Madison Medical Center

All Charges

Charge

Type

Setting

Price

VENTRALEX ST HERNIA PATCH SMALL

Facility

$2,676.00

Hospital Charge Code	1210202
Hospital Revenue Code	271
Rate for Payer: Cash Price	$2,408.40

VENTRALEX ST HERNIA PATCH SMALL

Facility

$2,676.00

Hospital Charge Code	1210202
Hospital Revenue Code	271
Min. Negotiated Rate	$963.36
Max. Negotiated Rate	$1,910.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$1,584.19
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$1,910.66
Rate for Payer: Cash Price	$2,408.40
Rate for Payer: UnitedHealthcare Commercial	$1,784.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$963.36

VENTRICULAR SHUNT PROCEDURES

Facility

$15,891.56

Service Code	APR-DRG 0221
Min. Negotiated Rate	$15,891.56
Max. Negotiated Rate	$15,891.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,891.56
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,891.56
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,891.56
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,891.56

VENTRICULAR SHUNT PROCEDURES

Facility

$19,826.31

Service Code	APR-DRG 0222
Min. Negotiated Rate	$19,826.31
Max. Negotiated Rate	$19,826.31
Rate for Payer: Aetna Better Health Medicaid/QHP	$19,826.31
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19,826.31
Rate for Payer: Home State Health Plan Medicaid Managed Care	$19,826.31
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19,826.31

VENTRICULAR SHUNT PROCEDURES

Facility

$27,161.44

Service Code	APR-DRG 0223
Min. Negotiated Rate	$27,161.44
Max. Negotiated Rate	$27,161.44
Rate for Payer: Aetna Better Health Medicaid/QHP	$27,161.44
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$27,161.44
Rate for Payer: Home State Health Plan Medicaid Managed Care	$27,161.44
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$27,161.44

VENTRICULAR SHUNT PROCEDURES

Facility

$49,526.48

Service Code	APR-DRG 0224
Min. Negotiated Rate	$49,526.48
Max. Negotiated Rate	$49,526.48
Rate for Payer: Aetna Better Health Medicaid/QHP	$49,526.48
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$49,526.48
Rate for Payer: Home State Health Plan Medicaid Managed Care	$49,526.48
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$49,526.48

VENTRICULAR SHUNT PROCEDURES WITH CC

Facility

$37,063.16

Service Code	MSDRG 032
Min. Negotiated Rate	$18,531.58
Max. Negotiated Rate	$37,063.16
Rate for Payer: Aetna Medicare Advantage	$18,531.58
Rate for Payer: Cigna Commercial HMO & PPO	$18,531.58
Rate for Payer: Home State Health Plan Medicare Advantage	$18,531.58
Rate for Payer: Humana Commercial	$37,063.16
Rate for Payer: Humana Medicare Advantage	$18,531.58

VENTRICULAR SHUNT PROCEDURES WITH MCC

Facility

$74,260.84

Service Code	MSDRG 031
Min. Negotiated Rate	$37,130.42
Max. Negotiated Rate	$74,260.84
Rate for Payer: Aetna Medicare Advantage	$37,130.42
Rate for Payer: Cigna Commercial HMO & PPO	$37,130.42
Rate for Payer: Home State Health Plan Medicare Advantage	$37,130.42
Rate for Payer: Humana Commercial	$74,260.84
Rate for Payer: Humana Medicare Advantage	$37,130.42

VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$29,688.82

Service Code	MSDRG 033
Min. Negotiated Rate	$14,844.41
Max. Negotiated Rate	$29,688.82
Rate for Payer: Aetna Medicare Advantage	$14,844.41
Rate for Payer: Cigna Commercial HMO & PPO	$14,844.41
Rate for Payer: Home State Health Plan Medicare Advantage	$14,844.41
Rate for Payer: Humana Commercial	$29,688.82
Rate for Payer: Humana Medicare Advantage	$14,844.41

VENT TUBE

Facility

$110.00

Hospital Charge Code	2822527
Hospital Revenue Code	271
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$78.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$65.12
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$78.54
Rate for Payer: Cash Price	$99.00
Rate for Payer: UnitedHealthcare Commercial	$73.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$39.60

VENT TUBE

Facility

$110.00

Hospital Charge Code	2822527
Hospital Revenue Code	271
Rate for Payer: Cash Price	$99.00

VENT-TUBING

Facility

$124.00

Hospital Charge Code	4500225
Hospital Revenue Code	271
Min. Negotiated Rate	$44.64
Max. Negotiated Rate	$88.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$73.41
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$88.54
Rate for Payer: Cash Price	$111.60
Rate for Payer: UnitedHealthcare Commercial	$82.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.64

VENT-TUBING

Facility

$124.00

Hospital Charge Code	4500225
Hospital Revenue Code	271
Rate for Payer: Cash Price	$111.60

VERAPAMIL 120MG TAB EMP

Facility

$13.00

Service Code	NDC 591034501
Hospital Charge Code	2619624
Hospital Revenue Code	250
Rate for Payer: Cash Price	$11.70

VERAPAMIL 120MG TAB EMP

Facility

$13.00

Service Code	NDC 591034501
Hospital Charge Code	2619624
Hospital Revenue Code	250
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

VERAPAMIL 80MG TAB EMP

Facility

$21.00

Service Code	NDC 591034301
Hospital Charge Code	2619217
Hospital Revenue Code	250
Rate for Payer: Cash Price	$18.90

VERAPAMIL 80MG TAB EMP

Facility

$21.00

Service Code	NDC 591034301
Hospital Charge Code	2619217
Hospital Revenue Code	250
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

VERAPAMIL (CALAN) 5MG INJ 2ML VIAL

Facility

$185.00

Service Code	NDC 4.3066E+10
Hospital Charge Code	2656525
Hospital Revenue Code	250
Rate for Payer: Cash Price	$166.50

VERAPAMIL (CALAN) 5MG INJ 2ML VIAL

Facility

$185.00

Service Code	NDC 4.3066E+10
Hospital Charge Code	2656525
Hospital Revenue Code	250
Min. Negotiated Rate	$66.60
Max. Negotiated Rate	$132.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$109.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$132.09
Rate for Payer: Cash Price	$166.50
Rate for Payer: UnitedHealthcare Commercial	$123.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$66.60

VERAPAMIL (CALAN) 80MG TAB

Facility

$34.00

Service Code	NDC 2.3155E+10
Hospital Charge Code	2656515
Hospital Revenue Code	250
Rate for Payer: Cash Price	$30.60

VERAPAMIL (CALAN) 80MG TAB

Facility

$34.00

Service Code	NDC 2.3155E+10
Hospital Charge Code	2656515
Hospital Revenue Code	250
Min. Negotiated Rate	$12.24
Max. Negotiated Rate	$24.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$20.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$24.28
Rate for Payer: Cash Price	$30.60
Rate for Payer: UnitedHealthcare Commercial	$22.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.24

VERAPAMIL (CALAN SR) 180MG SR TAB

Facility

$24.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2656521
Hospital Revenue Code	250
Rate for Payer: Cash Price	$21.60

VERAPAMIL (CALAN SR) 180MG SR TAB

Facility

$24.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2656521
Hospital Revenue Code	250
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

VERAPAMIL (VERELAN) 240MG SR CAP EMP

Facility

$24.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2656522
Hospital Revenue Code	250
Rate for Payer: Cash Price	$21.60

VERAPAMIL (VERELAN) 240MG SR CAP EMP

Facility

$24.00

Service Code	NDC 5.1079E+10
Hospital Charge Code	2656522
Hospital Revenue Code	250
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

Know your out-of-pocket cost for care.

All Charges