Madison Medical Center

All Charges

Charge

Type

Setting

Price

METFORMIN (GLUCOPHAGE) 850MG TAB

Facility

$21.00

Service Code	NDC 6.2584E+10
Hospital Charge Code	2626266
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 (GLUCOPHAGE)ER 750MG TAB

Facility

$21.00

Hospital Charge Code	2626609
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 (GLUCOPHAGE)ER 750MG TAB

Facility

$21.00

Hospital Charge Code	2626609
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

METHACHOLINE 100MG 20ML VIAL

Facility

$187.00

Service Code	NDC 6.4281E+10
Hospital Charge Code	2698383
Hospital Revenue Code	250
Rate for Payer: Cash Price	$168.30

METHACHOLINE 100MG 20ML VIAL

Facility

$187.00

Service Code	NDC 6.4281E+10
Hospital Charge Code	2698383
Hospital Revenue Code	250
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

METHACHOLINE CHALLENGE

Facility

$836.00

Service Code	CPT 94070
Hospital Charge Code	4595070
Hospital Revenue Code	460
Min. Negotiated Rate	$300.96
Max. Negotiated Rate	$762.48
Rate for Payer: Aetna Better Health Medicaid/QHP	$336.38
Rate for Payer: Aetna Medicare Advantage	$381.24
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$494.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$596.90
Rate for Payer: Cash Price	$752.40
Rate for Payer: Cash Price	$752.40
Rate for Payer: Cash Price	$752.40
Rate for Payer: Cigna Commercial HMO & PPO	$381.24
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$336.38
Rate for Payer: Home State Health Plan Medicaid Managed Care	$359.93
Rate for Payer: Home State Health Plan Medicare Advantage	$381.24
Rate for Payer: Humana Commercial	$762.48
Rate for Payer: Humana Medicare Advantage	$381.24
Rate for Payer: UnitedHealthcare Commercial	$557.61
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$336.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$300.96

METHACHOLINE CHALLENGE

Facility

$836.00

Service Code	CPT 94070
Hospital Charge Code	4595070
Hospital Revenue Code	460
Rate for Payer: Cash Price	$752.40

METHADONE BLOOD

Facility

$417.00

Service Code	CPT 80342
Hospital Charge Code	2283840
Hospital Revenue Code	301
Rate for Payer: Cash Price	$375.30

METHADONE BLOOD

Facility

$417.00

Service Code	CPT 80342
Hospital Charge Code	2283840
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$297.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$246.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$297.74
Rate for Payer: Cash Price	$375.30
Rate for Payer: Cash Price	$375.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$150.12

METHADONE ORAL CONC. 10MG/ML NH

Facility

$167.00

Service Code	NDC 1E+11
Hospital Charge Code	2620053
Hospital Revenue Code	250
Min. Negotiated Rate	$60.12
Max. Negotiated Rate	$119.24
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$98.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$119.24
Rate for Payer: Cash Price	$150.30
Rate for Payer: UnitedHealthcare Commercial	$111.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.12

METHADONE ORAL CONC. 10MG/ML NH

Facility

$167.00

Service Code	NDC 1E+11
Hospital Charge Code	2620053
Hospital Revenue Code	250
Rate for Payer: Cash Price	$150.30

METHANOL URINE

Facility

$234.00

Service Code	CPT 84600
Hospital Charge Code	2224600
Hospital Revenue Code	301
Rate for Payer: Cash Price	$210.60

METHANOL URINE

Facility

$234.00

Service Code	CPT 84600
Hospital Charge Code	2224600
Hospital Revenue Code	301
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$167.08
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.40
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$138.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$167.08
Rate for Payer: Cash Price	$210.60
Rate for Payer: Cash Price	$210.60
Rate for Payer: Cash Price	$210.60
Rate for Payer: Cigna Commercial HMO & PPO	$17.11
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.48
Rate for Payer: Home State Health Plan Medicare Advantage	$17.11
Rate for Payer: Humana Commercial	$34.22
Rate for Payer: Humana Medicare Advantage	$17.11
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$84.24

METHEMOGLOBIN, BLOOD

Facility

$51.00

Service Code	CPT 83050
Hospital Charge Code	227047
Hospital Revenue Code	305
Rate for Payer: Cash Price	$45.90

METHEMOGLOBIN, BLOOD

Facility

$51.00

Service Code	CPT 83050
Hospital Charge Code	227047
Hospital Revenue Code	305
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$36.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.38
Rate for Payer: Aetna Medicare Advantage	$8.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$30.19
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$36.41
Rate for Payer: Cash Price	$45.90
Rate for Payer: Cash Price	$45.90
Rate for Payer: Cash Price	$45.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.20
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.38
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7.90
Rate for Payer: Home State Health Plan Medicare Advantage	$8.20
Rate for Payer: Humana Commercial	$16.40
Rate for Payer: Humana Medicare Advantage	$8.20
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.36

METHENAMINE HIPPURATE 1GM TAB EMP

Facility

$20.00

Service Code	NDC 6.5862E+10
Hospital Charge Code	2627019
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METHENAMINE HIPPURATE 1GM TAB EMP

Facility

$20.00

Service Code	NDC 6.5862E+10
Hospital Charge Code	2627019
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

METHIMAZOLE 5MG TAB EMP

Facility

$15.00

Service Code	NDC 1E+11
Hospital Charge Code	2619749
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

METHIMAZOLE 5MG TAB EMP

Facility

$15.00

Service Code	NDC 1E+11
Hospital Charge Code	2619749
Hospital Revenue Code	250
Rate for Payer: Cash Price	$13.50

METHIMAZOLE (TAPAZOLE)10MG TAB

Facility

$24.00

Service Code	NDC 185021001
Hospital Charge Code	260494
Hospital Revenue Code	250
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

METHIMAZOLE (TAPAZOLE)10MG TAB

Facility

$24.00

Service Code	NDC 185021001
Hospital Charge Code	260494
Hospital Revenue Code	250
Rate for Payer: Cash Price	$21.60

METHIMAZOLE (TAPAZOLE)10MG TAB

Facility

$45.00

Service Code	NDC 185021001
Hospital Charge Code	2697609
Hospital Revenue Code	250
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

METHIMAZOLE (TAPAZOLE)10MG TAB

Facility

$45.00

Service Code	NDC 185021001
Hospital Charge Code	2697609
Hospital Revenue Code	250
Rate for Payer: Cash Price	$40.50

METHOCARBAMOL 500MG TAB EMP

Facility

$20.00

Service Code	NDC 3.1722E+10
Hospital Charge Code	2619125
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

METHOCARBAMOL 500MG TAB EMP

Facility

$20.00

Service Code	NDC 3.1722E+10
Hospital Charge Code	2619125
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

Know your out-of-pocket cost for care.

All Charges