Madison Medical Center

All Charges

Charge

Type

Setting

Price

STRAPPING UNIV. ELBOW-STAT DEROYAL

Facility

$35.00

Hospital Charge Code	4070015
Hospital Revenue Code	271
Rate for Payer: Cash Price	$31.50

STRAPPING UNIV. ELBOW-STAT DEROYAL

Facility

$35.00

Hospital Charge Code	4070015
Hospital Revenue Code	271
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

STRAPPING UNNA BOOT

Professional

Both

$82.00

Service Code	CPT 29580
Hospital Charge Code	4129580
Hospital Revenue Code	975
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$53.12
Rate for Payer: Aetna Commercial/Medicare Advantage	$22.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$48.29
Rate for Payer: Cash Price	$73.80
Rate for Payer: Cash Price	$73.80
Rate for Payer: Cigna Commercial HMO & PPO	$22.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$48.29
Rate for Payer: Home State Health Plan Medicaid Managed Care	$53.12
Rate for Payer: Home State Health Plan Medicare Advantage	$22.91
Rate for Payer: Optum Medicare Advantage	$28.70
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$48.29

STREP A RAPID

Facility

$168.00

Service Code	CPT 87081
Hospital Charge Code	3013500
Hospital Revenue Code	306
Rate for Payer: Cash Price	$151.20

STREP A RAPID

Facility

$168.00

Service Code	CPT 87081
Hospital Charge Code	3013500
Hospital Revenue Code	306
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$119.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$5.97
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$99.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$119.95
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cash Price	$151.20
Rate for Payer: Cigna Commercial HMO & PPO	$6.63
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5.97
Rate for Payer: Home State Health Plan Medicaid Managed Care	$6.39
Rate for Payer: Home State Health Plan Medicare Advantage	$6.63
Rate for Payer: Humana Commercial	$13.26
Rate for Payer: Humana Medicare Advantage	$6.63
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.48

STREP A RAPID PCR

Facility

$108.00

Service Code	CPT 87651
Hospital Charge Code	2287651
Hospital Revenue Code	306
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$77.11
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	$63.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$77.11
Rate for Payer: Cash Price	$97.20
Rate for Payer: Cash Price	$97.20
Rate for Payer: Cash Price	$97.20
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	$38.88

STREP A RAPID PCR

Facility

$108.00

Service Code	CPT 87651
Hospital Charge Code	2287651
Hospital Revenue Code	306
Rate for Payer: Cash Price	$97.20

STRIATIONAL ANTIBODIES

Facility

$72.00

Service Code	CPT 86255
Hospital Charge Code	2286257
Hospital Revenue Code	301
Rate for Payer: Cash Price	$64.80

STRIATIONAL ANTIBODIES

Facility

$72.00

Service Code	CPT 86255
Hospital Charge Code	2286257
Hospital Revenue Code	301
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$51.41
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.85
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$42.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$51.41
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cash Price	$64.80
Rate for Payer: Cigna Commercial HMO & PPO	$12.05
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.61
Rate for Payer: Home State Health Plan Medicare Advantage	$12.05
Rate for Payer: Humana Commercial	$24.10
Rate for Payer: Humana Medicare Advantage	$12.05
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.92

STRIPS SURGICAL

Facility

$96.00

Hospital Charge Code	128866
Hospital Revenue Code	271
Rate for Payer: Cash Price	$86.40

STRIPS SURGICAL

Facility

$96.00

Hospital Charge Code	128866
Hospital Revenue Code	271
Min. Negotiated Rate	$34.56
Max. Negotiated Rate	$68.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$56.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$68.54
Rate for Payer: Cash Price	$86.40
Rate for Payer: UnitedHealthcare Commercial	$64.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.56

STRKER FLOATION MATTRESS

Facility

$210.00

Hospital Charge Code	57968
Hospital Revenue Code	290
Rate for Payer: Cash Price	$189.00

STRKER FLOATION MATTRESS

Facility

$210.00

Hospital Charge Code	57968
Hospital Revenue Code	290
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$149.94
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$124.32
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$149.94
Rate for Payer: Cash Price	$189.00
Rate for Payer: UnitedHealthcare Commercial	$140.07

STRYKER FLOATION MATT PUMP

Facility

$105.00

Hospital Charge Code	57967
Hospital Revenue Code	940
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$74.97
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$62.16
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$74.97
Rate for Payer: Cash Price	$94.50
Rate for Payer: UnitedHealthcare Commercial	$70.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.80

STRYKER FLOATION MATT PUMP

Facility

$105.00

Hospital Charge Code	57967
Hospital Revenue Code	940
Rate for Payer: Cash Price	$94.50

ST SPEECH THER SWAL TREATMNT 1HR

Facility

$189.00

Service Code	CPT 92526
Hospital Charge Code	4792526
Hospital Revenue Code	441
Rate for Payer: Cash Price	$170.10

ST SPEECH THER SWAL TREATMNT 1HR

Facility

$189.00

Service Code	CPT 92526
Hospital Charge Code	4792526
Hospital Revenue Code	441
Min. Negotiated Rate	$68.04
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$74.07
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	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$74.07
Rate for Payer: Home State Health Plan Medicaid Managed Care	$79.25
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$74.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$68.04

ST SP THER SESS 1 HR

Facility

$189.00

Service Code	CPT 92507
Hospital Charge Code	4792507
Hospital Revenue Code	441
Min. Negotiated Rate	$67.14
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$67.14
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	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Cash Price	$170.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$67.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$71.84
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$67.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$68.04

ST SP THER SESS 1 HR

Facility

$189.00

Service Code	CPT 92507
Hospital Charge Code	4792507
Hospital Revenue Code	441
Rate for Payer: Cash Price	$170.10

ST SP THER SESS 30

Facility

$124.00

Service Code	CPT 92507
Hospital Charge Code	4700023
Hospital Revenue Code	441
Min. Negotiated Rate	$44.64
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$67.14
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	$111.60
Rate for Payer: Cash Price	$111.60
Rate for Payer: Cash Price	$111.60
Rate for Payer: Cash Price	$111.60
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$67.14
Rate for Payer: Home State Health Plan Medicaid Managed Care	$71.84
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$67.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.64

ST SP THER SESS 30

Facility

$124.00

Service Code	CPT 92507
Hospital Charge Code	4700023
Hospital Revenue Code	441
Rate for Payer: Cash Price	$111.60

ST SWAL FUNC SP EVAL

Facility

$271.00

Service Code	CPT 92611
Hospital Charge Code	4792611
Hospital Revenue Code	441
Min. Negotiated Rate	$80.38
Max. Negotiated Rate	$136.00
Rate for Payer: Cash Price	$243.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$80.38
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	$243.90
Rate for Payer: Cash Price	$243.90
Rate for Payer: Cash Price	$243.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$80.38
Rate for Payer: Home State Health Plan Medicaid Managed Care	$86.01
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$80.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$97.56

ST SWAL FUNC SP EVAL

Facility

$271.00

Service Code	CPT 92611
Hospital Charge Code	4792611
Hospital Revenue Code	441
Rate for Payer: Cash Price	$243.90

ST SWAL FUNC SP EVAL BEDSIDE

Facility

$271.00

Service Code	CPT 92610
Hospital Charge Code	4792610
Hospital Revenue Code	441
Rate for Payer: Cash Price	$243.90

ST SWAL FUNC SP EVAL BEDSIDE

Facility

$271.00

Service Code	CPT 92610
Hospital Charge Code	4792610
Hospital Revenue Code	441
Min. Negotiated Rate	$74.58
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Better Health Medicaid/QHP	$74.58
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	$243.90
Rate for Payer: Cash Price	$243.90
Rate for Payer: Cash Price	$243.90
Rate for Payer: Cash Price	$243.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$74.58
Rate for Payer: Home State Health Plan Medicaid Managed Care	$79.80
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$74.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$97.56

Know your out-of-pocket cost for care.

All Charges