Madison Medical Center

All Charges

Charge

Type

Setting

Price

STOCKINET 6X72--(SURG)

Facility

$75.00

Hospital Charge Code	2819452
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$53.55
Rate for Payer: Cash Price	$67.50
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: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

STOCKINET 6X72--(SURG)

Facility

$75.00

Hospital Charge Code	2819452
Hospital Revenue Code	272
Rate for Payer: Cash Price	$67.50

STOCKINET ORTHO 4

Facility

$13.00

Hospital Charge Code	2819448
Hospital Revenue Code	271
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$9.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$9.28
Rate for Payer: Cash Price	$11.70
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.68

STOCKINET ORTHO 4

Facility

$13.00

Hospital Charge Code	2819448
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

STOCKINET SURG 2

Facility

$16.00

Hospital Charge Code	2819446
Hospital Revenue Code	271
Rate for Payer: Cash Price	$14.40

STOCKINET SURG 2

Facility

$16.00

Hospital Charge Code	2819446
Hospital Revenue Code	271
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$11.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$9.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$11.42
Rate for Payer: Cash Price	$14.40
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.76

STOCKINET SURG 5 IMPERVIOUS 12 X 48

Facility

$22.00

Hospital Charge Code	2819449
Hospital Revenue Code	271
Rate for Payer: Cash Price	$19.80

STOCKINET SURG 5 IMPERVIOUS 12 X 48

Facility

$22.00

Hospital Charge Code	2819449
Hospital Revenue Code	271
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$15.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: UnitedHealthcare Commercial	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

STOCKINET TUBING 3

Facility

$21.00

Hospital Charge Code	2819447
Hospital Revenue Code	271
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

STOCKINET TUBING 3

Facility

$21.00

Hospital Charge Code	2819447
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.90

STOCKINGS EX-LG, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819464
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS EX-LG, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819464
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS EX-LG, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819460
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS EX-LG, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819460
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS LG, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819463
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS LG, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819463
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS LG, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819459
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS LG, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819459
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS MED, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819462
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS MED, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819462
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS MED, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819458
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS MED, THIGH HIGH

Facility

$60.00

Hospital Charge Code	2819458
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS SM, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819461
Hospital Revenue Code	271
Rate for Payer: Cash Price	$54.00

STOCKINGS SM, KNEE HIGH

Facility

$60.00

Hospital Charge Code	2819461
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

STOCKINGS, XXLG

Facility

$60.00

Hospital Charge Code	2819457
Hospital Revenue Code	271
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$42.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$35.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$42.84
Rate for Payer: Cash Price	$54.00
Rate for Payer: UnitedHealthcare Commercial	$40.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.60

Know your out-of-pocket cost for care.

All Charges