Ghs i and d perirectal abscess 46040 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$703.33
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.
$4,019.00
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.
$97.34 with PGT vs $4,168.00 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 | $97.34 | ↓ -86% |
| BCBS | Medicare|All Plans | $99.32 | ↓ -86% |
| AETNA | Medicare|All Plans | $99.32 | ↓ -86% |
| UNITED | Medicare|All Plans | $101.31 | ↓ -86% |
| AMERIVANTAGE | Medicare|All Plans | $102.30 | ↓ -85% |
| SCANHealth | Medicare|All Plans | $106.28 | ↓ -85% |
| Ambetter | Commercial|All Plans | $144.02 | ↓ -80% |
| Wellpoint | Commercial|Exchange | $148.98 | ↓ -79% |
| Wellpoint | Medicaid|All Other Plans | $192.53 | ↓ -73% |
| Wellpoint | Medicaid|STAR | $264.73 | ↓ -62% |
| Bright Health | Commercial|All Plans | $285.59 | ↓ -59% |
| Ellwood | Commercial|All Plans | $297.96 | ↓ -58% |
| Entrust | Commercial|All Plans | $320.88 | ↓ -54% |
| NX Health | Commercial|All Plans | $322.79 | ↓ -54% |
| Health Smart | Commercial|All Plans | $420.20 | ↓ -40% |
| SUPERIOR | Medicaid|CHIP | $451.58 | ↓ -36% |
| First Health | Commercial|All Plans | $458.40 | ↓ -35% |
| UNITED | Medicaid|STARKIDS | $460.61 | ↓ -35% |
| UNITED | Medicaid|All Other Plans | $460.61 | ↓ -35% |
| Humana | Commercial|All Plans | $466.04 | ↓ -34% |
| BCBS | Medicaid|STARKIDS | $474.16 | ↓ -33% |
| SUPERIOR | Medicaid|All Other Plans | $474.16 | ↓ -33% |
| Cigna | Commercial|All Other Plans | $488.96 | ↓ -30% |
| Aetna | Commercial|All Plans | $504.24 | ↓ -28% |
| PHCS | Commercial|All Plans | $649.40 | ↓ -8% |
| SUPERIOR | Medicaid|STAR | $654.79 | ↓ -7% |
| Multiplan | Commercial|All Plans | $687.60 | ↓ -2% |
| BCBS-TX | Commercial|Ref Lab | $764.00 | ↑ +9% |
| SUPERIOR | Medicaid|STARPLUS | $1,119.92 | ↑ +59% |
| UNITED | Medicaid|STARPLUS | $1,142.50 | ↑ +62% |
| BCBS-TX | Commercial|Blue Premier | $1,405.91 | ↑ +100% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,415.95 | ↑ +101% |
| BCBS-TX | Commercial|HMO | $1,506.33 | ↑ +114% |
| BCBS-TX | Commercial|PPO | $1,656.96 | ↑ +136% |
| United | Commercial|Exchange | $2,124.00 | ↑ +202% |
| Cigna | Commercial|Local Plus | $3,711.00 | ↑ +428% |
| United | Commercial|All Other Plans | $4,168.00 | ↑ +493% |
Visitor-reported prices
Comments
Ghs i and d perirectal abscess 46040 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $6,545.71 | $1,255.28 – $2,991.88 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $3,267.70 | $429.26 – $4,084.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $4,078.12 | $459.31 – $6,117.17 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,668.87 | $429.26 – $4,586.09 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $3,267.70 | $429.26 – $4,084.62 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $4,078.12 | $459.31 – $6,117.17 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $4,078.12 | $429.26 – $6,117.17 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,668.87 | $429.26 – $5,503.31 |