Madison Medical Center

All Charges

Charge

Type

Setting

Price

METHOCARBAMOL 750MG TAB EMP

Facility

$20.00

Service Code	NDC 7.6385E+10
Hospital Charge Code	2619849
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 750MG TAB EMP

Facility

$20.00

Service Code	NDC 7.6385E+10
Hospital Charge Code	2619849
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METHOCARBAMOL (ROBAXIN) 500MG TAB

Facility

$21.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2655495
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

METHOCARBAMOL (ROBAXIN) 500MG TAB

Facility

$21.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2655495
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

METHOCARB(ROBAXIN)100MG/ML INJ 10ML

Facility

$147.00

Service Code	HCPCS J2800
Hospital Charge Code	2626358
Hospital Revenue Code	250
Min. Negotiated Rate	$52.92
Max. Negotiated Rate	$104.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$87.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$104.96
Rate for Payer: Cash Price	$132.30
Rate for Payer: UnitedHealthcare Commercial	$98.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$52.92

METHOCARB(ROBAXIN)100MG/ML INJ 10ML

Facility

$147.00

Service Code	HCPCS J2800
Hospital Charge Code	2626358
Hospital Revenue Code	250
Rate for Payer: Cash Price	$132.30

METHOTREX 50MG/2ML INJ 5 SDVIALS EMP

Facility

$171.00

Service Code	NDC 6.1703E+10
Hospital Charge Code	2623908
Hospital Revenue Code	250
Rate for Payer: Cash Price	$153.90

METHOTREX 50MG/2ML INJ 5 SDVIALS EMP

Facility

$171.00

Service Code	NDC 6.1703E+10
Hospital Charge Code	2623908
Hospital Revenue Code	250
Min. Negotiated Rate	$61.56
Max. Negotiated Rate	$122.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$101.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$122.09
Rate for Payer: Cash Price	$153.90
Rate for Payer: UnitedHealthcare Commercial	$114.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.56

METHOTREXATE 25MG/ML INJ 2ML MDV EMP

Facility

$171.00

Service Code	NDC 6.1703E+10
Hospital Charge Code	2620904
Hospital Revenue Code	250
Min. Negotiated Rate	$61.56
Max. Negotiated Rate	$122.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$101.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$122.09
Rate for Payer: Cash Price	$153.90
Rate for Payer: UnitedHealthcare Commercial	$114.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.56

METHOTREXATE 25MG/ML INJ 2ML MDV EMP

Facility

$171.00

Service Code	NDC 6.1703E+10
Hospital Charge Code	2620904
Hospital Revenue Code	250
Rate for Payer: Cash Price	$153.90

METHOTREXATE 2.5MG TAB EMP

Facility

$42.00

Service Code	NDC 54455015
Hospital Charge Code	2619126
Hospital Revenue Code	250
Rate for Payer: Cash Price	$37.80

METHOTREXATE 2.5MG TAB EMP

Facility

$42.00

Service Code	NDC 54455015
Hospital Charge Code	2619126
Hospital Revenue Code	250
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

METHOXAMINE INJ

Facility

$147.00

Hospital Charge Code	2058072
Hospital Revenue Code	370
Rate for Payer: Cash Price	$132.30

METHOXAMINE INJ

Facility

$147.00

Hospital Charge Code	2058072
Hospital Revenue Code	370
Min. Negotiated Rate	$52.92
Max. Negotiated Rate	$104.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$87.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$104.96
Rate for Payer: Cash Price	$132.30
Rate for Payer: UnitedHealthcare Commercial	$98.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$52.92

METHYLENE BLUE 1% 10MG INJ 1ML

Facility

$166.00

Service Code	NDC 1.7478E+10
Hospital Charge Code	2655472
Hospital Revenue Code	250
Min. Negotiated Rate	$59.76
Max. Negotiated Rate	$118.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$98.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$118.52
Rate for Payer: Cash Price	$149.40
Rate for Payer: UnitedHealthcare Commercial	$110.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$59.76

METHYLENE BLUE 1% 10MG INJ 1ML

Facility

$166.00

Service Code	NDC 1.7478E+10
Hospital Charge Code	2655472
Hospital Revenue Code	250
Rate for Payer: Cash Price	$149.40

METHYLMALONIC ACID

Facility

$245.00

Service Code	CPT 83921
Hospital Charge Code	2282131
Hospital Revenue Code	301
Rate for Payer: Cash Price	$220.50

METHYLMALONIC ACID

Facility

$245.00

Service Code	CPT 83921
Hospital Charge Code	2282131
Hospital Revenue Code	301
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$174.93
Rate for Payer: Aetna Better Health Medicaid/QHP	$19.09
Rate for Payer: Aetna Medicare Advantage	$21.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$145.04
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$174.93
Rate for Payer: Cash Price	$220.50
Rate for Payer: Cash Price	$220.50
Rate for Payer: Cash Price	$220.50
Rate for Payer: Cigna Commercial HMO & PPO	$21.21
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19.09
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20.43
Rate for Payer: Home State Health Plan Medicare Advantage	$21.21
Rate for Payer: Humana Commercial	$42.42
Rate for Payer: Humana Medicare Advantage	$21.21
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$88.20

METHYLPRED 4MG DOSEPAK 21 TABS

Facility

$149.00

Service Code	NDC 603459315
Hospital Charge Code	2626301
Hospital Revenue Code	250
Min. Negotiated Rate	$53.64
Max. Negotiated Rate	$106.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$88.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$106.39
Rate for Payer: Cash Price	$134.10
Rate for Payer: UnitedHealthcare Commercial	$99.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$53.64

METHYLPRED 4MG DOSEPAK 21 TABS

Facility

$149.00

Service Code	NDC 603459315
Hospital Charge Code	2626301
Hospital Revenue Code	250
Rate for Payer: Cash Price	$134.10

METHYLPRED 4MG DOSEPAK 21 TABS EMP

Facility

$149.00

Service Code	NDC 603459315
Hospital Charge Code	2621914
Hospital Revenue Code	250
Min. Negotiated Rate	$53.64
Max. Negotiated Rate	$106.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$88.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$106.39
Rate for Payer: Cash Price	$134.10
Rate for Payer: UnitedHealthcare Commercial	$99.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$53.64

METHYLPRED 4MG DOSEPAK 21 TABS EMP

Facility

$149.00

Service Code	NDC 603459315
Hospital Charge Code	2621914
Hospital Revenue Code	250
Rate for Payer: Cash Price	$134.10

METHYLPRED ACETATE 40MG IM INJ 1ML

Facility

$89.00

Service Code	HCPCS J1010
Hospital Charge Code	2655550
Hospital Revenue Code	250
Min. Negotiated Rate	$32.04
Max. Negotiated Rate	$63.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$52.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$63.55
Rate for Payer: Cash Price	$80.10
Rate for Payer: UnitedHealthcare Commercial	$59.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.04

METHYLPRED ACETATE 40MG IM INJ 1ML

Facility

$89.00

Service Code	HCPCS J1010
Hospital Charge Code	2655550
Hospital Revenue Code	250
Rate for Payer: Cash Price	$80.10

METHYLPRED ACETATE 40MG IM MDV 5ML

Facility

$81.00

Service Code	HCPCS J1010
Hospital Charge Code	2620307
Hospital Revenue Code	250
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

Know your out-of-pocket cost for care.

All Charges