Madison Medical Center

All Charges

Charge

Type

Setting

Price

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$7,426.59

Service Code	APR-DRG 8101
Min. Negotiated Rate	$7,426.59
Max. Negotiated Rate	$7,426.59
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,426.59
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,426.59
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,426.59
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,426.59

HEMORRHOIDAL CREAM 28GM TUBE

Facility

$37.00

Service Code	NDC 5732086810
Hospital Charge Code	2620525
Hospital Revenue Code	250
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$26.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$26.42
Rate for Payer: Cash Price	$33.30
Rate for Payer: UnitedHealthcare Commercial	$24.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.32

HEMORRHOIDAL CREAM 28GM TUBE

Facility

$37.00

Service Code	NDC 5732086810
Hospital Charge Code	2620525
Hospital Revenue Code	250
Rate for Payer: Cash Price	$33.30

HEMORRHOIDAL HC (ANUSOL) 25MG SUPP

Facility

$77.00

Service Code	NDC 1.6571E+10
Hospital Charge Code	2655150
Hospital Revenue Code	250
Rate for Payer: Cash Price	$69.30

HEMORRHOIDAL HC (ANUSOL) 25MG SUPP

Facility

$77.00

Service Code	NDC 1.6571E+10
Hospital Charge Code	2655150
Hospital Revenue Code	250
Min. Negotiated Rate	$27.72
Max. Negotiated Rate	$54.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$45.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$54.98
Rate for Payer: Cash Price	$69.30
Rate for Payer: UnitedHealthcare Commercial	$51.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.72

HEMORRHOIDAL OINT 57GM TUBE

Facility

$40.00

Service Code	NDC 904672602
Hospital Charge Code	2623387
Hospital Revenue Code	250
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

HEMORRHOIDAL OINT 57GM TUBE

Facility

$40.00

Service Code	NDC 904672602
Hospital Charge Code	2623387
Hospital Revenue Code	250
Rate for Payer: Cash Price	$36.00

HEMORRHOIDECTOMY

Professional

Both

$1,615.00

Service Code	CPT 46260
Hospital Charge Code	4146260
Hospital Revenue Code	975
Min. Negotiated Rate	$367.01
Max. Negotiated Rate	$565.25
Rate for Payer: Aetna Commercial/Medicare Advantage	$448.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$367.01
Rate for Payer: Cash Price	$1,453.50
Rate for Payer: Cash Price	$1,453.50
Rate for Payer: Cigna Commercial HMO & PPO	$448.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$367.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$403.71
Rate for Payer: Home State Health Plan Medicare Advantage	$448.70
Rate for Payer: Optum Medicare Advantage	$565.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$367.01

HEMORRHOIDECTOMY, BY SIMPLE LIG RUBBER B

Facility

$263.00

Service Code	CPT 46221
Hospital Charge Code	4446221
Hospital Revenue Code	521
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$1,900.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$838.31
Rate for Payer: Aetna Medicare Advantage	$950.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$155.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$187.78
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cash Price	$236.70
Rate for Payer: Cigna Commercial HMO & PPO	$950.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$754.48
Rate for Payer: Home State Health Plan Medicaid Managed Care	$896.99
Rate for Payer: Home State Health Plan Medicare Advantage	$950.10
Rate for Payer: Humana Commercial	$1,900.20
Rate for Payer: Humana Medicare Advantage	$950.10
Rate for Payer: UnitedHealthcare Commercial	$175.42
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$838.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

HEMORRHOIDECTOMY, BY SIMPLE LIG RUBBER B

Facility

$263.00

Service Code	CPT 46221
Hospital Charge Code	4446221
Hospital Revenue Code	521
Rate for Payer: Cash Price	$236.70

HEMORRHOIDECTOMY, EXC OF EXTERNAL TAGS

Facility

$347.00

Service Code	CPT 46230
Hospital Charge Code	4446230
Hospital Revenue Code	521
Rate for Payer: Cash Price	$312.30

HEMORRHOIDECTOMY, EXC OF EXTERNAL TAGS

Facility

$347.00

Service Code	CPT 46230
Hospital Charge Code	4446230
Hospital Revenue Code	521
Min. Negotiated Rate	$173.53
Max. Negotiated Rate	$5,671.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$2,502.11
Rate for Payer: Aetna Medicare Advantage	$2,835.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$205.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$247.76
Rate for Payer: Cash Price	$312.30
Rate for Payer: Cash Price	$312.30
Rate for Payer: Cash Price	$312.30
Rate for Payer: Cash Price	$312.30
Rate for Payer: Cigna Commercial HMO & PPO	$2,835.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$2,251.90
Rate for Payer: Home State Health Plan Medicaid Managed Care	$2,677.26
Rate for Payer: Home State Health Plan Medicare Advantage	$2,835.78
Rate for Payer: Humana Commercial	$5,671.56
Rate for Payer: Humana Medicare Advantage	$2,835.78
Rate for Payer: UnitedHealthcare Commercial	$231.45
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$2,502.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

HEMORRHOIDECTOMY,INT & EXT COMPLEX OR EX

Professional

Both

$1,995.00

Service Code	CPT 46260
Hospital Charge Code	5446260
Hospital Revenue Code	975
Min. Negotiated Rate	$367.01
Max. Negotiated Rate	$698.25
Rate for Payer: Aetna Commercial/Medicare Advantage	$448.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$367.01
Rate for Payer: Cash Price	$1,795.50
Rate for Payer: Cash Price	$1,795.50
Rate for Payer: Cigna Commercial HMO & PPO	$448.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$367.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$403.71
Rate for Payer: Home State Health Plan Medicare Advantage	$448.70
Rate for Payer: Optum Medicare Advantage	$698.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$367.01

HEMORRHOIDECTOMY W/FISSURECTOMY .

Facility

$1,691.00

Service Code	CPT 46261
Hospital Charge Code	4146261
Hospital Revenue Code	521
Rate for Payer: Cash Price	$1,521.90

HEMORRHOIDECTOMY W/FISSURECTOMY .

Facility

$1,691.00

Service Code	CPT 46261
Hospital Charge Code	4146261
Hospital Revenue Code	521
Min. Negotiated Rate	$173.53
Max. Negotiated Rate	$5,671.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$2,502.11
Rate for Payer: Aetna Medicare Advantage	$2,835.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,001.07
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,207.37
Rate for Payer: Cash Price	$1,521.90
Rate for Payer: Cash Price	$1,521.90
Rate for Payer: Cash Price	$1,521.90
Rate for Payer: Cash Price	$1,521.90
Rate for Payer: Cigna Commercial HMO & PPO	$2,835.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$2,251.90
Rate for Payer: Home State Health Plan Medicaid Managed Care	$2,677.26
Rate for Payer: Home State Health Plan Medicare Advantage	$2,835.78
Rate for Payer: Humana Commercial	$5,671.56
Rate for Payer: Humana Medicare Advantage	$2,835.78
Rate for Payer: UnitedHealthcare Commercial	$1,127.90
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$2,502.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

HEMOSIDERIN STAIN URINE

Facility

$52.00

Service Code	CPT 83070
Hospital Charge Code	2283070
Hospital Revenue Code	305
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$37.13
Rate for Payer: Aetna Better Health Medicaid/QHP	$4.28
Rate for Payer: Aetna Medicare Advantage	$4.75
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$30.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$37.13
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cigna Commercial HMO & PPO	$4.75
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$4.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4.58
Rate for Payer: Home State Health Plan Medicare Advantage	$4.75
Rate for Payer: Humana Commercial	$9.50
Rate for Payer: Humana Medicare Advantage	$4.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$4.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.72

HEMOSIDERIN STAIN URINE

Facility

$52.00

Service Code	CPT 83070
Hospital Charge Code	2283070
Hospital Revenue Code	305
Rate for Payer: Cash Price	$46.80

HEMOVAC

Facility

$299.00

Hospital Charge Code	127852
Hospital Revenue Code	271
Rate for Payer: Cash Price	$269.10

HEMOVAC

Facility

$299.00

Hospital Charge Code	127852
Hospital Revenue Code	271
Min. Negotiated Rate	$107.64
Max. Negotiated Rate	$213.49
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$177.01
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$213.49
Rate for Payer: Cash Price	$269.10
Rate for Payer: UnitedHealthcare Commercial	$199.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$107.64

HENDL COMP SCREW 4.0MMX46MM (STRYKER)

Facility

$903.00

Hospital Charge Code	123419
Hospital Revenue Code	271
Rate for Payer: Cash Price	$812.70

HENDL COMP SCREW 4.0MMX46MM (STRYKER)

Facility

$903.00

Hospital Charge Code	123419
Hospital Revenue Code	271
Min. Negotiated Rate	$325.08
Max. Negotiated Rate	$644.74
Rate for Payer: Cash Price	$812.70
Rate for Payer: UnitedHealthcare Commercial	$602.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$534.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$644.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$325.08

HEPARIN 10000U INJ 1ML

Facility

$65.00

Service Code	HCPCS J1644
Hospital Charge Code	2655170
Hospital Revenue Code	250
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$46.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$38.48
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$46.41
Rate for Payer: Cash Price	$58.50
Rate for Payer: UnitedHealthcare Commercial	$43.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.40

HEPARIN 10000U INJ 1ML

Facility

$65.00

Service Code	HCPCS J1644
Hospital Charge Code	2655170
Hospital Revenue Code	250
Rate for Payer: Cash Price	$58.50

HEPARIN 25000U/250ML DEX 5% 250ML PREMIX

Facility

$542.00

Service Code	NDC 409452030
Hospital Charge Code	2625826
Hospital Revenue Code	250
Rate for Payer: Cash Price	$487.80

HEPARIN 25000U/250ML DEX 5% 250ML PREMIX

Facility

$542.00

Service Code	NDC 409452030
Hospital Charge Code	2625826
Hospital Revenue Code	250
Min. Negotiated Rate	$195.12
Max. Negotiated Rate	$386.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$320.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$386.99
Rate for Payer: Cash Price	$487.80
Rate for Payer: UnitedHealthcare Commercial	$361.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$195.12

Know your out-of-pocket cost for care.

All Charges