Complx repair enel 2.6-7.5 cm 13152 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$163.28
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.
$933.00
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.
$88.68 with PGT vs $3,711.00 with Cigna — 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 | $88.68 | ↓ -46% |
| BCBS | Medicare|All Plans | $90.48 | ↓ -45% |
| AETNA | Medicare|All Plans | $90.48 | ↓ -45% |
| UNITED | Medicare|All Plans | $92.29 | ↓ -43% |
| AMERIVANTAGE | Medicare|All Plans | $93.20 | ↓ -43% |
| SCANHealth | Medicare|All Plans | $96.82 | ↓ -41% |
| Ambetter | Commercial|All Plans | $131.20 | ↓ -20% |
| Wellpoint | Commercial|Exchange | $135.72 | ↓ -17% |
| Wellpoint | Medicaid|All Other Plans | $175.40 | ↑ +7% |
| SUPERIOR | Medicaid|CHIP | $228.07 | ↑ +40% |
| UNITED | Medicaid|STARKIDS | $232.63 | ↑ +42% |
| UNITED | Medicaid|All Other Plans | $232.63 | ↑ +42% |
| SUPERIOR | Medicaid|All Other Plans | $239.47 | ↑ +47% |
| BCBS | Medicaid|STARKIDS | $239.47 | ↑ +47% |
| Wellpoint | Medicaid|STAR | $241.17 | ↑ +48% |
| Bright Health | Commercial|All Plans | $260.17 | ↑ +59% |
| Ellwood | Commercial|All Plans | $271.44 | ↑ +66% |
| Entrust | Commercial|All Plans | $292.32 | ↑ +79% |
| NX Health | Commercial|All Plans | $294.06 | ↑ +80% |
| SUPERIOR | Medicaid|STAR | $330.70 | ↑ +103% |
| Health Smart | Commercial|All Plans | $382.80 | ↑ +134% |
| First Health | Commercial|All Plans | $417.60 | ↑ +156% |
| Humana | Commercial|All Plans | $424.56 | ↑ +160% |
| Cigna | Commercial|All Other Plans | $445.44 | ↑ +173% |
| Aetna | Commercial|All Plans | $459.36 | ↑ +181% |
| SUPERIOR | Medicaid|STARPLUS | $565.61 | ↑ +246% |
| UNITED | Medicaid|STARPLUS | $577.02 | ↑ +253% |
| PHCS | Commercial|All Plans | $591.60 | ↑ +262% |
| Multiplan | Commercial|All Plans | $626.40 | ↑ +284% |
| BCBS-TX | Commercial|Blue Premier | $695.83 | ↑ +326% |
| BCBS-TX | Commercial|Ref Lab | $696.00 | ↑ +326% |
| BCBS-TX | Commercial|Blue Advantage HMO | $700.80 | ↑ +329% |
| BCBS-TX | Commercial|HMO | $745.53 | ↑ +357% |
| BCBS-TX | Commercial|PPO | $820.08 | ↑ +402% |
| United | Commercial|Exchange | $1,508.00 | ↑ +824% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +1713% |
| Cigna | Commercial|Local Plus | $3,711.00 | ↑ +2173% |
Visitor-reported prices
Comments
Complx repair enel 2.6-7.5 cm 13152 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $3,552.77 | $621.28 – $4,826.69 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $1,622.55 | $216.80 – $2,028.19 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,637.79 | $71.00 – $2,456.68 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,622.55 | $71.00 – $2,028.19 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $1,622.55 | $216.80 – $2,028.19 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,637.79 | $85.00 – $2,456.68 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,637.79 | $216.80 – $2,456.68 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,622.55 | $71.00 – $2,433.82 |