Madison Medical Center

All Charges

Charge

Type

Setting

Price

ANTEPARTUM WITHOUT O.R. PROCEDURE

Facility

$7,893.74

Service Code	APR-DRG 5662
Min. Negotiated Rate	$7,893.74
Max. Negotiated Rate	$7,893.74
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,893.74
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,893.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,893.74
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,893.74

ANTEPARTUM WITHOUT O.R. PROCEDURE

Facility

$7,572.02

Service Code	APR-DRG 5661
Min. Negotiated Rate	$7,572.02
Max. Negotiated Rate	$7,572.02
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,572.02
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,572.02
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,572.02
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,572.02

ANTEPARTUM WITHOUT O.R. PROCEDURE

Facility

$11,476.04

Service Code	APR-DRG 5663
Min. Negotiated Rate	$11,476.04
Max. Negotiated Rate	$11,476.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$11,476.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11,476.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11,476.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11,476.04

ANTEPARTUM WITHOUT O.R. PROCEDURE

Facility

$23,414.68

Service Code	APR-DRG 5664
Min. Negotiated Rate	$23,414.68
Max. Negotiated Rate	$23,414.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$23,414.68
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23,414.68
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23,414.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23,414.68

ANTE-POST C-SECTION

Facility

$3,357.00

Service Code	CPT 59510
Hospital Charge Code	5259510
Hospital Revenue Code	521
Rate for Payer: Cash Price	$3,021.30

ANTE-POST C-SECTION

Facility

$3,357.00

Service Code	CPT 59510
Hospital Charge Code	5259510
Hospital Revenue Code	521
Min. Negotiated Rate	$173.53
Max. Negotiated Rate	$2,396.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,987.34
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$2,396.90
Rate for Payer: Cash Price	$3,021.30
Rate for Payer: Cash Price	$3,021.30
Rate for Payer: UnitedHealthcare Commercial	$2,239.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ANTIADRENAL ANTIBODIES

Facility

$196.00

Service Code	CPT 86255
Hospital Charge Code	2286259
Hospital Revenue Code	301
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$139.94
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	$116.03
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$139.94
Rate for Payer: Cash Price	$176.40
Rate for Payer: Cash Price	$176.40
Rate for Payer: Cash Price	$176.40
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	$70.56

ANTIADRENAL ANTIBODIES

Facility

$196.00

Service Code	CPT 86255
Hospital Charge Code	2286259
Hospital Revenue Code	301
Rate for Payer: Cash Price	$176.40

ANTIBODY SCREENING

Facility

$25.00

Service Code	CPT 86850
Hospital Charge Code	4286850
Hospital Revenue Code	521
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$46.98
Rate for Payer: Aetna Medicare Advantage	$9.77
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.85
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cigna Commercial HMO & PPO	$9.77
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$42.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$50.27
Rate for Payer: Home State Health Plan Medicare Advantage	$9.77
Rate for Payer: Humana Commercial	$19.54
Rate for Payer: Humana Medicare Advantage	$9.77
Rate for Payer: UnitedHealthcare Commercial	$16.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$46.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ANTIBODY SCREENING

Facility

$25.00

Service Code	CPT 86850
Hospital Charge Code	4286850
Hospital Revenue Code	521
Rate for Payer: Cash Price	$22.50

ANTI C1q IGG (RDL)

Facility

$201.00

Service Code	CPT 83516
Hospital Charge Code	2285320
Hospital Revenue Code	302
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$143.51
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.38
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$118.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$143.51
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cigna Commercial HMO & PPO	$11.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.38
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.11
Rate for Payer: Home State Health Plan Medicare Advantage	$11.53
Rate for Payer: Humana Commercial	$23.06
Rate for Payer: Humana Medicare Advantage	$11.53
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$72.36

ANTI C1q IGG (RDL)

Facility

$201.00

Service Code	CPT 83516
Hospital Charge Code	2285320
Hospital Revenue Code	302
Rate for Payer: Cash Price	$180.90

ANTICHROMATIN ANTIBODIES

Facility

$37.00

Service Code	CPT 86235
Hospital Charge Code	2286299
Hospital Revenue Code	302
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$35.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.14
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$26.42
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cigna Commercial HMO & PPO	$17.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.27
Rate for Payer: Home State Health Plan Medicare Advantage	$17.93
Rate for Payer: Humana Commercial	$35.86
Rate for Payer: Humana Medicare Advantage	$17.93
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.32

ANTICHROMATIN ANTIBODIES

Facility

$37.00

Service Code	CPT 86235
Hospital Charge Code	2286299
Hospital Revenue Code	302
Rate for Payer: Cash Price	$33.30

ANTI DNSA GROUP B STREP AB

Facility

$90.00

Service Code	CPT 86215
Hospital Charge Code	2286210
Hospital Revenue Code	305
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$64.26
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.93
Rate for Payer: Aetna Medicare Advantage	$13.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$53.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$64.26
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cash Price	$81.00
Rate for Payer: Cigna Commercial HMO & PPO	$13.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.93
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.77
Rate for Payer: Home State Health Plan Medicare Advantage	$13.25
Rate for Payer: Humana Commercial	$26.50
Rate for Payer: Humana Medicare Advantage	$13.25
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.40

ANTI DNSA GROUP B STREP AB

Facility

$90.00

Service Code	CPT 86215
Hospital Charge Code	2286210
Hospital Revenue Code	305
Rate for Payer: Cash Price	$81.00

ANTI-FOG MEDICHOICE

Facility

$39.00

Hospital Charge Code	126901
Hospital Revenue Code	271
Rate for Payer: Cash Price	$35.10

ANTI-FOG MEDICHOICE

Facility

$39.00

Hospital Charge Code	126901
Hospital Revenue Code	271
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$27.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$27.85
Rate for Payer: Cash Price	$35.10
Rate for Payer: UnitedHealthcare Commercial	$26.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.04

ANTIGEN COVID TEST

Facility

$126.00

Service Code	CPT 87426
Hospital Charge Code	9787426
Hospital Revenue Code	521
Rate for Payer: Cash Price	$113.40

ANTIGEN COVID TEST

Facility

$126.00

Service Code	CPT 87426
Hospital Charge Code	9787426
Hospital Revenue Code	521
Min. Negotiated Rate	$28.62
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$31.80
Rate for Payer: Aetna Medicare Advantage	$35.33
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: Cash Price	$113.40
Rate for Payer: Cash Price	$113.40
Rate for Payer: Cash Price	$113.40
Rate for Payer: Cigna Commercial HMO & PPO	$35.33
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28.62
Rate for Payer: Home State Health Plan Medicaid Managed Care	$34.03
Rate for Payer: Home State Health Plan Medicare Advantage	$35.33
Rate for Payer: Humana Commercial	$70.66
Rate for Payer: Humana Medicare Advantage	$35.33
Rate for Payer: UnitedHealthcare Commercial	$84.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ANTI-HMGCR AB

Facility

$356.00

Service Code	CPT 83520
Hospital Charge Code	2284005
Hospital Revenue Code	302
Rate for Payer: Cash Price	$320.40

ANTI-HMGCR AB

Facility

$356.00

Service Code	CPT 83520
Hospital Charge Code	2284005
Hospital Revenue Code	302
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$254.18
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.54
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$210.75
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$254.18
Rate for Payer: Cash Price	$320.40
Rate for Payer: Cash Price	$320.40
Rate for Payer: Cash Price	$320.40
Rate for Payer: Cigna Commercial HMO & PPO	$17.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.54
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.63
Rate for Payer: Home State Health Plan Medicare Advantage	$17.27
Rate for Payer: Humana Commercial	$34.54
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$128.16

ANTI-MOG

Facility

$946.00

Service Code	CPT 86255
Hospital Charge Code	2285000
Hospital Revenue Code	301
Rate for Payer: Cash Price	$851.40

ANTI-MOG

Facility

$946.00

Service Code	CPT 86255
Hospital Charge Code	2285000
Hospital Revenue Code	301
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$675.44
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	$560.03
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$675.44
Rate for Payer: Cash Price	$851.40
Rate for Payer: Cash Price	$851.40
Rate for Payer: Cash Price	$851.40
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	$340.56

ANTIMULLERIAN

Facility

$382.00

Service Code	CPT 82397
Hospital Charge Code	2203520
Hospital Revenue Code	301
Rate for Payer: Cash Price	$343.80

Know your out-of-pocket cost for care.

All Charges