Lipase at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$54.25
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.
$310.00
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.
$6.20 with United vs $279.00 with Multiplan — 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 |
|---|---|---|---|
| United | Commercial|Exchange | $6.20 | ↓ -89% |
| PGT | Medicare|All Plans | $6.76 | ↓ -88% |
| BCBS | Medicare|All Plans | $6.89 | ↓ -87% |
| AETNA | Medicare|All Plans | $6.89 | ↓ -87% |
| UNITED | Medicare|All Plans | $7.03 | ↓ -87% |
| AMERIVANTAGE | Medicare|All Plans | $7.10 | ↓ -87% |
| SCANHealth | Medicare|All Plans | $7.37 | ↓ -86% |
| BCBS-TX | Commercial|Ref Lab | $7.50 | ↓ -86% |
| SUPERIOR | Medicaid|CHIP | $9.44 | ↓ -83% |
| UNITED | Medicaid|STARKIDS | $9.63 | ↓ -82% |
| UNITED | Medicaid|All Other Plans | $9.63 | ↓ -82% |
| SUPERIOR | Medicaid|All Other Plans | $9.91 | ↓ -82% |
| BCBS | Medicaid|STARKIDS | $9.91 | ↓ -82% |
| Ambetter | Commercial|All Plans | $9.99 | ↓ -82% |
| Wellpoint | Commercial|Exchange | $10.34 | ↓ -81% |
| Bright Health | Commercial|All Plans | $12.26 | ↓ -77% |
| United | Commercial|All Other Plans | $13.39 | ↓ -75% |
| SUPERIOR | Medicaid|STAR | $13.69 | ↓ -75% |
| Entrust | Commercial|All Plans | $13.78 | ↓ -75% |
| Cigna | Commercial|Local Plus | $15.09 | ↓ -72% |
| Ellwood | Commercial|All Plans | $20.67 | ↓ -62% |
| NX Health | Commercial|All Plans | $22.39 | ↓ -59% |
| SUPERIOR | Medicaid|STARPLUS | $23.41 | ↓ -57% |
| UNITED | Medicaid|STARPLUS | $23.88 | ↓ -56% |
| BCBS-TX | Commercial|Blue Premier | $24.18 | ↓ -55% |
| BCBS-TX | Commercial|Blue Advantage HMO | $24.18 | ↓ -55% |
| BCBS-TX | Commercial|HMO | $24.67 | ↓ -55% |
| BCBS-TX | Commercial|PPO | $28.46 | ↓ -48% |
| Wellpoint | Medicaid|All Other Plans | $78.12 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $107.42 | ↑ +98% |
| Health Smart | Commercial|All Plans | $170.50 | ↑ +214% |
| First Health | Commercial|All Plans | $186.00 | ↑ +243% |
| Humana | Commercial|All Plans | $189.10 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $198.40 | ↑ +266% |
| Aetna | Commercial|All Plans | $204.60 | ↑ +277% |
| PHCS | Commercial|All Plans | $263.50 | ↑ +386% |
| Multiplan | Commercial|All Plans | $279.00 | ↑ +414% |
Visitor-reported prices
Comments
Lipase at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $326.49 | $6.20 – $26.53 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $130.62 | $5.79 – $16.54 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $93.58 | $2.32 – $16.88 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $93.58 | $5.79 – $16.54 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $130.62 | $5.79 – $16.54 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $93.58 | $6.20 – $16.88 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $93.58 | $5.79 – $16.88 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $93.58 | $5.79 – $16.88 |