Cyclosporine modified 25 mg capsule at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$0.07
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.
?
What you pay up front if you don't use insurance.
$0.35
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.
?
The hospital's undiscounted list price — almost no one pays this.
$0.05 with BCBS vs $1.37 with United — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| BCBS | Medicare|All Plans | $0.05 | ↓ -29% |
| AETNA | Medicare|All Plans | $0.05 | ↓ -29% |
| UNITED | Medicare|All Plans | $0.05 | ↓ -29% |
| PGT | Medicare|All Plans | $0.05 | ↓ -29% |
| AMERIVANTAGE | Medicare|All Plans | $0.05 | ↓ -29% |
| SCANHealth | Medicare|All Plans | $0.05 | ↓ -29% |
| Ambetter | Commercial|All Plans | $0.07 | ↑ +0% |
| Wellpoint | Commercial|Exchange | $0.07 | ↑ +0% |
| Wellpoint | Medicaid|All Other Plans | $0.09 | ↑ +29% |
| Wellpoint | Medicaid|STAR | $0.13 | ↑ +86% |
| Bright Health | Commercial|All Plans | $0.14 | ↑ +100% |
| Ellwood | Commercial|All Plans | $0.14 | ↑ +100% |
| NX Health | Commercial|All Plans | $0.15 | ↑ +114% |
| Entrust | Commercial|All Plans | $0.15 | ↑ +114% |
| Health Smart | Commercial|All Plans | $0.20 | ↑ +186% |
| First Health | Commercial|All Plans | $0.21 | ↑ +200% |
| Humana | Commercial|All Plans | $0.22 | ↑ +214% |
| Cigna | Commercial|All Other Plans | $0.23 | ↑ +229% |
| Aetna | Commercial|All Plans | $0.24 | ↑ +243% |
| PHCS | Commercial|All Plans | $0.30 | ↑ +329% |
| Multiplan | Commercial|All Plans | $0.32 | ↑ +357% |
| BCBS-TX | Commercial|Blue Advantage HMO | $0.35 | ↑ +400% |
| BCBS-TX | Commercial|PPO | $0.35 | ↑ +400% |
| BCBS-TX | Commercial|HMO | $0.35 | ↑ +400% |
| Cigna | Commercial|Local Plus | $0.35 | ↑ +400% |
| BCBS-TX | Commercial|Blue Premier | $0.35 | ↑ +400% |
| BCBS-TX | Commercial|Ref Lab | $0.35 | ↑ +400% |
| United | Commercial|Exchange | $0.83 | ↑ +1086% |
| United | Commercial|All Other Plans | $1.37 | ↑ +1857% |
Visitor-reported prices
Comments
Cyclosporine modified 25 mg capsule at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | $9.58 | $2.69 – $3.19 |
| St. Luke's Health - Patients Medical Center | Pasadena | $1.11 | $0.86 – $3.15 |
| Baylor St Luke's Medical Center | Houston | $1.50 | $0.11 – $0.48 |
| St. Luke's Health Memorial Lufkin | Lufkin | $5.85 | $0.96 – $35.06 |
| HCA HOUSTON PEARLAND | Pearland | $7.87 | $0.74 – $7.11 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $1.50 | $0.11 – $0.48 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $1.50 | $0.11 – $0.48 |
| HCA HOUSTON SOUTHEAST | PASADENA | $36.74 | $0.74 – $7.11 |