Passy muir valve metal trach at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$4.38
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.
$25.00
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.
$3.19 with PGT vs $25.00 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 | $3.19 | ↓ -27% |
| BCBS | Medicare|All Plans | $3.25 | ↓ -26% |
| AETNA | Medicare|All Plans | $3.25 | ↓ -26% |
| UNITED | Medicare|All Plans | $3.32 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $3.35 | ↓ -24% |
| SCANHealth | Medicare|All Plans | $3.48 | ↓ -21% |
| Ambetter | Commercial|All Plans | $4.72 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $4.88 | ↑ +11% |
| United | Commercial|Exchange | $5.00 | ↑ +14% |
| BCBS-TX | Commercial|Blue Advantage HMO | $5.50 | ↑ +26% |
| BCBS-TX | Commercial|Blue Premier | $6.25 | ↑ +43% |
| Wellpoint | Medicaid|All Other Plans | $6.30 | ↑ +44% |
| BCBS-TX | Commercial|HMO | $6.75 | ↑ +54% |
| BCBS-TX | Commercial|PPO | $7.25 | ↑ +66% |
| Cigna | Commercial|Local Plus | $7.75 | ↑ +77% |
| United | Commercial|All Other Plans | $8.25 | ↑ +88% |
| Wellpoint | Medicaid|STAR | $8.67 | ↑ +98% |
| Bright Health | Commercial|All Plans | $9.35 | ↑ +113% |
| Ellwood | Commercial|All Plans | $9.75 | ↑ +123% |
| Entrust | Commercial|All Plans | $10.50 | ↑ +140% |
| NX Health | Commercial|All Plans | $10.57 | ↑ +141% |
| Health Smart | Commercial|All Plans | $13.75 | ↑ +214% |
| First Health | Commercial|All Plans | $15.00 | ↑ +242% |
| Humana | Commercial|All Plans | $15.25 | ↑ +248% |
| Cigna | Commercial|All Other Plans | $16.00 | ↑ +265% |
| Aetna | Commercial|All Plans | $16.50 | ↑ +277% |
| PHCS | Commercial|All Plans | $21.25 | ↑ +385% |
| Multiplan | Commercial|All Plans | $22.50 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $25.00 | ↑ +471% |
Visitor-reported prices
Comments
Passy muir valve metal trach at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $339.37 | $74.63 – $351.20 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $339.37 | $54.22 – $395.10 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $263.40 | $52.68 – $351.20 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $339.37 | $70.24 – $351.20 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $339.37 | $84.55 – $395.10 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $339.37 | $136.09 – $395.10 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $263.40 | $87.80 – $395.10 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $339.37 | $70.24 – $351.20 |