Pq kyphplsty 1 bdy lumb w/img at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$3,022.95
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.
?
What you pay up front if you don't use insurance.
$17,274.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$2,200.71 with PGT vs $18,403.00 with United — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $2,200.71 | ↓ -27% |
| AETNA | Medicare|All Plans | $2,245.62 | ↓ -26% |
| BCBS | Medicare|All Plans | $2,245.62 | ↓ -26% |
| UNITED | Medicare|All Plans | $2,290.54 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $2,312.99 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $2,402.82 | ↓ -21% |
| SUPERIOR | Medicaid|CHIP | $2,523.24 | ↓ -17% |
| UNITED | Medicaid|All Other Plans | $2,573.70 | ↓ -15% |
| UNITED | Medicaid|STARKIDS | $2,573.70 | ↓ -15% |
| SUPERIOR | Medicaid|All Other Plans | $2,649.40 | ↓ -12% |
| BCBS | Medicaid|STARKIDS | $2,649.40 | ↓ -12% |
| Ambetter | Commercial|All Plans | $3,256.15 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $3,368.43 | ↑ +11% |
| SUPERIOR | Medicaid|STAR | $3,658.70 | ↑ +21% |
| Wellpoint | Medicaid|All Other Plans | $4,353.05 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $5,985.45 | ↑ +98% |
| SUPERIOR | Medicaid|STARPLUS | $6,257.64 | ↑ +107% |
| UNITED | Medicaid|STARPLUS | $6,383.80 | ↑ +111% |
| Bright Health | Commercial|All Plans | $6,457.03 | ↑ +114% |
| Ellwood | Commercial|All Plans | $6,736.86 | ↑ +123% |
| Entrust | Commercial|All Plans | $7,255.08 | ↑ +140% |
| NX Health | Commercial|All Plans | $7,298.27 | ↑ +141% |
| BCBS-TX | Commercial|Blue Premier | $8,374.73 | ↑ +177% |
| BCBS-TX | Commercial|Blue Advantage HMO | $8,434.55 | ↑ +179% |
| Cigna | Commercial|Local Plus | $8,464.26 | ↑ +180% |
| BCBS-TX | Commercial|HMO | $8,972.93 | ↑ +197% |
| United | Commercial|Exchange | $9,379.00 | ↑ +210% |
| Health Smart | Commercial|All Plans | $9,500.70 | ↑ +214% |
| BCBS-TX | Commercial|PPO | $9,870.22 | ↑ +227% |
| First Health | Commercial|All Plans | $10,364.40 | ↑ +243% |
| Humana | Commercial|All Plans | $10,537.14 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $11,055.36 | ↑ +266% |
| Aetna | Commercial|All Plans | $11,400.84 | ↑ +277% |
| PHCS | Commercial|All Plans | $14,682.90 | ↑ +386% |
| Multiplan | Commercial|All Plans | $15,546.60 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $17,274.00 | ↑ +471% |
| United | Commercial|All Other Plans | $18,403.00 | ↑ +509% |
Visitor-reported prices
Comments
Pq kyphplsty 1 bdy lumb w/img at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $10,430.78 | $2,398.52 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $10,620.65 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $12,736.87 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $10,430.78 | $2,398.52 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $10,620.65 | $85.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $10,620.65 | $2,398.52 – $17,722.46 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $12,736.87 | $71.00 – $19,105.31 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $10,430.78 | $2,398.52 – $17,722.46 |