Madison Medical Center

All Charges

Charge

Type

Setting

Price

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	5287880
Hospital Revenue Code	521
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.88
Rate for Payer: Aetna Medicare Advantage	$16.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.39
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.92
Rate for Payer: Home State Health Plan Medicare Advantage	$16.53
Rate for Payer: Humana Commercial	$33.06
Rate for Payer: Humana Medicare Advantage	$16.53
Rate for Payer: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	9187880
Hospital Revenue Code	521
Rate for Payer: Cash Price	$67.50

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	9687880
Hospital Revenue Code	301
Rate for Payer: Cash Price	$67.50

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	4287880
Hospital Revenue Code	301
Rate for Payer: Cash Price	$67.50

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	4187880
Hospital Revenue Code	301
Rate for Payer: Cash Price	$67.50

RAPID STREP

Facility

$18.00

Service Code	CPT 81025
Hospital Charge Code	4488403
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.75
Rate for Payer: Aetna Medicare Advantage	$8.61
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: Cash Price	$16.20
Rate for Payer: Cash Price	$16.20
Rate for Payer: Cigna Commercial HMO & PPO	$8.61
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.75
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.29
Rate for Payer: Home State Health Plan Medicare Advantage	$8.61
Rate for Payer: Humana Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$8.61
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	9687880
Hospital Revenue Code	301
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.88
Rate for Payer: Aetna Medicare Advantage	$16.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.92
Rate for Payer: Home State Health Plan Medicare Advantage	$16.53
Rate for Payer: Humana Commercial	$33.06
Rate for Payer: Humana Medicare Advantage	$16.53
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	4287880
Hospital Revenue Code	301
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.88
Rate for Payer: Aetna Medicare Advantage	$16.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.92
Rate for Payer: Home State Health Plan Medicare Advantage	$16.53
Rate for Payer: Humana Commercial	$33.06
Rate for Payer: Humana Medicare Advantage	$16.53
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	9187880
Hospital Revenue Code	521
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.88
Rate for Payer: Aetna Medicare Advantage	$16.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.39
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.92
Rate for Payer: Home State Health Plan Medicare Advantage	$16.53
Rate for Payer: Humana Commercial	$33.06
Rate for Payer: Humana Medicare Advantage	$16.53
Rate for Payer: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	4187880
Hospital Revenue Code	301
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.88
Rate for Payer: Aetna Medicare Advantage	$16.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cash Price	$67.50
Rate for Payer: Cigna Commercial HMO & PPO	$16.53
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.88
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.92
Rate for Payer: Home State Health Plan Medicare Advantage	$16.53
Rate for Payer: Humana Commercial	$33.06
Rate for Payer: Humana Medicare Advantage	$16.53
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

RAPID STREP

Facility

$75.00

Service Code	CPT 87880
Hospital Charge Code	5287880
Hospital Revenue Code	521
Rate for Payer: Cash Price	$67.50

RAPID STREP

Facility

$18.00

Service Code	CPT 81025
Hospital Charge Code	4488403
Hospital Revenue Code	301
Rate for Payer: Cash Price	$16.20

RAPLON 20MG/ML VIAL

Facility

$156.00

Hospital Charge Code	2058005
Hospital Revenue Code	370
Rate for Payer: Cash Price	$140.40

RAPLON 20MG/ML VIAL

Facility

$156.00

Hospital Charge Code	2058005
Hospital Revenue Code	370
Min. Negotiated Rate	$56.16
Max. Negotiated Rate	$111.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$92.35
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$111.38
Rate for Payer: Cash Price	$140.40
Rate for Payer: UnitedHealthcare Commercial	$104.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$56.16

RAZOR, SINGLE

Facility

$18.00

Hospital Charge Code	2818611
Hospital Revenue Code	271
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

RAZOR, SINGLE

Facility

$18.00

Hospital Charge Code	2818611
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

RBC MAGNESIUM

Facility

$118.00

Service Code	CPT 83735
Hospital Charge Code	2283735
Hospital Revenue Code	307
Rate for Payer: Cash Price	$106.20

RBC MAGNESIUM

Facility

$118.00

Service Code	CPT 83735
Hospital Charge Code	2283735
Hospital Revenue Code	307
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$84.25
Rate for Payer: Aetna Better Health Medicaid/QHP	$6.03
Rate for Payer: Aetna Medicare Advantage	$6.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$69.86
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$84.25
Rate for Payer: Cash Price	$106.20
Rate for Payer: Cash Price	$106.20
Rate for Payer: Cash Price	$106.20
Rate for Payer: Cigna Commercial HMO & PPO	$6.70
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$6.03
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.45
Rate for Payer: Home State Health Plan Medicare Advantage	$6.70
Rate for Payer: Humana Commercial	$13.40
Rate for Payer: Humana Medicare Advantage	$6.70
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$6.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.48

RECOVERY 1ST HOUR

Facility

$1,408.00

Hospital Charge Code	1218001
Hospital Revenue Code	710
Min. Negotiated Rate	$506.88
Max. Negotiated Rate	$1,005.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$833.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,005.31
Rate for Payer: Cash Price	$1,267.20
Rate for Payer: UnitedHealthcare Commercial	$939.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$506.88

RECOVERY 1ST HOUR

Facility

$1,408.00

Hospital Charge Code	1218001
Hospital Revenue Code	710
Rate for Payer: Cash Price	$1,267.20

RECOVERY ADDITIONAL PER 1/2 HR

Facility

$494.00

Hospital Charge Code	1218003
Hospital Revenue Code	710
Rate for Payer: Cash Price	$444.60

RECOVERY ADDITIONAL PER 1/2 HR

Facility

$494.00

Hospital Charge Code	1218003
Hospital Revenue Code	710
Min. Negotiated Rate	$177.84
Max. Negotiated Rate	$352.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$292.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$352.72
Rate for Payer: Cash Price	$444.60
Rate for Payer: UnitedHealthcare Commercial	$329.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$177.84

RECTAL RESECTION WITH CC

Facility

$40,390.36

Service Code	MSDRG 333
Min. Negotiated Rate	$20,195.18
Max. Negotiated Rate	$40,390.36
Rate for Payer: Aetna Medicare Advantage	$20,195.18
Rate for Payer: Cigna Commercial HMO & PPO	$20,195.18
Rate for Payer: Home State Health Plan Medicare Advantage	$20,195.18
Rate for Payer: Humana Commercial	$40,390.36
Rate for Payer: Humana Medicare Advantage	$20,195.18

RECTAL RESECTION WITH MCC

Facility

$60,619.58

Service Code	MSDRG 332
Min. Negotiated Rate	$30,309.79
Max. Negotiated Rate	$60,619.58
Rate for Payer: Aetna Medicare Advantage	$30,309.79
Rate for Payer: Cigna Commercial HMO & PPO	$30,309.79
Rate for Payer: Home State Health Plan Medicare Advantage	$30,309.79
Rate for Payer: Humana Commercial	$60,619.58
Rate for Payer: Humana Medicare Advantage	$30,309.79

RECTAL RESECTION WITHOUT CC/MCC

Facility

$29,294.96

Service Code	MSDRG 334
Min. Negotiated Rate	$14,647.48
Max. Negotiated Rate	$29,294.96
Rate for Payer: Aetna Medicare Advantage	$14,647.48
Rate for Payer: Cigna Commercial HMO & PPO	$14,647.48
Rate for Payer: Home State Health Plan Medicare Advantage	$14,647.48
Rate for Payer: Humana Commercial	$29,294.96
Rate for Payer: Humana Medicare Advantage	$14,647.48

Know your out-of-pocket cost for care.

All Charges