Madison Medical Center

All Charges

Charge

Type

Setting

Price

HEEL,WALK,DUALADULT

Facility

$60.00

Hospital Charge Code	288715
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

HEMATOCRIT

Facility

$67.00

Service Code	CPT 85014
Hospital Charge Code	228101
Hospital Revenue Code	305
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$47.84
Rate for Payer: Aetna Better Health Medicaid/QHP	$2.13
Rate for Payer: Aetna Medicare Advantage	$2.37
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: Cash Price	$60.30
Rate for Payer: Cash Price	$60.30
Rate for Payer: Cigna Commercial HMO & PPO	$2.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$2.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$2.28
Rate for Payer: Home State Health Plan Medicare Advantage	$2.37
Rate for Payer: Humana Commercial	$4.74
Rate for Payer: Humana Medicare Advantage	$2.37
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$2.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

HEMATOCRIT

Facility

$67.00

Service Code	CPT 85014
Hospital Charge Code	228101
Hospital Revenue Code	305
Rate for Payer: Cash Price	$60.30

HEMATOLOGY CONSULT AEL

Facility

$80.00

Service Code	CPT 85060
Hospital Charge Code	222217
Hospital Revenue Code	310
Rate for Payer: Cash Price	$72.00

HEMATOLOGY CONSULT AEL

Facility

$80.00

Service Code	CPT 85060
Hospital Charge Code	222217
Hospital Revenue Code	310
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$57.12
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.36
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.12
Rate for Payer: Cash Price	$72.00
Rate for Payer: Cash Price	$72.00
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.80

HEMICOLECTOMY

Professional

Both

$3,433.00

Service Code	CPT 44160
Hospital Charge Code	4144160
Hospital Revenue Code	975
Min. Negotiated Rate	$937.24
Max. Negotiated Rate	$1,201.55
Rate for Payer: Aetna Commercial/Medicare Advantage	$1,109.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$937.24
Rate for Payer: Cash Price	$3,089.70
Rate for Payer: Cash Price	$3,089.70
Rate for Payer: Cigna Commercial HMO & PPO	$1,109.85
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$937.24
Rate for Payer: Home State Health Plan Medicaid Managed Care	$1,030.96
Rate for Payer: Home State Health Plan Medicare Advantage	$1,109.85
Rate for Payer: Optum Medicare Advantage	$1,201.55
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$937.24

HEMOCCULT EACH SLIDE

Facility

$12.00

Service Code	CPT 82270
Hospital Charge Code	5282270
Hospital Revenue Code	521
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$3.94
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$8.57
Rate for Payer: Cash Price	$10.80
Rate for Payer: Cash Price	$10.80
Rate for Payer: Cash Price	$10.80
Rate for Payer: Cash Price	$10.80
Rate for Payer: Cigna Commercial HMO & PPO	$4.38
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4.22
Rate for Payer: Home State Health Plan Medicare Advantage	$4.38
Rate for Payer: Humana Commercial	$8.76
Rate for Payer: Humana Medicare Advantage	$4.38
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

HEMOCCULT EACH SLIDE

Facility

$12.00

Service Code	CPT 82270
Hospital Charge Code	5282270
Hospital Revenue Code	521
Rate for Payer: Cash Price	$10.80

HEMOGLOBIN

Facility

$67.00

Service Code	CPT 85018
Hospital Charge Code	228102
Hospital Revenue Code	305
Rate for Payer: Cash Price	$60.30

HEMOGLOBIN

Facility

$14.00

Service Code	CPT 85018
Hospital Charge Code	4285018
Hospital Revenue Code	301
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$2.13
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.29
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.00
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cigna Commercial HMO & PPO	$2.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$2.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$2.28
Rate for Payer: Home State Health Plan Medicare Advantage	$2.37
Rate for Payer: Humana Commercial	$4.74
Rate for Payer: Humana Medicare Advantage	$2.37
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$2.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04

HEMOGLOBIN

Facility

$14.00

Service Code	CPT 85018
Hospital Charge Code	4285018
Hospital Revenue Code	301
Rate for Payer: Cash Price	$12.60

HEMOGLOBIN

Facility

$67.00

Service Code	CPT 85018
Hospital Charge Code	228102
Hospital Revenue Code	305
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$47.84
Rate for Payer: Aetna Better Health Medicaid/QHP	$2.13
Rate for Payer: Aetna Medicare Advantage	$2.37
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: Cash Price	$60.30
Rate for Payer: Cash Price	$60.30
Rate for Payer: Cigna Commercial HMO & PPO	$2.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$2.13
Rate for Payer: Home State Health Plan Medicaid Managed Care	$2.28
Rate for Payer: Home State Health Plan Medicare Advantage	$2.37
Rate for Payer: Humana Commercial	$4.74
Rate for Payer: Humana Medicare Advantage	$2.37
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$2.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

HEMOGLOBIN A2

Facility

$165.00

Service Code	CPT 83021
Hospital Charge Code	228265
Hospital Revenue Code	305
Rate for Payer: Cash Price	$148.50

HEMOGLOBIN A2

Facility

$165.00

Service Code	CPT 83021
Hospital Charge Code	228265
Hospital Revenue Code	305
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$117.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.25
Rate for Payer: Aetna Medicare Advantage	$18.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$97.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$117.81
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cigna Commercial HMO & PPO	$18.06
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.39
Rate for Payer: Home State Health Plan Medicare Advantage	$18.06
Rate for Payer: Humana Commercial	$36.12
Rate for Payer: Humana Medicare Advantage	$18.06
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$59.40

HEMOGLOBIN ELECTROPHORESIS

Facility

$48.00

Service Code	CPT 83020
Hospital Charge Code	4283020
Hospital Revenue Code	521
Min. Negotiated Rate	$10.42
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.58
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$28.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$34.27
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cash Price	$43.20
Rate for Payer: Cigna Commercial HMO & PPO	$12.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.42
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.39
Rate for Payer: Home State Health Plan Medicare Advantage	$12.87
Rate for Payer: Humana Commercial	$25.74
Rate for Payer: Humana Medicare Advantage	$12.87
Rate for Payer: UnitedHealthcare Commercial	$32.02
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

HEMOGLOBIN ELECTROPHORESIS

Facility

$48.00

Service Code	CPT 83020
Hospital Charge Code	4283020
Hospital Revenue Code	521
Rate for Payer: Cash Price	$43.20

HEMOGLOBIN FRAC PROFILE

Facility

$100.00

Service Code	CPT 83021
Hospital Charge Code	228105
Hospital Revenue Code	305
Rate for Payer: Cash Price	$90.00

HEMOGLOBIN FRAC PROFILE

Facility

$100.00

Service Code	CPT 83021
Hospital Charge Code	228105
Hospital Revenue Code	305
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.25
Rate for Payer: Aetna Medicare Advantage	$18.06
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	$18.06
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.39
Rate for Payer: Home State Health Plan Medicare Advantage	$18.06
Rate for Payer: Humana Commercial	$36.12
Rate for Payer: Humana Medicare Advantage	$18.06
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

HEMOGLOBIN FREE URINE

Facility

$161.00

Service Code	CPT 83069
Hospital Charge Code	2283069
Hospital Revenue Code	307
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$114.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$3.56
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$95.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$114.95
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cigna Commercial HMO & PPO	$3.95
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$3.81
Rate for Payer: Home State Health Plan Medicare Advantage	$3.95
Rate for Payer: Humana Commercial	$7.90
Rate for Payer: Humana Medicare Advantage	$3.95
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.96

HEMOGLOBIN FREE URINE

Facility

$161.00

Service Code	CPT 83069
Hospital Charge Code	2283069
Hospital Revenue Code	307
Rate for Payer: Cash Price	$144.90

HEMOGLOBIN PLASMA

Facility

$357.00

Service Code	CPT 83051
Hospital Charge Code	2283051
Hospital Revenue Code	305
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$254.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$6.58
Rate for Payer: Aetna Medicare Advantage	$7.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$211.34
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$254.90
Rate for Payer: Cash Price	$321.30
Rate for Payer: Cash Price	$321.30
Rate for Payer: Cash Price	$321.30
Rate for Payer: Cigna Commercial HMO & PPO	$7.31
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7.04
Rate for Payer: Home State Health Plan Medicare Advantage	$7.31
Rate for Payer: Humana Commercial	$14.62
Rate for Payer: Humana Medicare Advantage	$7.31
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$128.52

HEMOGLOBIN PLASMA

Facility

$357.00

Service Code	CPT 83051
Hospital Charge Code	2283051
Hospital Revenue Code	305
Rate for Payer: Cash Price	$321.30

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$29,286.09

Service Code	APR-DRG 8104
Min. Negotiated Rate	$29,286.09
Max. Negotiated Rate	$29,286.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$29,286.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$29,286.09
Rate for Payer: Home State Health Plan Medicaid Managed Care	$29,286.09
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$29,286.09

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$15,868.09

Service Code	APR-DRG 8103
Min. Negotiated Rate	$15,868.09
Max. Negotiated Rate	$15,868.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,868.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,868.09
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,868.09
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,868.09

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$10,305.42

Service Code	APR-DRG 8102
Min. Negotiated Rate	$10,305.42
Max. Negotiated Rate	$10,305.42
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,305.42
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,305.42
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,305.42
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,305.42

Know your out-of-pocket cost for care.

All Charges