Cystoscopy removal of clots at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$500.15
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.
$2,858.00
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.
$61.41 with PGT vs $4,980.59 with BCBS-TX — 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 | $61.41 | ↓ -88% |
| BCBS | Medicare|All Plans | $62.66 | ↓ -87% |
| AETNA | Medicare|All Plans | $62.66 | ↓ -87% |
| UNITED | Medicare|All Plans | $63.92 | ↓ -87% |
| AMERIVANTAGE | Medicare|All Plans | $64.54 | ↓ -87% |
| SCANHealth | Medicare|All Plans | $67.05 | ↓ -87% |
| Ambetter | Commercial|All Plans | $90.86 | ↓ -82% |
| Wellpoint | Commercial|Exchange | $93.99 | ↓ -81% |
| Wellpoint | Medicaid|All Other Plans | $121.47 | ↓ -76% |
| Wellpoint | Medicaid|STAR | $167.02 | ↓ -67% |
| Bright Health | Commercial|All Plans | $180.18 | ↓ -64% |
| Ellwood | Commercial|All Plans | $187.98 | ↓ -62% |
| Entrust | Commercial|All Plans | $202.44 | ↓ -60% |
| NX Health | Commercial|All Plans | $203.65 | ↓ -59% |
| Health Smart | Commercial|All Plans | $265.10 | ↓ -47% |
| First Health | Commercial|All Plans | $289.20 | ↓ -42% |
| Humana | Commercial|All Plans | $294.02 | ↓ -41% |
| Cigna | Commercial|All Other Plans | $308.48 | ↓ -38% |
| Aetna | Commercial|All Plans | $318.12 | ↓ -36% |
| PHCS | Commercial|All Plans | $409.70 | ↓ -18% |
| Multiplan | Commercial|All Plans | $433.80 | ↓ -13% |
| BCBS-TX | Commercial|Ref Lab | $482.00 | ↓ -4% |
| SUPERIOR | Medicaid|CHIP | $1,202.33 | ↑ +140% |
| UNITED | Medicaid|STARKIDS | $1,226.38 | ↑ +145% |
| UNITED | Medicaid|All Other Plans | $1,226.38 | ↑ +145% |
| BCBS | Medicaid|STARKIDS | $1,262.45 | ↑ +152% |
| SUPERIOR | Medicaid|All Other Plans | $1,262.45 | ↑ +152% |
| SUPERIOR | Medicaid|STAR | $1,743.38 | ↑ +249% |
| United | Commercial|Exchange | $2,124.00 | ↑ +325% |
| SUPERIOR | Medicaid|STARPLUS | $2,981.78 | ↑ +496% |
| UNITED | Medicaid|STARPLUS | $3,041.89 | ↑ +508% |
| Cigna | Commercial|Local Plus | $3,346.00 | ↑ +569% |
| United | Commercial|All Other Plans | $4,168.00 | ↑ +733% |
| BCBS-TX | Commercial|Blue Premier | $4,225.96 | ↑ +745% |
| BCBS-TX | Commercial|Blue Advantage HMO | $4,256.14 | ↑ +751% |
| BCBS-TX | Commercial|HMO | $4,527.81 | ↑ +805% |
| BCBS-TX | Commercial|PPO | $4,980.59 | ↑ +896% |
Visitor-reported prices
Comments
Cystoscopy removal of clots at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $2,829.82 | $71.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,236.11 | $71.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $2,829.82 | $85.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $2,829.82 | $1,142.90 – $8,636.11 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,236.11 | $71.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $2,829.82 | $71.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $2,829.82 | $71.00 – $8,636.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $3,236.11 | $71.00 – $8,636.11 |