Adenovirus assay w/optic at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$3.68
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$21.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$5.30 with Wellpoint vs $75.42 with UNITED — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Wellpoint | Medicaid|All Other Plans | $5.30 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $7.28 | ↑ +98% |
| Health Smart | Commercial|All Plans | $11.55 | ↑ +214% |
| First Health | Commercial|All Plans | $12.60 | ↑ +242% |
| Humana | Commercial|All Plans | $12.81 | ↑ +248% |
| Cigna | Commercial|All Other Plans | $13.44 | ↑ +265% |
| Aetna | Commercial|All Plans | $13.86 | ↑ +277% |
| PHCS | Commercial|All Plans | $17.85 | ↑ +385% |
| Multiplan | Commercial|All Plans | $18.90 | ↑ +414% |
| United | Commercial|Exchange | $19.58 | ↑ +432% |
| BCBS-TX | Commercial|Blue Advantage HMO | $21.00 | ↑ +471% |
| BCBS-TX | Commercial|Ref Lab | $21.00 | ↑ +471% |
| BCBS-TX | Commercial|Blue Premier | $21.00 | ↑ +471% |
| United | Commercial|All Other Plans | $21.00 | ↑ +471% |
| BCBS-TX | Commercial|HMO | $21.00 | ↑ +471% |
| BCBS-TX | Commercial|PPO | $21.00 | ↑ +471% |
| PGT | Medicare|All Plans | $21.33 | ↑ +480% |
| AETNA | Medicare|All Plans | $21.76 | ↑ +491% |
| BCBS | Medicare|All Plans | $21.76 | ↑ +491% |
| UNITED | Medicare|All Plans | $22.20 | ↑ +503% |
| AMERIVANTAGE | Medicare|All Plans | $22.41 | ↑ +509% |
| SCANHealth | Medicare|All Plans | $23.28 | ↑ +533% |
| SUPERIOR | Medicaid|CHIP | $29.81 | ↑ +710% |
| UNITED | Medicaid|STARKIDS | $30.41 | ↑ +726% |
| UNITED | Medicaid|All Other Plans | $30.41 | ↑ +726% |
| SUPERIOR | Medicaid|All Other Plans | $31.30 | ↑ +751% |
| BCBS | Medicaid|STARKIDS | $31.30 | ↑ +751% |
| Ambetter | Commercial|All Plans | $31.55 | ↑ +757% |
| Wellpoint | Commercial|Exchange | $32.64 | ↑ +787% |
| Bright Health | Commercial|All Plans | $38.73 | ↑ +952% |
| SUPERIOR | Medicaid|STAR | $43.22 | ↑ +1074% |
| Entrust | Commercial|All Plans | $43.52 | ↑ +1083% |
| Cigna | Commercial|Local Plus | $47.55 | ↑ +1192% |
| Ellwood | Commercial|All Plans | $65.28 | ↑ +1674% |
| NX Health | Commercial|All Plans | $70.72 | ↑ +1822% |
| SUPERIOR | Medicaid|STARPLUS | $73.93 | ↑ +1909% |
| UNITED | Medicaid|STARPLUS | $75.42 | ↑ +1949% |
Visitor-reported prices
Comments
Adenovirus assay w/optic at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $98.51 | $12.00 – $147.76 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $98.51 | $12.00 – $123.14 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $98.51 | $12.00 – $147.76 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $98.51 | $8.00 – $147.76 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $98.51 | $12.00 – $147.76 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $98.51 | $18.28 – $123.14 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $98.51 | $12.00 – $147.76 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $98.51 | $12.00 – $147.76 |