Destruction benign lesions < 14 lesions at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$46.73
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.
$267.00
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.
$21.54 with PGT vs $2,960.00 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 | $21.54 | ↓ -54% |
| BCBS | Medicare|All Plans | $21.97 | ↓ -53% |
| AETNA | Medicare|All Plans | $21.97 | ↓ -53% |
| UNITED | Medicare|All Plans | $22.41 | ↓ -52% |
| AMERIVANTAGE | Medicare|All Plans | $22.63 | ↓ -52% |
| SCANHealth | Medicare|All Plans | $23.51 | ↓ -50% |
| Ambetter | Commercial|All Plans | $31.86 | ↓ -32% |
| Wellpoint | Commercial|Exchange | $32.96 | ↓ -29% |
| Wellpoint | Medicaid|All Other Plans | $42.59 | ↓ -9% |
| Wellpoint | Medicaid|STAR | $58.56 | ↑ +25% |
| Bright Health | Commercial|All Plans | $63.18 | ↑ +35% |
| SUPERIOR | Medicaid|CHIP | $64.08 | ↑ +37% |
| UNITED | Medicaid|All Other Plans | $65.37 | ↑ +40% |
| UNITED | Medicaid|STARKIDS | $65.37 | ↑ +40% |
| Ellwood | Commercial|All Plans | $65.91 | ↑ +41% |
| SUPERIOR | Medicaid|All Other Plans | $67.29 | ↑ +44% |
| BCBS | Medicaid|STARKIDS | $67.29 | ↑ +44% |
| Entrust | Commercial|All Plans | $70.98 | ↑ +52% |
| NX Health | Commercial|All Plans | $71.41 | ↑ +53% |
| SUPERIOR | Medicaid|STAR | $92.92 | ↑ +99% |
| Health Smart | Commercial|All Plans | $92.95 | ↑ +99% |
| First Health | Commercial|All Plans | $101.40 | ↑ +117% |
| Humana | Commercial|All Plans | $103.09 | ↑ +121% |
| Cigna | Commercial|All Other Plans | $108.16 | ↑ +131% |
| Aetna | Commercial|All Plans | $111.54 | ↑ +139% |
| Cigna | Commercial|Local Plus | $130.83 | ↑ +180% |
| PHCS | Commercial|All Plans | $143.65 | ↑ +207% |
| Multiplan | Commercial|All Plans | $152.10 | ↑ +225% |
| SUPERIOR | Medicaid|STARPLUS | $158.92 | ↑ +240% |
| UNITED | Medicaid|STARPLUS | $162.13 | ↑ +247% |
| BCBS-TX | Commercial|Ref Lab | $169.00 | ↑ +262% |
| BCBS-TX | Commercial|Blue Premier | $244.62 | ↑ +423% |
| BCBS-TX | Commercial|Blue Advantage HMO | $246.37 | ↑ +427% |
| BCBS-TX | Commercial|HMO | $262.10 | ↑ +461% |
| BCBS-TX | Commercial|PPO | $288.30 | ↑ +517% |
| United | Commercial|Exchange | $1,508.00 | ↑ +3127% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +6234% |
Visitor-reported prices
Comments
Destruction benign lesions < 14 lesions at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $210.98 | $59.78 – $495.95 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $197.32 | $40.62 – $495.95 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $261.23 | $52.25 – $495.95 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $210.98 | $56.26 – $495.95 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $197.32 | $63.34 – $495.95 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $197.32 | $101.95 – $495.95 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $261.23 | $71.00 – $495.95 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $210.98 | $56.26 – $495.95 |