Drainage absc/cyst/hmtma/vestibule mouth smpl at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$116.55
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.
$666.00
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.
$34.79 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 | $34.79 | ↓ -70% |
| BCBS | Medicare|All Plans | $35.49 | ↓ -70% |
| AETNA | Medicare|All Plans | $35.49 | ↓ -70% |
| UNITED | Medicare|All Plans | $36.20 | ↓ -69% |
| AMERIVANTAGE | Medicare|All Plans | $36.56 | ↓ -69% |
| SCANHealth | Medicare|All Plans | $37.98 | ↓ -67% |
| Ambetter | Commercial|All Plans | $51.47 | ↓ -56% |
| Wellpoint | Commercial|Exchange | $53.24 | ↓ -54% |
| Wellpoint | Medicaid|All Other Plans | $68.80 | ↓ -41% |
| Wellpoint | Medicaid|STAR | $94.60 | ↓ -19% |
| Bright Health | Commercial|All Plans | $102.05 | ↓ -12% |
| Ellwood | Commercial|All Plans | $106.47 | ↓ -9% |
| Entrust | Commercial|All Plans | $114.66 | ↓ -2% |
| NX Health | Commercial|All Plans | $115.35 | ↓ -1% |
| SUPERIOR | Medicaid|CHIP | $138.63 | ↑ +19% |
| UNITED | Medicaid|STARKIDS | $141.40 | ↑ +21% |
| UNITED | Medicaid|All Other Plans | $141.40 | ↑ +21% |
| BCBS | Medicaid|STARKIDS | $145.56 | ↑ +25% |
| SUPERIOR | Medicaid|All Other Plans | $145.56 | ↑ +25% |
| Health Smart | Commercial|All Plans | $150.15 | ↑ +29% |
| First Health | Commercial|All Plans | $163.80 | ↑ +41% |
| Humana | Commercial|All Plans | $166.53 | ↑ +43% |
| Cigna | Commercial|All Other Plans | $174.72 | ↑ +50% |
| Aetna | Commercial|All Plans | $180.18 | ↑ +55% |
| SUPERIOR | Medicaid|STAR | $201.01 | ↑ +72% |
| PHCS | Commercial|All Plans | $232.05 | ↑ +99% |
| BCBS-TX | Commercial|Blue Premier | $232.92 | ↑ +100% |
| BCBS-TX | Commercial|Blue Advantage HMO | $234.58 | ↑ +101% |
| Multiplan | Commercial|All Plans | $245.70 | ↑ +111% |
| BCBS-TX | Commercial|HMO | $249.56 | ↑ +114% |
| BCBS-TX | Commercial|Ref Lab | $273.00 | ↑ +134% |
| BCBS-TX | Commercial|PPO | $274.51 | ↑ +136% |
| Cigna | Commercial|Local Plus | $326.34 | ↑ +180% |
| SUPERIOR | Medicaid|STARPLUS | $343.80 | ↑ +195% |
| UNITED | Medicaid|STARPLUS | $350.73 | ↑ +201% |
| United | Commercial|Exchange | $1,508.00 | ↑ +1194% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +2440% |
Visitor-reported prices
Comments
Drainage absc/cyst/hmtma/vestibule mouth smpl at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $866.92 | $131.78 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $889.91 | $71.00 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $718.77 | $71.00 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $866.92 | $131.78 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $889.91 | $85.00 – $1,742.94 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $889.91 | $131.78 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $718.77 | $71.00 – $1,742.94 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $866.92 | $131.78 – $1,742.94 |