Madison Medical Center

All Charges

Charge

Type

Setting

Price

RFA RADIO FREQUENCY ABLATION

Facility

$677.00

Hospital Charge Code	2656571
Hospital Revenue Code	259
Min. Negotiated Rate	$243.72
Max. Negotiated Rate	$483.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$400.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$483.38
Rate for Payer: Cash Price	$609.30
Rate for Payer: UnitedHealthcare Commercial	$451.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$243.72

RFA RADIO FREQUENCY ABLATION

Facility

$677.00

Hospital Charge Code	2656571
Hospital Revenue Code	259
Min. Negotiated Rate	$451.56
Max. Negotiated Rate	$451.56
Rate for Payer: Cash Price	$609.30
Rate for Payer: UnitedHealthcare Commercial	$451.56

RHEUMASSURE (LABCORP 504509)

Facility

$407.00

Hospital Charge Code	2218152
Hospital Revenue Code	301
Rate for Payer: Cash Price	$366.30

RHEUMASSURE (LABCORP 504509)

Facility

$407.00

Hospital Charge Code	2218152
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$290.60
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$240.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$290.60
Rate for Payer: Cash Price	$366.30
Rate for Payer: Cash Price	$366.30
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$146.52

RHEUMATOID FACTOR

Facility

$79.00

Service Code	CPT 86431
Hospital Charge Code	2218151
Hospital Revenue Code	301
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$56.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$46.77
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$56.41
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cigna Commercial HMO & PPO	$5.67
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5.46
Rate for Payer: Home State Health Plan Medicare Advantage	$5.67
Rate for Payer: Humana Commercial	$11.34
Rate for Payer: Humana Medicare Advantage	$5.67
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.44

RHEUMATOID FACTOR

Facility

$79.00

Service Code	CPT 86431
Hospital Charge Code	2218151
Hospital Revenue Code	301
Rate for Payer: Cash Price	$71.10

RHEUMATOID FACTOR (LABCORP)

Facility

$79.00

Service Code	CPT 86431
Hospital Charge Code	2218150
Hospital Revenue Code	301
Rate for Payer: Cash Price	$71.10

RHEUMATOID FACTOR (LABCORP)

Facility

$79.00

Service Code	CPT 86431
Hospital Charge Code	2218150
Hospital Revenue Code	301
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$56.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$46.77
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$56.41
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cash Price	$71.10
Rate for Payer: Cigna Commercial HMO & PPO	$5.67
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5.46
Rate for Payer: Home State Health Plan Medicare Advantage	$5.67
Rate for Payer: Humana Commercial	$11.34
Rate for Payer: Humana Medicare Advantage	$5.67
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.44

RH GAMMA GLOBULIN IM (J2790)

Facility

$41.00

Service Code	HCPCS J2790
Hospital Charge Code	4290743
Hospital Revenue Code	521
Min. Negotiated Rate	$24.27
Max. Negotiated Rate	$173.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$24.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$29.27
Rate for Payer: Cash Price	$36.90
Rate for Payer: Cash Price	$36.90
Rate for Payer: UnitedHealthcare Commercial	$27.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

RH GAMMA GLOBULIN IM (J2790)

Facility

$41.00

Service Code	HCPCS J2790
Hospital Charge Code	4290743
Hospital Revenue Code	521
Rate for Payer: Cash Price	$36.90

RHINO ROCKET

Facility

$52.00

Hospital Charge Code	2814015
Hospital Revenue Code	271
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$37.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$30.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$37.13
Rate for Payer: Cash Price	$46.80
Rate for Payer: UnitedHealthcare Commercial	$34.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.72

RHINO ROCKET

Facility

$52.00

Hospital Charge Code	2814015
Hospital Revenue Code	271
Rate for Payer: Cash Price	$46.80

RHYTHM ECG, 1-3 LEADS W/ INTER & REPORT

Facility

$288.00

Service Code	CPT 93041
Hospital Charge Code	4593040
Hospital Revenue Code	730
Min. Negotiated Rate	$53.18
Max. Negotiated Rate	$205.63
Rate for Payer: Aetna Better Health Medicaid/QHP	$53.18
Rate for Payer: Aetna Medicare Advantage	$60.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$170.50
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$205.63
Rate for Payer: Cash Price	$259.20
Rate for Payer: Cash Price	$259.20
Rate for Payer: Cash Price	$259.20
Rate for Payer: Cigna Commercial HMO & PPO	$60.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$53.18
Rate for Payer: Home State Health Plan Medicaid Managed Care	$56.90
Rate for Payer: Home State Health Plan Medicare Advantage	$60.27
Rate for Payer: Humana Commercial	$120.54
Rate for Payer: Humana Medicare Advantage	$60.27
Rate for Payer: UnitedHealthcare Commercial	$192.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$53.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.68

RHYTHM ECG, 1-3 LEADS W/ INTER & REPORT

Facility

$288.00

Service Code	CPT 93041
Hospital Charge Code	4593040
Hospital Revenue Code	730
Rate for Payer: Cash Price	$259.20

RIB BELT--UNIVERSAL/FEMALE

Facility

$214.00

Hospital Charge Code	282174
Hospital Revenue Code	271
Rate for Payer: Cash Price	$192.60

RIB BELT--UNIVERSAL/FEMALE

Facility

$214.00

Hospital Charge Code	282174
Hospital Revenue Code	271
Min. Negotiated Rate	$77.04
Max. Negotiated Rate	$152.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$126.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$152.80
Rate for Payer: Cash Price	$192.60
Rate for Payer: UnitedHealthcare Commercial	$142.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$77.04

RIB BELT--UNIVERSAL/MALE

Facility

$214.00

Hospital Charge Code	282175
Hospital Revenue Code	271
Min. Negotiated Rate	$77.04
Max. Negotiated Rate	$152.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$126.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$152.80
Rate for Payer: Cash Price	$192.60
Rate for Payer: UnitedHealthcare Commercial	$142.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$77.04

RIB BELT--UNIVERSAL/MALE

Facility

$214.00

Hospital Charge Code	282175
Hospital Revenue Code	271
Rate for Payer: Cash Price	$192.60

RIBOSOMAL P ANTIBODY

Facility

$594.00

Service Code	CPT 83516
Hospital Charge Code	2283524
Hospital Revenue Code	302
Rate for Payer: Cash Price	$534.60

RIBOSOMAL P ANTIBODY

Facility

$594.00

Service Code	CPT 83516
Hospital Charge Code	2283524
Hospital Revenue Code	302
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$424.12
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	$351.65
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$424.12
Rate for Payer: Cash Price	$534.60
Rate for Payer: Cash Price	$534.60
Rate for Payer: Cash Price	$534.60
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	$213.84

RIBS XRAY LT

Facility

$572.00

Service Code	CPT 71100
Hospital Charge Code	3218112
Hospital Revenue Code	320
Rate for Payer: Cash Price	$514.80

RIBS XRAY LT

Facility

$572.00

Service Code	CPT 71100
Hospital Charge Code	3218112
Hospital Revenue Code	320
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$408.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$78.45
Rate for Payer: Aetna Medicare Advantage	$88.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$338.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$408.41
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cigna Commercial HMO & PPO	$88.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$78.45
Rate for Payer: Home State Health Plan Medicaid Managed Care	$83.94
Rate for Payer: Home State Health Plan Medicare Advantage	$88.91
Rate for Payer: Humana Commercial	$177.82
Rate for Payer: Humana Medicare Advantage	$88.91
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$78.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$205.92

RIBS XRAY RT

Facility

$572.00

Service Code	CPT 71100
Hospital Charge Code	3218111
Hospital Revenue Code	320
Rate for Payer: Cash Price	$514.80

RIBS XRAY RT

Facility

$572.00

Service Code	CPT 71100
Hospital Charge Code	3218111
Hospital Revenue Code	320
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$408.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$78.45
Rate for Payer: Aetna Medicare Advantage	$88.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$338.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$408.41
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cigna Commercial HMO & PPO	$88.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$78.45
Rate for Payer: Home State Health Plan Medicaid Managed Care	$83.94
Rate for Payer: Home State Health Plan Medicare Advantage	$88.91
Rate for Payer: Humana Commercial	$177.82
Rate for Payer: Humana Medicare Advantage	$88.91
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$78.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$205.92

RICKETTSIA DNA-PCR (LABCORP)

Facility

$632.00

Service Code	CPT 87798
Hospital Charge Code	2286040
Hospital Revenue Code	302
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$451.25
Rate for Payer: Aetna Better Health Medicaid/QHP	$31.58
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$374.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$451.25
Rate for Payer: Cash Price	$568.80
Rate for Payer: Cash Price	$568.80
Rate for Payer: Cash Price	$568.80
Rate for Payer: Cigna Commercial HMO & PPO	$35.09
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$31.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$33.79
Rate for Payer: Home State Health Plan Medicare Advantage	$35.09
Rate for Payer: Humana Commercial	$70.18
Rate for Payer: Humana Medicare Advantage	$35.09
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$31.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$227.52

Know your out-of-pocket cost for care.

All Charges