Off/op cnsltj new/est low 30 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$64.58
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.
$369.00
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.
$47.02 with PGT vs $369.00 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 | $47.02 | ↓ -27% |
| BCBS | Medicare|All Plans | $47.97 | ↓ -26% |
| AETNA | Medicare|All Plans | $47.97 | ↓ -26% |
| UNITED | Medicare|All Plans | $48.93 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $49.41 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $51.33 | ↓ -21% |
| Ambetter | Commercial|All Plans | $69.56 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $71.96 | ↑ +11% |
| United | Commercial|Exchange | $77.00 | ↑ +19% |
| SUPERIOR | Medicaid|CHIP | $88.56 | ↑ +37% |
| UNITED | Medicaid|STARKIDS | $90.34 | ↑ +40% |
| UNITED | Medicaid|All Other Plans | $90.34 | ↑ +40% |
| Wellpoint | Medicaid|All Other Plans | $92.99 | ↑ +44% |
| SUPERIOR | Medicaid|All Other Plans | $92.99 | ↑ +44% |
| BCBS | Medicaid|STARKIDS | $92.99 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $127.86 | ↑ +98% |
| SUPERIOR | Medicaid|STAR | $128.42 | ↑ +99% |
| Bright Health | Commercial|All Plans | $137.94 | ↑ +114% |
| Ellwood | Commercial|All Plans | $143.91 | ↑ +123% |
| United | Commercial|All Other Plans | $152.00 | ↑ +135% |
| Entrust | Commercial|All Plans | $154.98 | ↑ +140% |
| NX Health | Commercial|All Plans | $155.91 | ↑ +141% |
| Cigna | Commercial|Local Plus | $180.81 | ↑ +180% |
| BCBS-TX | Commercial|Blue Advantage HMO | $193.65 | ↑ +200% |
| Health Smart | Commercial|All Plans | $202.95 | ↑ +214% |
| SUPERIOR | Medicaid|STARPLUS | $219.63 | ↑ +240% |
| First Health | Commercial|All Plans | $221.40 | ↑ +243% |
| UNITED | Medicaid|STARPLUS | $224.06 | ↑ +247% |
| Humana | Commercial|All Plans | $225.09 | ↑ +249% |
| BCBS-TX | Commercial|Blue Premier | $227.71 | ↑ +253% |
| Cigna | Commercial|All Other Plans | $236.16 | ↑ +266% |
| BCBS-TX | Commercial|HMO | $241.33 | ↑ +274% |
| Aetna | Commercial|All Plans | $243.54 | ↑ +277% |
| BCBS-TX | Commercial|PPO | $268.58 | ↑ +316% |
| PHCS | Commercial|All Plans | $313.65 | ↑ +386% |
| Multiplan | Commercial|All Plans | $332.10 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $369.00 | ↑ +471% |
Visitor-reported prices
Comments
Off/op cnsltj new/est low 30 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St. Joseph Health College Station Hospital | College Station | $64.58 | $77.00 – $313.65 |
| St. Luke's Health - Brazosport Hospital | Lake Jackson | $203.00 | $87.00 – $290.00 |
| St. Joseph Health Grimes Hospital | Navasota | $64.58 | $77.00 – $409.59 |
| St. Joseph Health Burleson Hospital | Caldwell | $64.58 | $77.00 – $332.10 |
| Covenant Hospital Plainview | Plainview | $75.18 | $205.32 – $214.35 |
| Texas Health Hospital Mansfield | Mansfield | $301.72 | $133.41 – $133.41 |
| Texas Health Huguley Hospital Fort Worth South | Burleson | $301.72 | $133.41 – $133.41 |
| Adventhealth Rollins Brook | Lampasas | not published | $374.64 – $374.64 |