Madison Medical Center

All Charges

Charge

Type

Setting

Price

RABEPRAZOLE 20MG TAB EMP

Facility

$10.00

Service Code	NDC 7.2888E+10
Hospital Charge Code	2627065
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$7.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$5.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7.14
Rate for Payer: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

RABIES IMM GLOB 150IU/ML 10ML

Facility

$16,193.00

Service Code	HCPCS 90376
Hospital Charge Code	2621784
Hospital Revenue Code	250
Min. Negotiated Rate	$352.44
Max. Negotiated Rate	$11,561.80
Rate for Payer: Aetna Medicare Advantage	$352.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$9,586.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$11,561.80
Rate for Payer: Cash Price	$14,573.70
Rate for Payer: Cash Price	$14,573.70
Rate for Payer: Cigna Commercial HMO & PPO	$352.44
Rate for Payer: Home State Health Plan Medicare Advantage	$352.44
Rate for Payer: Humana Commercial	$704.88
Rate for Payer: Humana Medicare Advantage	$352.44
Rate for Payer: UnitedHealthcare Commercial	$10,800.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,829.48

RABIES IMM GLOB 150IU/ML 10ML

Facility

$16,193.00

Service Code	HCPCS 90376
Hospital Charge Code	2621784
Hospital Revenue Code	250
Rate for Payer: Cash Price	$14,573.70

RABIES IMM GLOB 300IU 2ML VIAL

Facility

$3,714.00

Service Code	HCPCS 90376
Hospital Charge Code	2626438
Hospital Revenue Code	250
Rate for Payer: Cash Price	$3,342.60

RABIES IMM GLOB 300IU 2ML VIAL

Facility

$3,714.00

Service Code	HCPCS 90376
Hospital Charge Code	2626438
Hospital Revenue Code	250
Min. Negotiated Rate	$352.44
Max. Negotiated Rate	$2,651.80
Rate for Payer: Aetna Medicare Advantage	$352.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$2,198.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$2,651.80
Rate for Payer: Cash Price	$3,342.60
Rate for Payer: Cash Price	$3,342.60
Rate for Payer: Cigna Commercial HMO & PPO	$352.44
Rate for Payer: Home State Health Plan Medicare Advantage	$352.44
Rate for Payer: Humana Commercial	$704.88
Rate for Payer: Humana Medicare Advantage	$352.44
Rate for Payer: UnitedHealthcare Commercial	$2,477.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,337.04

RABIES TITER

Facility

$351.00

Service Code	CPT 86382
Hospital Charge Code	2286311
Hospital Revenue Code	301
Min. Negotiated Rate	$15.22
Max. Negotiated Rate	$250.61
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.22
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$207.79
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$250.61
Rate for Payer: Cash Price	$315.90
Rate for Payer: Cash Price	$315.90
Rate for Payer: Cash Price	$315.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.22
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.29
Rate for Payer: Home State Health Plan Medicare Advantage	$16.91
Rate for Payer: Humana Commercial	$33.82
Rate for Payer: Humana Medicare Advantage	$16.91
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$126.36

RABIES TITER

Facility

$351.00

Service Code	CPT 86382
Hospital Charge Code	2286311
Hospital Revenue Code	301
Rate for Payer: Cash Price	$315.90

RABIES VACCINE (RABAVERT) INJ

Facility

$1,225.00

Service Code	HCPCS 90675
Hospital Charge Code	2626437
Hospital Revenue Code	250
Min. Negotiated Rate	$331.98
Max. Negotiated Rate	$874.65
Rate for Payer: Aetna Medicare Advantage	$331.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$725.20
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$874.65
Rate for Payer: Cash Price	$1,102.50
Rate for Payer: Cash Price	$1,102.50
Rate for Payer: Cigna Commercial HMO & PPO	$331.98
Rate for Payer: Home State Health Plan Medicare Advantage	$331.98
Rate for Payer: Humana Commercial	$663.96
Rate for Payer: Humana Medicare Advantage	$331.98
Rate for Payer: UnitedHealthcare Commercial	$817.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$441.00

RABIES VACCINE (RABAVERT) INJ

Facility

$1,225.00

Service Code	HCPCS 90675
Hospital Charge Code	2626437
Hospital Revenue Code	250
Rate for Payer: Cash Price	$1,102.50

RACEMIC EPI 2.25% INH SOL 0.5ML

Facility

$42.00

Service Code	HCPCS J7608
Hospital Charge Code	2626446
Hospital Revenue Code	250
Min. Negotiated Rate	$15.12
Max. Negotiated Rate	$29.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$24.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$29.99
Rate for Payer: Cash Price	$37.80
Rate for Payer: UnitedHealthcare Commercial	$28.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.12

RACEMIC EPI 2.25% INH SOL 0.5ML

Facility

$42.00

Service Code	HCPCS J7608
Hospital Charge Code	2626446
Hospital Revenue Code	250
Rate for Payer: Cash Price	$37.80

RADIO ABLATION CATHETER

Facility

$106.00

Hospital Charge Code	1219441
Hospital Revenue Code	272
Rate for Payer: Cash Price	$95.40

RADIO ABLATION CATHETER

Facility

$106.00

Hospital Charge Code	1219441
Hospital Revenue Code	272
Min. Negotiated Rate	$38.16
Max. Negotiated Rate	$75.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$62.75
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$75.68
Rate for Payer: Cash Price	$95.40
Rate for Payer: UnitedHealthcare Commercial	$70.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.16

RADIO ABLATION DISP ELECTRODE

Facility

$452.00

Hospital Charge Code	1219487
Hospital Revenue Code	360
Min. Negotiated Rate	$162.72
Max. Negotiated Rate	$301.48
Rate for Payer: Cash Price	$406.80
Rate for Payer: UnitedHealthcare Commercial	$301.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$162.72

RADIO ABLATION DISP ELECTRODE

Facility

$452.00

Hospital Charge Code	1219487
Hospital Revenue Code	360
Rate for Payer: Cash Price	$406.80

RADIOTHERAPY

Facility

$46,191.54

Service Code	MSDRG 849
Min. Negotiated Rate	$23,095.77
Max. Negotiated Rate	$46,191.54
Rate for Payer: Aetna Medicare Advantage	$23,095.77
Rate for Payer: Cigna Commercial HMO & PPO	$23,095.77
Rate for Payer: Home State Health Plan Medicare Advantage	$23,095.77
Rate for Payer: Humana Commercial	$46,191.54
Rate for Payer: Humana Medicare Advantage	$23,095.77

RADIOTHERAPY

Facility

$27,600.59

Service Code	APR-DRG 6923
Min. Negotiated Rate	$27,600.59
Max. Negotiated Rate	$27,600.59
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,600.59
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,600.59
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,600.59
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,600.59

RADIOTHERAPY

Facility

$15,922.99

Service Code	APR-DRG 6922
Min. Negotiated Rate	$15,922.99
Max. Negotiated Rate	$15,922.99
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,922.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,922.99
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,922.99
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,922.99

RADIOTHERAPY

Facility

$33,131.99

Service Code	APR-DRG 6924
Min. Negotiated Rate	$33,131.99
Max. Negotiated Rate	$33,131.99
Rate for Payer: Aetna Better Health Medicaid/QHP	$33,131.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33,131.99
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33,131.99
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33,131.99

RADIOTHERAPY

Facility

$7,840.85

Service Code	APR-DRG 6921
Min. Negotiated Rate	$7,840.85
Max. Negotiated Rate	$7,840.85
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,840.85
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,840.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,840.85
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,840.85

RAM CANNULA

Facility

$67.00

Hospital Charge Code	4519010
Hospital Revenue Code	271
Rate for Payer: Cash Price	$60.30

RAM CANNULA

Facility

$67.00

Hospital Charge Code	4519010
Hospital Revenue Code	271
Min. Negotiated Rate	$24.12
Max. Negotiated Rate	$47.84
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: UnitedHealthcare Commercial	$44.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.12

RAMELTEON 8MG TAB EMP

Facility

$18.00

Service Code	NDC 6.4764E+10
Hospital Charge Code	2624581
Hospital Revenue Code	250
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

RAMELTEON 8MG TAB EMP

Facility

$18.00

Service Code	NDC 6.4764E+10
Hospital Charge Code	2624581
Hospital Revenue Code	250
Rate for Payer: Cash Price	$16.20

RAMIPRIL (ALTACE) 10MG CAP

Facility

$11.00

Service Code	NDC 6.8084E+10
Hospital Charge Code	260654
Hospital Revenue Code	250
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$7.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$6.51
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7.85
Rate for Payer: Cash Price	$9.90
Rate for Payer: UnitedHealthcare Commercial	$7.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.96

Know your out-of-pocket cost for care.

All Charges