Ins/rpl pm gen exist sgl lead at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$2,347.80
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.
$13,416.00
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.
$1,709.20 with PGT vs $14,638.38 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 | $1,709.20 | ↓ -27% |
| BCBS | Medicare|All Plans | $1,744.08 | ↓ -26% |
| AETNA | Medicare|All Plans | $1,744.08 | ↓ -26% |
| UNITED | Medicare|All Plans | $1,778.97 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $1,796.41 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $1,866.17 | ↓ -21% |
| Ambetter | Commercial|All Plans | $2,528.92 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $2,616.12 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $3,380.84 | ↑ +44% |
| Cigna | Commercial|Local Plus | $3,711.00 | ↑ +58% |
| Wellpoint | Medicaid|STAR | $4,648.65 | ↑ +98% |
| Bright Health | Commercial|All Plans | $5,014.91 | ↑ +114% |
| United | Commercial|Exchange | $5,085.00 | ↑ +117% |
| Ellwood | Commercial|All Plans | $5,232.24 | ↑ +123% |
| Entrust | Commercial|All Plans | $5,634.72 | ↑ +140% |
| NX Health | Commercial|All Plans | $5,668.26 | ↑ +141% |
| SUPERIOR | Medicaid|CHIP | $5,785.92 | ↑ +146% |
| UNITED | Medicaid|STARKIDS | $5,901.64 | ↑ +151% |
| UNITED | Medicaid|All Other Plans | $5,901.64 | ↑ +151% |
| BCBS | Medicaid|STARKIDS | $6,075.22 | ↑ +159% |
| SUPERIOR | Medicaid|All Other Plans | $6,075.22 | ↑ +159% |
| Health Smart | Commercial|All Plans | $7,378.80 | ↑ +214% |
| First Health | Commercial|All Plans | $8,049.60 | ↑ +243% |
| Humana | Commercial|All Plans | $8,183.76 | ↑ +249% |
| SUPERIOR | Medicaid|STAR | $8,389.58 | ↑ +257% |
| Cigna | Commercial|All Other Plans | $8,586.24 | ↑ +266% |
| Aetna | Commercial|All Plans | $8,854.56 | ↑ +277% |
| United | Commercial|All Other Plans | $9,978.00 | ↑ +325% |
| BCBS-TX | Commercial|Blue Premier | $10,698.59 | ↑ +356% |
| BCBS-TX | Commercial|Blue Advantage HMO | $10,775.01 | ↑ +359% |
| PHCS | Commercial|All Plans | $11,403.60 | ↑ +386% |
| BCBS-TX | Commercial|HMO | $11,462.78 | ↑ +388% |
| Multiplan | Commercial|All Plans | $12,074.40 | ↑ +414% |
| BCBS-TX | Commercial|PPO | $12,609.05 | ↑ +437% |
| BCBS-TX | Commercial|Ref Lab | $13,416.00 | ↑ +471% |
| SUPERIOR | Medicaid|STARPLUS | $14,349.08 | ↑ +511% |
| UNITED | Medicaid|STARPLUS | $14,638.38 | ↑ +523% |
Visitor-reported prices
Comments
Ins/rpl pm gen exist sgl lead at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $10,687.75 | $2,763.00 – $21,045.99 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $7,336.78 | $1,510.15 – $21,045.99 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $11,030.18 | $5,499.92 – $21,045.99 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $10,687.75 | $2,763.00 – $21,045.99 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $7,336.78 | $2,763.00 – $21,045.99 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $7,336.78 | $2,763.00 – $21,045.99 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $11,030.18 | $2,763.00 – $21,045.99 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $10,687.75 | $2,763.00 – $21,045.99 |