Madison Medical Center

All Charges

Charge

Type

Setting

Price

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

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC

Facility

$41,997.94

Service Code	MSDRG 327
Min. Negotiated Rate	$20,998.97
Max. Negotiated Rate	$41,997.94
Rate for Payer: Aetna Medicare Advantage	$20,998.97
Rate for Payer: Cigna Commercial HMO & PPO	$20,998.97
Rate for Payer: Home State Health Plan Medicare Advantage	$20,998.97
Rate for Payer: Humana Commercial	$41,997.94
Rate for Payer: Humana Medicare Advantage	$20,998.97

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC

Facility

$82,307.70

Service Code	MSDRG 326
Min. Negotiated Rate	$41,153.85
Max. Negotiated Rate	$82,307.70
Rate for Payer: Aetna Medicare Advantage	$41,153.85
Rate for Payer: Cigna Commercial HMO & PPO	$41,153.85
Rate for Payer: Home State Health Plan Medicare Advantage	$41,153.85
Rate for Payer: Humana Commercial	$82,307.70
Rate for Payer: Humana Medicare Advantage	$41,153.85

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC

Facility

$28,734.14

Service Code	MSDRG 328
Min. Negotiated Rate	$14,367.07
Max. Negotiated Rate	$28,734.14
Rate for Payer: Aetna Medicare Advantage	$14,367.07
Rate for Payer: Cigna Commercial HMO & PPO	$14,367.07
Rate for Payer: Home State Health Plan Medicare Advantage	$14,367.07
Rate for Payer: Humana Commercial	$28,734.14
Rate for Payer: Humana Medicare Advantage	$14,367.07

STOMA PASTE

Facility

$28.00

Service Code	CPT A4364
Hospital Charge Code	287394
Hospital Revenue Code	271
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$19.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$16.58
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$19.99
Rate for Payer: Cash Price	$25.20
Rate for Payer: UnitedHealthcare Commercial	$18.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.08

STOMA PASTE

Facility

$28.00

Service Code	CPT A4364
Hospital Charge Code	287394
Hospital Revenue Code	271
Rate for Payer: Cash Price	$25.20

STOMATITIS COCKTAIL ALA/DON/LIDO 30ML

Facility

$208.00

Service Code	NDC 7.1914E+10
Hospital Charge Code	2656217
Hospital Revenue Code	250
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$148.51
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$123.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$148.51
Rate for Payer: Cash Price	$187.20
Rate for Payer: UnitedHealthcare Commercial	$138.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$74.88

STOMATITIS COCKTAIL ALA/DON/LIDO 30ML

Facility

$208.00

Service Code	NDC 7.1914E+10
Hospital Charge Code	2656217
Hospital Revenue Code	250
Rate for Payer: Cash Price	$187.20

STONE ANALYSIS

Facility

$119.00

Service Code	CPT 82360
Hospital Charge Code	2219282
Hospital Revenue Code	306
Rate for Payer: Cash Price	$107.10

STONE ANALYSIS

Facility

$119.00

Service Code	CPT 82360
Hospital Charge Code	2219282
Hospital Revenue Code	306
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$84.97
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.58
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$70.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$84.97
Rate for Payer: Cash Price	$107.10
Rate for Payer: Cash Price	$107.10
Rate for Payer: Cash Price	$107.10
Rate for Payer: Cigna Commercial HMO & PPO	$12.87
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.39
Rate for Payer: Home State Health Plan Medicare Advantage	$12.87
Rate for Payer: Humana Commercial	$25.74
Rate for Payer: Humana Medicare Advantage	$12.87
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84

.STONE ANALYSIS WITH PHOTO

Facility

$65.00

Service Code	CPT 82365
Hospital Charge Code	22442
Hospital Revenue Code	307
Rate for Payer: Cash Price	$58.50

.STONE ANALYSIS WITH PHOTO

Facility

$65.00

Service Code	CPT 82365
Hospital Charge Code	22442
Hospital Revenue Code	307
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$46.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.61
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$38.48
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$46.41
Rate for Payer: Cash Price	$58.50
Rate for Payer: Cash Price	$58.50
Rate for Payer: Cash Price	$58.50
Rate for Payer: Cigna Commercial HMO & PPO	$12.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.61
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.42
Rate for Payer: Home State Health Plan Medicare Advantage	$12.90
Rate for Payer: Humana Commercial	$25.80
Rate for Payer: Humana Medicare Advantage	$12.90
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.40

STONE BASKET

Facility

$744.00

Hospital Charge Code	2819478
Hospital Revenue Code	271
Rate for Payer: Cash Price	$669.60

STONE BASKET

Facility

$744.00

Hospital Charge Code	2819478
Hospital Revenue Code	271
Min. Negotiated Rate	$267.84
Max. Negotiated Rate	$531.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$440.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$531.22
Rate for Payer: Cash Price	$669.60
Rate for Payer: UnitedHealthcare Commercial	$496.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$267.84

ST ONSET SPEECH THERAPY SWALLOWING

Facility

$4.00

Hospital Charge Code	478996
Hospital Revenue Code	441
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$136.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$100.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$136.00
Rate for Payer: Cash Price	$3.60
Rate for Payer: Cash Price	$3.60
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.44

ST ONSET SPEECH THERAPY SWALLOWING

Facility

$4.00

Hospital Charge Code	478996
Hospital Revenue Code	441
Rate for Payer: Cash Price	$3.60

STOOK INFLUENZA A & B CLIA WAVED

Facility

$71.00

Service Code	CPT 87804
Hospital Charge Code	9787804
Hospital Revenue Code	521
Min. Negotiated Rate	$13.41
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.90
Rate for Payer: Aetna Medicare Advantage	$16.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$42.03
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$50.69
Rate for Payer: Cash Price	$63.90
Rate for Payer: Cash Price	$63.90
Rate for Payer: Cash Price	$63.90
Rate for Payer: Cash Price	$63.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.55
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.41
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.94
Rate for Payer: Home State Health Plan Medicare Advantage	$16.55
Rate for Payer: Humana Commercial	$33.10
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: UnitedHealthcare Commercial	$47.36
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

STOOK INFLUENZA A & B CLIA WAVED

Facility

$71.00

Service Code	CPT 87804
Hospital Charge Code	9787804
Hospital Revenue Code	521
Rate for Payer: Cash Price	$63.90

STOOK OCCULT BLOOD

Facility

$25.00

Service Code	CPT 82270
Hospital Charge Code	9782270
Hospital Revenue Code	521
Rate for Payer: Cash Price	$22.50

STOOK OCCULT BLOOD

Facility

$25.00

Service Code	CPT 82270
Hospital Charge Code	9782270
Hospital Revenue Code	521
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$3.94
Rate for Payer: Aetna Medicare Advantage	$4.38
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: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cigna Commercial HMO & PPO	$4.38
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3.55
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4.22
Rate for Payer: Home State Health Plan Medicare Advantage	$4.38
Rate for Payer: Humana Commercial	$8.76
Rate for Payer: Humana Medicare Advantage	$4.38
Rate for Payer: UnitedHealthcare Commercial	$16.68
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

STOOL OCCULT BLOOD

Facility

$14.00

Service Code	CPT 82270
Hospital Charge Code	4282270
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$3.94
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.29
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.00
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cash Price	$12.60
Rate for Payer: Cigna Commercial HMO & PPO	$4.38
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$4.22
Rate for Payer: Home State Health Plan Medicare Advantage	$4.38
Rate for Payer: Humana Commercial	$8.76
Rate for Payer: Humana Medicare Advantage	$4.38
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04

STOOL OCCULT BLOOD

Facility

$14.00

Service Code	CPT 82270
Hospital Charge Code	4282270
Hospital Revenue Code	301
Rate for Payer: Cash Price	$12.60

STOPCOCK 4-WAY

Facility

$40.00

Hospital Charge Code	2819479
Hospital Revenue Code	271
Rate for Payer: Cash Price	$36.00

STOPCOCK 4-WAY

Facility

$40.00

Hospital Charge Code	2819479
Hospital Revenue Code	271
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$28.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$28.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: UnitedHealthcare Commercial	$26.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.40

STRAPPING ANKLE

Professional

Both

$64.00

Service Code	CPT 29540
Hospital Charge Code	4129540
Hospital Revenue Code	975
Min. Negotiated Rate	$15.11
Max. Negotiated Rate	$26.97
Rate for Payer: Aetna Commercial/Medicare Advantage	$15.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$24.52
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cash Price	$57.60
Rate for Payer: Cigna Commercial HMO & PPO	$15.11
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$24.52
Rate for Payer: Home State Health Plan Medicaid Managed Care	$26.97
Rate for Payer: Home State Health Plan Medicare Advantage	$15.11
Rate for Payer: Optum Medicare Advantage	$22.40
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$24.52

Know your out-of-pocket cost for care.

All Charges