Madison Medical Center

All Charges

Charge

Type

Setting

Price

SCHIZOAFFECTIVE DISORDERS

Facility

$51,464.79

Service Code	APR-DRG 7614
Min. Negotiated Rate	$51,464.79
Max. Negotiated Rate	$51,464.79
Rate for Payer: Aetna Better Health Medicaid/QHP	$51,464.79
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$51,464.79
Rate for Payer: Home State Health Plan Medicaid Managed Care	$51,464.79
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$51,464.79

SCHIZOAFFECTIVE DISORDERS

Facility

$21,925.74

Service Code	APR-DRG 7613
Min. Negotiated Rate	$21,925.74
Max. Negotiated Rate	$21,925.74
Rate for Payer: Aetna Better Health Medicaid/QHP	$21,925.74
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$21,925.74
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21,925.74
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$21,925.74

SCHIZOAFFECTIVE DISORDERS

Facility

$16,651.99

Service Code	APR-DRG 7611
Min. Negotiated Rate	$16,651.99
Max. Negotiated Rate	$16,651.99
Rate for Payer: Aetna Better Health Medicaid/QHP	$16,651.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16,651.99
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16,651.99
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16,651.99

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$64,005.71

Service Code	APR-DRG 7504
Min. Negotiated Rate	$64,005.71
Max. Negotiated Rate	$64,005.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$64,005.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$64,005.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$64,005.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$64,005.71

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$20,450.66

Service Code	APR-DRG 7502
Min. Negotiated Rate	$20,450.66
Max. Negotiated Rate	$20,450.66
Rate for Payer: Aetna Better Health Medicaid/QHP	$20,450.66
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$20,450.66
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20,450.66
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$20,450.66

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$34,315.78

Service Code	APR-DRG 7503
Min. Negotiated Rate	$34,315.78
Max. Negotiated Rate	$34,315.78
Rate for Payer: Aetna Better Health Medicaid/QHP	$34,315.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$34,315.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$34,315.78
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$34,315.78

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$14,889.34

Service Code	APR-DRG 7501
Min. Negotiated Rate	$14,889.34
Max. Negotiated Rate	$14,889.34
Rate for Payer: Aetna Better Health Medicaid/QHP	$14,889.34
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14,889.34
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14,889.34
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14,889.34

SCIATIC NERVE INJ

Professional

Both

$640.00

Service Code	CPT 64445
Hospital Charge Code	4164445
Hospital Revenue Code	975
Min. Negotiated Rate	$63.84
Max. Negotiated Rate	$224.00
Rate for Payer: Aetna Commercial/Medicare Advantage	$63.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$95.65
Rate for Payer: Cash Price	$576.00
Rate for Payer: Cash Price	$576.00
Rate for Payer: Cigna Commercial HMO & PPO	$63.84
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$95.65
Rate for Payer: Home State Health Plan Medicaid Managed Care	$105.22
Rate for Payer: Home State Health Plan Medicare Advantage	$63.84
Rate for Payer: Optum Medicare Advantage	$224.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$95.65

SCLERODERMA ANTIBODY (Scl-70)

Facility

$89.00

Service Code	CPT 86235
Hospital Charge Code	2219220
Hospital Revenue Code	302
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$63.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.14
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$52.69
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$63.55
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cash Price	$80.10
Rate for Payer: Cigna Commercial HMO & PPO	$17.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.27
Rate for Payer: Home State Health Plan Medicare Advantage	$17.93
Rate for Payer: Humana Commercial	$35.86
Rate for Payer: Humana Medicare Advantage	$17.93
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.04

SCLERODERMA ANTIBODY (Scl-70)

Facility

$89.00

Service Code	CPT 86235
Hospital Charge Code	2219220
Hospital Revenue Code	302
Rate for Payer: Cash Price	$80.10

SCOLIOSIS SURVEY

Facility

$591.00

Service Code	CPT 72082
Hospital Charge Code	3272082
Hospital Revenue Code	320
Min. Negotiated Rate	$94.24
Max. Negotiated Rate	$421.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$94.24
Rate for Payer: Aetna Medicare Advantage	$106.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$349.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$421.97
Rate for Payer: Cash Price	$531.90
Rate for Payer: Cash Price	$531.90
Rate for Payer: Cash Price	$531.90
Rate for Payer: Cigna Commercial HMO & PPO	$106.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$94.24
Rate for Payer: Home State Health Plan Medicaid Managed Care	$100.84
Rate for Payer: Home State Health Plan Medicare Advantage	$106.81
Rate for Payer: Humana Commercial	$213.62
Rate for Payer: Humana Medicare Advantage	$106.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$94.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$212.76

SCOLIOSIS SURVEY

Facility

$591.00

Service Code	CPT 72082
Hospital Charge Code	3272082
Hospital Revenue Code	320
Rate for Payer: Cash Price	$531.90

SCOPOLA MINE 1MG/72HR PAT EMP

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2626142
Hospital Revenue Code	250
Rate for Payer: Cash Price	$72.90

SCOPOLA MINE 1MG/72HR PAT EMP

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2626142
Hospital Revenue Code	250
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

SCOPOLAM (TRANSDERM SCOP) 1.5MG PAT

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2626368
Hospital Revenue Code	250
Rate for Payer: Cash Price	$72.90

SCOPOLAM (TRANSDERM SCOP) 1.5MG PAT

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2626368
Hospital Revenue Code	250
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

SCOPOLAM (TRANSDERM SCOP) 1.5MG PAT EMP

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2623540
Hospital Revenue Code	250
Rate for Payer: Cash Price	$72.90

SCOPOLAM (TRANSDERM SCOP) 1.5MG PAT EMP

Facility

$81.00

Service Code	NDC 1.0019E+10
Hospital Charge Code	2623540
Hospital Revenue Code	250
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

SCREW-CANNULATED 2.0MM 14/6MM

Facility

$641.00

Hospital Charge Code	123425
Hospital Revenue Code	271
Rate for Payer: Cash Price	$576.90

SCREW-CANNULATED 2.0MM 14/6MM

Facility

$641.00

Hospital Charge Code	123425
Hospital Revenue Code	271
Min. Negotiated Rate	$230.76
Max. Negotiated Rate	$457.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$379.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$457.67
Rate for Payer: Cash Price	$576.90
Rate for Payer: UnitedHealthcare Commercial	$427.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$230.76

SCREW-CANNULATED 2.0MM 16/7

Facility

$641.00

Hospital Charge Code	123392
Hospital Revenue Code	271
Rate for Payer: Cash Price	$576.90

SCREW-CANNULATED 2.0MM 16/7

Facility

$641.00

Hospital Charge Code	123392
Hospital Revenue Code	271
Min. Negotiated Rate	$230.76
Max. Negotiated Rate	$457.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$379.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$457.67
Rate for Payer: Cash Price	$576.90
Rate for Payer: UnitedHealthcare Commercial	$427.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$230.76

SCREW CANNULATED 2.4mm X 16mm

Facility

$643.00

Hospital Charge Code	127779
Hospital Revenue Code	271
Min. Negotiated Rate	$231.48
Max. Negotiated Rate	$459.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$380.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$459.10
Rate for Payer: Cash Price	$578.70
Rate for Payer: UnitedHealthcare Commercial	$428.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$231.48

SCREW CANNULATED 2.4mm X 16mm

Facility

$643.00

Hospital Charge Code	127779
Hospital Revenue Code	271
Rate for Payer: Cash Price	$578.70

SCREW - CANNULATED 3.0MM 16/4MM

Facility

$641.00

Hospital Charge Code	123393
Hospital Revenue Code	271
Min. Negotiated Rate	$230.76
Max. Negotiated Rate	$457.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$379.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$457.67
Rate for Payer: Cash Price	$576.90
Rate for Payer: UnitedHealthcare Commercial	$427.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$230.76

Know your out-of-pocket cost for care.

All Charges