer: Cash Price	$315.00
Rate for Payer: Cash Price	$315.00
Rate for Payer: Cigna Commercial HMO & PPO	$34.18
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$63.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$69.99
Rate for Payer: Home State Health Plan Medicare Advantage	$34.18
Rate for Payer: Optum Medicare Advantage	$122.50
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$63.63

ELECTROSURG PROBE +II PENCIL HRD CONTROL

Facility

$463.00

Service Code	CPT Y7506
Hospital Charge Code	127281
Hospital Revenue Code	271
Min. Negotiated Rate	$166.68
Max. Negotiated Rate	$330.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$274.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$330.58
Rate for Payer: Cash Price	$416.70
Rate for Payer: UnitedHealthcare Commercial	$308.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$166.68

ELECTROSURG PROBE +II PENCIL HRD CONTROL

Facility

$463.00

Service Code	CPT Y7506
Hospital Charge Code	127281
Hospital Revenue Code	271
Rate for Payer: Cash Price	$416.70

EMERGEN-C PROBIOTICS PLUS PACKET

Facility

$10.00

Service Code	NDC 1E+11
Hospital Charge Code	2622567
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$7.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$5.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7.14
Rate for Payer: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

EMERGEN-C PROBIOTICS PLUS PACKET

Facility

$10.00

Service Code	NDC 1E+11
Hospital Charge Code	2622567
Hospital Revenue Code	250
Rate for Payer: Cash Price	$9.00

EMERGENCY DEPT VISIT MIN VISIT

Facility

$107.00

Service Code	CPT 99281
Hospital Charge Code	4299281
Rate for Payer: Cash Price	$96.30

EMERGENCY SERVICES IN OFFICE IN ADD OV

Facility

$125.00

Service Code	CPT 99058
Hospital Charge Code	9899058
Hospital Revenue Code	521
Rate for Payer: Cash Price	$112.50

EMERGENCY SERVICES IN OFFICE IN ADD OV

Facility

$125.00

Service Code	CPT 99058
Hospital Charge Code	9899058
Hospital Revenue Code	521
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$173.53
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: UnitedHealthcare Commercial	$83.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

EMERGENCY SURG ADD 1/2 HR.

Facility

$1,072.00

Hospital Charge Code	1200101
Hospital Revenue Code	360
Min. Negotiated Rate	$385.92
Max. Negotiated Rate	$715.02
Rate for Payer: Cash Price	$964.80
Rate for Payer: UnitedHealthcare Commercial	$715.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$385.92

EMERGENCY SURG ADD 1/2 HR.

Facility

$1,072.00

Hospital Charge Code	1200101
Hospital Revenue Code	360
Rate for Payer: Cash Price	$964.80

Know your out-of-pocket cost for care.

All Charges