Madison Medical Center

All Charges

Charge

Type

Setting

Price

MEPILEX BORDER SACRUM

Facility

$44.00

Hospital Charge Code	80000349
Hospital Revenue Code	272
Rate for Payer: Cash Price	$39.60

MERCURY BLOOD

Facility

$162.00

Service Code	CPT 83825
Hospital Charge Code	2283825
Hospital Revenue Code	301
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$115.67
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.63
Rate for Payer: Aetna Medicare Advantage	$16.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$95.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$115.67
Rate for Payer: Cash Price	$145.80
Rate for Payer: Cash Price	$145.80
Rate for Payer: Cash Price	$145.80
Rate for Payer: Cigna Commercial HMO & PPO	$16.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.65
Rate for Payer: Home State Health Plan Medicare Advantage	$16.26
Rate for Payer: Humana Commercial	$32.52
Rate for Payer: Humana Medicare Advantage	$16.26
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$58.32

MERCURY BLOOD

Facility

$162.00

Service Code	CPT 83825
Hospital Charge Code	2283825
Hospital Revenue Code	301
Rate for Payer: Cash Price	$145.80

MERCURY URINE

Facility

$165.00

Service Code	CPT 83825
Hospital Charge Code	2283826
Hospital Revenue Code	301
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$117.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.63
Rate for Payer: Aetna Medicare Advantage	$16.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$97.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$117.81
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cash Price	$148.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.65
Rate for Payer: Home State Health Plan Medicare Advantage	$16.26
Rate for Payer: Humana Commercial	$32.52
Rate for Payer: Humana Medicare Advantage	$16.26
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$59.40

MERCURY URINE

Facility

$165.00

Service Code	CPT 83825
Hospital Charge Code	2283826
Hospital Revenue Code	301
Rate for Payer: Cash Price	$148.50

MEROPENEM (MERREM) 1GM IVPB

Facility

$280.00

Service Code	HCPCS J0743
Hospital Charge Code	2626478
Hospital Revenue Code	250
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$199.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$165.76
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$199.92
Rate for Payer: Cash Price	$252.00
Rate for Payer: UnitedHealthcare Commercial	$186.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$100.80

MEROPENEM (MERREM) 1GM IVPB

Facility

$280.00

Service Code	HCPCS J0743
Hospital Charge Code	2626478
Hospital Revenue Code	250
Rate for Payer: Cash Price	$252.00

MEROPENEM (MERREM) 500MG INJ

Facility

$127.00

Service Code	HCPCS J0743
Hospital Charge Code	2626622
Hospital Revenue Code	250
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$90.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$75.18
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$90.68
Rate for Payer: Cash Price	$114.30
Rate for Payer: UnitedHealthcare Commercial	$84.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$45.72

MEROPENEM (MERREM) 500MG INJ

Facility

$127.00

Service Code	HCPCS J0743
Hospital Charge Code	2626622
Hospital Revenue Code	250
Rate for Payer: Cash Price	$114.30

MEROPENEM + NS : 1GM + 100ML MINIBAG

Facility

$280.00

Service Code	HCPCS J0743
Hospital Charge Code	2625973
Hospital Revenue Code	250
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$199.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$165.76
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$199.92
Rate for Payer: Cash Price	$252.00
Rate for Payer: UnitedHealthcare Commercial	$186.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$100.80

MEROPENEM + NS : 1GM + 100ML MINIBAG

Facility

$280.00

Service Code	HCPCS J0743
Hospital Charge Code	2625973
Hospital Revenue Code	250
Rate for Payer: Cash Price	$252.00

MEROPENEM + NS : 500MG + 100ML MINIBAG

Facility

$366.00

Service Code	HCPCS J0743
Hospital Charge Code	2626623
Hospital Revenue Code	250
Min. Negotiated Rate	$131.76
Max. Negotiated Rate	$261.32
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$216.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$261.32
Rate for Payer: Cash Price	$329.40
Rate for Payer: UnitedHealthcare Commercial	$244.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$131.76

MEROPENEM + NS : 500MG + 100ML MINIBAG

Facility

$366.00

Service Code	HCPCS J0743
Hospital Charge Code	2626623
Hospital Revenue Code	250
Rate for Payer: Cash Price	$329.40

MESH 3X6, BARD #0112680

Facility

$169.00

Hospital Charge Code	1269046
Hospital Revenue Code	271
Rate for Payer: Cash Price	$152.10

MESH 3X6, BARD #0112680

Facility

$169.00

Hospital Charge Code	1269046
Hospital Revenue Code	271
Min. Negotiated Rate	$60.84
Max. Negotiated Rate	$120.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$100.05
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$120.67
Rate for Payer: Cash Price	$152.10
Rate for Payer: UnitedHealthcare Commercial	$112.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.84

MESH, MERSILENE

Facility

$784.00

Hospital Charge Code	2813850
Hospital Revenue Code	271
Rate for Payer: Cash Price	$705.60

MESH, MERSILENE

Facility

$784.00

Hospital Charge Code	2813850
Hospital Revenue Code	271
Min. Negotiated Rate	$282.24
Max. Negotiated Rate	$559.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$464.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$559.78
Rate for Payer: Cash Price	$705.60
Rate for Payer: UnitedHealthcare Commercial	$522.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$282.24

MESH PLUG LARGE

Facility

$1,672.00

Hospital Charge Code	1210304
Hospital Revenue Code	271
Min. Negotiated Rate	$601.92
Max. Negotiated Rate	$1,193.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$989.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,193.81
Rate for Payer: Cash Price	$1,504.80
Rate for Payer: UnitedHealthcare Commercial	$1,115.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$601.92

MESH PLUG LARGE

Facility

$1,672.00

Hospital Charge Code	1210304
Hospital Revenue Code	271
Rate for Payer: Cash Price	$1,504.80

MESH PLUG MED

Facility

$1,660.00

Hospital Charge Code	1210206
Hospital Revenue Code	271
Min. Negotiated Rate	$597.60
Max. Negotiated Rate	$1,185.24
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$982.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,185.24
Rate for Payer: Cash Price	$1,494.00
Rate for Payer: UnitedHealthcare Commercial	$1,107.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.60

MESH PLUG MED

Facility

$1,660.00

Hospital Charge Code	1210206
Hospital Revenue Code	271
Rate for Payer: Cash Price	$1,494.00

MESH PLUG SMALL

Facility

$1,648.00

Hospital Charge Code	1210203
Hospital Revenue Code	271
Rate for Payer: Cash Price	$1,483.20

MESH PLUG SMALL

Facility

$1,648.00

Hospital Charge Code	1210203
Hospital Revenue Code	271
Min. Negotiated Rate	$593.28
Max. Negotiated Rate	$1,176.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$975.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,176.67
Rate for Payer: Cash Price	$1,483.20
Rate for Payer: UnitedHealthcare Commercial	$1,099.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$593.28

MESH PLUG XLRG

Facility

$1,864.00

Hospital Charge Code	1210305
Hospital Revenue Code	271
Min. Negotiated Rate	$671.04
Max. Negotiated Rate	$1,330.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,103.49
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,330.90
Rate for Payer: Cash Price	$1,677.60
Rate for Payer: UnitedHealthcare Commercial	$1,243.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$671.04

MESH PLUG XLRG

Facility

$1,864.00

Hospital Charge Code	1210305
Hospital Revenue Code	271
Rate for Payer: Cash Price	$1,677.60

Know your out-of-pocket cost for care.

All Charges