Ins/rpl pm gen exist dual lead at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$2,336.60
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.
$13,352.00
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.
$1,701.05 with PGT vs $17,133.79 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 | $1,701.05 | ↓ -27% |
| BCBS | Medicare|All Plans | $1,735.76 | ↓ -26% |
| AETNA | Medicare|All Plans | $1,735.76 | ↓ -26% |
| UNITED | Medicare|All Plans | $1,770.48 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $1,787.84 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $1,857.27 | ↓ -21% |
| Ambetter | Commercial|All Plans | $2,516.86 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $2,603.64 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $3,364.71 | ↑ +44% |
| Cigna | Commercial|Local Plus | $3,711.00 | ↑ +59% |
| Wellpoint | Medicaid|STAR | $4,626.47 | ↑ +98% |
| Bright Health | Commercial|All Plans | $4,990.98 | ↑ +114% |
| United | Commercial|Exchange | $5,085.00 | ↑ +118% |
| Ellwood | Commercial|All Plans | $5,207.28 | ↑ +123% |
| Entrust | Commercial|All Plans | $5,607.84 | ↑ +140% |
| NX Health | Commercial|All Plans | $5,641.22 | ↑ +141% |
| SUPERIOR | Medicaid|CHIP | $6,772.25 | ↑ +190% |
| UNITED | Medicaid|STARKIDS | $6,907.69 | ↑ +196% |
| UNITED | Medicaid|All Other Plans | $6,907.69 | ↑ +196% |
| BCBS | Medicaid|STARKIDS | $7,110.86 | ↑ +204% |
| SUPERIOR | Medicaid|All Other Plans | $7,110.86 | ↑ +204% |
| Health Smart | Commercial|All Plans | $7,343.60 | ↑ +214% |
| First Health | Commercial|All Plans | $8,011.20 | ↑ +243% |
| Humana | Commercial|All Plans | $8,144.72 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $8,545.28 | ↑ +266% |
| Aetna | Commercial|All Plans | $8,812.32 | ↑ +277% |
| SUPERIOR | Medicaid|STAR | $9,819.76 | ↑ +320% |
| United | Commercial|All Other Plans | $9,978.00 | ↑ +327% |
| PHCS | Commercial|All Plans | $11,349.20 | ↑ +386% |
| Multiplan | Commercial|All Plans | $12,016.80 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $13,352.00 | ↑ +471% |
| BCBS-TX | Commercial|Blue Premier | $14,352.72 | ↑ +514% |
| BCBS-TX | Commercial|Blue Advantage HMO | $14,455.24 | ↑ +519% |
| BCBS-TX | Commercial|HMO | $15,377.91 | ↑ +558% |
| SUPERIOR | Medicaid|STARPLUS | $16,795.18 | ↑ +619% |
| BCBS-TX | Commercial|PPO | $16,915.70 | ↑ +624% |
| UNITED | Medicaid|STARPLUS | $17,133.79 | ↑ +633% |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $11,936.76 | $2,763.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $9,089.75 | $1,870.97 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $10,930.91 | $6,022.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $11,936.76 | $2,763.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $9,089.75 | $2,763.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $9,089.75 | $2,763.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $10,930.91 | $2,763.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $11,936.76 | $2,763.00 – $26,452.82 |