Madison Medical Center

All Charges

Charge

Type

Setting

Price

SUTURE, SILK 3-0 BLK FS-1 18

Facility

$20.00

Hospital Charge Code	2819079
Hospital Revenue Code	271
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$14.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$14.28
Rate for Payer: Cash Price	$18.00
Rate for Payer: UnitedHealthcare Commercial	$13.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20

SUTURE, SILK 3-0 BLK FS-1 18

Facility

$20.00

Hospital Charge Code	2819079
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.00

SUTURE, SILK 4-0 BLK FS2 18

Facility

$22.00

Hospital Charge Code	2819078
Hospital Revenue Code	271
Rate for Payer: Cash Price	$19.80

SUTURE, SILK 4-0 BLK FS2 18

Facility

$22.00

Hospital Charge Code	2819078
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

SUTURE, SILK 4-0, P-3

Facility

$24.00

Hospital Charge Code	2819068
Hospital Revenue Code	271
Rate for Payer: Cash Price	$21.60

SUTURE, SILK 4-0, P-3

Facility

$24.00

Hospital Charge Code	2819068
Hospital Revenue Code	271
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$17.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$14.21
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$17.14
Rate for Payer: Cash Price	$21.60
Rate for Payer: UnitedHealthcare Commercial	$16.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.64

SUTURE, TEVDEK

Facility

$48.00

Hospital Charge Code	2819023
Hospital Revenue Code	271
Rate for Payer: Cash Price	$43.20

SUTURE, TEVDEK

Facility

$48.00

Hospital Charge Code	2819023
Hospital Revenue Code	271
Min. Negotiated Rate	$17.28
Max. Negotiated Rate	$34.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$28.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$34.27
Rate for Payer: Cash Price	$43.20
Rate for Payer: UnitedHealthcare Commercial	$32.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.28

SUTURE, VICRYL 0 UR-6 #J603H

Facility

$13.00

Hospital Charge Code	2819047
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

SUTURE, VICRYL 0 UR-6 #J603H

Facility

$13.00

Hospital Charge Code	2819047
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

SUTURE, VICRYL 1, #J347H

Facility

$22.00

Hospital Charge Code	2818073
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

SUTURE, VICRYL 1, #J347H

Facility

$22.00

Hospital Charge Code	2818073
Hospital Revenue Code	271
Rate for Payer: Cash Price	$19.80

SUTURE, VICRYL 2-0 CT-1, #J339H

Facility

$13.00

Hospital Charge Code	2819073
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

SUTURE, VICRYL 2-0 CT-1, #J339H

Facility

$13.00

Hospital Charge Code	2819073
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

SUTURE, VICRYL 2-0 CT-2, #J269H

Facility

$13.00

Hospital Charge Code	2819048
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

SUTURE, VICRYL 2-0 CT-2, #J269H

Facility

$13.00

Hospital Charge Code	2819048
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

SUTURE, VICRYL 2-0 CT-3, #J328H

Facility

$13.00

Hospital Charge Code	2819049
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

SUTURE, VICRYL 2-0 CT-3, #J328H

Facility

$13.00

Hospital Charge Code	2819049
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

SUTURE, VICRYL 2-0, #J105T

Facility

$42.00

Hospital Charge Code	2819052
Hospital Revenue Code	210
Min. Negotiated Rate	$1,519.00
Max. Negotiated Rate	$1,958.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,778.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,958.00
Rate for Payer: Cash Price	$37.80
Rate for Payer: UnitedHealthcare Commercial	$1,519.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,754.00

SUTURE VICRYL 2.0, PS-2: J428H

Facility

$12.00

Hospital Charge Code	2819085
Hospital Revenue Code	272
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$8.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.10
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$8.57
Rate for Payer: Cash Price	$10.80
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.32

SUTURE VICRYL 2.0, PS-2: J428H

Facility

$12.00

Hospital Charge Code	2819085
Hospital Revenue Code	272
Rate for Payer: Cash Price	$10.80

SUTURE, VICRYL 2-0 SH, #J417H

Facility

$13.00

Hospital Charge Code	2819050
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

SUTURE, VICRYL 2-0 SH, #J417H

Facility

$13.00

Hospital Charge Code	2819050
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

SUTURE VICRYL 3.0, PS-2: J497G

Facility

$21.00

Hospital Charge Code	2819041
Hospital Revenue Code	272
Rate for Payer: Cash Price	$18.90

SUTURE VICRYL 3.0, PS-2: J497G

Facility

$21.00

Hospital Charge Code	2819041
Hospital Revenue Code	272
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

Know your out-of-pocket cost for care.

All Charges