Ear irrigation 69209 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$29.05
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.
$166.00
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.
$21.15 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 | $21.15 | ↓ -27% |
| BCBS | Medicare|All Plans | $21.58 | ↓ -26% |
| AETNA | Medicare|All Plans | $21.58 | ↓ -26% |
| UNITED | Medicare|All Plans | $22.02 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $22.23 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $23.10 | ↓ -20% |
| Ambetter | Commercial|All Plans | $31.30 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $32.37 | ↑ +11% |
| SUPERIOR | Medicaid|CHIP | $39.84 | ↑ +37% |
| UNITED | Medicaid|All Other Plans | $40.64 | ↑ +40% |
| UNITED | Medicaid|STARKIDS | $40.64 | ↑ +40% |
| SUPERIOR | Medicaid|All Other Plans | $41.84 | ↑ +44% |
| BCBS | Medicaid|STARKIDS | $41.84 | ↑ +44% |
| Wellpoint | Medicaid|All Other Plans | $41.84 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $57.52 | ↑ +98% |
| SUPERIOR | Medicaid|STAR | $57.77 | ↑ +99% |
| Bright Health | Commercial|All Plans | $62.06 | ↑ +114% |
| Ellwood | Commercial|All Plans | $64.74 | ↑ +123% |
| Entrust | Commercial|All Plans | $69.72 | ↑ +140% |
| NX Health | Commercial|All Plans | $70.14 | ↑ +141% |
| BCBS-TX | Commercial|Blue Premier | $77.01 | ↑ +165% |
| BCBS-TX | Commercial|Blue Advantage HMO | $77.56 | ↑ +167% |
| Cigna | Commercial|Local Plus | $81.34 | ↑ +180% |
| BCBS-TX | Commercial|HMO | $82.52 | ↑ +184% |
| BCBS-TX | Commercial|PPO | $90.77 | ↑ +212% |
| Health Smart | Commercial|All Plans | $91.30 | ↑ +214% |
| SUPERIOR | Medicaid|STARPLUS | $98.81 | ↑ +240% |
| First Health | Commercial|All Plans | $99.60 | ↑ +243% |
| UNITED | Medicaid|STARPLUS | $100.80 | ↑ +247% |
| Humana | Commercial|All Plans | $101.26 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $106.24 | ↑ +266% |
| Aetna | Commercial|All Plans | $109.56 | ↑ +277% |
| PHCS | Commercial|All Plans | $141.10 | ↑ +386% |
| Multiplan | Commercial|All Plans | $149.40 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $166.00 | ↑ +471% |
| United | Commercial|Exchange | $1,508.00 | ↑ +5091% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +10089% |
Visitor-reported prices
Comments
Ear irrigation 69209 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $461.34 | $68.76 – $4,826.69 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $215.33 | $56.30 – $269.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $84.92 | $17.48 – $151.53 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $123.74 | $24.75 – $154.67 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $215.33 | $56.30 – $269.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $84.92 | $27.26 – $151.53 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $84.92 | $43.87 – $151.53 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $123.74 | $41.25 – $185.61 |