Madison Medical Center

All Charges

Charge

Type

Setting

Price

BETA 2 GLYCOPROTEIN,IGA

Facility

$54.00

Service Code	CPT 86146
Hospital Charge Code	2286150
Hospital Revenue Code	302
Rate for Payer: Cash Price	$48.60

BETA 2 GLYCOPROTEIN IGG

Facility

$54.00

Service Code	CPT 86146
Hospital Charge Code	2286152
Hospital Revenue Code	302
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$50.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$22.91
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$31.97
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$38.56
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cigna Commercial HMO & PPO	$25.45
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24.51
Rate for Payer: Home State Health Plan Medicare Advantage	$25.45
Rate for Payer: Humana Commercial	$50.90
Rate for Payer: Humana Medicare Advantage	$25.45
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.44

BETA 2 GLYCOPROTEIN IGG

Facility

$54.00

Service Code	CPT 86146
Hospital Charge Code	2286152
Hospital Revenue Code	302
Rate for Payer: Cash Price	$48.60

BETA 2 GLYCOPROTEIN,IGM

Facility

$54.00

Service Code	CPT 86146
Hospital Charge Code	2286151
Hospital Revenue Code	302
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$50.90
Rate for Payer: Aetna Better Health Medicaid/QHP	$22.91
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$31.97
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$38.56
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cash Price	$48.60
Rate for Payer: Cigna Commercial HMO & PPO	$25.45
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22.91
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24.51
Rate for Payer: Home State Health Plan Medicare Advantage	$25.45
Rate for Payer: Humana Commercial	$50.90
Rate for Payer: Humana Medicare Advantage	$25.45
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.44

BETA 2 GLYCOPROTEIN,IGM

Facility

$54.00

Service Code	CPT 86146
Hospital Charge Code	2286151
Hospital Revenue Code	302
Rate for Payer: Cash Price	$48.60

BETA 2 MICROGLOBULIN

Facility

$102.00

Service Code	CPT 82232
Hospital Charge Code	2282232
Hospital Revenue Code	305
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$72.83
Rate for Payer: Aetna Better Health Medicaid/QHP	$14.56
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$60.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$72.83
Rate for Payer: Cash Price	$91.80
Rate for Payer: Cash Price	$91.80
Rate for Payer: Cash Price	$91.80
Rate for Payer: Cigna Commercial HMO & PPO	$16.18
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$14.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15.58
Rate for Payer: Home State Health Plan Medicare Advantage	$16.18
Rate for Payer: Humana Commercial	$32.36
Rate for Payer: Humana Medicare Advantage	$16.18
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$14.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.72

BETA 2 MICROGLOBULIN

Facility

$102.00

Service Code	CPT 82232
Hospital Charge Code	2282232
Hospital Revenue Code	305
Rate for Payer: Cash Price	$91.80

BETADINE SOL-GAL.

Facility

$126.00

Hospital Charge Code	282145
Hospital Revenue Code	271
Rate for Payer: Cash Price	$113.40

BETADINE SOL-GAL.

Facility

$126.00

Hospital Charge Code	282145
Hospital Revenue Code	271
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$89.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$74.59
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$89.96
Rate for Payer: Cash Price	$113.40
Rate for Payer: UnitedHealthcare Commercial	$84.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$45.36

BETADINE SOLUTION

Facility

$20.00

Hospital Charge Code	282144
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

BETADINE SOLUTION

Facility

$20.00

Hospital Charge Code	282144
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.00

BETADINE SURGICAL SCRUB-MEDICHOICE

Facility

$10.00

Hospital Charge Code	1217068
Hospital Revenue Code	271
Rate for Payer: Cash Price	$9.00

BETADINE SURGICAL SCRUB-MEDICHOICE

Facility

$10.00

Hospital Charge Code	1217068
Hospital Revenue Code	271
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$7.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$5.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7.14
Rate for Payer: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

BETADINE SWABSTICK

Facility

$16.00

Hospital Charge Code	282146
Hospital Revenue Code	271
Rate for Payer: Cash Price	$14.40

BETADINE SWABSTICK

Facility

$16.00

Hospital Charge Code	282146
Hospital Revenue Code	271
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$11.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$9.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$11.42
Rate for Payer: Cash Price	$14.40
Rate for Payer: UnitedHealthcare Commercial	$10.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.76

BETA HYDROXYBUTYRATE

Facility

$134.00

Service Code	CPT 82010
Hospital Charge Code	2282010
Hospital Revenue Code	305
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$95.68
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.35
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$79.33
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$95.68
Rate for Payer: Cash Price	$120.60
Rate for Payer: Cash Price	$120.60
Rate for Payer: Cash Price	$120.60
Rate for Payer: Cigna Commercial HMO & PPO	$8.17
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.35
Rate for Payer: Home State Health Plan Medicaid Managed Care	$7.86
Rate for Payer: Home State Health Plan Medicare Advantage	$8.17
Rate for Payer: Humana Commercial	$16.34
Rate for Payer: Humana Medicare Advantage	$8.17
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$48.24

BETA HYDROXYBUTYRATE

Facility

$134.00

Service Code	CPT 82010
Hospital Charge Code	2282010
Hospital Revenue Code	305
Rate for Payer: Cash Price	$120.60

BETAMETHASONE (CELESTONE) 6MG INJ 1ML

Facility

$75.00

Service Code	HCPCS J0702
Hospital Charge Code	2657121
Hospital Revenue Code	250
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$53.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$44.40
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$53.55
Rate for Payer: Cash Price	$67.50
Rate for Payer: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.00

BETAMETHASONE (CELESTONE) 6MG INJ 1ML

Facility

$75.00

Service Code	HCPCS J0702
Hospital Charge Code	2657121
Hospital Revenue Code	250
Rate for Payer: Cash Price	$67.50

BETAMETH SOD PHOS & ACE 30MG/5ML IM INJ

Facility

$65.00

Service Code	NDC 517072001
Hospital Charge Code	2697049
Hospital Revenue Code	250
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$46.41
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: UnitedHealthcare Commercial	$43.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.40

BETAMETH SOD PHOS & ACE 30MG/5ML IM INJ

Facility

$65.00

Service Code	NDC 517072001
Hospital Charge Code	2697049
Hospital Revenue Code	250
Rate for Payer: Cash Price	$58.50

BETAMETH VAL 0.1% CREAM 15 GM EMP

Facility

$182.00

Service Code	NDC 1E+11
Hospital Charge Code	2623522
Hospital Revenue Code	250
Rate for Payer: Cash Price	$163.80

BETAMETH VAL 0.1% CREAM 15 GM EMP

Facility

$182.00

Service Code	NDC 1E+11
Hospital Charge Code	2623522
Hospital Revenue Code	250
Min. Negotiated Rate	$65.52
Max. Negotiated Rate	$129.95
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: UnitedHealthcare Commercial	$121.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.52

BETAMETH VAL 0.1% LOTION 60ML EMP

Facility

$182.00

Service Code	NDC 1E+11
Hospital Charge Code	2622712
Hospital Revenue Code	250
Rate for Payer: Cash Price	$163.80

BETAMETH VAL 0.1% LOTION 60ML EMP

Facility

$182.00

Service Code	NDC 1E+11
Hospital Charge Code	2622712
Hospital Revenue Code	250
Min. Negotiated Rate	$65.52
Max. Negotiated Rate	$129.95
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: UnitedHealthcare Commercial	$121.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.52

Know your out-of-pocket cost for care.

All Charges