Tc-99m mertiatide at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$343.70
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.
$1,964.00
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.
$250.22 with PGT vs $1,964.00 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 | $250.22 | ↓ -27% |
| AETNA | Medicare|All Plans | $255.32 | ↓ -26% |
| BCBS | Medicare|All Plans | $255.32 | ↓ -26% |
| UNITED | Medicare|All Plans | $260.43 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $262.98 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $273.20 | ↓ -21% |
| Ambetter | Commercial|All Plans | $370.22 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $382.98 | ↑ +11% |
| United | Commercial|Exchange | $392.80 | ↑ +14% |
| Wellpoint | Medicaid|All Other Plans | $494.93 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $680.53 | ↑ +98% |
| United | Commercial|All Other Plans | $707.04 | ↑ +106% |
| Bright Health | Commercial|All Plans | $734.15 | ↑ +114% |
| Ellwood | Commercial|All Plans | $765.96 | ↑ +123% |
| Entrust | Commercial|All Plans | $824.88 | ↑ +140% |
| NX Health | Commercial|All Plans | $829.79 | ↑ +141% |
| Cigna | Commercial|Local Plus | $962.36 | ↑ +180% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,064.92 | ↑ +210% |
| Health Smart | Commercial|All Plans | $1,080.20 | ↑ +214% |
| First Health | Commercial|All Plans | $1,178.40 | ↑ +243% |
| Humana | Commercial|All Plans | $1,198.04 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $1,256.96 | ↑ +266% |
| Aetna | Commercial|All Plans | $1,296.24 | ↑ +277% |
| PHCS | Commercial|All Plans | $1,669.40 | ↑ +386% |
| BCBS-TX | Commercial|Blue Premier | $1,736.28 | ↑ +405% |
| Multiplan | Commercial|All Plans | $1,767.60 | ↑ +414% |
| BCBS-TX | Commercial|HMO | $1,782.58 | ↑ +419% |
| BCBS-TX | Commercial|Ref Lab | $1,964.00 | ↑ +471% |
| BCBS-TX | Commercial|PPO | $1,964.00 | ↑ +471% |
Visitor-reported prices
Comments
Tc-99m mertiatide at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD | $3,133.94 | $1,308.90 – $9,055.57 |
| HCA HOUSTON KINGWOOD | HUMBLE | $2,515.31 | $1,308.90 – $9,055.57 |
| HCA HOUSTON NORTHWEST | SPRING | $2,611.33 | $1,308.90 – $9,055.57 |
| St. Luke's Health - Patients Medical Center | Pasadena | $893.40 | $100.00 – $1,914.42 |
| Baylor St Luke's Medical Center | Houston | $944.65 | $100.00 – $2,699.00 |
| St. Luke's Health Memorial Lufkin | Lufkin | $290.54 | $100.00 – $1,651.40 |
| HCA HOUSTON PEARLAND | Pearland | $2,699.87 | $1,308.90 – $9,055.57 |
| St. Luke's Health - Springwoods Village Hospital | Spring | $944.65 | $100.00 – $2,699.00 |