Tc-99m arcitumomab at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$587.30
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.
$3,356.00
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.
$427.56 with PGT vs $3,356.00 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 | $427.56 | ↓ -27% |
| AETNA | Medicare|All Plans | $436.28 | ↓ -26% |
| BCBS | Medicare|All Plans | $436.28 | ↓ -26% |
| UNITED | Medicare|All Plans | $445.01 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $449.37 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $466.82 | ↓ -21% |
| Ambetter | Commercial|All Plans | $632.61 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $654.42 | ↑ +11% |
| United | Commercial|Exchange | $671.20 | ↑ +14% |
| Wellpoint | Medicaid|All Other Plans | $845.72 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $1,162.86 | ↑ +98% |
| United | Commercial|All Other Plans | $1,208.16 | ↑ +106% |
| Bright Health | Commercial|All Plans | $1,254.48 | ↑ +114% |
| Ellwood | Commercial|All Plans | $1,308.84 | ↑ +123% |
| Entrust | Commercial|All Plans | $1,409.52 | ↑ +140% |
| NX Health | Commercial|All Plans | $1,417.91 | ↑ +141% |
| Cigna | Commercial|Local Plus | $1,644.44 | ↑ +180% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,704.30 | ↑ +190% |
| Health Smart | Commercial|All Plans | $1,845.80 | ↑ +214% |
| First Health | Commercial|All Plans | $2,013.60 | ↑ +243% |
| Humana | Commercial|All Plans | $2,047.16 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $2,147.84 | ↑ +266% |
| Aetna | Commercial|All Plans | $2,214.96 | ↑ +277% |
| BCBS-TX | Commercial|Blue Premier | $2,778.75 | ↑ +373% |
| PHCS | Commercial|All Plans | $2,852.60 | ↑ +386% |
| BCBS-TX | Commercial|HMO | $2,852.85 | ↑ +386% |
| Multiplan | Commercial|All Plans | $3,020.40 | ↑ +414% |
| BCBS-TX | Commercial|PPO | $3,260.40 | ↑ +455% |
| BCBS-TX | Commercial|Ref Lab | $3,356.00 | ↑ +471% |
Visitor-reported prices
Comments
Tc-99m arcitumomab at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | $12,806.58 | $2,138.32 – $12,028.90 |
| St. Joseph Health College Station Hospital | College Station | $587.30 | $671.20 – $2,852.60 |
| St. Joseph Health Grimes Hospital | Navasota | $587.30 | $671.20 – $3,725.16 |
| St. Joseph Health Burleson Hospital | Caldwell | $587.30 | $671.20 – $3,020.40 |
| Adventhealth Rollins Brook | Lampasas | not published | $4,754.75 – $4,754.75 |
| HCA HOUSTON MEDICAL CENTER | Houston | not published | $2,138.32 – $12,028.90 |
| Covenant Children's Hospital | Lubbock | not published | $4,618.90 – $4,931.02 |
| HCA HOUSTON CONROE | CONROE | not published | $2,138.32 – $12,028.90 |