Madison Medical Center

All Charges

Charge

Type

Setting

Price

THERMOMETER, ORAL

Facility

$45.00

Hospital Charge Code	2819273
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

THERMOMETER, ORAL

Facility

$45.00

Hospital Charge Code	2819273
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

THERMOMETER, RECTAL

Facility

$39.00

Hospital Charge Code	2819272
Hospital Revenue Code	271
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$27.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$27.85
Rate for Payer: Cash Price	$35.10
Rate for Payer: UnitedHealthcare Commercial	$26.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.04

THERMOMETER, RECTAL

Facility

$39.00

Hospital Charge Code	2819272
Hospital Revenue Code	271
Rate for Payer: Cash Price	$35.10

THIAMINE (VITAMIN B1)

Facility

$182.00

Service Code	CPT 84425
Hospital Charge Code	2284425
Hospital Revenue Code	301
Rate for Payer: Cash Price	$163.80

THIAMINE (VITAMIN B1)

Facility

$182.00

Service Code	CPT 84425
Hospital Charge Code	2284425
Hospital Revenue Code	301
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$129.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$19.11
Rate for Payer: Aetna Medicare Advantage	$21.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$107.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$129.95
Rate for Payer: Cash Price	$163.80
Rate for Payer: Cash Price	$163.80
Rate for Payer: Cash Price	$163.80
Rate for Payer: Cigna Commercial HMO & PPO	$21.23
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19.11
Rate for Payer: Home State Health Plan Medicaid Managed Care	$20.45
Rate for Payer: Home State Health Plan Medicare Advantage	$21.23
Rate for Payer: Humana Commercial	$42.46
Rate for Payer: Humana Medicare Advantage	$21.23
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.52

THIAMINE (VITAMIN B1) 100MG/ML INJ

Facility

$40.00

Service Code	HCPCS J3411
Hospital Charge Code	2696422
Hospital Revenue Code	250
Rate for Payer: Cash Price	$36.00

THIAMINE (VITAMIN B1) 100MG/ML INJ

Facility

$40.00

Service Code	HCPCS J3411
Hospital Charge Code	2696422
Hospital Revenue Code	250
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

THIAMINE (VITAMIN B 1) 100MG TAB

Facility

$18.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2626349
Hospital Revenue Code	250
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

THIAMINE (VITAMIN B 1) 100MG TAB

Facility

$18.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2626349
Hospital Revenue Code	250
Rate for Payer: Cash Price	$16.20

THIAMINE (VIT B1) 200MG INJ 2ML VIAL

Facility

$79.00

Service Code	HCPCS J3411
Hospital Charge Code	2656338
Hospital Revenue Code	250
Rate for Payer: Cash Price	$71.10

THIAMINE (VIT B1) 200MG INJ 2ML VIAL

Facility

$79.00

Service Code	HCPCS J3411
Hospital Charge Code	2656338
Hospital Revenue Code	250
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$56.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$46.77
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$56.41
Rate for Payer: Cash Price	$71.10
Rate for Payer: UnitedHealthcare Commercial	$52.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.44

THIAMYLAL INJ

Facility

$91.00

Hospital Charge Code	202035
Hospital Revenue Code	370
Rate for Payer: Cash Price	$81.90

THIAMYLAL INJ

Facility

$91.00

Hospital Charge Code	202035
Hospital Revenue Code	370
Min. Negotiated Rate	$32.76
Max. Negotiated Rate	$64.97
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$53.87
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$64.97
Rate for Payer: Cash Price	$81.90
Rate for Payer: UnitedHealthcare Commercial	$60.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$32.76

THIOPURINE METABOLITES

Facility

$866.00

Service Code	CPT 80375
Hospital Charge Code	2280375
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$618.32
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$512.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$618.32
Rate for Payer: Cash Price	$779.40
Rate for Payer: Cash Price	$779.40
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$311.76

THIOPURINE METABOLITES

Facility

$866.00

Service Code	CPT 80375
Hospital Charge Code	2280375
Hospital Revenue Code	301
Rate for Payer: Cash Price	$779.40

THIOPURINE METHYLTRANSFERASE

Facility

$561.00

Service Code	CPT 82657
Hospital Charge Code	2286145
Hospital Revenue Code	301
Rate for Payer: Cash Price	$504.90

THIOPURINE METHYLTRANSFERASE

Facility

$561.00

Service Code	CPT 82657
Hospital Charge Code	2286145
Hospital Revenue Code	301
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$400.55
Rate for Payer: Aetna Better Health Medicaid/QHP	$19.95
Rate for Payer: Aetna Medicare Advantage	$22.17
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$332.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$400.55
Rate for Payer: Cash Price	$504.90
Rate for Payer: Cash Price	$504.90
Rate for Payer: Cash Price	$504.90
Rate for Payer: Cigna Commercial HMO & PPO	$22.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19.95
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21.35
Rate for Payer: Home State Health Plan Medicare Advantage	$22.17
Rate for Payer: Humana Commercial	$44.34
Rate for Payer: Humana Medicare Advantage	$22.17
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$201.96

THORACENTESIS

Professional

Both

$1,272.00

Service Code	CPT 32554
Hospital Charge Code	1832000
Hospital Revenue Code	981
Min. Negotiated Rate	$77.18
Max. Negotiated Rate	$445.20
Rate for Payer: Aetna Commercial/Medicare Advantage	$77.18
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$356.45
Rate for Payer: Cash Price	$1,144.80
Rate for Payer: Cash Price	$1,144.80
Rate for Payer: Cigna Commercial HMO & PPO	$77.18
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$356.45
Rate for Payer: Home State Health Plan Medicaid Managed Care	$392.10
Rate for Payer: Home State Health Plan Medicare Advantage	$77.18
Rate for Payer: Optum Medicare Advantage	$445.20
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$356.45

THORACENTESS TRAY

Facility

$244.00

Hospital Charge Code	2820532
Hospital Revenue Code	271
Rate for Payer: Cash Price	$219.60

THORACENTESS TRAY

Facility

$244.00

Hospital Charge Code	2820532
Hospital Revenue Code	271
Min. Negotiated Rate	$87.84
Max. Negotiated Rate	$174.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$144.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$174.22
Rate for Payer: Cash Price	$219.60
Rate for Payer: UnitedHealthcare Commercial	$162.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$87.84

THORACIC SPINE XRAY

Facility

$572.00

Service Code	CPT 72072
Hospital Charge Code	3220121
Hospital Revenue Code	320
Min. Negotiated Rate	$94.24
Max. Negotiated Rate	$408.41
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	$338.62
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$408.41
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
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	$205.92

THORACIC SPINE XRAY

Facility

$572.00

Service Code	CPT 72072
Hospital Charge Code	3220121
Hospital Revenue Code	320
Rate for Payer: Cash Price	$514.80

THORAZINE

Facility

$83.00

Service Code	CPT 80342
Hospital Charge Code	2280342
Hospital Revenue Code	301
Rate for Payer: Cash Price	$74.70

THORAZINE

Facility

$83.00

Service Code	CPT 80342
Hospital Charge Code	2280342
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$59.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$49.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$59.26
Rate for Payer: Cash Price	$74.70
Rate for Payer: Cash Price	$74.70
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.88

Know your out-of-pocket cost for care.

All Charges