Alys cplx sp/pn npgt w/prgrm at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$160.83
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.
$919.00
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.
$33.00 with PGT vs $610.00 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 |
|---|---|---|---|
| PGT | Medicare|All Plans | $33.00 | ↓ -79% |
| AETNA | Medicare|All Plans | $33.67 | ↓ -79% |
| BCBS | Medicare|All Plans | $33.67 | ↓ -79% |
| UNITED | Medicare|All Plans | $34.35 | ↓ -79% |
| AMERIVANTAGE | Medicare|All Plans | $34.69 | ↓ -78% |
| SCANHealth | Medicare|All Plans | $36.03 | ↓ -78% |
| Ambetter | Commercial|All Plans | $48.83 | ↓ -70% |
| Wellpoint | Commercial|Exchange | $50.51 | ↓ -69% |
| Wellpoint | Medicaid|All Other Plans | $65.27 | ↓ -59% |
| BCBS-TX | Commercial|Blue Advantage HMO | $85.35 | ↓ -47% |
| Wellpoint | Medicaid|STAR | $89.75 | ↓ -44% |
| Bright Health | Commercial|All Plans | $96.82 | ↓ -40% |
| BCBS-TX | Commercial|Blue Premier | $100.36 | ↓ -38% |
| Ellwood | Commercial|All Plans | $101.01 | ↓ -37% |
| BCBS-TX | Commercial|HMO | $106.37 | ↓ -34% |
| Entrust | Commercial|All Plans | $108.78 | ↓ -32% |
| NX Health | Commercial|All Plans | $109.43 | ↓ -32% |
| BCBS-TX | Commercial|PPO | $118.38 | ↓ -26% |
| Cigna | Commercial|Local Plus | $126.91 | ↓ -21% |
| Health Smart | Commercial|All Plans | $142.45 | ↓ -11% |
| First Health | Commercial|All Plans | $155.40 | ↓ -3% |
| Humana | Commercial|All Plans | $157.99 | ↓ -2% |
| Cigna | Commercial|All Other Plans | $165.76 | ↑ +3% |
| Aetna | Commercial|All Plans | $170.94 | ↑ +6% |
| PHCS | Commercial|All Plans | $220.15 | ↑ +37% |
| Multiplan | Commercial|All Plans | $233.10 | ↑ +45% |
| BCBS-TX | Commercial|Ref Lab | $259.00 | ↑ +61% |
| United | Commercial|Exchange | $311.00 | ↑ +93% |
| United | Commercial|All Other Plans | $610.00 | ↑ +279% |
Visitor-reported prices
Comments
Alys cplx sp/pn npgt w/prgrm at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $417.47 | $85.93 – $626.21 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $614.16 | $90.72 – $767.70 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $417.47 | $90.72 – $626.21 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $417.47 | $215.69 – $626.21 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $614.16 | $90.72 – $921.24 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $417.47 | $83.49 – $521.84 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $417.47 | $90.72 – $626.21 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $614.16 | $90.72 – $921.24 |