Madison Medical Center

All Charges

Charge

Type

Setting

Price

PARICALCITOL (ZEMPLAR) 2MCG/ML INJ

Facility

$58.00

Service Code	NDC 8290305200
Hospital Charge Code	2619449
Hospital Revenue Code	250
Min. Negotiated Rate	$20.88
Max. Negotiated Rate	$41.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$34.34
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$41.41
Rate for Payer: Cash Price	$52.20
Rate for Payer: UnitedHealthcare Commercial	$38.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.88

PARIETAL AB

Facility

$208.00

Service Code	CPT 83516
Hospital Charge Code	2286200
Hospital Revenue Code	301
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$148.51
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	$123.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$148.51
Rate for Payer: Cash Price	$187.20
Rate for Payer: Cash Price	$187.20
Rate for Payer: Cash Price	$187.20
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	$74.88

PARIETAL AB

Facility

$208.00

Service Code	CPT 83516
Hospital Charge Code	2286200
Hospital Revenue Code	301
Rate for Payer: Cash Price	$187.20

PARING/CUTTING OF BENIGN HYPERKERATOTIC

Facility

$105.00

Service Code	CPT 11055
Hospital Charge Code	9311055
Hospital Revenue Code	521
Rate for Payer: Cash Price	$94.50

PARING/CUTTING OF BENIGN HYPERKERATOTIC

Facility

$105.00

Service Code	CPT 11055
Hospital Charge Code	9311055
Hospital Revenue Code	521
Min. Negotiated Rate	$62.16
Max. Negotiated Rate	$409.96
Rate for Payer: Aetna Better Health Medicaid/QHP	$180.86
Rate for Payer: Aetna Medicare Advantage	$204.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$62.16
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$74.97
Rate for Payer: Cash Price	$94.50
Rate for Payer: Cash Price	$94.50
Rate for Payer: Cash Price	$94.50
Rate for Payer: Cash Price	$94.50
Rate for Payer: Cigna Commercial HMO & PPO	$204.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$162.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$193.52
Rate for Payer: Home State Health Plan Medicare Advantage	$204.98
Rate for Payer: Humana Commercial	$409.96
Rate for Payer: Humana Medicare Advantage	$204.98
Rate for Payer: UnitedHealthcare Commercial	$70.03
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$180.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

PARING OR CUTTING 2-5

Facility

$100.00

Service Code	CPT 11056
Hospital Charge Code	9811056
Hospital Revenue Code	521
Rate for Payer: Cash Price	$90.00

PARING OR CUTTING 2-5

Facility

$100.00

Service Code	CPT 11056
Hospital Charge Code	9811056
Hospital Revenue Code	521
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$409.96
Rate for Payer: Aetna Better Health Medicaid/QHP	$180.86
Rate for Payer: Aetna Medicare Advantage	$204.98
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: Cash Price	$90.00
Rate for Payer: Cigna Commercial HMO & PPO	$204.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$162.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$193.52
Rate for Payer: Home State Health Plan Medicare Advantage	$204.98
Rate for Payer: Humana Commercial	$409.96
Rate for Payer: Humana Medicare Advantage	$204.98
Rate for Payer: UnitedHealthcare Commercial	$66.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$180.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

PARING OR CUTTING BEN HYPERKER LESION

Facility

$70.00

Service Code	CPT 11055
Hospital Charge Code	9811055
Hospital Revenue Code	521
Rate for Payer: Cash Price	$63.00

PARING OR CUTTING BEN HYPERKER LESION

Facility

$70.00

Service Code	CPT 11055
Hospital Charge Code	9811055
Hospital Revenue Code	521
Min. Negotiated Rate	$41.44
Max. Negotiated Rate	$409.96
Rate for Payer: Aetna Better Health Medicaid/QHP	$180.86
Rate for Payer: Aetna Medicare Advantage	$204.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$41.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$49.98
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cigna Commercial HMO & PPO	$204.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$162.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$193.52
Rate for Payer: Home State Health Plan Medicare Advantage	$204.98
Rate for Payer: Humana Commercial	$409.96
Rate for Payer: Humana Medicare Advantage	$204.98
Rate for Payer: UnitedHealthcare Commercial	$46.69
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$180.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

PARING OR CUTTING OF CORNS

Facility

$70.00

Service Code	CPT 11055
Hospital Charge Code	3911055
Hospital Revenue Code	521
Min. Negotiated Rate	$41.44
Max. Negotiated Rate	$409.96
Rate for Payer: Aetna Better Health Medicaid/QHP	$180.86
Rate for Payer: Aetna Medicare Advantage	$204.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$41.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$49.98
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cash Price	$63.00
Rate for Payer: Cigna Commercial HMO & PPO	$204.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$162.77
Rate for Payer: Home State Health Plan Medicaid Managed Care	$193.52
Rate for Payer: Home State Health Plan Medicare Advantage	$204.98
Rate for Payer: Humana Commercial	$409.96
Rate for Payer: Humana Medicare Advantage	$204.98
Rate for Payer: UnitedHealthcare Commercial	$46.69
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$180.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

PARING OR CUTTING OF CORNS

Facility

$70.00

Service Code	CPT 11055
Hospital Charge Code	3911055
Hospital Revenue Code	521
Rate for Payer: Cash Price	$63.00

PAROTID GLAND X-RAY

Facility

$62.00

Hospital Charge Code	3216111
Hospital Revenue Code	320
Rate for Payer: Cash Price	$55.80

PAROTID GLAND X-RAY

Facility

$62.00

Hospital Charge Code	3216111
Hospital Revenue Code	320
Min. Negotiated Rate	$22.32
Max. Negotiated Rate	$175.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$36.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$44.27
Rate for Payer: Cash Price	$55.80
Rate for Payer: Cash Price	$55.80
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.32

.PAROTID SPEC PROT IGA

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816861
Hospital Revenue Code	302
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$39.27
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	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
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	$19.80

.PAROTID SPEC PROT IGA

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816861
Hospital Revenue Code	302
Rate for Payer: Cash Price	$49.50

.PAROTID SPEC PROT IGG

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816860
Hospital Revenue Code	302
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$39.27
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	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
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	$19.80

.PAROTID SPEC PROT IGG

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816860
Hospital Revenue Code	302
Rate for Payer: Cash Price	$49.50

.PAROTID SPEC PROT IGM

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816862
Hospital Revenue Code	302
Rate for Payer: Cash Price	$49.50

.PAROTID SPEC PROT IGM

Facility

$55.00

Service Code	CPT 83520
Hospital Charge Code	22816862
Hospital Revenue Code	302
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$39.27
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	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
Rate for Payer: Cash Price	$49.50
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	$19.80

PAROXETINE 10MG TAB EMP

Facility

$43.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2698082
Hospital Revenue Code	250
Rate for Payer: Cash Price	$38.70

PAROXETINE 10MG TAB EMP

Facility

$43.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2698082
Hospital Revenue Code	250
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$30.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$25.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$30.70
Rate for Payer: Cash Price	$38.70
Rate for Payer: UnitedHealthcare Commercial	$28.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.48

PAROXETINE 20MG TAB EMP

Facility

$43.00

Service Code	NDC 378700293
Hospital Charge Code	2619061
Hospital Revenue Code	250
Rate for Payer: Cash Price	$38.70

PAROXETINE 20MG TAB EMP

Facility

$43.00

Service Code	NDC 378700293
Hospital Charge Code	2619061
Hospital Revenue Code	250
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$30.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$25.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$30.70
Rate for Payer: Cash Price	$38.70
Rate for Payer: UnitedHealthcare Commercial	$28.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.48

PAROXETINE 30MG TAB EMP

Facility

$20.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2620262
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.00

PAROXETINE 30MG TAB EMP

Facility

$20.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2620262
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$14.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: UnitedHealthcare Commercial	$13.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20

Know your out-of-pocket cost for care.

All Charges