Exc benign tal 0.5 < cm 11400 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$205.63
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.
$1,175.00
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.
$24.21 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 | $24.21 | ↓ -88% |
| BCBS | Medicare|All Plans | $24.70 | ↓ -88% |
| AETNA | Medicare|All Plans | $24.70 | ↓ -88% |
| UNITED | Medicare|All Plans | $25.20 | ↓ -88% |
| AMERIVANTAGE | Medicare|All Plans | $25.45 | ↓ -88% |
| SCANHealth | Medicare|All Plans | $26.43 | ↓ -87% |
| Ambetter | Commercial|All Plans | $35.82 | ↓ -83% |
| Wellpoint | Commercial|Exchange | $37.05 | ↓ -82% |
| Wellpoint | Medicaid|All Other Plans | $47.88 | ↓ -77% |
| Wellpoint | Medicaid|STAR | $65.84 | ↓ -68% |
| Bright Health | Commercial|All Plans | $71.03 | ↓ -65% |
| Ellwood | Commercial|All Plans | $74.10 | ↓ -64% |
| Entrust | Commercial|All Plans | $79.80 | ↓ -61% |
| NX Health | Commercial|All Plans | $80.28 | ↓ -61% |
| SUPERIOR | Medicaid|CHIP | $81.84 | ↓ -60% |
| UNITED | Medicaid|STARKIDS | $83.48 | ↓ -59% |
| UNITED | Medicaid|All Other Plans | $83.48 | ↓ -59% |
| SUPERIOR | Medicaid|All Other Plans | $85.93 | ↓ -58% |
| BCBS | Medicaid|STARKIDS | $85.93 | ↓ -58% |
| Health Smart | Commercial|All Plans | $104.50 | ↓ -49% |
| First Health | Commercial|All Plans | $114.00 | ↓ -45% |
| Humana | Commercial|All Plans | $115.90 | ↓ -44% |
| SUPERIOR | Medicaid|STAR | $118.67 | ↓ -42% |
| Cigna | Commercial|All Other Plans | $121.60 | ↓ -41% |
| Aetna | Commercial|All Plans | $125.40 | ↓ -39% |
| BCBS-TX | Commercial|Blue Premier | $129.35 | ↓ -37% |
| BCBS-TX | Commercial|Blue Advantage HMO | $130.27 | ↓ -37% |
| BCBS-TX | Commercial|HMO | $138.59 | ↓ -33% |
| BCBS-TX | Commercial|PPO | $152.44 | ↓ -26% |
| PHCS | Commercial|All Plans | $161.50 | ↓ -21% |
| Multiplan | Commercial|All Plans | $171.00 | ↓ -17% |
| BCBS-TX | Commercial|Ref Lab | $190.00 | ↓ -8% |
| SUPERIOR | Medicaid|STARPLUS | $202.96 | ↓ -1% |
| UNITED | Medicaid|STARPLUS | $207.06 | ↑ +1% |
| United | Commercial|Exchange | $1,508.00 | ↑ +633% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +1304% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +1339% |
Visitor-reported prices
Comments
Exc benign tal 0.5 < cm 11400 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $805.70 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,196.08 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $805.70 | $83.24 – $2,975.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $805.70 | $77.79 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,196.08 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $805.70 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $805.70 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $1,196.08 | $71.00 – $2,975.00 |