Colonoscopy (with biopsy) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$97.30
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.
$556.00
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.
$70.84 with PGT vs $4,168.00 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 | $70.84 | ↓ -27% |
| BCBS | Medicare|All Plans | $72.28 | ↓ -26% |
| AETNA | Medicare|All Plans | $72.28 | ↓ -26% |
| UNITED | Medicare|All Plans | $73.73 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $74.45 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $77.34 | ↓ -21% |
| Ambetter | Commercial|All Plans | $104.81 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $108.42 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $140.12 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $192.66 | ↑ +98% |
| Bright Health | Commercial|All Plans | $207.84 | ↑ +114% |
| Ellwood | Commercial|All Plans | $216.84 | ↑ +123% |
| Entrust | Commercial|All Plans | $233.52 | ↑ +140% |
| NX Health | Commercial|All Plans | $234.91 | ↑ +141% |
| Health Smart | Commercial|All Plans | $305.80 | ↑ +214% |
| First Health | Commercial|All Plans | $333.60 | ↑ +243% |
| Humana | Commercial|All Plans | $339.16 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $355.84 | ↑ +266% |
| Aetna | Commercial|All Plans | $366.96 | ↑ +277% |
| SUPERIOR | Medicaid|CHIP | $451.58 | ↑ +364% |
| UNITED | Medicaid|STARKIDS | $460.61 | ↑ +373% |
| UNITED | Medicaid|All Other Plans | $460.61 | ↑ +373% |
| PHCS | Commercial|All Plans | $472.60 | ↑ +386% |
| BCBS | Medicaid|STARKIDS | $474.16 | ↑ +387% |
| SUPERIOR | Medicaid|All Other Plans | $474.16 | ↑ +387% |
| Multiplan | Commercial|All Plans | $500.40 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $556.00 | ↑ +471% |
| SUPERIOR | Medicaid|STAR | $654.79 | ↑ +573% |
| SUPERIOR | Medicaid|STARPLUS | $1,119.92 | ↑ +1051% |
| UNITED | Medicaid|STARPLUS | $1,142.50 | ↑ +1074% |
| BCBS-TX | Commercial|Blue Premier | $1,405.91 | ↑ +1345% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,415.95 | ↑ +1355% |
| BCBS-TX | Commercial|HMO | $1,506.33 | ↑ +1448% |
| BCBS-TX | Commercial|PPO | $1,656.96 | ↑ +1603% |
| United | Commercial|Exchange | $2,124.00 | ↑ +2083% |
| Cigna | Commercial|Local Plus | $3,346.00 | ↑ +3339% |
| United | Commercial|All Other Plans | $4,168.00 | ↑ +4184% |
Visitor-reported prices
Comments
Colonoscopy (with biopsy) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Luke's Health - Patients Medical Center | Pasadena | $1,521.45 | $2,608.20 – $3,260.25 |
| Texas Health Hospital Mansfield | Mansfield | $8,895.96 | $1,060.46 – $2,761.00 |
| Texas Health Huguley Hospital Fort Worth South | Burleson | $8,895.96 | $1,060.46 – $2,761.00 |
| Adventhealth Rollins Brook | Lampasas | not published | $1,255.28 – $2,991.88 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | not published | $429.26 – $4,063.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | not published | $459.31 – $3,630.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | not published | $429.26 – $3,421.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | not published | $429.26 – $4,063.00 |