Madison Medical Center

All Charges

Charge

Type

Setting

Price

ANA SCREEN, IFA PATTERN IF POS

Facility

$55.00

Service Code	CPT 86038
Hospital Charge Code	2286038
Hospital Revenue Code	302
Rate for Payer: Cash Price	$49.50

ANASTOMOSIS

Professional

Both

$3,581.00

Service Code	CPT 47760
Hospital Charge Code	4147760
Hospital Revenue Code	975
Min. Negotiated Rate	$1,253.35
Max. Negotiated Rate	$1,998.57
Rate for Payer: Cash Price	$3,222.90
Rate for Payer: Aetna Commercial/Medicare Advantage	$1,998.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$1,700.29
Rate for Payer: Cash Price	$3,222.90
Rate for Payer: Cigna Commercial HMO & PPO	$1,998.57
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$1,700.29
Rate for Payer: Home State Health Plan Medicaid Managed Care	$1,870.32
Rate for Payer: Home State Health Plan Medicare Advantage	$1,998.57
Rate for Payer: Optum Medicare Advantage	$1,253.35
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$1,700.29

ANASTROZOLE (ARIMIDEX) 1MG TAB EMP

Facility

$101.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2625586
Hospital Revenue Code	250
Min. Negotiated Rate	$36.36
Max. Negotiated Rate	$72.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.79
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$72.11
Rate for Payer: Cash Price	$90.90
Rate for Payer: UnitedHealthcare Commercial	$67.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.36

ANASTROZOLE (ARIMIDEX) 1MG TAB EMP

Facility

$101.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2625586
Hospital Revenue Code	250
Rate for Payer: Cash Price	$90.90

.ANA TITER

Facility

$142.00

Service Code	CPT 86039
Hospital Charge Code	2286039
Hospital Revenue Code	302
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$101.39
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.04
Rate for Payer: Aetna Medicare Advantage	$11.16
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$84.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$101.39
Rate for Payer: Cash Price	$127.80
Rate for Payer: Cash Price	$127.80
Rate for Payer: Cash Price	$127.80
Rate for Payer: Cigna Commercial HMO & PPO	$11.16
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10.74
Rate for Payer: Home State Health Plan Medicare Advantage	$11.16
Rate for Payer: Humana Commercial	$22.32
Rate for Payer: Humana Medicare Advantage	$11.16
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.12

.ANA TITER

Facility

$142.00

Service Code	CPT 86039
Hospital Charge Code	2286039
Hospital Revenue Code	302
Rate for Payer: Cash Price	$127.80

.ANCA-C

Facility

$100.00

Service Code	CPT 86021
Hospital Charge Code	2286001
Hospital Revenue Code	302
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$13.55
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$71.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cigna Commercial HMO & PPO	$15.05
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14.50
Rate for Payer: Home State Health Plan Medicare Advantage	$15.05
Rate for Payer: Humana Commercial	$30.10
Rate for Payer: Humana Medicare Advantage	$15.05
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

.ANCA-C

Facility

$100.00

Service Code	CPT 86021
Hospital Charge Code	2286001
Hospital Revenue Code	302
Rate for Payer: Cash Price	$90.00

.ANCA-P

Facility

$100.00

Service Code	CPT 86256
Hospital Charge Code	2286002
Hospital Revenue Code	302
Rate for Payer: Cash Price	$90.00

.ANCA-P

Facility

$100.00

Service Code	CPT 86256
Hospital Charge Code	2286002
Hospital Revenue Code	302
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.85
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$59.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$71.40
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cash Price	$90.00
Rate for Payer: Cigna Commercial HMO & PPO	$12.05
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.61
Rate for Payer: Home State Health Plan Medicare Advantage	$12.05
Rate for Payer: Humana Commercial	$24.10
Rate for Payer: Humana Medicare Advantage	$12.05
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

ANCA PROFILE

Facility

$32.00

Service Code	CPT 86021
Hospital Charge Code	2283521
Hospital Revenue Code	302
Rate for Payer: Cash Price	$28.80

ANCA PROFILE

Facility

$32.00

Service Code	CPT 86021
Hospital Charge Code	2283521
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$30.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$13.55
Rate for Payer: Aetna Medicare Advantage	$15.05
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: Cash Price	$28.80
Rate for Payer: Cash Price	$28.80
Rate for Payer: Cigna Commercial HMO & PPO	$15.05
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14.50
Rate for Payer: Home State Health Plan Medicare Advantage	$15.05
Rate for Payer: Humana Commercial	$30.10
Rate for Payer: Humana Medicare Advantage	$15.05
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.52

ANCHORAGE FIXATION PIN(STRYKER)

Facility

$762.00

Hospital Charge Code	123405
Hospital Revenue Code	271
Min. Negotiated Rate	$274.32
Max. Negotiated Rate	$544.07
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$451.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$544.07
Rate for Payer: Cash Price	$685.80
Rate for Payer: UnitedHealthcare Commercial	$508.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$274.32

ANCHORAGE FIXATION PIN(STRYKER)

Facility

$762.00

Hospital Charge Code	123405
Hospital Revenue Code	271
Rate for Payer: Cash Price	$685.80

ANCHORAGE REAMER(CP) (STRYKER)

Facility

$1,737.00

Hospital Charge Code	123404
Hospital Revenue Code	271
Rate for Payer: Cash Price	$1,563.30

ANCHORAGE REAMER(CP) (STRYKER)

Facility

$1,737.00

Hospital Charge Code	123404
Hospital Revenue Code	271
Min. Negotiated Rate	$625.32
Max. Negotiated Rate	$1,240.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,028.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,240.22
Rate for Payer: Cash Price	$1,563.30
Rate for Payer: UnitedHealthcare Commercial	$1,158.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$625.32

ANDEXANET ALFA COAG FCTR Xa RECOM INACT

Facility

$10,333.00

Service Code	NDC 310320004
Hospital Charge Code	2625915
Hospital Revenue Code	250
Rate for Payer: Cash Price	$9,299.70

ANDEXANET ALFA COAG FCTR Xa RECOM INACT

Facility

$10,333.00

Service Code	NDC 310320004
Hospital Charge Code	2625915
Hospital Revenue Code	250
Min. Negotiated Rate	$3,719.88
Max. Negotiated Rate	$7,377.76
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$6,117.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7,377.76
Rate for Payer: Cash Price	$9,299.70
Rate for Payer: UnitedHealthcare Commercial	$6,892.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,719.88

ANDROSTENEDIONE

Facility

$171.00

Service Code	CPT 82157
Hospital Charge Code	221950
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$122.09
Rate for Payer: Aetna Better Health Medicaid/QHP	$26.35
Rate for Payer: Aetna Medicare Advantage	$29.28
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: Cash Price	$153.90
Rate for Payer: Cash Price	$153.90
Rate for Payer: Cigna Commercial HMO & PPO	$29.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$26.35
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28.19
Rate for Payer: Home State Health Plan Medicare Advantage	$29.28
Rate for Payer: Humana Commercial	$58.56
Rate for Payer: Humana Medicare Advantage	$29.28
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$26.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.56

ANDROSTENEDIONE

Facility

$171.00

Service Code	CPT 82157
Hospital Charge Code	221950
Hospital Revenue Code	301
Rate for Payer: Cash Price	$153.90

ANESTHESIA 1ST 15 MIN

Facility

$165.00

Hospital Charge Code	2024460
Hospital Revenue Code	370
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$117.81
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: UnitedHealthcare Commercial	$110.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$59.40

ANESTHESIA 1ST 15 MIN

Facility

$165.00

Hospital Charge Code	2024460
Hospital Revenue Code	370
Rate for Payer: Cash Price	$148.50

ANESTHESIA CIRCUIT

Facility

$67.00

Hospital Charge Code	281271
Hospital Revenue Code	270
Min. Negotiated Rate	$24.12
Max. Negotiated Rate	$47.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$39.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$47.84
Rate for Payer: Cash Price	$60.30
Rate for Payer: UnitedHealthcare Commercial	$44.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

ANESTHESIA CIRCUIT

Facility

$67.00

Hospital Charge Code	281271
Hospital Revenue Code	270
Rate for Payer: Cash Price	$60.30

ANESTHESIA GAS MACHINE

Facility

$418.00

Hospital Charge Code	2824462
Hospital Revenue Code	370
Min. Negotiated Rate	$150.48
Max. Negotiated Rate	$298.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$247.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$298.45
Rate for Payer: Cash Price	$376.20
Rate for Payer: UnitedHealthcare Commercial	$278.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$150.48

Know your out-of-pocket cost for care.

All Charges