Madison Medical Center

All Charges

Charge

Type

Setting

Price

THYROID DISORDERS

Facility

$7,482.30

Service Code	APR-DRG 4271
Min. Negotiated Rate	$7,482.30
Max. Negotiated Rate	$7,482.30
Rate for Payer: Aetna Better Health Medicaid/QHP	$7,482.30
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7,482.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7,482.30
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7,482.30

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$48,676.85

Service Code	APR-DRG 4044
Min. Negotiated Rate	$48,676.85
Max. Negotiated Rate	$48,676.85
Rate for Payer: Aetna Better Health Medicaid/QHP	$48,676.85
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$48,676.85
Rate for Payer: Home State Health Plan Medicaid Managed Care	$48,676.85
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$48,676.85

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$17,859.86

Service Code	APR-DRG 4042
Min. Negotiated Rate	$17,859.86
Max. Negotiated Rate	$17,859.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$17,859.86
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$17,859.86
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17,859.86
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$17,859.86

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$5,006.27

Service Code	APR-DRG 4041
Min. Negotiated Rate	$5,006.27
Max. Negotiated Rate	$5,006.27
Rate for Payer: Aetna Better Health Medicaid/QHP	$5,006.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$5,006.27
Rate for Payer: Home State Health Plan Medicaid Managed Care	$5,006.27
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$5,006.27

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES

Facility

$28,796.92

Service Code	APR-DRG 4043
Min. Negotiated Rate	$28,796.92
Max. Negotiated Rate	$28,796.92
Rate for Payer: Aetna Better Health Medicaid/QHP	$28,796.92
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$28,796.92
Rate for Payer: Home State Health Plan Medicaid Managed Care	$28,796.92
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$28,796.92

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC

Facility

$27,114.80

Service Code	MSDRG 626
Min. Negotiated Rate	$13,557.40
Max. Negotiated Rate	$27,114.80
Rate for Payer: Aetna Medicare Advantage	$13,557.40
Rate for Payer: Cigna Commercial HMO & PPO	$13,557.40
Rate for Payer: Home State Health Plan Medicare Advantage	$13,557.40
Rate for Payer: Humana Commercial	$27,114.80
Rate for Payer: Humana Medicare Advantage	$13,557.40

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC

Facility

$51,105.28

Service Code	MSDRG 625
Min. Negotiated Rate	$25,552.64
Max. Negotiated Rate	$51,105.28
Rate for Payer: Aetna Medicare Advantage	$25,552.64
Rate for Payer: Cigna Commercial HMO & PPO	$25,552.64
Rate for Payer: Home State Health Plan Medicare Advantage	$25,552.64
Rate for Payer: Humana Commercial	$51,105.28
Rate for Payer: Humana Medicare Advantage	$25,552.64

THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC

Facility

$24,431.54

Service Code	MSDRG 627
Min. Negotiated Rate	$12,215.77
Max. Negotiated Rate	$24,431.54
Rate for Payer: Aetna Medicare Advantage	$12,215.77
Rate for Payer: Cigna Commercial HMO & PPO	$12,215.77
Rate for Payer: Home State Health Plan Medicare Advantage	$12,215.77
Rate for Payer: Humana Commercial	$24,431.54
Rate for Payer: Humana Medicare Advantage	$12,215.77

THYROTROPIN RECEPTOR AB

Facility

$106.00

Service Code	CPT 83520
Hospital Charge Code	2284230
Hospital Revenue Code	301
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$75.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.54
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$62.75
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$75.68
Rate for Payer: Cash Price	$95.40
Rate for Payer: Cash Price	$95.40
Rate for Payer: Cash Price	$95.40
Rate for Payer: Cigna Commercial HMO & PPO	$17.27
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15.54
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.63
Rate for Payer: Home State Health Plan Medicare Advantage	$17.27
Rate for Payer: Humana Commercial	$34.54
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.16

THYROTROPIN RECEPTOR AB

Facility

$106.00

Service Code	CPT 83520
Hospital Charge Code	2284230
Hospital Revenue Code	301
Rate for Payer: Cash Price	$95.40

THYROTROPIN RELEASING HORMONE

Facility

$584.00

Service Code	CPT 83519
Hospital Charge Code	2284235
Hospital Revenue Code	301
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$416.98
Rate for Payer: Aetna Better Health Medicaid/QHP	$16.56
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$345.73
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$416.98
Rate for Payer: Cash Price	$525.60
Rate for Payer: Cash Price	$525.60
Rate for Payer: Cash Price	$525.60
Rate for Payer: Cigna Commercial HMO & PPO	$18.40
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$16.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$17.72
Rate for Payer: Home State Health Plan Medicare Advantage	$18.40
Rate for Payer: Humana Commercial	$36.80
Rate for Payer: Humana Medicare Advantage	$18.40
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$16.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.24

THYROTROPIN RELEASING HORMONE

Facility

$584.00

Service Code	CPT 83519
Hospital Charge Code	2284235
Hospital Revenue Code	301
Rate for Payer: Cash Price	$525.60

THYROXINE-BINDING GLOBULIN, SERUM

Facility

$37.00

Service Code	CPT 84442
Hospital Charge Code	22284442
Hospital Revenue Code	301
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$29.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$13.30
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$26.42
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cash Price	$33.30
Rate for Payer: Cigna Commercial HMO & PPO	$14.78
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$14.23
Rate for Payer: Home State Health Plan Medicare Advantage	$14.78
Rate for Payer: Humana Commercial	$29.56
Rate for Payer: Humana Medicare Advantage	$14.78
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$13.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.32

THYROXINE-BINDING GLOBULIN, SERUM

Facility

$37.00

Service Code	CPT 84442
Hospital Charge Code	22284442
Hospital Revenue Code	301
Rate for Payer: Cash Price	$33.30

TIBC

Facility

$186.00

Service Code	CPT 83550
Hospital Charge Code	2219164
Hospital Revenue Code	301
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$132.80
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.87
Rate for Payer: Aetna Medicare Advantage	$8.74
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$110.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$132.80
Rate for Payer: Cash Price	$167.40
Rate for Payer: Cash Price	$167.40
Rate for Payer: Cash Price	$167.40
Rate for Payer: Cigna Commercial HMO & PPO	$8.74
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.87
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.42
Rate for Payer: Home State Health Plan Medicare Advantage	$8.74
Rate for Payer: Humana Commercial	$17.48
Rate for Payer: Humana Medicare Advantage	$8.74
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$66.96

TIBC

Facility

$186.00

Service Code	CPT 83550
Hospital Charge Code	2219164
Hospital Revenue Code	301
Rate for Payer: Cash Price	$167.40

TICAGRELOR (BRILINTA) 90MG TAB UD

Facility

$46.00

Service Code	NDC 186077739
Hospital Charge Code	2625911
Hospital Revenue Code	250
Rate for Payer: Cash Price	$41.40

TICAGRELOR (BRILINTA) 90MG TAB UD

Facility

$46.00

Service Code	NDC 186077739
Hospital Charge Code	2625911
Hospital Revenue Code	250
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$32.84
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$27.23
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.84
Rate for Payer: Cash Price	$41.40
Rate for Payer: UnitedHealthcare Commercial	$30.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.56

TIGECYCLINE (TYGACIL) 50MG IVPB

Facility

$474.00

Service Code	HCPCS J1200
Hospital Charge Code	2626460
Hospital Revenue Code	250
Rate for Payer: Cash Price	$426.60

TIGECYCLINE (TYGACIL) 50MG IVPB

Facility

$474.00

Service Code	HCPCS J1200
Hospital Charge Code	2626460
Hospital Revenue Code	250
Min. Negotiated Rate	$170.64
Max. Negotiated Rate	$338.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$280.61
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$338.44
Rate for Payer: Cash Price	$426.60
Rate for Payer: UnitedHealthcare Commercial	$316.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$170.64

TIGER TAIL URETERAL CATHETER

Facility

$55.00

Hospital Charge Code	1299000
Hospital Revenue Code	272
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$39.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: UnitedHealthcare Commercial	$36.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.80

TIGER TAIL URETERAL CATHETER

Facility

$55.00

Hospital Charge Code	1299000
Hospital Revenue Code	272
Rate for Payer: Cash Price	$49.50

TIMOLOL 0.5% OP SOL 15ML EMP

Facility

$58.00

Service Code	NDC 7.6478E+10
Hospital Charge Code	2622569
Hospital Revenue Code	250
Min. Negotiated Rate	$20.88
Max. Negotiated Rate	$41.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$34.34
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$41.41
Rate for Payer: Cash Price	$52.20
Rate for Payer: UnitedHealthcare Commercial	$38.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.88

TIMOLOL 0.5% OP SOL 15ML EMP

Facility

$58.00

Service Code	NDC 7.6478E+10
Hospital Charge Code	2622569
Hospital Revenue Code	250
Rate for Payer: Cash Price	$52.20

TIMOLOL 0.5% (TIMOPTIC XE)OP GEL 5ML EMP

Facility

$985.00

Service Code	NDC 6.2332E+10
Hospital Charge Code	2624157
Hospital Revenue Code	250
Rate for Payer: Cash Price	$886.50

Know your out-of-pocket cost for care.

All Charges