Madison Medical Center

All Charges

Charge

Type

Setting

Price

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

RICKETTSIA TYPHI AB

Facility

$276.00

Service Code	CPT 86757
Hospital Charge Code	2219202
Hospital Revenue Code	302
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$197.06
Rate for Payer: Aetna Better Health Medicaid/QHP	$17.42
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$163.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$197.06
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cigna Commercial HMO & PPO	$19.35
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17.42
Rate for Payer: Home State Health Plan Medicaid Managed Care	$18.64
Rate for Payer: Home State Health Plan Medicare Advantage	$19.35
Rate for Payer: Humana Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$19.35
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$99.36

RICKETTSIA TYPHI AB

Facility

$276.00

Service Code	CPT 86757
Hospital Charge Code	2219202
Hospital Revenue Code	302
Rate for Payer: Cash Price	$248.40

RIFAMPIN 300MG CAP

Facility

$21.00

Service Code	NDC 6.818E+10
Hospital Charge Code	2619505
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

RIFAMPIN 300MG CAP

Facility

$21.00

Service Code	NDC 6.818E+10
Hospital Charge Code	2619505
Hospital Revenue Code	250
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$14.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$12.43
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.99
Rate for Payer: Cash Price	$18.90
Rate for Payer: UnitedHealthcare Commercial	$14.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.56

RIFAXIMIN 200MG TAB

Facility

$100.00

Service Code	NDC 6.5649E+10
Hospital Charge Code	2621995
Hospital Revenue Code	250
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$71.40
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: UnitedHealthcare Commercial	$66.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.00

RIFAXIMIN 200MG TAB

Facility

$100.00

Service Code	NDC 6.5649E+10
Hospital Charge Code	2621995
Hospital Revenue Code	250
Rate for Payer: Cash Price	$90.00

RING, SKIN BARRIER SOFTFLEX

Facility

$18.00

Hospital Charge Code	287905
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

RING, SKIN BARRIER SOFTFLEX

Facility

$18.00

Hospital Charge Code	287905
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

RISEDRONATE (ACTONEL) 35MG TAB

Facility

$255.00

Service Code	NDC 430047203
Hospital Charge Code	2604181
Hospital Revenue Code	250
Rate for Payer: Cash Price	$229.50

RISEDRONATE (ACTONEL) 35MG TAB

Facility

$255.00

Service Code	NDC 430047203
Hospital Charge Code	2604181
Hospital Revenue Code	250
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$182.07
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$150.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$182.07
Rate for Payer: Cash Price	$229.50
Rate for Payer: UnitedHealthcare Commercial	$170.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.80

RISPERIDONE

Facility

$423.00

Service Code	CPT 80342
Hospital Charge Code	2280298
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$302.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$250.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$302.02
Rate for Payer: Cash Price	$380.70
Rate for Payer: Cash Price	$380.70
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.28

RISPERIDONE

Facility

$423.00

Service Code	CPT 80342
Hospital Charge Code	2280298
Hospital Revenue Code	301
Rate for Payer: Cash Price	$380.70

RISPERIDONE (RISPERDAL) 0.5MG TAB

Facility

$35.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2626303
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$24.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$20.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$24.99
Rate for Payer: Cash Price	$31.50
Rate for Payer: UnitedHealthcare Commercial	$23.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60

RISPERIDONE (RISPERDAL) 0.5MG TAB

Facility

$35.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2626303
Hospital Revenue Code	250
Rate for Payer: Cash Price	$31.50

RISPERIDONE (RISPERDAL) 1MG TAB

Facility

$25.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2656150
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$17.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.85
Rate for Payer: Cash Price	$22.50
Rate for Payer: UnitedHealthcare Commercial	$16.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.00

RISPERIDONE (RISPERDAL) 1MG TAB

Facility

$25.00

Service Code	NDC 6.8382E+10
Hospital Charge Code	2656150
Hospital Revenue Code	250
Rate for Payer: Cash Price	$22.50

RISTOCETIN COFACTOR

Facility

$273.00

Service Code	CPT 85245
Hospital Charge Code	2285245
Hospital Revenue Code	301
Rate for Payer: Cash Price	$245.70

RISTOCETIN COFACTOR

Facility

$273.00

Service Code	CPT 85245
Hospital Charge Code	2285245
Hospital Revenue Code	301
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$194.92
Rate for Payer: Aetna Better Health Medicaid/QHP	$20.65
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$161.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$194.92
Rate for Payer: Cash Price	$245.70
Rate for Payer: Cash Price	$245.70
Rate for Payer: Cash Price	$245.70
Rate for Payer: Cigna Commercial HMO & PPO	$22.94
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20.65
Rate for Payer: Home State Health Plan Medicaid Managed Care	$22.10
Rate for Payer: Home State Health Plan Medicare Advantage	$22.94
Rate for Payer: Humana Commercial	$45.88
Rate for Payer: Humana Medicare Advantage	$22.94
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$98.28

RITALIN

Facility

$129.00

Service Code	CPT 80299
Hospital Charge Code	2280299
Hospital Revenue Code	301
Min. Negotiated Rate	$16.78
Max. Negotiated Rate	$92.11
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.78
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$76.37
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$92.11
Rate for Payer: Cash Price	$116.10
Rate for Payer: Cash Price	$116.10
Rate for Payer: Cash Price	$116.10
Rate for Payer: Cigna Commercial HMO & PPO	$18.64
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.95
Rate for Payer: Home State Health Plan Medicare Advantage	$18.64
Rate for Payer: Humana Commercial	$37.28
Rate for Payer: Humana Medicare Advantage	$18.64
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.44

RITALIN

Facility

$129.00

Service Code	CPT 80299
Hospital Charge Code	2280299
Hospital Revenue Code	301
Rate for Payer: Cash Price	$116.10

RITUXIMAB (RITUXAN) 100MG 10ML IVPB

Facility

$7,464.00

Service Code	HCPCS J9310
Hospital Charge Code	2626562
Hospital Revenue Code	335
Min. Negotiated Rate	$2,687.04
Max. Negotiated Rate	$5,329.30
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4,418.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5,329.30
Rate for Payer: Cash Price	$6,717.60
Rate for Payer: UnitedHealthcare Commercial	$4,978.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,687.04

RITUXIMAB (RITUXAN) 100MG 10ML IVPB

Facility

$7,464.00

Service Code	HCPCS J9310
Hospital Charge Code	2626562
Hospital Revenue Code	335
Rate for Payer: Cash Price	$6,717.60

RITUXIMAB (RITUXAN) 500MG 50ML IVPB

Facility

$37,099.00

Service Code	HCPCS J9310
Hospital Charge Code	2626563
Hospital Revenue Code	335
Rate for Payer: Cash Price	$33,389.10

RITUXIMAB (RITUXAN) 500MG 50ML IVPB

Facility

$37,099.00

Service Code	HCPCS J9310
Hospital Charge Code	2626563
Hospital Revenue Code	335
Min. Negotiated Rate	$13,355.64
Max. Negotiated Rate	$26,488.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21,962.61
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$26,488.69
Rate for Payer: Cash Price	$33,389.10
Rate for Payer: UnitedHealthcare Commercial	$24,745.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,355.64

Know your out-of-pocket cost for care.

All Charges