Madison Medical Center

All Charges

Charge

Type

Setting

Price

TROCAR-5MM

Facility

$320.00

Hospital Charge Code	1219104
Hospital Revenue Code	271
Rate for Payer: Cash Price	$288.00

TROCAR BLUNT TIP

Facility

$445.00

Hospital Charge Code	123326
Hospital Revenue Code	271
Min. Negotiated Rate	$160.20
Max. Negotiated Rate	$317.73
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$263.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$317.73
Rate for Payer: Cash Price	$400.50
Rate for Payer: UnitedHealthcare Commercial	$296.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$160.20

TROCAR BLUNT TIP

Facility

$445.00

Hospital Charge Code	123326
Hospital Revenue Code	271
Rate for Payer: Cash Price	$400.50

TROCAR-SURGISPIKE 5MM

Facility

$320.00

Hospital Charge Code	1219106
Hospital Revenue Code	271
Rate for Payer: Cash Price	$288.00

TROCAR-SURGISPIKE 5MM

Facility

$320.00

Hospital Charge Code	1219106
Hospital Revenue Code	271
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$228.48
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$189.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$228.48
Rate for Payer: Cash Price	$288.00
Rate for Payer: UnitedHealthcare Commercial	$213.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$115.20

TROCAR & SYRINGES (BLUNT TIP) 10MM

Facility

$677.00

Service Code	CPT Y7506
Hospital Charge Code	127280
Hospital Revenue Code	271
Min. Negotiated Rate	$243.72
Max. Negotiated Rate	$483.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$400.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$483.38
Rate for Payer: Cash Price	$609.30
Rate for Payer: UnitedHealthcare Commercial	$451.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$243.72

TROCAR & SYRINGES (BLUNT TIP) 10MM

Facility

$677.00

Service Code	CPT Y7506
Hospital Charge Code	127280
Hospital Revenue Code	271
Rate for Payer: Cash Price	$609.30

TROCAR XLONG 150MM (EACH)

Facility

$494.00

Hospital Charge Code	1219114
Hospital Revenue Code	271
Min. Negotiated Rate	$177.84
Max. Negotiated Rate	$352.72
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$292.45
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$352.72
Rate for Payer: Cash Price	$444.60
Rate for Payer: UnitedHealthcare Commercial	$329.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$177.84

TROCAR XLONG 150MM (EACH)

Facility

$494.00

Hospital Charge Code	1219114
Hospital Revenue Code	271
Rate for Payer: Cash Price	$444.60

TROPONIN I

Facility

$276.00

Service Code	CPT 84484
Hospital Charge Code	2284484
Hospital Revenue Code	301
Rate for Payer: Cash Price	$248.40

TROPONIN I

Facility

$276.00

Service Code	CPT 84484
Hospital Charge Code	2284484
Hospital Revenue Code	301
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$197.06
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.22
Rate for Payer: Aetna Medicare Advantage	$12.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$163.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$197.06
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cigna Commercial HMO & PPO	$12.47
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.22
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.01
Rate for Payer: Home State Health Plan Medicare Advantage	$12.47
Rate for Payer: Humana Commercial	$24.94
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$99.36

TROPONIN I (PATHFAST)

Facility

$276.00

Service Code	CPT 84484
Hospital Charge Code	2284487
Hospital Revenue Code	301
Rate for Payer: Cash Price	$248.40

TROPONIN I (PATHFAST)

Facility

$276.00

Service Code	CPT 84484
Hospital Charge Code	2284487
Hospital Revenue Code	301
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$197.06
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.22
Rate for Payer: Aetna Medicare Advantage	$12.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$163.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$197.06
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cash Price	$248.40
Rate for Payer: Cigna Commercial HMO & PPO	$12.47
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.22
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.01
Rate for Payer: Home State Health Plan Medicare Advantage	$12.47
Rate for Payer: Humana Commercial	$24.94
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$99.36

TROPONIN T (LABCORP)

Facility

$280.00

Service Code	CPT 84484
Hospital Charge Code	2284486
Hospital Revenue Code	302
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$199.92
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.22
Rate for Payer: Aetna Medicare Advantage	$12.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$165.76
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$199.92
Rate for Payer: Cash Price	$252.00
Rate for Payer: Cash Price	$252.00
Rate for Payer: Cash Price	$252.00
Rate for Payer: Cigna Commercial HMO & PPO	$12.47
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.22
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.01
Rate for Payer: Home State Health Plan Medicare Advantage	$12.47
Rate for Payer: Humana Commercial	$24.94
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$100.80

TROPONIN T (LABCORP)

Facility

$280.00

Service Code	CPT 84484
Hospital Charge Code	2284486
Hospital Revenue Code	302
Rate for Payer: Cash Price	$252.00

TRU-CUT NDL

Facility

$20.00

Hospital Charge Code	125209
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.00

TRU-CUT NDL

Facility

$20.00

Hospital Charge Code	125209
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

TRYPANOSOMA CRUZI AB IGG (AEL)

Facility

$161.00

Service Code	CPT 86753
Hospital Charge Code	2286753
Hospital Revenue Code	301
Rate for Payer: Cash Price	$144.90

TRYPANOSOMA CRUZI AB IGG (AEL)

Facility

$161.00

Service Code	CPT 86753
Hospital Charge Code	2286753
Hospital Revenue Code	301
Min. Negotiated Rate	$11.15
Max. Negotiated Rate	$114.95
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.15
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$95.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$114.95
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cash Price	$144.90
Rate for Payer: Cigna Commercial HMO & PPO	$12.39
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.15
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.93
Rate for Payer: Home State Health Plan Medicare Advantage	$12.39
Rate for Payer: Humana Commercial	$24.78
Rate for Payer: Humana Medicare Advantage	$12.39
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.96

TRYPSIN

Facility

$444.00

Service Code	CPT 83519
Hospital Charge Code	228519
Hospital Revenue Code	302
Rate for Payer: Cash Price	$399.60

TRYPSIN

Facility

$444.00

Service Code	CPT 83519
Hospital Charge Code	228519
Hospital Revenue Code	302
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$317.02
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	$262.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$317.02
Rate for Payer: Cash Price	$399.60
Rate for Payer: Cash Price	$399.60
Rate for Payer: Cash Price	$399.60
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	$159.84

TRYPTASE

Facility

$309.00

Service Code	CPT 83520
Hospital Charge Code	224260
Hospital Revenue Code	301
Rate for Payer: Cash Price	$278.10

TRYPTASE

Facility

$309.00

Service Code	CPT 83520
Hospital Charge Code	224260
Hospital Revenue Code	301
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$220.63
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	$182.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$220.63
Rate for Payer: Cash Price	$278.10
Rate for Payer: Cash Price	$278.10
Rate for Payer: Cash Price	$278.10
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	$111.24

TSH

Facility

$61.00

Service Code	CPT 84443
Hospital Charge Code	4284443
Hospital Revenue Code	521
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$15.12
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$36.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$43.55
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cash Price	$54.90
Rate for Payer: Cigna Commercial HMO & PPO	$16.80
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$13.61
Rate for Payer: Home State Health Plan Medicaid Managed Care	$16.18
Rate for Payer: Home State Health Plan Medicare Advantage	$16.80
Rate for Payer: Humana Commercial	$33.60
Rate for Payer: Humana Medicare Advantage	$16.80
Rate for Payer: UnitedHealthcare Commercial	$40.69
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

TSH

Facility

$264.00

Service Code	CPT 84443
Hospital Charge Code	2220101
Hospital Revenue Code	301
Rate for Payer: Cash Price	$237.60

Know your out-of-pocket cost for care.

All Charges