Ins pm gen w/exist mlt leads at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$3,189.73
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.
$18,227.00
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.
$2,322.12 with PGT vs $30,216.81 with BCBS-TX — 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 | $2,322.12 | ↓ -27% |
| BCBS | Medicare|All Plans | $2,369.51 | ↓ -26% |
| AETNA | Medicare|All Plans | $2,369.51 | ↓ -26% |
| UNITED | Medicare|All Plans | $2,416.91 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $2,440.60 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $2,535.38 | ↓ -21% |
| Ambetter | Commercial|All Plans | $3,435.79 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $3,554.27 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $4,593.21 | ↑ +44% |
| United | Commercial|Exchange | $5,085.00 | ↑ +59% |
| Wellpoint | Medicaid|STAR | $6,315.66 | ↑ +98% |
| Bright Health | Commercial|All Plans | $6,813.26 | ↑ +114% |
| Ellwood | Commercial|All Plans | $7,108.53 | ↑ +123% |
| Entrust | Commercial|All Plans | $7,655.34 | ↑ +140% |
| NX Health | Commercial|All Plans | $7,700.91 | ↑ +141% |
| Cigna | Commercial|Local Plus | $9,871.00 | ↑ +209% |
| United | Commercial|All Other Plans | $9,978.00 | ↑ +213% |
| Health Smart | Commercial|All Plans | $10,024.85 | ↑ +214% |
| SUPERIOR | Medicaid|CHIP | $10,381.64 | ↑ +225% |
| UNITED | Medicaid|STARKIDS | $10,589.27 | ↑ +232% |
| UNITED | Medicaid|All Other Plans | $10,589.27 | ↑ +232% |
| BCBS | Medicaid|STARKIDS | $10,900.72 | ↑ +242% |
| SUPERIOR | Medicaid|All Other Plans | $10,900.72 | ↑ +242% |
| First Health | Commercial|All Plans | $10,936.20 | ↑ +243% |
| Humana | Commercial|All Plans | $11,118.47 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $11,665.28 | ↑ +266% |
| Aetna | Commercial|All Plans | $12,029.82 | ↑ +277% |
| SUPERIOR | Medicaid|STAR | $15,053.38 | ↑ +372% |
| PHCS | Commercial|All Plans | $15,492.95 | ↑ +386% |
| Multiplan | Commercial|All Plans | $16,404.30 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $18,227.00 | ↑ +471% |
| BCBS-TX | Commercial|Blue Premier | $25,638.51 | ↑ +704% |
| SUPERIOR | Medicaid|STARPLUS | $25,746.47 | ↑ +707% |
| BCBS-TX | Commercial|Blue Advantage HMO | $25,821.64 | ↑ +710% |
| UNITED | Medicaid|STARPLUS | $26,265.55 | ↑ +723% |
| BCBS-TX | Commercial|HMO | $27,469.83 | ↑ +761% |
| BCBS-TX | Commercial|PPO | $30,216.81 | ↑ +847% |
Visitor-reported prices
Comments
Ins pm gen w/exist mlt leads at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $19,886.41 | $6,299.00 – $48,269.91 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $10,353.83 | $2,131.16 – $48,269.91 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $16,463.38 | $9,868.48 – $48,269.91 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $19,886.41 | $9,868.48 – $48,269.91 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $10,353.83 | $6,277.87 – $48,269.91 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $10,353.83 | $9,491.01 – $48,269.91 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $16,463.38 | $9,868.48 – $48,269.91 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $19,886.41 | $9,868.48 – $48,269.91 |