Established Patient Office Visit (level 4) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$148.58
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.
$849.00
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.
$22.68 with PGT vs $304.82 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 | $22.68 | ↓ -85% |
| BCBS | Medicare|All Plans | $23.14 | ↓ -84% |
| AETNA | Medicare|All Plans | $23.14 | ↓ -84% |
| UNITED | Medicare|All Plans | $23.61 | ↓ -84% |
| AMERIVANTAGE | Medicare|All Plans | $23.84 | ↓ -84% |
| SCANHealth | Medicare|All Plans | $24.76 | ↓ -83% |
| Ambetter | Commercial|All Plans | $33.56 | ↓ -77% |
| Wellpoint | Commercial|Exchange | $34.71 | ↓ -77% |
| Wellpoint | Medicaid|All Other Plans | $44.86 | ↓ -70% |
| Wellpoint | Medicaid|STAR | $61.68 | ↓ -58% |
| Bright Health | Commercial|All Plans | $66.54 | ↓ -55% |
| Ellwood | Commercial|All Plans | $69.42 | ↓ -53% |
| Entrust | Commercial|All Plans | $74.76 | ↓ -50% |
| NX Health | Commercial|All Plans | $75.21 | ↓ -49% |
| United | Commercial|Exchange | $77.00 | ↓ -48% |
| Health Smart | Commercial|All Plans | $97.90 | ↓ -34% |
| First Health | Commercial|All Plans | $106.80 | ↓ -28% |
| Humana | Commercial|All Plans | $108.58 | ↓ -27% |
| Cigna | Commercial|All Other Plans | $113.92 | ↓ -23% |
| Aetna | Commercial|All Plans | $117.48 | ↓ -21% |
| SUPERIOR | Medicaid|CHIP | $120.48 | ↓ -19% |
| UNITED | Medicaid|All Other Plans | $122.89 | ↓ -17% |
| UNITED | Medicaid|STARKIDS | $122.89 | ↓ -17% |
| BCBS | Medicaid|STARKIDS | $126.51 | ↓ -15% |
| SUPERIOR | Medicaid|All Other Plans | $126.51 | ↓ -15% |
| PHCS | Commercial|All Plans | $151.30 | ↑ +2% |
| United | Commercial|All Other Plans | $152.00 | ↑ +2% |
| BCBS-TX | Commercial|Blue Advantage HMO | $159.22 | ↑ +7% |
| Multiplan | Commercial|All Plans | $160.20 | ↑ +8% |
| SUPERIOR | Medicaid|STAR | $174.70 | ↑ +18% |
| BCBS-TX | Commercial|PPO | $178.00 | ↑ +20% |
| BCBS-TX | Commercial|Ref Lab | $178.00 | ↑ +20% |
| BCBS-TX | Commercial|Blue Premier | $178.00 | ↑ +20% |
| BCBS-TX | Commercial|HMO | $178.00 | ↑ +20% |
| Cigna | Commercial|Local Plus | $245.98 | ↑ +66% |
| SUPERIOR | Medicaid|STARPLUS | $298.80 | ↑ +101% |
| UNITED | Medicaid|STARPLUS | $304.82 | ↑ +105% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $439.04 | $308.04 – $308.04 |
| Baylor St Luke's Medical Center | Houston | $168.70 | $82.00 – $482.00 |
| St. Luke's Health Memorial Lufkin | Lufkin | $83.39 | $73.75 – $442.48 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $168.70 | $74.00 – $482.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $168.70 | $74.00 – $482.00 |
| St. Joseph Health College Station Hospital | College Station | $148.58 | $77.00 – $245.98 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $168.70 | $74.00 – $482.00 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $163.87 | $45.00 – $194.85 |