Madison Medical Center

All Charges

Charge

Type

Setting

Price

BLAKE DRAINS

Facility

$184.00

Hospital Charge Code	124719
Hospital Revenue Code	271
Rate for Payer: Cash Price	$165.60

BLAKE DRAINS

Facility

$184.00

Hospital Charge Code	124719
Hospital Revenue Code	271
Min. Negotiated Rate	$66.24
Max. Negotiated Rate	$131.38
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$108.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$131.38
Rate for Payer: Cash Price	$165.60
Rate for Payer: UnitedHealthcare Commercial	$122.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$66.24

BLASTOMYCES ANTIBODY

Facility

$110.00

Service Code	CPT 86612
Hospital Charge Code	2286691
Hospital Revenue Code	305
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$78.54
Rate for Payer: Aetna Better Health Medicaid/QHP	$11.61
Rate for Payer: Aetna Medicare Advantage	$12.90
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: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cigna Commercial HMO & PPO	$12.90
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$11.61
Rate for Payer: Home State Health Plan Medicaid Managed Care	$12.42
Rate for Payer: Home State Health Plan Medicare Advantage	$12.90
Rate for Payer: Humana Commercial	$25.80
Rate for Payer: Humana Medicare Advantage	$12.90
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$11.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$39.60

BLASTOMYCES ANTIBODY

Facility

$110.00

Service Code	CPT 86612
Hospital Charge Code	2286691
Hospital Revenue Code	305
Rate for Payer: Cash Price	$99.00

BLASTOMYCES ANTIGEN

Facility

$449.00

Service Code	CPT 87449
Hospital Charge Code	2286690
Hospital Revenue Code	305
Min. Negotiated Rate	$10.78
Max. Negotiated Rate	$320.59
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.78
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$265.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$320.59
Rate for Payer: Cash Price	$404.10
Rate for Payer: Cash Price	$404.10
Rate for Payer: Cash Price	$404.10
Rate for Payer: Cigna Commercial HMO & PPO	$11.98
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.78
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.53
Rate for Payer: Home State Health Plan Medicare Advantage	$11.98
Rate for Payer: Humana Commercial	$23.96
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$161.64

BLASTOMYCES ANTIGEN

Facility

$449.00

Service Code	CPT 87449
Hospital Charge Code	2286690
Hospital Revenue Code	305
Rate for Payer: Cash Price	$404.10

BLEPHARATOMY DRAINAGE OF ABSCESS, EYELID

Facility

$590.00

Service Code	CPT 67700
Hospital Charge Code	9867700
Hospital Revenue Code	521
Min. Negotiated Rate	$173.53
Max. Negotiated Rate	$648.56
Rate for Payer: Aetna Better Health Medicaid/QHP	$286.12
Rate for Payer: Aetna Medicare Advantage	$324.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$349.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$421.26
Rate for Payer: Cash Price	$531.00
Rate for Payer: Cash Price	$531.00
Rate for Payer: Cash Price	$531.00
Rate for Payer: Cash Price	$531.00
Rate for Payer: Cigna Commercial HMO & PPO	$324.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$257.51
Rate for Payer: Home State Health Plan Medicaid Managed Care	$306.15
Rate for Payer: Home State Health Plan Medicare Advantage	$324.28
Rate for Payer: Humana Commercial	$648.56
Rate for Payer: Humana Medicare Advantage	$324.28
Rate for Payer: UnitedHealthcare Commercial	$393.53
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$286.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

BLEPHARATOMY DRAINAGE OF ABSCESS, EYELID

Facility

$590.00

Service Code	CPT 67700
Hospital Charge Code	9867700
Hospital Revenue Code	521
Rate for Payer: Cash Price	$531.00

BLOOD FILTER

Facility

$96.00

Hospital Charge Code	282518
Hospital Revenue Code	271
Rate for Payer: Cash Price	$86.40

BLOOD FILTER

Facility

$96.00

Hospital Charge Code	282518
Hospital Revenue Code	271
Min. Negotiated Rate	$34.56
Max. Negotiated Rate	$68.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$56.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$68.54
Rate for Payer: Cash Price	$86.40
Rate for Payer: UnitedHealthcare Commercial	$64.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.56

BLOOD GAS ANALYSIS

Facility

$448.00

Service Code	CPT 82803
Hospital Charge Code	2200200
Hospital Revenue Code	301
Rate for Payer: Cash Price	$403.20

BLOOD GAS ANALYSIS

Facility

$448.00

Service Code	CPT 82803
Hospital Charge Code	2200200
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$319.87
Rate for Payer: Aetna Better Health Medicaid/QHP	$23.46
Rate for Payer: Aetna Medicare Advantage	$26.07
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$265.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$319.87
Rate for Payer: Cash Price	$403.20
Rate for Payer: Cash Price	$403.20
Rate for Payer: Cash Price	$403.20
Rate for Payer: Cigna Commercial HMO & PPO	$26.07
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$23.46
Rate for Payer: Home State Health Plan Medicaid Managed Care	$25.10
Rate for Payer: Home State Health Plan Medicare Advantage	$26.07
Rate for Payer: Humana Commercial	$52.14
Rate for Payer: Humana Medicare Advantage	$26.07
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$23.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$161.28

BLOOD RH

Facility

$15.00

Service Code	CPT 86901
Hospital Charge Code	4286901
Hospital Revenue Code	521
Rate for Payer: Cash Price	$13.50

BLOOD RH

Facility

$15.00

Service Code	CPT 86901
Hospital Charge Code	4286901
Hospital Revenue Code	521
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$33.67
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.88
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.71
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cigna Commercial HMO & PPO	$2.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$30.30
Rate for Payer: Home State Health Plan Medicaid Managed Care	$36.03
Rate for Payer: Home State Health Plan Medicare Advantage	$2.99
Rate for Payer: Humana Commercial	$5.98
Rate for Payer: Humana Medicare Advantage	$2.99
Rate for Payer: UnitedHealthcare Commercial	$10.01
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$33.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

BLOOD SEC PUMP SET

Facility

$70.00

Hospital Charge Code	281025
Hospital Revenue Code	271
Rate for Payer: Cash Price	$63.00

BLOOD SEC PUMP SET

Facility

$70.00

Hospital Charge Code	281025
Hospital Revenue Code	271
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$49.98
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$41.44
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$49.98
Rate for Payer: Cash Price	$63.00
Rate for Payer: UnitedHealthcare Commercial	$46.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.20

BLOOD/SOLUTION SET Y-TYPE(2C6750H)TUBING

Facility

$55.00

Hospital Charge Code	2802517
Hospital Revenue Code	250
Rate for Payer: Cash Price	$49.50

BLOOD/SOLUTION SET Y-TYPE(2C6750H)TUBING

Facility

$55.00

Hospital Charge Code	2802517
Hospital Revenue Code	250
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

BLOOD SUGER

Facility

$17.00

Service Code	CPT 82947
Hospital Charge Code	4282947
Hospital Revenue Code	521
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$3.54
Rate for Payer: Aetna Medicare Advantage	$3.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.06
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.14
Rate for Payer: Cash Price	$15.30
Rate for Payer: Cash Price	$15.30
Rate for Payer: Cash Price	$15.30
Rate for Payer: Cash Price	$15.30
Rate for Payer: Cigna Commercial HMO & PPO	$3.93
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$3.19
Rate for Payer: Home State Health Plan Medicaid Managed Care	$3.79
Rate for Payer: Home State Health Plan Medicare Advantage	$3.93
Rate for Payer: Humana Commercial	$7.86
Rate for Payer: Humana Medicare Advantage	$3.93
Rate for Payer: UnitedHealthcare Commercial	$11.34
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$3.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

BLOOD SUGER

Facility

$17.00

Service Code	CPT 82947
Hospital Charge Code	4282947
Hospital Revenue Code	521
Rate for Payer: Cash Price	$15.30

BLOOD TUBING

Facility

$91.00

Hospital Charge Code	282517
Hospital Revenue Code	271
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

BLOOD TUBING

Facility

$91.00

Hospital Charge Code	282517
Hospital Revenue Code	271
Rate for Payer: Cash Price	$81.90

BLOOD TYPE

Facility

$15.00

Service Code	CPT 86900
Hospital Charge Code	4286900
Hospital Revenue Code	521
Rate for Payer: Cash Price	$13.50

BLOOD TYPE

Facility

$15.00

Service Code	CPT 86900
Hospital Charge Code	4286900
Hospital Revenue Code	521
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$173.53
Rate for Payer: Aetna Better Health Medicaid/QHP	$119.94
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$8.88
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$10.71
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cash Price	$13.50
Rate for Payer: Cigna Commercial HMO & PPO	$2.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$107.95
Rate for Payer: Home State Health Plan Medicaid Managed Care	$128.34
Rate for Payer: Home State Health Plan Medicare Advantage	$2.99
Rate for Payer: Humana Commercial	$5.98
Rate for Payer: Humana Medicare Advantage	$2.99
Rate for Payer: UnitedHealthcare Commercial	$10.01
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$119.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

BLOOD TYPE ABO

Facility

$201.00

Service Code	CPT 86900
Hospital Charge Code	222145
Hospital Revenue Code	302
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$143.51
Rate for Payer: Aetna Better Health Medicaid/QHP	$119.94
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$118.99
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$143.51
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cash Price	$180.90
Rate for Payer: Cigna Commercial HMO & PPO	$2.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$119.94
Rate for Payer: Home State Health Plan Medicaid Managed Care	$128.34
Rate for Payer: Home State Health Plan Medicare Advantage	$2.99
Rate for Payer: Humana Commercial	$5.98
Rate for Payer: Humana Medicare Advantage	$2.99
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$119.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$72.36

Know your out-of-pocket cost for care.

All Charges