Madison Medical Center

All Charges

Charge

Type

Setting

Price

MAJOR SMALL BOWEL PROCEDURES

Facility

$68,938.61

Service Code	APR-DRG 2304
Min. Negotiated Rate	$68,938.61
Max. Negotiated Rate	$68,938.61
Rate for Payer: Aetna Better Health Medicaid/QHP	$68,938.61
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$68,938.61
Rate for Payer: Home State Health Plan Medicaid Managed Care	$68,938.61
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$68,938.61

MAJOR SMALL BOWEL PROCEDURES

Facility

$17,281.11

Service Code	APR-DRG 2302
Min. Negotiated Rate	$17,281.11
Max. Negotiated Rate	$17,281.11
Rate for Payer: Aetna Better Health Medicaid/QHP	$17,281.11
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17,281.11
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17,281.11
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17,281.11

MAJOR SMALL BOWEL PROCEDURES

Facility

$10,698.53

Service Code	APR-DRG 2301
Min. Negotiated Rate	$10,698.53
Max. Negotiated Rate	$10,698.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,698.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,698.53
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,698.53
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,698.53

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$25,687.76

Service Code	APR-DRG 2202
Min. Negotiated Rate	$25,687.76
Max. Negotiated Rate	$25,687.76
Rate for Payer: Aetna Better Health Medicaid/QHP	$25,687.76
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$25,687.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$25,687.76
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$25,687.76

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$73,175.68

Service Code	APR-DRG 2204
Min. Negotiated Rate	$73,175.68
Max. Negotiated Rate	$73,175.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$73,175.68
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$73,175.68
Rate for Payer: Home State Health Plan Medicaid Managed Care	$73,175.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$73,175.68

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$10,983.29

Service Code	APR-DRG 2201
Min. Negotiated Rate	$10,983.29
Max. Negotiated Rate	$10,983.29
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,983.29
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,983.29
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,983.29
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,983.29

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$36,227.28

Service Code	APR-DRG 2203
Min. Negotiated Rate	$36,227.28
Max. Negotiated Rate	$36,227.28
Rate for Payer: Aetna Better Health Medicaid/QHP	$36,227.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$36,227.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$36,227.28
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$36,227.28

MAJOR THUMB OR JOINT PROCEDURES

Facility

$24,758.62

Service Code	MSDRG 506
Min. Negotiated Rate	$12,379.31
Max. Negotiated Rate	$24,758.62
Rate for Payer: Aetna Medicare Advantage	$12,379.31
Rate for Payer: Cigna Commercial HMO & PPO	$12,379.31
Rate for Payer: Home State Health Plan Medicare Advantage	$12,379.31
Rate for Payer: Humana Commercial	$24,758.62
Rate for Payer: Humana Medicare Advantage	$12,379.31

MALE LUER LOCK ADAPTER

Facility

$18.00

Hospital Charge Code	2828399
Hospital Revenue Code	271
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

MALE LUER LOCK ADAPTER

Facility

$18.00

Hospital Charge Code	2828399
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$19,684.86

Service Code	APR-DRG 5014
Min. Negotiated Rate	$19,684.86
Max. Negotiated Rate	$19,684.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$19,684.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19,684.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$19,684.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19,684.86

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$3,793.30

Service Code	APR-DRG 5011
Min. Negotiated Rate	$3,793.30
Max. Negotiated Rate	$3,793.30
Rate for Payer: Aetna Better Health Medicaid/QHP	$3,793.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3,793.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$3,793.30
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3,793.30

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$9,897.90

Service Code	APR-DRG 5013
Min. Negotiated Rate	$9,897.90
Max. Negotiated Rate	$9,897.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,897.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,897.90
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,897.90
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,897.90

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$7,313.87

Service Code	APR-DRG 5012
Min. Negotiated Rate	$7,313.87
Max. Negotiated Rate	$7,313.87
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,313.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,313.87
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,313.87
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,313.87

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$9,107.62

Service Code	APR-DRG 2521
Min. Negotiated Rate	$9,107.62
Max. Negotiated Rate	$9,107.62
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,107.62
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,107.62
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,107.62
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,107.62

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$10,129.81

Service Code	APR-DRG 2522
Min. Negotiated Rate	$10,129.81
Max. Negotiated Rate	$10,129.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,129.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,129.81
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,129.81
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,129.81

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$14,145.88

Service Code	APR-DRG 2523
Min. Negotiated Rate	$14,145.88
Max. Negotiated Rate	$14,145.88
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,145.88
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,145.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,145.88
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,145.88

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$33,659.44

Service Code	APR-DRG 2524
Min. Negotiated Rate	$33,659.44
Max. Negotiated Rate	$33,659.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$33,659.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33,659.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33,659.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33,659.44

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$9,071.38

Service Code	APR-DRG 2061
Min. Negotiated Rate	$9,071.38
Max. Negotiated Rate	$9,071.38
Rate for Payer: Aetna Better Health Medicaid/QHP	$9,071.38
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$9,071.38
Rate for Payer: Home State Health Plan Medicaid Managed Care	$9,071.38
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$9,071.38

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$12,707.51

Service Code	APR-DRG 2062
Min. Negotiated Rate	$12,707.51
Max. Negotiated Rate	$12,707.51
Rate for Payer: Aetna Better Health Medicaid/QHP	$12,707.51
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$12,707.51
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12,707.51
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$12,707.51

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$27,718.93

Service Code	APR-DRG 2064
Min. Negotiated Rate	$27,718.93
Max. Negotiated Rate	$27,718.93
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,718.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,718.93
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,718.93
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,718.93

MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE

Facility

$15,477.37

Service Code	APR-DRG 2063
Min. Negotiated Rate	$15,477.37
Max. Negotiated Rate	$15,477.37
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,477.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,477.37
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,477.37
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,477.37

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$6,124.94

Service Code	APR-DRG 4661
Min. Negotiated Rate	$6,124.94
Max. Negotiated Rate	$6,124.94
Rate for Payer: Aetna Better Health Medicaid/QHP	$6,124.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6,124.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6,124.94
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6,124.94

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$13,546.98

Service Code	APR-DRG 4663
Min. Negotiated Rate	$13,546.98
Max. Negotiated Rate	$13,546.98
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,546.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,546.98
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,546.98
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,546.98

MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE

Facility

$24,612.54

Service Code	APR-DRG 4664
Min. Negotiated Rate	$24,612.54
Max. Negotiated Rate	$24,612.54
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,612.54
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,612.54
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,612.54
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,612.54

Know your out-of-pocket cost for care.

All Charges