Kit lead specify 5-6-5 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$12,358.15
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.
$70,618.00
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.
$35.80 with PGT vs $281.00 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 | $35.80 | ↓ -100% |
| BCBS | Medicare|All Plans | $36.53 | ↓ -100% |
| AETNA | Medicare|All Plans | $36.53 | ↓ -100% |
| UNITED | Medicare|All Plans | $37.27 | ↓ -100% |
| AMERIVANTAGE | Medicare|All Plans | $37.63 | ↓ -100% |
| SCANHealth | Medicare|All Plans | $39.09 | ↓ -100% |
| Ambetter | Commercial|All Plans | $52.97 | ↓ -100% |
| Wellpoint | Commercial|Exchange | $54.80 | ↓ -100% |
| United | Commercial|Exchange | $56.20 | ↓ -100% |
| BCBS-TX | Commercial|Blue Advantage HMO | $61.82 | ↓ -99% |
| BCBS-TX | Commercial|Blue Premier | $70.25 | ↓ -99% |
| Wellpoint | Medicaid|All Other Plans | $70.82 | ↓ -99% |
| Bright Health | Commercial|All Plans | $73.06 | ↓ -99% |
| BCBS-TX | Commercial|HMO | $75.87 | ↓ -99% |
| BCBS-TX | Commercial|PPO | $81.49 | ↓ -99% |
| Cigna | Commercial|Local Plus | $87.11 | ↓ -99% |
| United | Commercial|All Other Plans | $92.73 | ↓ -99% |
| Wellpoint | Medicaid|STAR | $97.37 | ↓ -99% |
| Ellwood | Commercial|All Plans | $109.59 | ↓ -99% |
| Entrust | Commercial|All Plans | $118.02 | ↓ -99% |
| NX Health | Commercial|All Plans | $118.73 | ↓ -99% |
| Health Smart | Commercial|All Plans | $154.55 | ↓ -99% |
| First Health | Commercial|All Plans | $168.60 | ↓ -99% |
| Humana | Commercial|All Plans | $171.41 | ↓ -99% |
| Cigna | Commercial|All Other Plans | $179.84 | ↓ -99% |
| Aetna | Commercial|All Plans | $185.46 | ↓ -98% |
| PHCS | Commercial|All Plans | $238.85 | ↓ -98% |
| Multiplan | Commercial|All Plans | $252.90 | ↓ -98% |
| BCBS-TX | Commercial|Ref Lab | $281.00 | ↓ -98% |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | $34,886.25 | not published |
| St. Luke's Health - Patients Medical Center | Pasadena | $7,868.91 | $75.64 – $270.12 |
| Baylor St Luke's Medical Center | Houston | $36,731.63 | $0.27 – $1,021.80 |
| St. Luke's Health Memorial Lufkin | Lufkin | $7,910.13 | $3,624.24 – $21,745.40 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $36,731.63 | $0.27 – $1,021.80 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $36,731.63 | $0.27 – $1,021.80 |
| St. Joseph Health College Station Hospital | College Station | $12,358.15 | $56.20 – $238.85 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $36,731.63 | $0.27 – $1,021.80 |