Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$2,501.45
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.
$14,294.00
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.
$1,821.06 with PGT vs $16,915.70 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 | $1,821.06 | ↓ -27% |
| BCBS | Medicare|All Plans | $1,858.22 | ↓ -26% |
| AETNA | Medicare|All Plans | $1,858.22 | ↓ -26% |
| UNITED | Medicare|All Plans | $1,895.39 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $1,913.97 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $1,988.30 | ↓ -21% |
| Ambetter | Commercial|All Plans | $2,694.42 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $2,787.33 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $3,602.09 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $4,952.88 | ↑ +98% |
| United | Commercial|Exchange | $5,085.00 | ↑ +103% |
| Bright Health | Commercial|All Plans | $5,343.10 | ↑ +114% |
| Ellwood | Commercial|All Plans | $5,574.66 | ↑ +123% |
| Entrust | Commercial|All Plans | $6,003.48 | ↑ +140% |
| NX Health | Commercial|All Plans | $6,039.22 | ↑ +141% |
| SUPERIOR | Medicaid|CHIP | $6,652.19 | ↑ +166% |
| UNITED | Medicaid|STARKIDS | $6,785.23 | ↑ +171% |
| UNITED | Medicaid|All Other Plans | $6,785.23 | ↑ +171% |
| BCBS | Medicaid|STARKIDS | $6,984.80 | ↑ +179% |
| SUPERIOR | Medicaid|All Other Plans | $6,984.80 | ↑ +179% |
| Health Smart | Commercial|All Plans | $7,861.70 | ↑ +214% |
| First Health | Commercial|All Plans | $8,576.40 | ↑ +243% |
| Humana | Commercial|All Plans | $8,719.34 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $9,148.16 | ↑ +266% |
| Aetna | Commercial|All Plans | $9,434.04 | ↑ +277% |
| SUPERIOR | Medicaid|STAR | $9,645.68 | ↑ +286% |
| Cigna | Commercial|Local Plus | $9,871.00 | ↑ +295% |
| United | Commercial|All Other Plans | $9,978.00 | ↑ +299% |
| PHCS | Commercial|All Plans | $12,149.90 | ↑ +386% |
| Multiplan | Commercial|All Plans | $12,864.60 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $14,294.00 | ↑ +471% |
| BCBS-TX | Commercial|Blue Premier | $14,352.72 | ↑ +474% |
| BCBS-TX | Commercial|Blue Advantage HMO | $14,455.24 | ↑ +478% |
| BCBS-TX | Commercial|HMO | $15,377.91 | ↑ +515% |
| SUPERIOR | Medicaid|STARPLUS | $16,497.43 | ↑ +560% |
| UNITED | Medicaid|STARPLUS | $16,830.04 | ↑ +573% |
| BCBS-TX | Commercial|PPO | $16,915.70 | ↑ +576% |
Visitor-reported prices
Comments
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $15,987.70 | $6,299.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $17,466.97 | $71.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $15,987.70 | $71.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $15,987.70 | $6,323.37 – $26,452.82 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $17,466.97 | $85.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $17,466.97 | $6,323.37 – $26,452.82 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $15,987.70 | $71.00 – $26,452.82 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $15,987.70 | $6,323.37 – $26,452.82 |