Prq revasc byp graft addl at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$757.23
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.
$4,327.00
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.
$551.26 with PGT vs $12,398.00 with Cigna — 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 | $551.26 | ↓ -27% |
| BCBS | Medicare|All Plans | $562.51 | ↓ -26% |
| AETNA | Medicare|All Plans | $562.51 | ↓ -26% |
| UNITED | Medicare|All Plans | $573.77 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $579.39 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $601.89 | ↓ -21% |
| Ambetter | Commercial|All Plans | $815.64 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $843.77 | ↑ +11% |
| UNITED | Medicaid|All Other Plans | $1,059.25 | ↑ +40% |
| Wellpoint | Medicaid|All Other Plans | $1,090.41 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $1,499.31 | ↑ +98% |
| Bright Health | Commercial|All Plans | $1,617.44 | ↑ +114% |
| Ellwood | Commercial|All Plans | $1,687.53 | ↑ +123% |
| Entrust | Commercial|All Plans | $1,817.34 | ↑ +140% |
| NX Health | Commercial|All Plans | $1,828.16 | ↑ +141% |
| Health Smart | Commercial|All Plans | $2,379.85 | ↑ +214% |
| First Health | Commercial|All Plans | $2,596.20 | ↑ +243% |
| UNITED | Medicaid|STARPLUS | $2,627.36 | ↑ +247% |
| Humana | Commercial|All Plans | $2,639.47 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $2,769.28 | ↑ +266% |
| Aetna | Commercial|All Plans | $2,855.82 | ↑ +277% |
| PHCS | Commercial|All Plans | $3,677.95 | ↑ +386% |
| Multiplan | Commercial|All Plans | $3,894.30 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $4,327.00 | ↑ +471% |
| United | Commercial|Exchange | $5,281.00 | ↑ +597% |
| United | Commercial|All Other Plans | $10,363.00 | ↑ +1269% |
| Cigna | Commercial|Local Plus | $12,398.00 | ↑ +1537% |
Visitor-reported prices
Comments
Prq revasc byp graft addl at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $15,079.29 | $4,272.47 – $21,362.33 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $15,079.29 | $3,103.82 – $22,618.94 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $14,660.42 | $2,932.08 – $18,325.52 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $15,079.29 | $4,021.14 – $21,362.33 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $15,079.29 | $4,840.45 – $22,618.94 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $15,079.29 | $7,790.97 – $22,618.94 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $14,660.42 | $4,886.81 – $21,990.63 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $15,079.29 | $4,021.14 – $21,362.33 |