New Patient Office Visit (level 5) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$208.78
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.
$1,193.00
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.
$37.59 with PGT vs $450.55 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 | $37.59 | ↓ -82% |
| BCBS | Medicare|All Plans | $38.35 | ↓ -82% |
| AETNA | Medicare|All Plans | $38.35 | ↓ -82% |
| UNITED | Medicare|All Plans | $39.12 | ↓ -81% |
| AMERIVANTAGE | Medicare|All Plans | $39.51 | ↓ -81% |
| SCANHealth | Medicare|All Plans | $41.04 | ↓ -80% |
| Ambetter | Commercial|All Plans | $55.61 | ↓ -73% |
| Wellpoint | Commercial|Exchange | $57.53 | ↓ -72% |
| Wellpoint | Medicaid|All Other Plans | $74.34 | ↓ -64% |
| United | Commercial|Exchange | $77.00 | ↓ -63% |
| Wellpoint | Medicaid|STAR | $102.22 | ↓ -51% |
| Bright Health | Commercial|All Plans | $110.28 | ↓ -47% |
| Ellwood | Commercial|All Plans | $115.05 | ↓ -45% |
| Entrust | Commercial|All Plans | $123.90 | ↓ -41% |
| NX Health | Commercial|All Plans | $124.64 | ↓ -40% |
| United | Commercial|All Other Plans | $152.00 | ↓ -27% |
| Health Smart | Commercial|All Plans | $162.25 | ↓ -22% |
| First Health | Commercial|All Plans | $177.00 | ↓ -15% |
| SUPERIOR | Medicaid|CHIP | $178.08 | ↓ -15% |
| Humana | Commercial|All Plans | $179.95 | ↓ -14% |
| UNITED | Medicaid|All Other Plans | $181.65 | ↓ -13% |
| UNITED | Medicaid|STARKIDS | $181.65 | ↓ -13% |
| BCBS | Medicaid|STARKIDS | $186.99 | ↓ -10% |
| SUPERIOR | Medicaid|All Other Plans | $186.99 | ↓ -10% |
| Cigna | Commercial|All Other Plans | $188.80 | ↓ -10% |
| Aetna | Commercial|All Plans | $194.70 | ↓ -7% |
| PHCS | Commercial|All Plans | $250.75 | ↑ +20% |
| SUPERIOR | Medicaid|STAR | $258.22 | ↑ +24% |
| Multiplan | Commercial|All Plans | $265.50 | ↑ +27% |
| BCBS-TX | Commercial|PPO | $295.00 | ↑ +41% |
| BCBS-TX | Commercial|HMO | $295.00 | ↑ +41% |
| BCBS-TX | Commercial|Ref Lab | $295.00 | ↑ +41% |
| BCBS-TX | Commercial|Blue Advantage HMO | $295.00 | ↑ +41% |
| BCBS-TX | Commercial|Blue Premier | $295.00 | ↑ +41% |
| Cigna | Commercial|Local Plus | $363.58 | ↑ +74% |
| SUPERIOR | Medicaid|STARPLUS | $441.64 | ↑ +112% |
| UNITED | Medicaid|STARPLUS | $450.55 | ↑ +116% |
Visitor-reported prices
Comments
New Patient Office Visit (level 5) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Rollins Brook | Lampasas | $1,075.78 | $659.08 – $659.08 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | $1,210.66 | $351.91 – $400.58 |
| Baylor St Luke's Medical Center | Houston | $251.65 | $82.00 – $719.00 |
| St. Luke's Health Memorial Lufkin | Lufkin | $246.90 | $100.00 – $671.98 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $251.65 | $74.00 – $719.00 |
| St. Luke's Health - Sugar Land Hospital | Sugar Land | $251.65 | $74.00 – $719.00 |
| St. Joseph Health College Station Hospital | College Station | $208.78 | $77.00 – $363.58 |
| St. Luke's Health - Lakeside Hospital | The Woodlands | $251.65 | $74.00 – $719.00 |