Low cost skin substitute app at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$211.23
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.
$1,207.00
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.
$153.78 with PGT vs $7,855.00 with Cigna — 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 | $153.78 | ↓ -27% |
| BCBS | Medicare|All Plans | $156.91 | ↓ -26% |
| AETNA | Medicare|All Plans | $156.91 | ↓ -26% |
| UNITED | Medicare|All Plans | $160.05 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $161.62 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $167.90 | ↓ -21% |
| Ambetter | Commercial|All Plans | $227.52 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $235.37 | ↑ +11% |
| SUPERIOR | Medicaid|CHIP | $289.68 | ↑ +37% |
| UNITED | Medicaid|All Other Plans | $295.48 | ↑ +40% |
| UNITED | Medicaid|STARKIDS | $295.48 | ↑ +40% |
| SUPERIOR | Medicaid|All Other Plans | $304.17 | ↑ +44% |
| BCBS | Medicaid|STARKIDS | $304.17 | ↑ +44% |
| Wellpoint | Medicaid|All Other Plans | $304.17 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $418.23 | ↑ +98% |
| SUPERIOR | Medicaid|STAR | $420.04 | ↑ +99% |
| Bright Health | Commercial|All Plans | $451.18 | ↑ +114% |
| Ellwood | Commercial|All Plans | $470.73 | ↑ +123% |
| Entrust | Commercial|All Plans | $506.94 | ↑ +140% |
| NX Health | Commercial|All Plans | $509.96 | ↑ +141% |
| Health Smart | Commercial|All Plans | $663.85 | ↑ +214% |
| SUPERIOR | Medicaid|STARPLUS | $718.41 | ↑ +240% |
| First Health | Commercial|All Plans | $724.20 | ↑ +243% |
| UNITED | Medicaid|STARPLUS | $732.90 | ↑ +247% |
| Humana | Commercial|All Plans | $736.27 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $772.48 | ↑ +266% |
| Aetna | Commercial|All Plans | $796.62 | ↑ +277% |
| PHCS | Commercial|All Plans | $1,025.95 | ↑ +386% |
| Multiplan | Commercial|All Plans | $1,086.30 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $1,207.00 | ↑ +471% |
| United | Commercial|Exchange | $2,124.00 | ↑ +906% |
| BCBS-TX | Commercial|Blue Premier | $2,271.84 | ↑ +976% |
| BCBS-TX | Commercial|Blue Advantage HMO | $2,288.06 | ↑ +983% |
| BCBS-TX | Commercial|HMO | $2,434.11 | ↑ +1052% |
| BCBS-TX | Commercial|PPO | $2,677.52 | ↑ +1168% |
| United | Commercial|All Other Plans | $4,168.00 | ↑ +1873% |
| Cigna | Commercial|Local Plus | $7,855.00 | ↑ +3619% |
Visitor-reported prices
Comments
Low cost skin substitute app at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | $2,431.38 | $1,660.87 – $4,524.00 |
| St. Joseph Health College Station Hospital | College Station | $211.23 | $663.85 – $1,207.00 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $208.95 | $89.55 – $298.50 |
| St. Joseph Health Grimes Hospital | Navasota | $211.23 | $437.66 – $1,339.77 |
| Covenant Medical Center | Lubbock | $2,431.38 | $1,688.91 – $16,636.00 |
| St. Joseph Health Burleson Hospital | Caldwell | $211.23 | $265.54 – $1,207.00 |
| Covenant Hospital Plainview | Plainview | $2,301.18 | $3,261.71 – $4,837.00 |
| Covenant Hospital Levelland | Levelland | $2,295.30 | $4,837.00 – $5,980.61 |