Madison Medical Center

All Charges

Charge

Type

Setting

Price

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

BLOOD TYPE RH

Facility

$147.00

Service Code	CPT 86901
Hospital Charge Code	2286901
Hospital Revenue Code	390
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$104.96
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	$87.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$104.96
Rate for Payer: Cash Price	$132.30
Rate for Payer: Cash Price	$132.30
Rate for Payer: Cash Price	$132.30
Rate for Payer: Cigna Commercial HMO & PPO	$2.99
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$33.67
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 Medicaid Managed Care	$33.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$52.92

BLOOD TYPE RH

Facility

$147.00

Service Code	CPT 86901
Hospital Charge Code	2286901
Hospital Revenue Code	390
Rate for Payer: Cash Price	$132.30

BLOOD VESSEL - SUTURE

Professional

Both

$3,787.00

Service Code	CPT 35860
Hospital Charge Code	1835860
Hospital Revenue Code	981
Min. Negotiated Rate	$625.99
Max. Negotiated Rate	$1,325.45
Rate for Payer: Aetna Commercial/Medicare Advantage	$750.88
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$625.99
Rate for Payer: Cash Price	$3,408.30
Rate for Payer: Cash Price	$3,408.30
Rate for Payer: Cigna Commercial HMO & PPO	$750.88
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$625.99
Rate for Payer: Home State Health Plan Medicaid Managed Care	$688.59
Rate for Payer: Home State Health Plan Medicare Advantage	$750.88
Rate for Payer: Optum Medicare Advantage	$1,325.45
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$625.99

BMP BASIC METABOLIC PROFILE

Facility

$301.00

Service Code	CPT 80048
Hospital Charge Code	2227777
Hospital Revenue Code	301
Rate for Payer: Cash Price	$270.90

BMP BASIC METABOLIC PROFILE

Facility

$301.00

Service Code	CPT 80048
Hospital Charge Code	2227777
Hospital Revenue Code	301
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$214.91
Rate for Payer: Aetna Better Health Medicaid/QHP	$7.61
Rate for Payer: Aetna Medicare Advantage	$8.46
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$178.19
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$214.91
Rate for Payer: Cash Price	$270.90
Rate for Payer: Cash Price	$270.90
Rate for Payer: Cash Price	$270.90
Rate for Payer: Cigna Commercial HMO & PPO	$8.46
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$7.61
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8.14
Rate for Payer: Home State Health Plan Medicare Advantage	$8.46
Rate for Payer: Humana Commercial	$16.92
Rate for Payer: Humana Medicare Advantage	$8.46
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$7.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$108.36

BNP(LABCORP ONLY)

Facility

$163.00

Service Code	CPT 83880
Hospital Charge Code	2283522
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$116.38
Rate for Payer: Aetna Better Health Medicaid/QHP	$35.33
Rate for Payer: Aetna Medicare Advantage	$39.26
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$96.50
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$116.38
Rate for Payer: Cash Price	$146.70
Rate for Payer: Cash Price	$146.70
Rate for Payer: Cash Price	$146.70
Rate for Payer: Cigna Commercial HMO & PPO	$39.26
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$35.33
Rate for Payer: Home State Health Plan Medicaid Managed Care	$37.80
Rate for Payer: Home State Health Plan Medicare Advantage	$39.26
Rate for Payer: Humana Commercial	$78.52
Rate for Payer: Humana Medicare Advantage	$39.26
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$35.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$58.68

BNP(LABCORP ONLY)

Facility

$163.00

Service Code	CPT 83880
Hospital Charge Code	2283522
Hospital Revenue Code	301
Rate for Payer: Cash Price	$146.70

BONE AGE STUDY

Facility

$324.00

Service Code	CPT 77072
Hospital Charge Code	3277022
Hospital Revenue Code	320
Rate for Payer: Cash Price	$291.60

BONE AGE STUDY

Facility

$324.00

Service Code	CPT 77072
Hospital Charge Code	3277022
Hospital Revenue Code	320
Min. Negotiated Rate	$94.24
Max. Negotiated Rate	$231.34
Rate for Payer: Aetna Better Health Medicaid/QHP	$94.24
Rate for Payer: Aetna Medicare Advantage	$106.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$191.81
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$231.34
Rate for Payer: Cash Price	$291.60
Rate for Payer: Cash Price	$291.60
Rate for Payer: Cash Price	$291.60
Rate for Payer: Cigna Commercial HMO & PPO	$106.81
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$94.24
Rate for Payer: Home State Health Plan Medicaid Managed Care	$100.84
Rate for Payer: Home State Health Plan Medicare Advantage	$106.81
Rate for Payer: Humana Commercial	$213.62
Rate for Payer: Humana Medicare Advantage	$106.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$94.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$116.64

BONE DECALCIFICATION

Facility

$70.00

Service Code	CPT 88311
Hospital Charge Code	2288311
Hospital Revenue Code	305
Rate for Payer: Cash Price	$63.00

BONE DECALCIFICATION

Facility

$70.00

Service Code	CPT 88311
Hospital Charge Code	2288311
Hospital Revenue Code	305
Min. Negotiated Rate	$21.00
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: Cash Price	$63.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.20

BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$23,930.78

Service Code	MSDRG 553
Min. Negotiated Rate	$11,965.39
Max. Negotiated Rate	$23,930.78
Rate for Payer: Aetna Medicare Advantage	$11,965.39
Rate for Payer: Cigna Commercial HMO & PPO	$11,965.39
Rate for Payer: Home State Health Plan Medicare Advantage	$11,965.39
Rate for Payer: Humana Commercial	$23,930.78
Rate for Payer: Humana Medicare Advantage	$11,965.39

BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Facility

$16,635.06

Service Code	MSDRG 554
Min. Negotiated Rate	$8,317.53
Max. Negotiated Rate	$16,635.06
Rate for Payer: Aetna Medicare Advantage	$8,317.53
Rate for Payer: Cigna Commercial HMO & PPO	$8,317.53
Rate for Payer: Home State Health Plan Medicare Advantage	$8,317.53
Rate for Payer: Humana Commercial	$16,635.06
Rate for Payer: Humana Medicare Advantage	$8,317.53

BONE MARROW ASPIRATION

Facility

$980.00

Service Code	CPT 38220
Hospital Charge Code	538220
Hospital Revenue Code	360
Min. Negotiated Rate	$352.80
Max. Negotiated Rate	$3,374.74
Rate for Payer: Aetna Better Health Medicaid/QHP	$1,488.83
Rate for Payer: Aetna Medicare Advantage	$1,687.37
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cash Price	$882.00
Rate for Payer: Cigna Commercial HMO & PPO	$1,687.37
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$1,488.83
Rate for Payer: Home State Health Plan Medicaid Managed Care	$1,593.05
Rate for Payer: Home State Health Plan Medicare Advantage	$1,687.37
Rate for Payer: Humana Commercial	$3,374.74
Rate for Payer: Humana Medicare Advantage	$1,687.37
Rate for Payer: UnitedHealthcare Commercial	$947.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$1,488.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$352.80

BONE MARROW ASPIRATION

Facility

$980.00

Service Code	CPT 38220
Hospital Charge Code	538220
Hospital Revenue Code	360
Rate for Payer: Cash Price	$882.00

BONE MARROW NEEDLE (INFUSION)

Facility

$52.00

Hospital Charge Code	282835
Hospital Revenue Code	271
Rate for Payer: Cash Price	$46.80

BONE MARROW NEEDLE (INFUSION)

Facility

$52.00

Hospital Charge Code	282835
Hospital Revenue Code	271
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$37.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$30.78
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$37.13
Rate for Payer: Cash Price	$46.80
Rate for Payer: UnitedHealthcare Commercial	$34.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.72

BONE MARROW TRAY

Facility

$129.00

Hospital Charge Code	282833
Hospital Revenue Code	271
Min. Negotiated Rate	$46.44
Max. Negotiated Rate	$92.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$76.37
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$92.11
Rate for Payer: Cash Price	$116.10
Rate for Payer: UnitedHealthcare Commercial	$86.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.44

BONE MARROW TRAY

Facility

$129.00

Hospital Charge Code	282833
Hospital Revenue Code	271
Rate for Payer: Cash Price	$116.10

BOTTLE BABY

Facility

$16.00

Hospital Charge Code	282822
Hospital Revenue Code	271
Rate for Payer: Cash Price	$14.40

BOTTLE BABY

Facility

$16.00

Hospital Charge Code	282822
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

BOUGIE ENDO TUBE INTRODUCER

Facility

$44.00

Hospital Charge Code	285825
Hospital Revenue Code	270
Min. Negotiated Rate	$15.84
Max. Negotiated Rate	$31.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.05
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$31.42
Rate for Payer: Cash Price	$39.60
Rate for Payer: UnitedHealthcare Commercial	$29.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.84

BOUGIE ENDO TUBE INTRODUCER

Facility

$44.00

Hospital Charge Code	285825
Hospital Revenue Code	270
Rate for Payer: Cash Price	$39.60

BOVIE PENCIL CONMED #131307A

Facility

$141.00

Hospital Charge Code	1251120
Hospital Revenue Code	271
Min. Negotiated Rate	$50.76
Max. Negotiated Rate	$100.67
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$83.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$100.67
Rate for Payer: Cash Price	$126.90
Rate for Payer: UnitedHealthcare Commercial	$94.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$50.76

Know your out-of-pocket cost for care.

All Charges