Established Patient Office Visit (level 3) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$214.20
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.
$1,224.00
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.
$15.42 with PGT vs $235.60 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 | $15.42 | ↓ -93% |
| BCBS | Medicare|All Plans | $15.73 | ↓ -93% |
| AETNA | Medicare|All Plans | $15.73 | ↓ -93% |
| UNITED | Medicare|All Plans | $16.05 | ↓ -93% |
| AMERIVANTAGE | Medicare|All Plans | $16.21 | ↓ -92% |
| SCANHealth | Medicare|All Plans | $16.84 | ↓ -92% |
| Ambetter | Commercial|All Plans | $22.81 | ↓ -89% |
| Wellpoint | Commercial|Exchange | $23.60 | ↓ -89% |
| Wellpoint | Medicaid|All Other Plans | $30.50 | ↓ -86% |
| Wellpoint | Medicaid|STAR | $41.93 | ↓ -80% |
| Bright Health | Commercial|All Plans | $45.23 | ↓ -79% |
| Ellwood | Commercial|All Plans | $47.19 | ↓ -78% |
| Entrust | Commercial|All Plans | $50.82 | ↓ -76% |
| NX Health | Commercial|All Plans | $51.13 | ↓ -76% |
| Health Smart | Commercial|All Plans | $66.55 | ↓ -69% |
| First Health | Commercial|All Plans | $72.60 | ↓ -66% |
| Humana | Commercial|All Plans | $73.81 | ↓ -66% |
| United | Commercial|Exchange | $77.00 | ↓ -64% |
| Cigna | Commercial|All Other Plans | $77.44 | ↓ -64% |
| Aetna | Commercial|All Plans | $79.86 | ↓ -63% |
| SUPERIOR | Medicaid|CHIP | $93.12 | ↓ -57% |
| UNITED | Medicaid|All Other Plans | $94.99 | ↓ -56% |
| UNITED | Medicaid|STARKIDS | $94.99 | ↓ -56% |
| SUPERIOR | Medicaid|All Other Plans | $97.78 | ↓ -54% |
| BCBS | Medicaid|STARKIDS | $97.78 | ↓ -54% |
| PHCS | Commercial|All Plans | $102.85 | ↓ -52% |
| BCBS-TX | Commercial|Blue Advantage HMO | $103.28 | ↓ -52% |
| Multiplan | Commercial|All Plans | $108.90 | ↓ -49% |
| BCBS-TX | Commercial|HMO | $121.00 | ↓ -44% |
| BCBS-TX | Commercial|Blue Premier | $121.00 | ↓ -44% |
| BCBS-TX | Commercial|Ref Lab | $121.00 | ↓ -44% |
| BCBS-TX | Commercial|PPO | $121.00 | ↓ -44% |
| SUPERIOR | Medicaid|STAR | $135.03 | ↓ -37% |
| United | Commercial|All Other Plans | $152.00 | ↓ -29% |
| Cigna | Commercial|Local Plus | $190.12 | ↓ -11% |
| SUPERIOR | Medicaid|STARPLUS | $230.94 | ↑ +8% |
| UNITED | Medicaid|STARPLUS | $235.60 | ↑ +10% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $361.22 | $199.82 – $199.82 |
| Baylor St Luke's Medical Center | Houston | $148.40 | $61.24 – $424.00 |
| St. Luke's Health Memorial Lufkin | Lufkin | $66.87 | $20.50 – $100.00 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $148.40 | $74.00 – $424.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $148.40 | $74.00 – $424.00 |
| St. Joseph Health College Station Hospital | College Station | $214.20 | $66.55 – $190.12 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $148.40 | $74.00 – $424.00 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $142.09 | $45.00 – $162.00 |