Lower Back (Lumbar Spine) MRI (with and without contrast) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$1,250.03
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.
$7,143.00
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.
$461.69 with SUPERIOR vs $7,143.00 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 |
|---|---|---|---|
| SUPERIOR | Medicaid|CHIP | $461.69 | ↓ -63% |
| UNITED | Medicaid|All Other Plans | $470.92 | ↓ -62% |
| UNITED | Medicaid|STARKIDS | $470.92 | ↓ -62% |
| BCBS | Medicaid|STARKIDS | $484.77 | ↓ -61% |
| SUPERIOR | Medicaid|All Other Plans | $484.77 | ↓ -61% |
| SUPERIOR | Medicaid|STAR | $669.45 | ↓ -46% |
| PGT | Medicare|All Plans | $910.02 | ↓ -27% |
| BCBS | Medicare|All Plans | $928.59 | ↓ -26% |
| AETNA | Medicare|All Plans | $928.59 | ↓ -26% |
| UNITED | Medicare|All Plans | $947.17 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $956.45 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $993.60 | ↓ -21% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,076.82 | ↓ -14% |
| SUPERIOR | Medicaid|STARPLUS | $1,144.99 | ↓ -8% |
| UNITED | Medicaid|STARPLUS | $1,168.08 | ↓ -7% |
| Cigna | Commercial|Local Plus | $1,169.00 | ↓ -6% |
| BCBS-TX | Commercial|Blue Premier | $1,244.83 | ↓ -0% |
| BCBS-TX | Commercial|HMO | $1,248.65 | ↓ -0% |
| Ambetter | Commercial|All Plans | $1,346.46 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $1,392.89 | ↑ +11% |
| Humana | Commercial|All Plans | $1,450.00 | ↑ +16% |
| BCBS-TX | Commercial|PPO | $1,466.30 | ↑ +17% |
| Wellpoint | Medicaid|All Other Plans | $1,800.04 | ↑ +44% |
| United | Commercial|Exchange | $2,011.00 | ↑ +61% |
| Wellpoint | Medicaid|STAR | $2,475.05 | ↑ +98% |
| Bright Health | Commercial|All Plans | $2,670.06 | ↑ +114% |
| Ellwood | Commercial|All Plans | $2,785.77 | ↑ +123% |
| Entrust | Commercial|All Plans | $3,000.06 | ↑ +140% |
| NX Health | Commercial|All Plans | $3,017.92 | ↑ +141% |
| Health Smart | Commercial|All Plans | $3,928.65 | ↑ +214% |
| United | Commercial|All Other Plans | $3,947.00 | ↑ +216% |
| First Health | Commercial|All Plans | $4,285.80 | ↑ +243% |
| Cigna | Commercial|All Other Plans | $4,571.52 | ↑ +266% |
| Aetna | Commercial|All Plans | $4,714.38 | ↑ +277% |
| PHCS | Commercial|All Plans | $6,071.55 | ↑ +386% |
| Multiplan | Commercial|All Plans | $6,428.70 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $7,143.00 | ↑ +471% |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (with and without contrast) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $5,565.11 | $1,779.42 – $1,779.42 |
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $3,196.33 | $329.13 – $3,995.41 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $3,200.98 | $494.01 – $4,801.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $3,167.94 | $329.13 – $3,959.93 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $3,196.33 | $329.13 – $3,995.41 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $3,200.98 | $332.94 – $4,801.46 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $3,200.98 | $329.13 – $4,801.46 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $3,167.94 | $329.13 – $4,751.91 |