Madison Medical Center

All Charges

Charge

Type

Setting

Price

NEEDLE, SPINAL

Facility

$121.00

Hospital Charge Code	2814282
Hospital Revenue Code	271
Rate for Payer: Cash Price	$108.90

NEISSERIA GONORRHOEAE NAA

Facility

$159.00

Service Code	CPT 87591
Hospital Charge Code	308011
Hospital Revenue Code	306
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$113.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$31.58
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$94.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$113.53
Rate for Payer: Cash Price	$143.10
Rate for Payer: Cash Price	$143.10
Rate for Payer: Cash Price	$143.10
Rate for Payer: Cigna Commercial HMO & PPO	$35.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33.79
Rate for Payer: Home State Health Plan Medicare Advantage	$35.09
Rate for Payer: Humana Commercial	$70.18
Rate for Payer: Humana Medicare Advantage	$35.09
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.24

NEISSERIA GONORRHOEAE NAA

Facility

$159.00

Service Code	CPT 87591
Hospital Charge Code	308011
Hospital Revenue Code	306
Rate for Payer: Cash Price	$143.10

NEONATAL AFTERCARE

Facility

$43,119.10

Service Code	APR-DRG 8632
Min. Negotiated Rate	$43,119.10
Max. Negotiated Rate	$43,119.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$43,119.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$43,119.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$43,119.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$43,119.10

NEONATAL AFTERCARE

Facility

$86,401.66

Service Code	APR-DRG 8633
Min. Negotiated Rate	$86,401.66
Max. Negotiated Rate	$86,401.66
Rate for Payer: Aetna Better Health Medicaid/QHP	$86,401.66
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$86,401.66
Rate for Payer: Home State Health Plan Medicaid Managed Care	$86,401.66
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$86,401.66

NEONATAL AFTERCARE

Facility

$18,622.86

Service Code	APR-DRG 8631
Min. Negotiated Rate	$18,622.86
Max. Negotiated Rate	$18,622.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$18,622.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$18,622.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18,622.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$18,622.86

NEONATAL AFTERCARE

Facility

$186,646.70

Service Code	APR-DRG 8634
Min. Negotiated Rate	$186,646.70
Max. Negotiated Rate	$186,646.70
Rate for Payer: Aetna Better Health Medicaid/QHP	$186,646.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$186,646.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$186,646.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$186,646.70

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$108,603.25

Service Code	APR-DRG 6033
Min. Negotiated Rate	$108,603.25
Max. Negotiated Rate	$108,603.25
Rate for Payer: Aetna Better Health Medicaid/QHP	$108,603.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$108,603.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$108,603.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$108,603.25

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$225,564.70

Service Code	APR-DRG 6034
Min. Negotiated Rate	$225,564.70
Max. Negotiated Rate	$225,564.70
Rate for Payer: Aetna Better Health Medicaid/QHP	$225,564.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$225,564.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$225,564.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$225,564.70

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$108,603.25

Service Code	APR-DRG 6032
Min. Negotiated Rate	$108,603.25
Max. Negotiated Rate	$108,603.25
Rate for Payer: Aetna Better Health Medicaid/QHP	$108,603.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$108,603.25
Rate for Payer: Home State Health Plan Medicaid Managed Care	$108,603.25
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$108,603.25

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$5,329.57

Service Code	APR-DRG 6031
Min. Negotiated Rate	$5,329.57
Max. Negotiated Rate	$5,329.57
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,329.57
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,329.57
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,329.57
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,329.57

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$142,081.65

Service Code	APR-DRG 6022
Min. Negotiated Rate	$142,081.65
Max. Negotiated Rate	$142,081.65
Rate for Payer: Aetna Better Health Medicaid/QHP	$142,081.65
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$142,081.65
Rate for Payer: Home State Health Plan Medicaid Managed Care	$142,081.65
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$142,081.65

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$118,921.34

Service Code	APR-DRG 6021
Min. Negotiated Rate	$118,921.34
Max. Negotiated Rate	$118,921.34
Rate for Payer: Aetna Better Health Medicaid/QHP	$118,921.34
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$118,921.34
Rate for Payer: Home State Health Plan Medicaid Managed Care	$118,921.34
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$118,921.34

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$243,260.27

Service Code	APR-DRG 6024
Min. Negotiated Rate	$243,260.27
Max. Negotiated Rate	$243,260.27
Rate for Payer: Aetna Better Health Medicaid/QHP	$243,260.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$243,260.27
Rate for Payer: Home State Health Plan Medicaid Managed Care	$243,260.27
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$243,260.27

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$218,903.91

Service Code	APR-DRG 6023
Min. Negotiated Rate	$218,903.91
Max. Negotiated Rate	$218,903.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$218,903.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$218,903.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$218,903.91
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$218,903.91

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$113,681.35

Service Code	APR-DRG 6084
Min. Negotiated Rate	$113,681.35
Max. Negotiated Rate	$113,681.35
Rate for Payer: Aetna Better Health Medicaid/QHP	$113,681.35
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$113,681.35
Rate for Payer: Home State Health Plan Medicaid Managed Care	$113,681.35
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$113,681.35

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$79,088.63

Service Code	APR-DRG 6082
Min. Negotiated Rate	$79,088.63
Max. Negotiated Rate	$79,088.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$79,088.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$79,088.63
Rate for Payer: Home State Health Plan Medicaid Managed Care	$79,088.63
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$79,088.63

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$56,190.79

Service Code	APR-DRG 6081
Min. Negotiated Rate	$56,190.79
Max. Negotiated Rate	$56,190.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$56,190.79
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$56,190.79
Rate for Payer: Home State Health Plan Medicaid Managed Care	$56,190.79
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$56,190.79

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$113,681.35

Service Code	APR-DRG 6083
Min. Negotiated Rate	$113,681.35
Max. Negotiated Rate	$113,681.35
Rate for Payer: Aetna Better Health Medicaid/QHP	$113,681.35
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$113,681.35
Rate for Payer: Home State Health Plan Medicaid Managed Care	$113,681.35
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$113,681.35

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$84,932.14

Service Code	APR-DRG 6071
Min. Negotiated Rate	$84,932.14
Max. Negotiated Rate	$84,932.14
Rate for Payer: Aetna Better Health Medicaid/QHP	$84,932.14
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$84,932.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$84,932.14
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$84,932.14

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$170,236.77

Service Code	APR-DRG 6073
Min. Negotiated Rate	$170,236.77
Max. Negotiated Rate	$170,236.77
Rate for Payer: Aetna Better Health Medicaid/QHP	$170,236.77
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$170,236.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$170,236.77
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$170,236.77

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$232,681.28

Service Code	APR-DRG 6074
Min. Negotiated Rate	$232,681.28
Max. Negotiated Rate	$232,681.28
Rate for Payer: Aetna Better Health Medicaid/QHP	$232,681.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$232,681.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$232,681.28
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$232,681.28

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$99,694.95

Service Code	APR-DRG 6072
Min. Negotiated Rate	$99,694.95
Max. Negotiated Rate	$99,694.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$99,694.95
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$99,694.95
Rate for Payer: Home State Health Plan Medicaid Managed Care	$99,694.95
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$99,694.95

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$31,336.20

Service Code	APR-DRG 6131
Min. Negotiated Rate	$31,336.20
Max. Negotiated Rate	$31,336.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$31,336.20
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31,336.20
Rate for Payer: Home State Health Plan Medicaid Managed Care	$31,336.20
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31,336.20

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$50,584.59

Service Code	APR-DRG 6132
Min. Negotiated Rate	$50,584.59
Max. Negotiated Rate	$50,584.59
Rate for Payer: Aetna Better Health Medicaid/QHP	$50,584.59
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$50,584.59
Rate for Payer: Home State Health Plan Medicaid Managed Care	$50,584.59
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$50,584.59

Know your out-of-pocket cost for care.

All Charges