Drain thigh/knee lesion 27301 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$558.78
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.
$3,193.00
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.
$118.10 with PGT vs $8,788.00 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 | $118.10 | ↓ -79% |
| BCBS | Medicare|All Plans | $120.51 | ↓ -78% |
| AETNA | Medicare|All Plans | $120.51 | ↓ -78% |
| UNITED | Medicare|All Plans | $122.93 | ↓ -78% |
| AMERIVANTAGE | Medicare|All Plans | $124.13 | ↓ -78% |
| SCANHealth | Medicare|All Plans | $128.95 | ↓ -77% |
| Ambetter | Commercial|All Plans | $174.74 | ↓ -69% |
| Wellpoint | Commercial|Exchange | $180.77 | ↓ -68% |
| Wellpoint | Medicaid|All Other Plans | $233.61 | ↓ -58% |
| Wellpoint | Medicaid|STAR | $321.21 | ↓ -43% |
| Bright Health | Commercial|All Plans | $346.52 | ↓ -38% |
| Ellwood | Commercial|All Plans | $361.53 | ↓ -35% |
| Entrust | Commercial|All Plans | $389.34 | ↓ -30% |
| NX Health | Commercial|All Plans | $391.66 | ↓ -30% |
| Health Smart | Commercial|All Plans | $509.85 | ↓ -9% |
| First Health | Commercial|All Plans | $556.20 | ↓ -0% |
| Humana | Commercial|All Plans | $565.47 | ↑ +1% |
| Cigna | Commercial|All Other Plans | $593.28 | ↑ +6% |
| Aetna | Commercial|All Plans | $611.82 | ↑ +9% |
| PHCS | Commercial|All Plans | $787.95 | ↑ +41% |
| Multiplan | Commercial|All Plans | $834.30 | ↑ +49% |
| SUPERIOR | Medicaid|CHIP | $857.59 | ↑ +53% |
| UNITED | Medicaid|All Other Plans | $874.74 | ↑ +57% |
| UNITED | Medicaid|STARKIDS | $874.74 | ↑ +57% |
| BCBS | Medicaid|STARKIDS | $900.47 | ↑ +61% |
| SUPERIOR | Medicaid|All Other Plans | $900.47 | ↑ +61% |
| BCBS-TX | Commercial|Ref Lab | $927.00 | ↑ +66% |
| SUPERIOR | Medicaid|STAR | $1,243.51 | ↑ +123% |
| SUPERIOR | Medicaid|STARPLUS | $2,126.82 | ↑ +281% |
| UNITED | Medicaid|STARPLUS | $2,169.70 | ↑ +288% |
| BCBS-TX | Commercial|Blue Premier | $3,246.45 | ↑ +481% |
| BCBS-TX | Commercial|Blue Advantage HMO | $3,269.63 | ↑ +485% |
| BCBS-TX | Commercial|HMO | $3,478.34 | ↑ +522% |
| Cigna | Commercial|Local Plus | $3,711.00 | ↑ +564% |
| BCBS-TX | Commercial|PPO | $3,826.17 | ↑ +585% |
| United | Commercial|Exchange | $4,479.00 | ↑ +702% |
| United | Commercial|All Other Plans | $8,788.00 | ↑ +1473% |
Visitor-reported prices
Comments
Drain thigh/knee lesion 27301 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $3,606.86 | $815.20 – $7,039.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $4,187.72 | $71.00 – $7,039.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,620.47 | $71.00 – $7,039.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $3,606.86 | $815.20 – $7,039.11 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $4,187.72 | $85.00 – $7,039.11 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $4,187.72 | $815.20 – $7,039.11 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,620.47 | $71.00 – $7,039.11 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $3,606.86 | $815.20 – $7,039.11 |