Madison Medical Center

All Charges

Charge

Type

Setting

Price

HF LIPID PANEL

Facility

$10.00

Hospital Charge Code	22111121
Hospital Revenue Code	301
Rate for Payer: Cash Price	$9.00

HF LIPID PANEL SPOUSE

Facility

$5.00

Hospital Charge Code	22111127
Hospital Revenue Code	301
Rate for Payer: Cash Price	$4.50

HF LIPID PANEL SPOUSE

Facility

$5.00

Hospital Charge Code	22111127
Hospital Revenue Code	301
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$21.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$2.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$3.57
Rate for Payer: Cash Price	$4.50
Rate for Payer: Cash Price	$4.50
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.80

HF PSA

Facility

$10.00

Hospital Charge Code	22111124
Hospital Revenue Code	302
Rate for Payer: Cash Price	$9.00

HF PSA

Facility

$10.00

Hospital Charge Code	22111124
Hospital Revenue Code	302
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$21.00
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: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

HF PSA SPOUSE

Facility

$8.00

Hospital Charge Code	22111130
Hospital Revenue Code	302
Rate for Payer: Cash Price	$7.20

HF PSA SPOUSE

Facility

$8.00

Hospital Charge Code	22111130
Hospital Revenue Code	302
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$21.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5.71
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.88

.HF SARS-COV-2 TOTAL ANTIBODES

Facility

$35.00

Service Code	CPT 84443
Hospital Charge Code	2287639
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$33.60
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.12
Rate for Payer: Aetna Medicare Advantage	$16.80
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: Cash Price	$31.50
Rate for Payer: Cash Price	$31.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.80
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.12
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.18
Rate for Payer: Home State Health Plan Medicare Advantage	$16.80
Rate for Payer: Humana Commercial	$33.60
Rate for Payer: Humana Medicare Advantage	$16.80
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60

.HF SARS-COV-2 TOTAL ANTIBODES

Facility

$35.00

Service Code	CPT 84443
Hospital Charge Code	2287639
Hospital Revenue Code	301
Rate for Payer: Cash Price	$31.50

HF TSH

Facility

$10.00

Hospital Charge Code	22111126
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$21.00
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: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

HF TSH

Facility

$10.00

Hospital Charge Code	22111126
Hospital Revenue Code	301
Rate for Payer: Cash Price	$9.00

HF TSH SPOUSE

Facility

$8.00

Hospital Charge Code	22111131
Hospital Revenue Code	301
Rate for Payer: Cash Price	$7.20

HF TSH SPOUSE

Facility

$8.00

Hospital Charge Code	22111131
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$21.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5.71
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.88

HF VITAMIN B12 SPOUSE

Facility

$8.00

Service Code	CPT 82607
Hospital Charge Code	22111136
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$30.16
Rate for Payer: Aetna Better Health Medicaid/QHP	$13.57
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5.71
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cigna Commercial HMO & PPO	$15.08
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.57
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14.52
Rate for Payer: Home State Health Plan Medicare Advantage	$15.08
Rate for Payer: Humana Commercial	$30.16
Rate for Payer: Humana Medicare Advantage	$15.08
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.88

HF VITAMIN B12 SPOUSE

Facility

$8.00

Service Code	CPT 82607
Hospital Charge Code	22111136
Hospital Revenue Code	301
Rate for Payer: Cash Price	$7.20

HF VIT D

Facility

$10.00

Hospital Charge Code	22111123
Hospital Revenue Code	301
Rate for Payer: Cash Price	$9.00

HF VIT D

Facility

$10.00

Hospital Charge Code	22111123
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$21.00
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: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

HF VIT D SPOUSE

Facility

$8.00

Hospital Charge Code	22111132
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$21.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5.71
Rate for Payer: Cash Price	$7.20
Rate for Payer: Cash Price	$7.20
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.88

HF VIT D SPOUSE

Facility

$8.00

Hospital Charge Code	22111132
Hospital Revenue Code	301
Rate for Payer: Cash Price	$7.20

HGB A1C

Facility

$144.00

Service Code	CPT 83036
Hospital Charge Code	2227059
Hospital Revenue Code	301
Rate for Payer: Cash Price	$129.60

HGB A1C

Facility

$144.00

Service Code	CPT 83036
Hospital Charge Code	2227059
Hospital Revenue Code	301
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$102.82
Rate for Payer: Aetna Better Health Medicaid/QHP	$8.74
Rate for Payer: Aetna Medicare Advantage	$9.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$85.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$102.82
Rate for Payer: Cash Price	$129.60
Rate for Payer: Cash Price	$129.60
Rate for Payer: Cash Price	$129.60
Rate for Payer: Cigna Commercial HMO & PPO	$9.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9.35
Rate for Payer: Home State Health Plan Medicare Advantage	$9.71
Rate for Payer: Humana Commercial	$19.42
Rate for Payer: Humana Medicare Advantage	$9.71
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.84

HGB A1C (LABCORP)

Facility

$100.00

Service Code	CPT 83036
Hospital Charge Code	2227058
Hospital Revenue Code	305
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$8.74
Rate for Payer: Aetna Medicare Advantage	$9.71
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	$9.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9.35
Rate for Payer: Home State Health Plan Medicare Advantage	$9.71
Rate for Payer: Humana Commercial	$19.42
Rate for Payer: Humana Medicare Advantage	$9.71
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

HGB A1C (LABCORP)

Facility

$100.00

Service Code	CPT 83036
Hospital Charge Code	2227058
Hospital Revenue Code	305
Rate for Payer: Cash Price	$90.00

HGB BY MONITOR

Facility

$60.00

Service Code	CPT 83036
Hospital Charge Code	9883036
Hospital Revenue Code	301
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$42.84
Rate for Payer: Aetna Better Health Medicaid/QHP	$8.74
Rate for Payer: Aetna Medicare Advantage	$9.71
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: Cash Price	$54.00
Rate for Payer: Cash Price	$54.00
Rate for Payer: Cigna Commercial HMO & PPO	$9.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9.35
Rate for Payer: Home State Health Plan Medicare Advantage	$9.71
Rate for Payer: Humana Commercial	$19.42
Rate for Payer: Humana Medicare Advantage	$9.71
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

HGB BY MONITOR

Facility

$60.00

Service Code	CPT 83036
Hospital Charge Code	9883036
Hospital Revenue Code	301
Rate for Payer: Cash Price	$54.00

Know your out-of-pocket cost for care.

All Charges