Madison Medical Center

All Charges

Charge

Type

Setting

Price

CATH, CHOLANGIOGRAM

Facility

$308.00

Hospital Charge Code	283062
Hospital Revenue Code	271
Min. Negotiated Rate	$110.88
Max. Negotiated Rate	$219.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$182.34
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$219.91
Rate for Payer: Cash Price	$277.20
Rate for Payer: UnitedHealthcare Commercial	$205.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$110.88

CATH, CHOLANGIOGRAM-INTRODUCER

Facility

$96.00

Hospital Charge Code	283064
Hospital Revenue Code	271
Rate for Payer: Cash Price	$86.40

CATH, CHOLANGIOGRAM-INTRODUCER

Facility

$96.00

Hospital Charge Code	283064
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

CATH,CLAMP

Facility

$22.00

Hospital Charge Code	283212
Hospital Revenue Code	271
Rate for Payer: Cash Price	$19.80

CATH,CLAMP

Facility

$22.00

Hospital Charge Code	283212
Hospital Revenue Code	271
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$15.71
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$13.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$15.71
Rate for Payer: Cash Price	$19.80
Rate for Payer: UnitedHealthcare Commercial	$14.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.92

CATH CUTDOWN

Facility

$39.00

Hospital Charge Code	283209
Hospital Revenue Code	271
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$27.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.09
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$27.85
Rate for Payer: Cash Price	$35.10
Rate for Payer: UnitedHealthcare Commercial	$26.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.04

CATH CUTDOWN

Facility

$39.00

Hospital Charge Code	283209
Hospital Revenue Code	271
Rate for Payer: Cash Price	$35.10

CATHETER EXTENSION SET

Facility

$24.00

Hospital Charge Code	2828374
Hospital Revenue Code	271
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

CATHETER EXTENSION SET

Facility

$24.00

Hospital Charge Code	2828374
Hospital Revenue Code	271
Rate for Payer: Cash Price	$21.60

CATHETER EXTENSION SET/DELUXE

Facility

$36.00

Hospital Charge Code	2828375
Hospital Revenue Code	271
Rate for Payer: Cash Price	$32.40

CATHETER EXTENSION SET/DELUXE

Facility

$36.00

Hospital Charge Code	2828375
Hospital Revenue Code	271
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$25.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.31
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$25.70
Rate for Payer: Cash Price	$32.40
Rate for Payer: UnitedHealthcare Commercial	$24.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.96

CATHETER, INSERTION OF NON-INDWELLING

Facility

$448.00

Service Code	CPT 51701
Hospital Charge Code	551701
Hospital Revenue Code	269
Rate for Payer: Cash Price	$403.20

CATHETER, INSERTION OF NON-INDWELLING

Professional

Both

$448.00

Service Code	CPT 51701
Hospital Charge Code	1851701
Hospital Revenue Code	981
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$156.80
Rate for Payer: Aetna Commercial/Medicare Advantage	$21.52
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care	$43.69
Rate for Payer: Cash Price	$403.20
Rate for Payer: Cash Price	$403.20
Rate for Payer: Cigna Commercial HMO & PPO	$21.52
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$43.69
Rate for Payer: Home State Health Plan Medicaid Managed Care	$48.06
Rate for Payer: Home State Health Plan Medicare Advantage	$21.52
Rate for Payer: Optum Medicare Advantage	$156.80
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$43.69

CATHETER, INSERTION OF NON-INDWELLING

Facility

$448.00

Service Code	CPT 51701
Hospital Charge Code	551701
Hospital Revenue Code	269
Min. Negotiated Rate	$119.94
Max. Negotiated Rate	$319.87
Rate for Payer: Aetna Better Health Medicaid/QHP	$119.94
Rate for Payer: Aetna Medicare Advantage	$135.93
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	$135.93
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	$135.93
Rate for Payer: Humana Commercial	$271.86
Rate for Payer: Humana Medicare Advantage	$135.93
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$119.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$161.28

CATHETERIZATION STRAIGHT BLADDER

Facility

$230.00

Service Code	CPT 51701
Hospital Charge Code	9851701
Hospital Revenue Code	521
Min. Negotiated Rate	$107.95
Max. Negotiated Rate	$271.86
Rate for Payer: Aetna Better Health Medicaid/QHP	$119.94
Rate for Payer: Aetna Medicare Advantage	$135.93
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$136.16
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$164.22
Rate for Payer: Cash Price	$207.00
Rate for Payer: Cash Price	$207.00
Rate for Payer: Cash Price	$207.00
Rate for Payer: Cash Price	$207.00
Rate for Payer: Cigna Commercial HMO & PPO	$135.93
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	$135.93
Rate for Payer: Humana Commercial	$271.86
Rate for Payer: Humana Medicare Advantage	$135.93
Rate for Payer: UnitedHealthcare Commercial	$153.41
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$119.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$173.53

CATHETERIZATION STRAIGHT BLADDER

Facility

$230.00

Service Code	CPT 51701
Hospital Charge Code	9851701
Hospital Revenue Code	521
Rate for Payer: Cash Price	$207.00

CATH, FOLEY 10FR-3CC

Facility

$37.00

Hospital Charge Code	283110
Hospital Revenue Code	271
Rate for Payer: Cash Price	$33.30

CATH, FOLEY 10FR-3CC

Facility

$37.00

Hospital Charge Code	283110
Hospital Revenue Code	271
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$26.42
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$21.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$26.42
Rate for Payer: Cash Price	$33.30
Rate for Payer: UnitedHealthcare Commercial	$24.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.32

CATH, FOLEY 12FR--5CC

Facility

$21.00

Hospital Charge Code	283112
Hospital Revenue Code	271
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

CATH, FOLEY 12FR--5CC

Facility

$21.00

Hospital Charge Code	283112
Hospital Revenue Code	271
Rate for Payer: Cash Price	$18.90

CATH, FOLEY 14FR--30CC LATEX

Facility

$13.00

Hospital Charge Code	283118
Hospital Revenue Code	271
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

CATH, FOLEY 14FR--30CC LATEX

Facility

$13.00

Hospital Charge Code	283118
Hospital Revenue Code	271
Rate for Payer: Cash Price	$11.70

CATH, FOLEY 14FR--5CC SILICONE

Facility

$21.00

Hospital Charge Code	2819029
Hospital Revenue Code	272
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

CATH, FOLEY 14FR--5CC SILICONE

Facility

$21.00

Hospital Charge Code	2819029
Hospital Revenue Code	272
Rate for Payer: Cash Price	$18.90

CATH FOLEY 16FR 10CC

Facility

$37.00

Hospital Charge Code	283361
Hospital Revenue Code	271
Rate for Payer: Cash Price	$33.30

Know your out-of-pocket cost for care.

All Charges