Rmvl icd gen w/rplc icd gen dual lead sys at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$7,889.53
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.
$45,083.00
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.
$5,743.58 with PGT vs $45,083.00 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 | $5,743.58 | ↓ -27% |
| BCBS | Medicare|All Plans | $5,860.79 | ↓ -26% |
| AETNA | Medicare|All Plans | $5,860.79 | ↓ -26% |
| UNITED | Medicare|All Plans | $5,978.01 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $6,036.62 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $6,271.05 | ↓ -21% |
| Ambetter | Commercial|All Plans | $8,498.15 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $8,791.19 | ↑ +11% |
| Cigna | Commercial|Local Plus | $9,871.00 | ↑ +25% |
| Wellpoint | Medicaid|All Other Plans | $11,360.92 | ↑ +44% |
| United | Commercial|Exchange | $14,480.00 | ↑ +84% |
| Wellpoint | Medicaid|STAR | $15,621.26 | ↑ +98% |
| Bright Health | Commercial|All Plans | $16,852.03 | ↑ +114% |
| SUPERIOR | Medicaid|CHIP | $17,185.96 | ↑ +118% |
| UNITED | Medicaid|All Other Plans | $17,529.68 | ↑ +122% |
| UNITED | Medicaid|STARKIDS | $17,529.68 | ↑ +122% |
| Ellwood | Commercial|All Plans | $17,582.37 | ↑ +123% |
| SUPERIOR | Medicaid|All Other Plans | $18,045.26 | ↑ +129% |
| BCBS | Medicaid|STARKIDS | $18,045.26 | ↑ +129% |
| Entrust | Commercial|All Plans | $18,934.86 | ↑ +140% |
| NX Health | Commercial|All Plans | $19,047.57 | ↑ +141% |
| Health Smart | Commercial|All Plans | $24,795.65 | ↑ +214% |
| SUPERIOR | Medicaid|STAR | $24,919.64 | ↑ +216% |
| First Health | Commercial|All Plans | $27,049.80 | ↑ +243% |
| Humana | Commercial|All Plans | $27,500.63 | ↑ +249% |
| United | Commercial|All Other Plans | $28,415.00 | ↑ +260% |
| Cigna | Commercial|All Other Plans | $28,853.12 | ↑ +266% |
| Aetna | Commercial|All Plans | $29,754.78 | ↑ +277% |
| BCBS-TX | Commercial|Blue Premier | $31,798.05 | ↑ +303% |
| BCBS-TX | Commercial|Blue Advantage HMO | $32,025.17 | ↑ +306% |
| BCBS-TX | Commercial|HMO | $34,069.34 | ↑ +332% |
| BCBS-TX | Commercial|PPO | $37,476.27 | ↑ +375% |
| PHCS | Commercial|All Plans | $38,320.55 | ↑ +386% |
| Multiplan | Commercial|All Plans | $40,574.70 | ↑ +414% |
| SUPERIOR | Medicaid|STARPLUS | $42,621.18 | ↑ +440% |
| UNITED | Medicaid|STARPLUS | $43,480.48 | ↑ +451% |
| BCBS-TX | Commercial|Ref Lab | $45,083.00 | ↑ +471% |
Visitor-reported prices
Comments
Rmvl icd gen w/rplc icd gen dual lead sys at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $43,926.37 | $6,299.00 – $58,392.49 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $53,511.93 | $11,014.54 – $80,267.90 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $31,991.42 | $15,811.00 – $58,392.49 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $43,926.37 | $16,336.46 – $58,392.49 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $53,511.93 | $15,811.00 – $80,267.90 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $53,511.93 | $13,462.00 – $80,267.90 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $31,991.42 | $15,811.00 – $58,392.49 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $43,926.37 | $16,336.46 – $58,392.49 |