Madison Medical Center

All Charges

Charge

Type

Setting

Price

MEDICATION LABEL

Facility

$24.00

Hospital Charge Code	1269036
Hospital Revenue Code	271
Rate for Payer: Cash Price	$21.60

MEDICATION LABEL

Facility

$24.00

Hospital Charge Code	1269036
Hospital Revenue Code	271
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$17.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.14
Rate for Payer: Cash Price	$21.60
Rate for Payer: UnitedHealthcare Commercial	$16.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.64

MEDIFIL PARTICLES

Facility

$113.00

Hospital Charge Code	2813102
Hospital Revenue Code	271
Rate for Payer: Cash Price	$101.70

MEDIFIL PARTICLES

Facility

$113.00

Hospital Charge Code	2813102
Hospital Revenue Code	271
Min. Negotiated Rate	$40.68
Max. Negotiated Rate	$80.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$66.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$80.68
Rate for Payer: Cash Price	$101.70
Rate for Payer: UnitedHealthcare Commercial	$75.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.68

MEDIPORE TAPE 2 #2962

Facility

$42.00

Hospital Charge Code	2820461
Hospital Revenue Code	271
Rate for Payer: Cash Price	$37.80

MEDIPORE TAPE 2 #2962

Facility

$42.00

Hospital Charge Code	2820461
Hospital Revenue Code	271
Min. Negotiated Rate	$15.12
Max. Negotiated Rate	$29.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$24.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$29.99
Rate for Payer: Cash Price	$37.80
Rate for Payer: UnitedHealthcare Commercial	$28.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.12

MEDOVAT DILATOR ESOPHAGEAL

Facility

$187.00

Hospital Charge Code	122511
Hospital Revenue Code	271
Rate for Payer: Cash Price	$168.30

MEDOVAT DILATOR ESOPHAGEAL

Facility

$187.00

Hospital Charge Code	122511
Hospital Revenue Code	271
Min. Negotiated Rate	$67.32
Max. Negotiated Rate	$133.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$110.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$133.52
Rate for Payer: Cash Price	$168.30
Rate for Payer: UnitedHealthcare Commercial	$124.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$67.32

MEDROXYPROG 2.5MG TAB EMP

Facility

$55.00

Service Code	NDC 5.9762E+10
Hospital Charge Code	2626019
Hospital Revenue Code	250
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$39.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: UnitedHealthcare Commercial	$36.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.80

MEDROXYPROG 2.5MG TAB EMP

Facility

$55.00

Service Code	NDC 5.9762E+10
Hospital Charge Code	2626019
Hospital Revenue Code	250
Rate for Payer: Cash Price	$49.50

MEGESTROL 40MG/ML SUSP 240ML

Facility

$670.00

Service Code	NDC 54354258
Hospital Charge Code	2697799
Hospital Revenue Code	250
Min. Negotiated Rate	$241.20
Max. Negotiated Rate	$478.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$396.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$478.38
Rate for Payer: Cash Price	$603.00
Rate for Payer: UnitedHealthcare Commercial	$446.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$241.20

MEGESTROL 40MG/ML SUSP 240ML

Facility

$670.00

Service Code	NDC 54354258
Hospital Charge Code	2697799
Hospital Revenue Code	250
Rate for Payer: Cash Price	$603.00

MEGESTROL 40MG/ML SUSP 240ML

Facility

$670.00

Service Code	NDC 6.0432E+10
Hospital Charge Code	2623503
Hospital Revenue Code	250
Min. Negotiated Rate	$241.20
Max. Negotiated Rate	$478.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$396.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$478.38
Rate for Payer: Cash Price	$603.00
Rate for Payer: UnitedHealthcare Commercial	$446.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$241.20

MEGESTROL 40MG/ML SUSP 240ML

Facility

$670.00

Service Code	NDC 6.0432E+10
Hospital Charge Code	2623503
Hospital Revenue Code	250
Rate for Payer: Cash Price	$603.00

MEGESTROL 40MG/ML SUSP 5ML (200MG)

Facility

$20.00

Service Code	NDC 54354258
Hospital Charge Code	2626375
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$14.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: UnitedHealthcare Commercial	$13.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20

MEGESTROL 40MG/ML SUSP 5ML (200MG)

Facility

$20.00

Service Code	NDC 54354258
Hospital Charge Code	2626375
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

MELANOCYTE STIM HORMONE

Facility

$443.00

Service Code	CPT 83519
Hospital Charge Code	2284308
Hospital Revenue Code	301
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$316.30
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.56
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$262.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$316.30
Rate for Payer: Cash Price	$398.70
Rate for Payer: Cash Price	$398.70
Rate for Payer: Cash Price	$398.70
Rate for Payer: Cigna Commercial HMO & PPO	$18.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.72
Rate for Payer: Home State Health Plan Medicare Advantage	$18.40
Rate for Payer: Humana Commercial	$36.80
Rate for Payer: Humana Medicare Advantage	$18.40
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.48

MELANOCYTE STIM HORMONE

Facility

$443.00

Service Code	CPT 83519
Hospital Charge Code	2284308
Hospital Revenue Code	301
Rate for Payer: Cash Price	$398.70

MELATONIN 3MG TAB

Facility

$25.00

Service Code	NDC 1.094E+10
Hospital Charge Code	2621501
Hospital Revenue Code	250
Rate for Payer: Cash Price	$22.50

MELATONIN 3MG TAB

Facility

$25.00

Service Code	NDC 1.094E+10
Hospital Charge Code	2621501
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$17.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.85
Rate for Payer: Cash Price	$22.50
Rate for Payer: UnitedHealthcare Commercial	$16.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.00

MELATONIN 5MG TAB UD

Facility

$25.00

Service Code	NDC 2.0555E+10
Hospital Charge Code	2622288
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$17.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.85
Rate for Payer: Cash Price	$22.50
Rate for Payer: UnitedHealthcare Commercial	$16.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.00

MELATONIN 5MG TAB UD

Facility

$25.00

Service Code	NDC 2.0555E+10
Hospital Charge Code	2622288
Hospital Revenue Code	250
Rate for Payer: Cash Price	$22.50

MELOXICAM (MOBIC) 15MG TAB EMP

Facility

$13.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2697252
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$9.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$9.28
Rate for Payer: Cash Price	$11.70
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.68

MELOXICAM (MOBIC) 15MG TAB EMP

Facility

$13.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2697252
Hospital Revenue Code	250
Rate for Payer: Cash Price	$11.70

MELOXICAM (MOBIC) 7.5MG TAB

Facility

$22.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2626599
Hospital Revenue Code	250
Rate for Payer: Cash Price	$19.80

Know your out-of-pocket cost for care.

All Charges