Madison Medical Center

All Charges

Charge

Type

Setting

Price

CAST SHRT ARM ELBOW TO FINGER

Professional

Both

$572.00

Service Code	CPT 29075
Hospital Charge Code	1829075
Hospital Revenue Code	981
Min. Negotiated Rate	$54.65
Max. Negotiated Rate	$200.20
Rate for Payer: Aetna Commercial/Medicare Advantage	$54.65
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$64.51
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cash Price	$514.80
Rate for Payer: Cigna Commercial HMO & PPO	$54.65
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$64.51
Rate for Payer: Home State Health Plan Medicaid Managed Care	$70.96
Rate for Payer: Home State Health Plan Medicare Advantage	$54.65
Rate for Payer: Optum Medicare Advantage	$200.20
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$64.51

CATECHOLAMINES, 24HR URINE

Facility

$52.00

Service Code	CPT 82384
Hospital Charge Code	223249
Hospital Revenue Code	301
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Better Health Medicaid/QHP	$22.73
Rate for Payer: Aetna Medicare Advantage	$25.25
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: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cigna Commercial HMO & PPO	$25.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24.32
Rate for Payer: Home State Health Plan Medicare Advantage	$25.25
Rate for Payer: Humana Commercial	$50.50
Rate for Payer: Humana Medicare Advantage	$25.25
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.72

CATECHOLAMINES, 24HR URINE

Facility

$52.00

Service Code	CPT 82384
Hospital Charge Code	223249
Hospital Revenue Code	301
Rate for Payer: Cash Price	$46.80

CATECHOLAMINES PLASMA

Facility

$236.00

Service Code	CPT 82384
Hospital Charge Code	223248
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Better Health Medicaid/QHP	$22.73
Rate for Payer: Aetna Medicare Advantage	$25.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$139.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$168.50
Rate for Payer: Cash Price	$212.40
Rate for Payer: Cash Price	$212.40
Rate for Payer: Cash Price	$212.40
Rate for Payer: Cigna Commercial HMO & PPO	$25.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24.32
Rate for Payer: Home State Health Plan Medicare Advantage	$25.25
Rate for Payer: Humana Commercial	$50.50
Rate for Payer: Humana Medicare Advantage	$25.25
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$84.96

CATECHOLAMINES PLASMA

Facility

$236.00

Service Code	CPT 82384
Hospital Charge Code	223248
Hospital Revenue Code	301
Rate for Payer: Cash Price	$212.40

CATECHOLAMINE UR FREE 24 HR

Facility

$52.00

Service Code	CPT 82384
Hospital Charge Code	223251
Hospital Revenue Code	301
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Better Health Medicaid/QHP	$22.73
Rate for Payer: Aetna Medicare Advantage	$25.25
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: Cash Price	$46.80
Rate for Payer: Cash Price	$46.80
Rate for Payer: Cigna Commercial HMO & PPO	$25.25
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$22.73
Rate for Payer: Home State Health Plan Medicaid Managed Care	$24.32
Rate for Payer: Home State Health Plan Medicare Advantage	$25.25
Rate for Payer: Humana Commercial	$50.50
Rate for Payer: Humana Medicare Advantage	$25.25
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$22.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.72

CATECHOLAMINE UR FREE 24 HR

Facility

$52.00

Service Code	CPT 82384
Hospital Charge Code	223251
Hospital Revenue Code	301
Rate for Payer: Cash Price	$46.80

CATH. BARD12 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409412
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

CATH. BARD12 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409412
Hospital Revenue Code	271
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

CATH. BARD12 (CARSON COUDE TIP)

Facility

$81.00

Hospital Charge Code	4016812
Hospital Revenue Code	271
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

CATH. BARD12 (CARSON COUDE TIP)

Facility

$81.00

Hospital Charge Code	4016812
Hospital Revenue Code	271
Rate for Payer: Cash Price	$72.90

CATH. BARD12 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000612
Hospital Revenue Code	271
Rate for Payer: Cash Price	$39.60

CATH. BARD12 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000612
Hospital Revenue Code	271
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

CATH. BARD14 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409414
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

CATH. BARD14 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409414
Hospital Revenue Code	271
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

CATH. BARD14 (CARSON COUDE TIP)

Facility

$81.00

Hospital Charge Code	4016814
Hospital Revenue Code	271
Rate for Payer: Cash Price	$72.90

CATH. BARD14 (CARSON COUDE TIP)

Facility

$81.00

Hospital Charge Code	4016814
Hospital Revenue Code	271
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$57.83
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$47.95
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$57.83
Rate for Payer: Cash Price	$72.90
Rate for Payer: UnitedHealthcare Commercial	$54.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.16

CATH. BARD14 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000614
Hospital Revenue Code	271
Rate for Payer: Cash Price	$39.60

CATH. BARD14 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000614
Hospital Revenue Code	271
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

CATH. BARD16 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409416
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

CATH. BARD16 (ALL PURPOSE)

Facility

$18.00

Hospital Charge Code	409416
Hospital Revenue Code	271
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

CATH. BARD16 (CARSON COUDE TIP)

Facility

$131.00

Hospital Charge Code	4016816
Hospital Revenue Code	271
Rate for Payer: Cash Price	$117.90

CATH. BARD16 (CARSON COUDE TIP)

Facility

$131.00

Hospital Charge Code	4016816
Hospital Revenue Code	271
Min. Negotiated Rate	$47.16
Max. Negotiated Rate	$93.53
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$77.55
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$93.53
Rate for Payer: Cash Price	$117.90
Rate for Payer: UnitedHealthcare Commercial	$87.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.16

CATH. BARD16 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000616
Hospital Revenue Code	271
Rate for Payer: Cash Price	$39.60

CATH. BARD16 (TIEMAN)

Facility

$44.00

Hospital Charge Code	4000616
Hospital Revenue Code	271
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

Know your out-of-pocket cost for care.

All Charges