Madison Medical Center

All Charges

Charge

Type

Setting

Price

CATH LEG STRAP MEDICHOICE #CLS1400

Facility

$55.00

Hospital Charge Code	283383
Hospital Revenue Code	271
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

CATH LEG STRAP MEDICHOICE #CLS1400

Facility

$55.00

Hospital Charge Code	283383
Hospital Revenue Code	271
Rate for Payer: Cash Price	$49.50

CATH PHILLIPS FOLLOWE

Facility

$223.00

Hospital Charge Code	283360
Hospital Revenue Code	271
Rate for Payer: Cash Price	$200.70

CATH PHILLIPS FOLLOWE

Facility

$223.00

Hospital Charge Code	283360
Hospital Revenue Code	271
Min. Negotiated Rate	$80.28
Max. Negotiated Rate	$159.22
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$132.02
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$159.22
Rate for Payer: Cash Price	$200.70
Rate for Payer: UnitedHealthcare Commercial	$148.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$80.28

CATH PLUG

Facility

$16.00

Hospital Charge Code	2816525
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

CATH PLUG

Facility

$16.00

Hospital Charge Code	2816525
Hospital Revenue Code	271
Rate for Payer: Cash Price	$14.40

CATH PUREWICK FEMALE EXTERNAL CATHETER

Facility

$81.00

Hospital Charge Code	283157
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 PUREWICK FEMALE EXTERNAL CATHETER

Facility

$81.00

Hospital Charge Code	283157
Hospital Revenue Code	271
Rate for Payer: Cash Price	$72.90

CATH QUICK,18GAX1 1

Facility

$40.00

Hospital Charge Code	283841
Hospital Revenue Code	271
Rate for Payer: Cash Price	$36.00

CATH QUICK,18GAX1 1

Facility

$40.00

Hospital Charge Code	283841
Hospital Revenue Code	271
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$28.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$23.68
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$28.56
Rate for Payer: Cash Price	$36.00
Rate for Payer: UnitedHealthcare Commercial	$26.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.40

CATH, ROBINSON 10FR #094100

Facility

$45.00

Hospital Charge Code	283101
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

CATH, ROBINSON 10FR #094100

Facility

$45.00

Hospital Charge Code	283101
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

CATH, ROBINSON 12FR #09412

Facility

$45.00

Hospital Charge Code	283102
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

CATH, ROBINSON 12FR #09412

Facility

$45.00

Hospital Charge Code	283102
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

CATH, ROBINSON 14FR #094140

Facility

$45.00

Hospital Charge Code	283105
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

CATH, ROBINSON 14FR #094140

Facility

$45.00

Hospital Charge Code	283105
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

CATH, ROBINSON 16FR #094160

Facility

$45.00

Hospital Charge Code	283106
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

CATH, ROBINSON 16FR #094160

Facility

$45.00

Hospital Charge Code	283106
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

CATH, ROBINSON 18FR #09418

Facility

$45.00

Hospital Charge Code	283107
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

CATH, ROBINSON 18FR #09418

Facility

$45.00

Hospital Charge Code	283107
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

CATH, ROBINSON 8FR #0094080

Facility

$18.00

Hospital Charge Code	283100
Hospital Revenue Code	271
Rate for Payer: Cash Price	$16.20

CATH, ROBINSON 8FR #0094080

Facility

$18.00

Hospital Charge Code	283100
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. SELF (MENTOR 245)

Facility

$16.00

Hospital Charge Code	4000245
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

CATH. SELF (MENTOR 245)

Facility

$16.00

Hospital Charge Code	4000245
Hospital Revenue Code	271
Rate for Payer: Cash Price	$14.40

CATH SUPRAPUBIC STAM

Facility

$273.00

Hospital Charge Code	283381
Hospital Revenue Code	271
Rate for Payer: Cash Price	$245.70

Know your out-of-pocket cost for care.

All Charges