Ghs moderate sedation < 5 yr, 30 min at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$515.90
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.
$2,948.00
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.
$51.64 with BCBS-TX vs $1,316.00 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 |
|---|---|---|---|
| BCBS-TX | Commercial|Blue Advantage HMO | $51.64 | ↓ -90% |
| BCBS-TX | Commercial|Blue Premier | $60.72 | ↓ -88% |
| BCBS-TX | Commercial|HMO | $64.36 | ↓ -88% |
| PGT | Medicare|All Plans | $65.11 | ↓ -87% |
| BCBS | Medicare|All Plans | $66.43 | ↓ -87% |
| AETNA | Medicare|All Plans | $66.43 | ↓ -87% |
| UNITED | Medicare|All Plans | $67.76 | ↓ -87% |
| AMERIVANTAGE | Medicare|All Plans | $68.43 | ↓ -87% |
| SCANHealth | Medicare|All Plans | $71.09 | ↓ -86% |
| BCBS-TX | Commercial|PPO | $71.62 | ↓ -86% |
| Ambetter | Commercial|All Plans | $96.33 | ↓ -81% |
| Wellpoint | Commercial|Exchange | $99.65 | ↓ -81% |
| SUPERIOR | Medicaid|CHIP | $122.64 | ↓ -76% |
| UNITED | Medicaid|All Other Plans | $125.10 | ↓ -76% |
| UNITED | Medicaid|STARKIDS | $125.10 | ↓ -76% |
| Wellpoint | Medicaid|All Other Plans | $128.78 | ↓ -75% |
| BCBS | Medicaid|STARKIDS | $128.78 | ↓ -75% |
| SUPERIOR | Medicaid|All Other Plans | $128.78 | ↓ -75% |
| Wellpoint | Medicaid|STAR | $177.07 | ↓ -66% |
| SUPERIOR | Medicaid|STAR | $177.83 | ↓ -66% |
| Bright Health | Commercial|All Plans | $191.02 | ↓ -63% |
| Ellwood | Commercial|All Plans | $199.29 | ↓ -61% |
| Entrust | Commercial|All Plans | $214.62 | ↓ -58% |
| NX Health | Commercial|All Plans | $215.90 | ↓ -58% |
| Cigna | Commercial|Local Plus | $250.39 | ↓ -51% |
| Health Smart | Commercial|All Plans | $281.05 | ↓ -46% |
| SUPERIOR | Medicaid|STARPLUS | $304.15 | ↓ -41% |
| First Health | Commercial|All Plans | $306.60 | ↓ -41% |
| UNITED | Medicaid|STARPLUS | $310.28 | ↓ -40% |
| Humana | Commercial|All Plans | $311.71 | ↓ -40% |
| Cigna | Commercial|All Other Plans | $327.04 | ↓ -37% |
| Aetna | Commercial|All Plans | $337.26 | ↓ -35% |
| PHCS | Commercial|All Plans | $434.35 | ↓ -16% |
| Multiplan | Commercial|All Plans | $459.90 | ↓ -11% |
| BCBS-TX | Commercial|Ref Lab | $511.00 | ↓ -1% |
| United | Commercial|Exchange | $670.00 | ↑ +30% |
| United | Commercial|All Other Plans | $1,316.00 | ↑ +155% |
Visitor-reported prices
Comments
Ghs moderate sedation < 5 yr, 30 min at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $1,290.89 | $99.91 – $99.91 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $240.00 | $68.00 – $340.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $240.00 | $49.40 – $360.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $240.00 | $48.00 – $300.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $240.00 | $60.72 – $340.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $240.00 | $77.04 – $360.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $240.00 | $124.00 – $360.00 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $240.00 | $78.37 – $360.00 |