Madison Medical Center

All Charges

Charge

Type

Setting

Price

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$15,609.58

Service Code	APR-DRG 3231
Min. Negotiated Rate	$15,609.58
Max. Negotiated Rate	$15,609.58
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,609.58
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,609.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,609.58
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,609.58

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$27,448.97

Service Code	APR-DRG 3233
Min. Negotiated Rate	$27,448.97
Max. Negotiated Rate	$27,448.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,448.97
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,448.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,448.97
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,448.97

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$44,853.04

Service Code	APR-DRG 3254
Min. Negotiated Rate	$44,853.04
Max. Negotiated Rate	$44,853.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$44,853.04
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$44,853.04
Rate for Payer: Home State Health Plan Medicaid Managed Care	$44,853.04
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$44,853.04

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$23,931.17

Service Code	APR-DRG 3251
Min. Negotiated Rate	$23,931.17
Max. Negotiated Rate	$23,931.17
Rate for Payer: Aetna Better Health Medicaid/QHP	$23,931.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23,931.17
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23,931.17
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23,931.17

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$27,044.95

Service Code	APR-DRG 3252
Min. Negotiated Rate	$27,044.95
Max. Negotiated Rate	$27,044.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,044.95
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,044.95
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,044.95
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,044.95

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$30,745.80

Service Code	APR-DRG 3253
Min. Negotiated Rate	$30,745.80
Max. Negotiated Rate	$30,745.80
Rate for Payer: Aetna Better Health Medicaid/QHP	$30,745.80
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$30,745.80
Rate for Payer: Home State Health Plan Medicaid Managed Care	$30,745.80
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$30,745.80

NON-EXTENSIVE BURNS

Facility

$35,944.64

Service Code	MSDRG 935
Min. Negotiated Rate	$17,972.32
Max. Negotiated Rate	$35,944.64
Rate for Payer: Aetna Medicare Advantage	$17,972.32
Rate for Payer: Cigna Commercial HMO & PPO	$17,972.32
Rate for Payer: Home State Health Plan Medicare Advantage	$17,972.32
Rate for Payer: Humana Commercial	$35,944.64
Rate for Payer: Humana Medicare Advantage	$17,972.32

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$13,193.81

Service Code	APR-DRG 7942
Min. Negotiated Rate	$13,193.81
Max. Negotiated Rate	$13,193.81
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,193.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,193.81
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,193.81
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,193.81

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$37,905.28

Service Code	APR-DRG 7944
Min. Negotiated Rate	$37,905.28
Max. Negotiated Rate	$37,905.28
Rate for Payer: Aetna Better Health Medicaid/QHP	$37,905.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$37,905.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$37,905.28
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$37,905.28

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$10,202.07

Service Code	APR-DRG 7941
Min. Negotiated Rate	$10,202.07
Max. Negotiated Rate	$10,202.07
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,202.07
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,202.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,202.07
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,202.07

NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$22,549.94

Service Code	APR-DRG 7943
Min. Negotiated Rate	$22,549.94
Max. Negotiated Rate	$22,549.94
Rate for Payer: Aetna Better Health Medicaid/QHP	$22,549.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22,549.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22,549.94
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22,549.94

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$29,384.76

Service Code	MSDRG 988
Min. Negotiated Rate	$14,692.38
Max. Negotiated Rate	$29,384.76
Rate for Payer: Aetna Medicare Advantage	$14,692.38
Rate for Payer: Cigna Commercial HMO & PPO	$14,692.38
Rate for Payer: Home State Health Plan Medicare Advantage	$14,692.38
Rate for Payer: Humana Commercial	$29,384.76
Rate for Payer: Humana Medicare Advantage	$14,692.38

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$57,569.62

Service Code	MSDRG 987
Min. Negotiated Rate	$28,784.81
Max. Negotiated Rate	$57,569.62
Rate for Payer: Aetna Medicare Advantage	$28,784.81
Rate for Payer: Cigna Commercial HMO & PPO	$28,784.81
Rate for Payer: Home State Health Plan Medicare Advantage	$28,784.81
Rate for Payer: Humana Commercial	$57,569.62
Rate for Payer: Humana Medicare Advantage	$28,784.81

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$22,411.24

Service Code	MSDRG 989
Min. Negotiated Rate	$11,205.62
Max. Negotiated Rate	$22,411.24
Rate for Payer: Aetna Medicare Advantage	$11,205.62
Rate for Payer: Cigna Commercial HMO & PPO	$11,205.62
Rate for Payer: Home State Health Plan Medicare Advantage	$11,205.62
Rate for Payer: Humana Commercial	$22,411.24
Rate for Payer: Humana Medicare Advantage	$11,205.62

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$47,303.01

Service Code	APR-DRG 9524
Min. Negotiated Rate	$47,303.01
Max. Negotiated Rate	$47,303.01
Rate for Payer: Aetna Better Health Medicaid/QHP	$47,303.01
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$47,303.01
Rate for Payer: Home State Health Plan Medicaid Managed Care	$47,303.01
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$47,303.01

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$13,031.10

Service Code	APR-DRG 9522
Min. Negotiated Rate	$13,031.10
Max. Negotiated Rate	$13,031.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$13,031.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13,031.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$13,031.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13,031.10

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$11,160.79

Service Code	APR-DRG 9521
Min. Negotiated Rate	$11,160.79
Max. Negotiated Rate	$11,160.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$11,160.79
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11,160.79
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11,160.79
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11,160.79

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$24,304.68

Service Code	APR-DRG 9523
Min. Negotiated Rate	$24,304.68
Max. Negotiated Rate	$24,304.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,304.68
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,304.68
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,304.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,304.68

NON GYN PREP

Facility

$67.00

Service Code	CPT 88104
Hospital Charge Code	2288105
Hospital Revenue Code	305
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$76.32
Rate for Payer: Aetna Better Health Medicaid/QHP	$33.67
Rate for Payer: Aetna Medicare Advantage	$38.16
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: Cash Price	$60.30
Rate for Payer: Cash Price	$60.30
Rate for Payer: Cigna Commercial HMO & PPO	$38.16
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33.67
Rate for Payer: Home State Health Plan Medicaid Managed Care	$36.03
Rate for Payer: Home State Health Plan Medicare Advantage	$38.16
Rate for Payer: Humana Commercial	$76.32
Rate for Payer: Humana Medicare Advantage	$38.16
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

NON GYN PREP

Facility

$67.00

Service Code	CPT 88104
Hospital Charge Code	2288105
Hospital Revenue Code	305
Rate for Payer: Cash Price	$60.30

NON GYN SMEAR

Facility

$63.00

Service Code	CPT 88160
Hospital Charge Code	2288160
Hospital Revenue Code	307
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$59.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$26.07
Rate for Payer: Aetna Medicare Advantage	$29.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$37.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$44.98
Rate for Payer: Cash Price	$56.70
Rate for Payer: Cash Price	$56.70
Rate for Payer: Cash Price	$56.70
Rate for Payer: Cigna Commercial HMO & PPO	$29.55
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$26.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27.89
Rate for Payer: Home State Health Plan Medicare Advantage	$29.55
Rate for Payer: Humana Commercial	$59.10
Rate for Payer: Humana Medicare Advantage	$29.55
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$26.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.68

NON GYN SMEAR

Facility

$63.00

Service Code	CPT 88160
Hospital Charge Code	2288160
Hospital Revenue Code	307
Rate for Payer: Cash Price	$56.70

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$15,892.32

Service Code	APR-DRG 4263
Min. Negotiated Rate	$15,892.32
Max. Negotiated Rate	$15,892.32
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,892.32
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,892.32
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,892.32
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,892.32

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$5,750.40

Service Code	APR-DRG 4261
Min. Negotiated Rate	$5,750.40
Max. Negotiated Rate	$5,750.40
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,750.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,750.40
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,750.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,750.40

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$24,274.48

Service Code	APR-DRG 4264
Min. Negotiated Rate	$24,274.48
Max. Negotiated Rate	$24,274.48
Rate for Payer: Aetna Better Health Medicaid/QHP	$24,274.48
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24,274.48
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24,274.48
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24,274.48

Know your out-of-pocket cost for care.

All Charges