Madison Medical Center

All Charges

Charge

Type

Setting

Price

METANEPHRINE FRAC PLASMA

Facility

$178.00

Service Code	CPT 83835
Hospital Charge Code	2213285
Hospital Revenue Code	301
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$127.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.25
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$105.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$127.09
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cash Price	$160.20
Rate for Payer: Cigna Commercial HMO & PPO	$16.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.32
Rate for Payer: Home State Health Plan Medicare Advantage	$16.94
Rate for Payer: Humana Commercial	$33.88
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.08

METANEPHRINE FRAC PLASMA

Facility

$178.00

Service Code	CPT 83835
Hospital Charge Code	2213285
Hospital Revenue Code	301
Rate for Payer: Cash Price	$160.20

METANEPHRINE FRAC URINE 24 HOUR

Facility

$131.00

Service Code	CPT 83835
Hospital Charge Code	2283835
Hospital Revenue Code	301
Rate for Payer: Cash Price	$117.90

METANEPHRINE FRAC URINE 24 HOUR

Facility

$131.00

Service Code	CPT 83835
Hospital Charge Code	2283835
Hospital Revenue Code	301
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$93.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.25
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$77.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$93.53
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.32
Rate for Payer: Home State Health Plan Medicare Advantage	$16.94
Rate for Payer: Humana Commercial	$33.88
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.16

METANEPHRINE RANDOM UR

Facility

$131.00

Service Code	CPT 83835
Hospital Charge Code	2283836
Hospital Revenue Code	301
Rate for Payer: Cash Price	$117.90

METANEPHRINE RANDOM UR

Facility

$131.00

Service Code	CPT 83835
Hospital Charge Code	2283836
Hospital Revenue Code	301
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$93.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.25
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$77.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$93.53
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cash Price	$117.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.32
Rate for Payer: Home State Health Plan Medicare Advantage	$16.94
Rate for Payer: Humana Commercial	$33.88
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.16

METARIMINOL INJ

Facility

$93.00

Service Code	HCPCS J2150
Hospital Charge Code	2058006
Hospital Revenue Code	370
Min. Negotiated Rate	$33.48
Max. Negotiated Rate	$66.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$55.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$66.40
Rate for Payer: Cash Price	$83.70
Rate for Payer: UnitedHealthcare Commercial	$62.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.48

METARIMINOL INJ

Facility

$93.00

Service Code	HCPCS J2150
Hospital Charge Code	2058006
Hospital Revenue Code	370
Rate for Payer: Cash Price	$83.70

METASTATIC SERIES

Facility

$1,238.00

Service Code	CPT 77074
Hospital Charge Code	3213199
Hospital Revenue Code	320
Min. Negotiated Rate	$94.24
Max. Negotiated Rate	$883.93
Rate for Payer: Aetna Better Health Medicaid/QHP	$94.24
Rate for Payer: Aetna Medicare Advantage	$106.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$732.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$883.93
Rate for Payer: Cash Price	$1,114.20
Rate for Payer: Cash Price	$1,114.20
Rate for Payer: Cash Price	$1,114.20
Rate for Payer: Cigna Commercial HMO & PPO	$106.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$94.24
Rate for Payer: Home State Health Plan Medicaid Managed Care	$100.84
Rate for Payer: Home State Health Plan Medicare Advantage	$106.81
Rate for Payer: Humana Commercial	$213.62
Rate for Payer: Humana Medicare Advantage	$106.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$94.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$445.68

METASTATIC SERIES

Facility

$1,238.00

Service Code	CPT 77074
Hospital Charge Code	3213199
Hospital Revenue Code	320
Rate for Payer: Cash Price	$1,114.20

METFORMIN

Facility

$460.00

Service Code	CPT 80299
Hospital Charge Code	224254
Hospital Revenue Code	301
Rate for Payer: Cash Price	$414.00

METFORMIN

Facility

$460.00

Service Code	CPT 80299
Hospital Charge Code	224254
Hospital Revenue Code	301
Min. Negotiated Rate	$16.78
Max. Negotiated Rate	$328.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.78
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$272.32
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$328.44
Rate for Payer: Cash Price	$414.00
Rate for Payer: Cash Price	$414.00
Rate for Payer: Cash Price	$414.00
Rate for Payer: Cigna Commercial HMO & PPO	$18.64
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.95
Rate for Payer: Home State Health Plan Medicare Advantage	$18.64
Rate for Payer: Humana Commercial	$37.28
Rate for Payer: Humana Medicare Advantage	$18.64
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$165.60

METFORMIN 1000MG TAB EMP

Facility

$22.00

Service Code	NDC 5.7664E+10
Hospital Charge Code	2619848
Hospital Revenue Code	250
Rate for Payer: Cash Price	$19.80

METFORMIN 1000MG TAB EMP

Facility

$22.00

Service Code	NDC 5.7664E+10
Hospital Charge Code	2619848
Hospital Revenue Code	250
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$15.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: UnitedHealthcare Commercial	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

METFORMIN 500MG TAB EMP

Facility

$20.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2697797
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METFORMIN 500MG TAB EMP

Facility

$20.00

Service Code	NDC 6.7877E+10
Hospital Charge Code	2697797
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

METFORMIN 850MG TAB EMP

Facility

$21.00

Service Code	NDC 5.7664E+10
Hospital Charge Code	2619379
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

METFORMIN 850MG TAB EMP

Facility

$21.00

Service Code	NDC 5.7664E+10
Hospital Charge Code	2619379
Hospital Revenue Code	250
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$14.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$12.43
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.99
Rate for Payer: Cash Price	$18.90
Rate for Payer: UnitedHealthcare Commercial	$14.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.56

METFORMIN ER 500MG EMP

Facility

$15.00

Service Code	NDC 5.1224E+10
Hospital Charge Code	2697379
Hospital Revenue Code	250
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$10.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.88
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.71
Rate for Payer: Cash Price	$13.50
Rate for Payer: UnitedHealthcare Commercial	$10.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.40

METFORMIN ER 500MG EMP

Facility

$15.00

Service Code	NDC 5.1224E+10
Hospital Charge Code	2697379
Hospital Revenue Code	250
Rate for Payer: Cash Price	$13.50

METFORMIN (GLUCOPHAGE) 1000MG TAB

Facility

$22.00

Service Code	NDC 904716461
Hospital Charge Code	2626296
Hospital Revenue Code	250
Rate for Payer: Cash Price	$19.80

METFORMIN (GLUCOPHAGE) 1000MG TAB

Facility

$22.00

Service Code	NDC 904716461
Hospital Charge Code	2626296
Hospital Revenue Code	250
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$15.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: UnitedHealthcare Commercial	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

METFORMIN (GLUCOPHAGE) 500MG TAB UD

Facility

$20.00

Service Code	NDC 6.0687E+10
Hospital Charge Code	2655094
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

METFORMIN (GLUCOPHAGE) 500MG TAB UD

Facility

$20.00

Service Code	NDC 6.0687E+10
Hospital Charge Code	2655094
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METFORMIN (GLUCOPHAGE) 850MG TAB

Facility

$21.00

Service Code	NDC 6.2584E+10
Hospital Charge Code	2626266
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

Know your out-of-pocket cost for care.

All Charges