New Patient Office Visit (level 4) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$261.63
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.
$1,495.00
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.
$34.53 with PGT vs $641.21 with UNITED — 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 | $34.53 | ↓ -87% |
| BCBS | Medicare|All Plans | $35.23 | ↓ -87% |
| AETNA | Medicare|All Plans | $35.23 | ↓ -87% |
| UNITED | Medicare|All Plans | $35.94 | ↓ -86% |
| AMERIVANTAGE | Medicare|All Plans | $36.29 | ↓ -86% |
| SCANHealth | Medicare|All Plans | $37.70 | ↓ -86% |
| Ambetter | Commercial|All Plans | $51.09 | ↓ -80% |
| Wellpoint | Commercial|Exchange | $52.85 | ↓ -80% |
| Wellpoint | Medicaid|All Other Plans | $68.30 | ↓ -74% |
| United | Commercial|Exchange | $77.00 | ↓ -71% |
| Wellpoint | Medicaid|STAR | $93.91 | ↓ -64% |
| Bright Health | Commercial|All Plans | $101.30 | ↓ -61% |
| Ellwood | Commercial|All Plans | $105.69 | ↓ -60% |
| Entrust | Commercial|All Plans | $113.82 | ↓ -56% |
| NX Health | Commercial|All Plans | $114.50 | ↓ -56% |
| Health Smart | Commercial|All Plans | $149.05 | ↓ -43% |
| United | Commercial|All Other Plans | $152.00 | ↓ -42% |
| First Health | Commercial|All Plans | $162.60 | ↓ -38% |
| Humana | Commercial|All Plans | $165.31 | ↓ -37% |
| Cigna | Commercial|All Other Plans | $173.44 | ↓ -34% |
| Aetna | Commercial|All Plans | $178.86 | ↓ -32% |
| PHCS | Commercial|All Plans | $230.35 | ↓ -12% |
| Multiplan | Commercial|All Plans | $243.90 | ↓ -7% |
| SUPERIOR | Medicaid|CHIP | $253.44 | ↓ -3% |
| UNITED | Medicaid|All Other Plans | $258.51 | ↓ -1% |
| UNITED | Medicaid|STARKIDS | $258.51 | ↓ -1% |
| BCBS-TX | Commercial|Blue Advantage HMO | $261.05 | ↓ -0% |
| BCBS | Medicaid|STARKIDS | $266.12 | ↑ +2% |
| SUPERIOR | Medicaid|All Other Plans | $266.12 | ↑ +2% |
| BCBS-TX | Commercial|Blue Premier | $271.00 | ↑ +4% |
| BCBS-TX | Commercial|HMO | $271.00 | ↑ +4% |
| BCBS-TX | Commercial|PPO | $271.00 | ↑ +4% |
| BCBS-TX | Commercial|Ref Lab | $271.00 | ↑ +4% |
| SUPERIOR | Medicaid|STAR | $367.49 | ↑ +40% |
| Cigna | Commercial|Local Plus | $517.44 | ↑ +98% |
| SUPERIOR | Medicaid|STARPLUS | $628.54 | ↑ +140% |
| UNITED | Medicaid|STARPLUS | $641.21 | ↑ +145% |
Visitor-reported prices
Comments
New Patient Office Visit (level 4) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $820.97 | $505.04 – $505.04 |
| Baylor St Luke's Medical Center | Houston | $238.35 | $82.00 – $681.00 |
| St. Luke's Health Memorial Lufkin | Lufkin | $102.36 | $94.25 – $565.49 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $238.35 | $74.00 – $681.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $238.35 | $74.00 – $681.00 |
| St. Joseph Health College Station Hospital | College Station | $261.63 | $77.00 – $517.44 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $238.35 | $74.00 – $681.00 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $240.62 | $45.00 – $275.40 |