Tc-99m diag per dose at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$3,620.05
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.
$20,686.00
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.
$610.12 with PGT vs $4,789.00 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 | $610.12 | ↓ -83% |
| AETNA | Medicare|All Plans | $622.57 | ↓ -83% |
| BCBS | Medicare|All Plans | $622.57 | ↓ -83% |
| UNITED | Medicare|All Plans | $635.03 | ↓ -82% |
| AMERIVANTAGE | Medicare|All Plans | $641.25 | ↓ -82% |
| SCANHealth | Medicare|All Plans | $666.15 | ↓ -82% |
| Ambetter | Commercial|All Plans | $902.73 | ↓ -75% |
| Wellpoint | Commercial|Exchange | $933.86 | ↓ -74% |
| United | Commercial|Exchange | $957.80 | ↓ -74% |
| Wellpoint | Medicaid|All Other Plans | $1,206.83 | ↓ -67% |
| Wellpoint | Medicaid|STAR | $1,659.39 | ↓ -54% |
| United | Commercial|All Other Plans | $1,724.04 | ↓ -52% |
| Bright Health | Commercial|All Plans | $1,790.13 | ↓ -51% |
| Ellwood | Commercial|All Plans | $1,867.71 | ↓ -48% |
| Entrust | Commercial|All Plans | $2,011.38 | ↓ -44% |
| NX Health | Commercial|All Plans | $2,023.36 | ↓ -44% |
| Cigna | Commercial|Local Plus | $2,346.61 | ↓ -35% |
| Health Smart | Commercial|All Plans | $2,633.95 | ↓ -27% |
| First Health | Commercial|All Plans | $2,873.40 | ↓ -21% |
| Humana | Commercial|All Plans | $2,921.29 | ↓ -19% |
| Cigna | Commercial|All Other Plans | $3,064.96 | ↓ -15% |
| Aetna | Commercial|All Plans | $3,160.74 | ↓ -13% |
| PHCS | Commercial|All Plans | $4,070.65 | ↑ +12% |
| Multiplan | Commercial|All Plans | $4,310.10 | ↑ +19% |
| BCBS-TX | Commercial|Ref Lab | $4,789.00 | ↑ +32% |