Biliary endoscopy thru skin at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$1,594.60
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.
$9,112.00
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.
$1,160.87 with PGT vs $18,403.00 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 | $1,160.87 | ↓ -27% |
| BCBS | Medicare|All Plans | $1,184.56 | ↓ -26% |
| AETNA | Medicare|All Plans | $1,184.56 | ↓ -26% |
| UNITED | Medicare|All Plans | $1,208.26 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $1,220.10 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $1,267.48 | ↓ -21% |
| Ambetter | Commercial|All Plans | $1,717.62 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $1,776.84 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $2,296.23 | ↑ +44% |
| SUPERIOR | Medicaid|CHIP | $2,965.95 | ↑ +86% |
| UNITED | Medicaid|STARKIDS | $3,025.27 | ↑ +90% |
| UNITED | Medicaid|All Other Plans | $3,025.27 | ↑ +90% |
| SUPERIOR | Medicaid|All Other Plans | $3,114.25 | ↑ +95% |
| BCBS | Medicaid|STARKIDS | $3,114.25 | ↑ +95% |
| Wellpoint | Medicaid|STAR | $3,157.31 | ↑ +98% |
| Bright Health | Commercial|All Plans | $3,406.07 | ↑ +114% |
| Ellwood | Commercial|All Plans | $3,553.68 | ↑ +123% |
| Entrust | Commercial|All Plans | $3,827.04 | ↑ +140% |
| NX Health | Commercial|All Plans | $3,849.82 | ↑ +141% |
| SUPERIOR | Medicaid|STAR | $4,300.63 | ↑ +170% |
| Health Smart | Commercial|All Plans | $5,011.60 | ↑ +214% |
| First Health | Commercial|All Plans | $5,467.20 | ↑ +243% |
| Humana | Commercial|All Plans | $5,558.32 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $5,831.68 | ↑ +266% |
| Aetna | Commercial|All Plans | $6,013.92 | ↑ +277% |
| BCBS-TX | Commercial|Blue Premier | $6,767.19 | ↑ +324% |
| BCBS-TX | Commercial|Blue Advantage HMO | $6,815.53 | ↑ +327% |
| BCBS-TX | Commercial|HMO | $7,250.57 | ↑ +355% |
| SUPERIOR | Medicaid|STARPLUS | $7,355.56 | ↑ +361% |
| UNITED | Medicaid|STARPLUS | $7,503.85 | ↑ +371% |
| PHCS | Commercial|All Plans | $7,745.20 | ↑ +386% |
| Cigna | Commercial|Local Plus | $7,855.00 | ↑ +393% |
| BCBS-TX | Commercial|PPO | $7,975.62 | ↑ +400% |
| Multiplan | Commercial|All Plans | $8,200.80 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $9,112.00 | ↑ +471% |
| United | Commercial|Exchange | $9,379.00 | ↑ +488% |
| United | Commercial|All Other Plans | $18,403.00 | ↑ +1054% |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON KINGWOOD | HUMBLE | $12,366.52 | $2,762.95 – $10,731.66 |
| Baylor St Luke's Medical Center | Houston | $8,487.50 | $5,460.00 – $24,250.00 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $8,487.50 | $5,460.00 – $24,250.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $8,487.50 | $5,460.00 – $24,250.00 |
| St. Joseph Health College Station Hospital | College Station | $1,594.60 | $5,011.60 – $9,112.00 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $8,487.50 | $6,547.50 – $24,250.00 |
| St. Joseph Health Grimes Hospital | Navasota | $1,594.60 | $3,304.02 – $10,114.32 |
| St. Luke's Health - The Vintage Hospital | Houston | $8,487.50 | $5,460.00 – $24,250.00 |