Madison Medical Center

All Charges

Charge

Type

Setting

Price

METOPROLOL TART 50MG TAB EMP

Facility

$126.00

Service Code	NDC 5.7664E+10
Hospital Charge Code	2618976
Hospital Revenue Code	250
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$89.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$74.59
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$89.96
Rate for Payer: Cash Price	$113.40
Rate for Payer: UnitedHealthcare Commercial	$84.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$45.36

METOPROLOL TART 50MG TAB (LOPRESSOR) UD

Facility

$19.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2697861
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

METOPROLOL TART 50MG TAB (LOPRESSOR) UD

Facility

$19.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2697861
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

METRONIDAZOLE 0.75% CRM 45GM EMP

Facility

$32.00

Service Code	NDC 299383645
Hospital Charge Code	2622381
Hospital Revenue Code	250
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$22.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$18.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$22.85
Rate for Payer: Cash Price	$28.80
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.52

METRONIDAZOLE 0.75% CRM 45GM EMP

Facility

$32.00

Service Code	NDC 299383645
Hospital Charge Code	2622381
Hospital Revenue Code	250
Rate for Payer: Cash Price	$28.80

METRONIDAZOLE 0.75% GEL 45GM EMP

Facility

$32.00

Service Code	NDC 6.6993E+10
Hospital Charge Code	2622797
Hospital Revenue Code	250
Rate for Payer: Cash Price	$28.80

METRONIDAZOLE 0.75% GEL 45GM EMP

Facility

$32.00

Service Code	NDC 6.6993E+10
Hospital Charge Code	2622797
Hospital Revenue Code	250
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$22.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$18.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$22.85
Rate for Payer: Cash Price	$28.80
Rate for Payer: UnitedHealthcare Commercial	$21.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.52

METRONIDAZOLE 1% 60 GM GEL EMP

Facility

$168.00

Service Code	NDC 299382060
Hospital Charge Code	2623089
Hospital Revenue Code	250
Rate for Payer: Cash Price	$151.20

METRONIDAZOLE 1% 60 GM GEL EMP

Facility

$168.00

Service Code	NDC 299382060
Hospital Charge Code	2623089
Hospital Revenue Code	250
Min. Negotiated Rate	$60.48
Max. Negotiated Rate	$119.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$99.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$119.95
Rate for Payer: Cash Price	$151.20
Rate for Payer: UnitedHealthcare Commercial	$112.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.48

METRONIDAZOLE 500MG PREMIX 100ML BAG

Facility

$147.00

Service Code	NDC 338105548
Hospital Charge Code	2655575
Hospital Revenue Code	250
Rate for Payer: Cash Price	$132.30

METRONIDAZOLE 500MG PREMIX 100ML BAG

Facility

$147.00

Service Code	NDC 338105548
Hospital Charge Code	2655575
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

METRONIDAZOLE 500MG TAB

Facility

$20.00

Service Code	NDC 6.0687E+10
Hospital Charge Code	2655571
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

METRONIDAZOLE 500MG TAB

Facility

$20.00

Service Code	NDC 6.0687E+10
Hospital Charge Code	2655571
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METRONIDAZOLE 500MG TAB EMP

Facility

$20.00

Service Code	NDC 2.3155E+10
Hospital Charge Code	2624119
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

METRONIDAZOLE 500MG TAB EMP

Facility

$20.00

Service Code	NDC 2.3155E+10
Hospital Charge Code	2624119
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METRONIDAZOLE (FLAGYL) 250MG TAB

Facility

$20.00

Hospital Charge Code	2655570
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

METRONIDAZOLE (FLAGYL) 250MG TAB

Facility

$20.00

Hospital Charge Code	2655570
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

METRONIDAZOLE VAG 0.75% GEL 70GM EMP

Facility

$30.00

Service Code	NDC 6.8682E+10
Hospital Charge Code	2623537
Hospital Revenue Code	250
Rate for Payer: Cash Price	$27.00

METRONIDAZOLE VAG 0.75% GEL 70GM EMP

Facility

$30.00

Service Code	NDC 6.8682E+10
Hospital Charge Code	2623537
Hospital Revenue Code	250
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$21.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$17.76
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$21.42
Rate for Payer: Cash Price	$27.00
Rate for Payer: UnitedHealthcare Commercial	$20.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80

MEXILETINE 150MG CAP EMP

Facility

$21.00

Service Code	NDC 6.2559E+10
Hospital Charge Code	2625545
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

MEXILETINE 150MG CAP EMP

Facility

$21.00

Service Code	NDC 6.2559E+10
Hospital Charge Code	2625545
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

MIBACURIUM INJ.

Facility

$121.00

Hospital Charge Code	2058063
Hospital Revenue Code	370
Rate for Payer: Cash Price	$108.90

MIBACURIUM INJ.

Facility

$121.00

Hospital Charge Code	2058063
Hospital Revenue Code	370
Min. Negotiated Rate	$43.56
Max. Negotiated Rate	$86.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$71.63
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$86.39
Rate for Payer: Cash Price	$108.90
Rate for Payer: UnitedHealthcare Commercial	$80.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$43.56

MICAFUNGIN 100MG IVPB

Facility

$1,106.00

Service Code	NDC 8290305200
Hospital Charge Code	2619330
Hospital Revenue Code	250
Min. Negotiated Rate	$398.16
Max. Negotiated Rate	$789.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$654.75
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$789.68
Rate for Payer: Cash Price	$995.40
Rate for Payer: UnitedHealthcare Commercial	$737.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$398.16

MICAFUNGIN 100MG IVPB

Facility

$1,106.00

Service Code	NDC 8290305200
Hospital Charge Code	2619330
Hospital Revenue Code	250
Rate for Payer: Cash Price	$995.40

Know your out-of-pocket cost for care.

All Charges