Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$200.20
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.
$1,144.00
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.
$29.31 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 | $29.31 | ↓ -85% |
| BCBS | Medicare|All Plans | $29.90 | ↓ -85% |
| AETNA | Medicare|All Plans | $29.90 | ↓ -85% |
| UNITED | Medicare|All Plans | $30.50 | ↓ -85% |
| AMERIVANTAGE | Medicare|All Plans | $30.80 | ↓ -85% |
| SCANHealth | Medicare|All Plans | $32.00 | ↓ -84% |
| Ambetter | Commercial|All Plans | $43.36 | ↓ -78% |
| Wellpoint | Commercial|Exchange | $44.85 | ↓ -78% |
| Wellpoint | Medicaid|All Other Plans | $57.96 | ↓ -71% |
| Wellpoint | Medicaid|STAR | $79.70 | ↓ -60% |
| Bright Health | Commercial|All Plans | $85.98 | ↓ -57% |
| Ellwood | Commercial|All Plans | $89.70 | ↓ -55% |
| Entrust | Commercial|All Plans | $96.60 | ↓ -52% |
| NX Health | Commercial|All Plans | $97.18 | ↓ -51% |
| SUPERIOR | Medicaid|CHIP | $101.06 | ↓ -50% |
| UNITED | Medicaid|STARKIDS | $103.08 | ↓ -49% |
| UNITED | Medicaid|All Other Plans | $103.08 | ↓ -49% |
| SUPERIOR | Medicaid|All Other Plans | $106.11 | ↓ -47% |
| BCBS | Medicaid|STARKIDS | $106.11 | ↓ -47% |
| Health Smart | Commercial|All Plans | $126.50 | ↓ -37% |
| First Health | Commercial|All Plans | $138.00 | ↓ -31% |
| Humana | Commercial|All Plans | $140.30 | ↓ -30% |
| SUPERIOR | Medicaid|STAR | $146.54 | ↓ -27% |
| Cigna | Commercial|All Other Plans | $147.20 | ↓ -26% |
| Aetna | Commercial|All Plans | $151.80 | ↓ -24% |
| BCBS-TX | Commercial|Blue Premier | $159.66 | ↓ -20% |
| BCBS-TX | Commercial|Blue Advantage HMO | $160.80 | ↓ -20% |
| BCBS-TX | Commercial|HMO | $171.06 | ↓ -15% |
| BCBS-TX | Commercial|PPO | $188.17 | ↓ -6% |
| PHCS | Commercial|All Plans | $195.50 | ↓ -2% |
| Multiplan | Commercial|All Plans | $207.00 | ↑ +3% |
| BCBS-TX | Commercial|Ref Lab | $230.00 | ↑ +15% |
| SUPERIOR | Medicaid|STARPLUS | $250.63 | ↑ +25% |
| UNITED | Medicaid|STARPLUS | $255.68 | ↑ +28% |
| United | Commercial|Exchange | $1,508.00 | ↑ +653% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +1343% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +1379% |
Visitor-reported prices
Comments
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $762.65 | $96.06 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,047.98 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,020.35 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $762.65 | $96.06 – $1,742.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,047.98 | $85.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,047.98 | $96.06 – $1,742.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,020.35 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $762.65 | $96.06 – $1,742.94 |