Adh-sendout at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$40.25
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.
$230.00
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.
$30.55 with United vs $207.00 with Multiplan — 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 |
|---|---|---|---|
| United | Commercial|Exchange | $30.55 | ↓ -24% |
| PGT | Medicare|All Plans | $33.27 | ↓ -17% |
| BCBS | Medicare|All Plans | $33.94 | ↓ -16% |
| AETNA | Medicare|All Plans | $33.94 | ↓ -16% |
| UNITED | Medicare|All Plans | $34.62 | ↓ -14% |
| AMERIVANTAGE | Medicare|All Plans | $34.96 | ↓ -13% |
| SCANHealth | Medicare|All Plans | $36.32 | ↓ -10% |
| BCBS-TX | Commercial|Ref Lab | $36.96 | ↓ -8% |
| SUPERIOR | Medicaid|CHIP | $46.49 | ↑ +16% |
| UNITED | Medicaid|STARKIDS | $47.42 | ↑ +18% |
| UNITED | Medicaid|All Other Plans | $47.42 | ↑ +18% |
| SUPERIOR | Medicaid|All Other Plans | $48.81 | ↑ +21% |
| BCBS | Medicaid|STARKIDS | $48.81 | ↑ +21% |
| Ambetter | Commercial|All Plans | $49.21 | ↑ +22% |
| Wellpoint | Commercial|Exchange | $50.91 | ↑ +26% |
| Wellpoint | Medicaid|All Other Plans | $57.96 | ↑ +44% |
| Bright Health | Commercial|All Plans | $60.41 | ↑ +50% |
| United | Commercial|All Other Plans | $65.99 | ↑ +64% |
| SUPERIOR | Medicaid|STAR | $67.41 | ↑ +67% |
| Entrust | Commercial|All Plans | $67.88 | ↑ +69% |
| Cigna | Commercial|Local Plus | $73.99 | ↑ +84% |
| Wellpoint | Medicaid|STAR | $79.70 | ↑ +98% |
| Ellwood | Commercial|All Plans | $101.82 | ↑ +153% |
| NX Health | Commercial|All Plans | $110.31 | ↑ +174% |
| SUPERIOR | Medicaid|STARPLUS | $115.30 | ↑ +186% |
| UNITED | Medicaid|STARPLUS | $117.62 | ↑ +192% |
| BCBS-TX | Commercial|Blue Advantage HMO | $119.13 | ↑ +196% |
| BCBS-TX | Commercial|Blue Premier | $119.13 | ↑ +196% |
| BCBS-TX | Commercial|HMO | $121.51 | ↑ +202% |
| Health Smart | Commercial|All Plans | $126.50 | ↑ +214% |
| First Health | Commercial|All Plans | $138.00 | ↑ +243% |
| BCBS-TX | Commercial|PPO | $140.17 | ↑ +248% |
| Humana | Commercial|All Plans | $140.30 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $147.20 | ↑ +266% |
| Aetna | Commercial|All Plans | $151.80 | ↑ +277% |
| PHCS | Commercial|All Plans | $195.50 | ↑ +386% |
| Multiplan | Commercial|All Plans | $207.00 | ↑ +414% |
Visitor-reported prices
Comments
Adh-sendout at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $433.43 | $30.55 – $130.67 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $435.33 | $10.00 – $84.38 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $414.60 | $12.00 – $101.25 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $414.60 | $12.00 – $84.38 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $435.33 | $10.00 – $84.38 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $414.60 | $12.00 – $101.25 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $414.60 | $8.00 – $101.25 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $414.60 | $12.00 – $101.25 |