Madison Medical Center

All Charges

Charge

Type

Setting

Price

LINE PIC

Facility

$468.00

Hospital Charge Code	2816677
Hospital Revenue Code	271
Min. Negotiated Rate	$168.48
Max. Negotiated Rate	$334.15
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$277.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$334.15
Rate for Payer: Cash Price	$421.20
Rate for Payer: UnitedHealthcare Commercial	$312.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$168.48

LINE PIC

Facility

$468.00

Hospital Charge Code	2816677
Hospital Revenue Code	271
Rate for Payer: Cash Price	$421.20

LINE PIC INSERTION

Facility

$841.00

Hospital Charge Code	2816678
Hospital Revenue Code	271
Min. Negotiated Rate	$302.76
Max. Negotiated Rate	$600.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$497.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$600.47
Rate for Payer: Cash Price	$756.90
Rate for Payer: UnitedHealthcare Commercial	$560.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$302.76

LINE PIC INSERTION

Facility

$841.00

Hospital Charge Code	2816678
Hospital Revenue Code	271
Rate for Payer: Cash Price	$756.90

LINEZOLID (ZYVOX) 600MG IVPB 300ML

Facility

$546.00

Service Code	NDC 9514001
Hospital Charge Code	2620231
Hospital Revenue Code	250
Min. Negotiated Rate	$196.56
Max. Negotiated Rate	$389.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$323.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$389.84
Rate for Payer: Cash Price	$491.40
Rate for Payer: UnitedHealthcare Commercial	$364.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$196.56

LINEZOLID (ZYVOX) 600MG IVPB 300ML

Facility

$546.00

Service Code	NDC 9514001
Hospital Charge Code	2620231
Hospital Revenue Code	250
Rate for Payer: Cash Price	$491.40

LINEZOLID (ZYVOX) 600MG TAB

Facility

$494.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2620232
Hospital Revenue Code	250
Rate for Payer: Cash Price	$444.60

LINEZOLID (ZYVOX) 600MG TAB

Facility

$494.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2620232
Hospital Revenue Code	250
Min. Negotiated Rate	$177.84
Max. Negotiated Rate	$352.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$292.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$352.72
Rate for Payer: Cash Price	$444.60
Rate for Payer: UnitedHealthcare Commercial	$329.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$177.84

LINZESS (LINACLOTIDE) 145MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120130
Hospital Charge Code	2622373
Hospital Revenue Code	250
Rate for Payer: Cash Price	$54.00

LINZESS (LINACLOTIDE) 145MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120130
Hospital Charge Code	2622373
Hospital Revenue Code	250
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

LINZESS (LINACLOTIDE) 290MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120230
Hospital Charge Code	2622513
Hospital Revenue Code	250
Rate for Payer: Cash Price	$54.00

LINZESS (LINACLOTIDE) 290MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120230
Hospital Charge Code	2622513
Hospital Revenue Code	250
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

LINZESS (LINACLOTIDE) 72MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120330
Hospital Charge Code	2625688
Hospital Revenue Code	250
Rate for Payer: Cash Price	$54.00

LINZESS (LINACLOTIDE) 72MCG CAP EMP

Facility

$60.00

Service Code	NDC 456120330
Hospital Charge Code	2625688
Hospital Revenue Code	250
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

LIOTHYRONINE (CYTOMEL) 25MCG TAB EMP

Facility

$18.00

Service Code	NDC 6.0793E+10
Hospital Charge Code	2622514
Hospital Revenue Code	250
Rate for Payer: Cash Price	$16.20

LIOTHYRONINE (CYTOMEL) 25MCG TAB EMP

Facility

$18.00

Service Code	NDC 6.0793E+10
Hospital Charge Code	2622514
Hospital Revenue Code	250
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

LIOTHYRONINE (CYTOMEL) 5MCG TAB EMP

Facility

$10.00

Service Code	NDC 1E+11
Hospital Charge Code	2622230
Hospital Revenue Code	250
Rate for Payer: Cash Price	$9.00

LIOTHYRONINE (CYTOMEL) 5MCG TAB EMP

Facility

$10.00

Service Code	NDC 1E+11
Hospital Charge Code	2622230
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

LIPASE

Facility

$195.00

Service Code	CPT 83690
Hospital Charge Code	2212188
Hospital Revenue Code	301
Rate for Payer: Cash Price	$175.50

LIPASE

Facility

$195.00

Service Code	CPT 83690
Hospital Charge Code	2212188
Hospital Revenue Code	301
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$139.23
Rate for Payer: Aetna Better Health Medicaid/QHP	$6.20
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$115.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$139.23
Rate for Payer: Cash Price	$175.50
Rate for Payer: Cash Price	$175.50
Rate for Payer: Cash Price	$175.50
Rate for Payer: Cigna Commercial HMO & PPO	$6.89
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.63
Rate for Payer: Home State Health Plan Medicare Advantage	$6.89
Rate for Payer: Humana Commercial	$13.78
Rate for Payer: Humana Medicare Advantage	$6.89
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.20

LIPID PANEL

Facility

$49.00

Service Code	CPT 80061
Hospital Charge Code	4280061
Hospital Revenue Code	521
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$12.05
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$29.01
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$34.99
Rate for Payer: Cash Price	$44.10
Rate for Payer: Cash Price	$44.10
Rate for Payer: Cash Price	$44.10
Rate for Payer: Cash Price	$44.10
Rate for Payer: Cigna Commercial HMO & PPO	$13.39
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.89
Rate for Payer: Home State Health Plan Medicare Advantage	$13.39
Rate for Payer: Humana Commercial	$26.78
Rate for Payer: Humana Medicare Advantage	$13.39
Rate for Payer: UnitedHealthcare Commercial	$32.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

LIPID PANEL

Facility

$49.00

Service Code	CPT 80061
Hospital Charge Code	4280061
Hospital Revenue Code	521
Rate for Payer: Cash Price	$44.10

LIPID PROF

Facility

$233.00

Service Code	CPT 80061
Hospital Charge Code	223169
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$166.36
Rate for Payer: Aetna Better Health Medicaid/QHP	$12.05
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$137.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$166.36
Rate for Payer: Cash Price	$209.70
Rate for Payer: Cash Price	$209.70
Rate for Payer: Cash Price	$209.70
Rate for Payer: Cigna Commercial HMO & PPO	$13.39
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12.05
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.89
Rate for Payer: Home State Health Plan Medicare Advantage	$13.39
Rate for Payer: Humana Commercial	$26.78
Rate for Payer: Humana Medicare Advantage	$13.39
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$83.88

LIPID PROF

Facility

$233.00

Service Code	CPT 80061
Hospital Charge Code	223169
Hospital Revenue Code	301
Rate for Payer: Cash Price	$209.70

LIPID PROF REFLEX DLDL

Facility

$233.00

Service Code	CPT 80061
Hospital Charge Code	223200
Hospital Revenue Code	301
Rate for Payer: Cash Price	$209.70

Know your out-of-pocket cost for care.

All Charges