Madison Medical Center

All Charges

Charge

Type

Setting

Price

ARM WITH TAB

Facility

$159.00

Hospital Charge Code	1220726
Hospital Revenue Code	272
Rate for Payer: Cash Price	$143.10

ARM WITH TAB

Facility

$159.00

Hospital Charge Code	1220726
Hospital Revenue Code	272
Min. Negotiated Rate	$57.24
Max. Negotiated Rate	$113.53
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: UnitedHealthcare Commercial	$106.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.24

ARSENIC

Facility

$152.00

Service Code	CPT 82175
Hospital Charge Code	2282175
Hospital Revenue Code	301
Min. Negotiated Rate	$17.07
Max. Negotiated Rate	$108.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$17.07
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$89.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$108.53
Rate for Payer: Cash Price	$136.80
Rate for Payer: Cash Price	$136.80
Rate for Payer: Cash Price	$136.80
Rate for Payer: Cigna Commercial HMO & PPO	$18.97
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18.26
Rate for Payer: Home State Health Plan Medicare Advantage	$18.97
Rate for Payer: Humana Commercial	$37.94
Rate for Payer: Humana Medicare Advantage	$18.97
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$54.72

ARSENIC

Facility

$152.00

Service Code	CPT 82175
Hospital Charge Code	2282175
Hospital Revenue Code	301
Rate for Payer: Cash Price	$136.80

ARTERIAL PUNCTURE

Facility

$201.00

Service Code	CPT 36600
Hospital Charge Code	2236600
Hospital Revenue Code	300
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$271.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$119.94
Rate for Payer: Aetna Medicare Advantage	$135.93
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	$135.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$119.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$128.34
Rate for Payer: Home State Health Plan Medicare Advantage	$135.93
Rate for Payer: Humana Commercial	$271.86
Rate for Payer: Humana Medicare Advantage	$135.93
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$119.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$72.36

ARTERIAL PUNCTURE

Facility

$201.00

Service Code	CPT 36600
Hospital Charge Code	2236600
Hospital Revenue Code	300
Rate for Payer: Cash Price	$180.90

ARTERIAL PUNCTURE FOR DIAGNOSI

Professional

Both

$217.00

Service Code	CPT 36600
Hospital Charge Code	1836600
Hospital Revenue Code	981
Min. Negotiated Rate	$12.73
Max. Negotiated Rate	$75.95
Rate for Payer: Aetna Commercial/Medicare Advantage	$12.73
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$21.64
Rate for Payer: Cash Price	$195.30
Rate for Payer: Cash Price	$195.30
Rate for Payer: Cigna Commercial HMO & PPO	$12.73
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21.64
Rate for Payer: Home State Health Plan Medicaid Managed Care	$23.80
Rate for Payer: Home State Health Plan Medicare Advantage	$12.73
Rate for Payer: Optum Medicare Advantage	$75.95
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21.64

ARTERIOGRAM TRAY

Facility

$199.00

Hospital Charge Code	281037
Hospital Revenue Code	271
Rate for Payer: Cash Price	$179.10

ARTERIOGRAM TRAY

Facility

$199.00

Hospital Charge Code	281037
Hospital Revenue Code	271
Min. Negotiated Rate	$71.64
Max. Negotiated Rate	$142.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$117.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$142.09
Rate for Payer: Cash Price	$179.10
Rate for Payer: UnitedHealthcare Commercial	$132.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$71.64

ARTHROCENTESIS,ASP, AND/OR INJ MAJOR JOI

Facility

$285.00

Service Code	CPT 20610
Hospital Charge Code	9320610
Hospital Revenue Code	521
Min. Negotiated Rate	$168.72
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$168.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$203.49
Rate for Payer: Cash Price	$256.50
Rate for Payer: Cash Price	$256.50
Rate for Payer: Cash Price	$256.50
Rate for Payer: Cash Price	$256.50
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$249.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$190.09
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ARTHROCENTESIS,ASP, AND/OR INJ MAJOR JOI

Facility

$285.00

Service Code	CPT 20610
Hospital Charge Code	9320610
Hospital Revenue Code	521
Rate for Payer: Cash Price	$256.50

ARTHROCENTESIS ASPERATION/INJ.

Professional

Both

$370.00

Service Code	CPT 20605
Hospital Charge Code	1820605
Hospital Revenue Code	981
Min. Negotiated Rate	$30.98
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial/Medicare Advantage	$30.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$41.26
Rate for Payer: Cash Price	$333.00
Rate for Payer: Cash Price	$333.00
Rate for Payer: Cigna Commercial HMO & PPO	$30.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$41.26
Rate for Payer: Home State Health Plan Medicaid Managed Care	$45.39
Rate for Payer: Home State Health Plan Medicare Advantage	$30.98
Rate for Payer: Optum Medicare Advantage	$129.50
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$41.26

Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance

Facility

$627.20

Service Code	CPT 20610
Hospital Revenue Code	360
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$276.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$135.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70

Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance

Facility

$627.20

Service Code	CPT 20610
Hospital Revenue Code	490
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$276.70
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$135.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70

ARTHROCENTESIS ASPIRATION INJ WRIST ELB

Facility

$205.00

Service Code	CPT 20605
Hospital Charge Code	9320605
Hospital Revenue Code	521
Rate for Payer: Cash Price	$184.50

ARTHROCENTESIS ASPIRATION INJ WRIST ELB

Facility

$205.00

Service Code	CPT 20605
Hospital Charge Code	9320605
Hospital Revenue Code	521
Min. Negotiated Rate	$121.36
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$121.36
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$146.37
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$249.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$136.74
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ARTHROCENTESIS, ASPIR/INJ INTERMED JOINT

Facility

$205.00

Service Code	CPT 20605
Hospital Charge Code	4120605
Hospital Revenue Code	521
Rate for Payer: Cash Price	$184.50

ARTHROCENTESIS, ASPIR/INJ INTERMED JOINT

Facility

$205.00

Service Code	CPT 20605
Hospital Charge Code	4120605
Hospital Revenue Code	521
Min. Negotiated Rate	$121.36
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$121.36
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$146.37
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cash Price	$184.50
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$249.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$136.74
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ARTHROCENTESIS, ASPIR/INJ SMALL JOINT

Facility

$190.00

Service Code	CPT 20600
Hospital Charge Code	4120600
Hospital Revenue Code	521
Min. Negotiated Rate	$112.48
Max. Negotiated Rate	$627.20
Rate for Payer: Aetna Better Health Medicaid/QHP	$276.70
Rate for Payer: Aetna Medicare Advantage	$313.60
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$112.48
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$135.66
Rate for Payer: Cash Price	$171.00
Rate for Payer: Cash Price	$171.00
Rate for Payer: Cash Price	$171.00
Rate for Payer: Cash Price	$171.00
Rate for Payer: Cigna Commercial HMO & PPO	$313.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$249.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$296.07
Rate for Payer: Home State Health Plan Medicare Advantage	$313.60
Rate for Payer: Humana Commercial	$627.20
Rate for Payer: Humana Medicare Advantage	$313.60
Rate for Payer: UnitedHealthcare Commercial	$126.73
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$276.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

ARTHROCENTESIS, ASPIR/INJ SMALL JOINT

Facility

$190.00

Service Code	CPT 20600
Hospital Charge Code	4120600
Hospital Revenue Code	521
Rate for Payer: Cash Price	$171.00

ARTHROCENTESIS LG ASPIR/INJ

Professional

Both

$487.00

Service Code	CPT 20610
Hospital Charge Code	1820610
Hospital Revenue Code	981
Min. Negotiated Rate	$38.30
Max. Negotiated Rate	$170.45
Rate for Payer: Aetna Commercial/Medicare Advantage	$38.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$48.86
Rate for Payer: Cash Price	$438.30
Rate for Payer: Cash Price	$438.30
Rate for Payer: Cigna Commercial HMO & PPO	$38.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$48.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$53.75
Rate for Payer: Home State Health Plan Medicare Advantage	$38.30
Rate for Payer: Optum Medicare Advantage	$170.45
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$48.86

ARTHROGRAM HIP LT

Facility

$661.00

Service Code	CPT 73525
Hospital Charge Code	3273526
Hospital Revenue Code	320
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$712.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$314.49
Rate for Payer: Aetna Medicare Advantage	$356.43
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$391.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$471.95
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cigna Commercial HMO & PPO	$356.43
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$314.49
Rate for Payer: Home State Health Plan Medicaid Managed Care	$336.50
Rate for Payer: Home State Health Plan Medicare Advantage	$356.43
Rate for Payer: Humana Commercial	$712.86
Rate for Payer: Humana Medicare Advantage	$356.43
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$314.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.96

ARTHROGRAM HIP LT

Facility

$661.00

Service Code	CPT 73525
Hospital Charge Code	3273526
Hospital Revenue Code	320
Rate for Payer: Cash Price	$594.90

ARTHROGRAM HIP RT

Facility

$661.00

Service Code	CPT 73525
Hospital Charge Code	3273525
Hospital Revenue Code	320
Rate for Payer: Cash Price	$594.90

ARTHROGRAM HIP RT

Facility

$661.00

Service Code	CPT 73525
Hospital Charge Code	3273525
Hospital Revenue Code	320
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$712.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$314.49
Rate for Payer: Aetna Medicare Advantage	$356.43
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$391.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$471.95
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cash Price	$594.90
Rate for Payer: Cigna Commercial HMO & PPO	$356.43
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$314.49
Rate for Payer: Home State Health Plan Medicaid Managed Care	$336.50
Rate for Payer: Home State Health Plan Medicare Advantage	$356.43
Rate for Payer: Humana Commercial	$712.86
Rate for Payer: Humana Medicare Advantage	$356.43
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$314.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.96

Know your out-of-pocket cost for care.

All Charges