Metatarsal joint implant at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$2,396.98
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.
$13,697.00
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.
$1,436.57 with PGT vs $11,276.00 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 | $1,436.57 | ↓ -40% |
| BCBS | Medicare|All Plans | $1,465.88 | ↓ -39% |
| AETNA | Medicare|All Plans | $1,465.88 | ↓ -39% |
| UNITED | Medicare|All Plans | $1,495.20 | ↓ -38% |
| AMERIVANTAGE | Medicare|All Plans | $1,509.86 | ↓ -37% |
| SCANHealth | Medicare|All Plans | $1,568.50 | ↓ -35% |
| Ambetter | Commercial|All Plans | $2,125.53 | ↓ -11% |
| Wellpoint | Commercial|Exchange | $2,198.82 | ↓ -8% |
| United | Commercial|Exchange | $2,255.20 | ↓ -6% |
| BCBS-TX | Commercial|Blue Advantage HMO | $2,480.72 | ↑ +3% |
| BCBS-TX | Commercial|Blue Premier | $2,819.00 | ↑ +18% |
| Wellpoint | Medicaid|All Other Plans | $2,841.56 | ↑ +19% |
| Bright Health | Commercial|All Plans | $2,931.76 | ↑ +22% |
| BCBS-TX | Commercial|HMO | $3,044.52 | ↑ +27% |
| BCBS-TX | Commercial|PPO | $3,270.04 | ↑ +36% |
| Cigna | Commercial|Local Plus | $3,495.56 | ↑ +46% |
| United | Commercial|All Other Plans | $3,721.08 | ↑ +55% |
| Wellpoint | Medicaid|STAR | $3,907.14 | ↑ +63% |
| Ellwood | Commercial|All Plans | $4,397.64 | ↑ +83% |
| Entrust | Commercial|All Plans | $4,735.92 | ↑ +98% |
| NX Health | Commercial|All Plans | $4,764.11 | ↑ +99% |
| Health Smart | Commercial|All Plans | $6,201.80 | ↑ +159% |
| First Health | Commercial|All Plans | $6,765.60 | ↑ +182% |
| Humana | Commercial|All Plans | $6,878.36 | ↑ +187% |
| Cigna | Commercial|All Other Plans | $7,216.64 | ↑ +201% |
| Aetna | Commercial|All Plans | $7,442.16 | ↑ +210% |
| PHCS | Commercial|All Plans | $9,584.60 | ↑ +300% |
| Multiplan | Commercial|All Plans | $10,148.40 | ↑ +323% |
| BCBS-TX | Commercial|Ref Lab | $11,276.00 | ↑ +370% |
Visitor-reported prices
Comments
Metatarsal joint implant at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $1,057.20 | $217.61 – $1,585.80 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,057.20 | $211.44 – $1,409.60 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $1,057.20 | $339.36 – $1,585.80 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $1,057.20 | $546.22 – $1,585.80 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,057.20 | $352.40 – $1,585.80 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $1,057.20 | $211.44 – $1,409.60 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $1,057.20 | $264.30 – $1,585.80 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $1,057.20 | $193.82 – $1,585.80 |