Tib/per revasc stent & ather 37231 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$6,323.45
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.
$36,134.00
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.
$4,603.48 with PGT vs $36,134.00 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 | $4,603.48 | ↓ -27% |
| AETNA | Medicare|All Plans | $4,697.42 | ↓ -26% |
| BCBS | Medicare|All Plans | $4,697.42 | ↓ -26% |
| UNITED | Medicare|All Plans | $4,791.37 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $4,838.35 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $5,026.24 | ↓ -21% |
| Ambetter | Commercial|All Plans | $6,811.26 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $7,046.13 | ↑ +11% |
| United | Commercial|Exchange | $8,688.00 | ↑ +37% |
| SUPERIOR | Medicaid|CHIP | $9,098.51 | ↑ +44% |
| Wellpoint | Medicaid|All Other Plans | $9,105.77 | ↑ +44% |
| UNITED | Medicaid|STARKIDS | $9,280.48 | ↑ +47% |
| UNITED | Medicaid|All Other Plans | $9,280.48 | ↑ +47% |
| SUPERIOR | Medicaid|All Other Plans | $9,553.44 | ↑ +51% |
| BCBS | Medicaid|STARKIDS | $9,553.44 | ↑ +51% |
| Wellpoint | Medicaid|STAR | $12,520.44 | ↑ +98% |
| SUPERIOR | Medicaid|STAR | $13,192.84 | ↑ +109% |
| Bright Health | Commercial|All Plans | $13,506.89 | ↑ +114% |
| Ellwood | Commercial|All Plans | $14,092.26 | ↑ +123% |
| Entrust | Commercial|All Plans | $15,176.28 | ↑ +140% |
| NX Health | Commercial|All Plans | $15,266.62 | ↑ +141% |
| United | Commercial|All Other Plans | $17,049.00 | ↑ +170% |
| Cigna | Commercial|Local Plus | $17,705.66 | ↑ +180% |
| Health Smart | Commercial|All Plans | $19,873.70 | ↑ +214% |
| First Health | Commercial|All Plans | $21,680.40 | ↑ +243% |
| Humana | Commercial|All Plans | $22,041.74 | ↑ +249% |
| BCBS-TX | Commercial|Blue Premier | $22,315.96 | ↑ +253% |
| BCBS-TX | Commercial|Blue Advantage HMO | $22,475.36 | ↑ +255% |
| SUPERIOR | Medicaid|STARPLUS | $22,564.30 | ↑ +257% |
| UNITED | Medicaid|STARPLUS | $23,019.23 | ↑ +264% |
| Cigna | Commercial|All Other Plans | $23,125.76 | ↑ +266% |
| Aetna | Commercial|All Plans | $23,848.44 | ↑ +277% |
| BCBS-TX | Commercial|HMO | $23,909.96 | ↑ +278% |
| BCBS-TX | Commercial|PPO | $26,300.95 | ↑ +316% |
| PHCS | Commercial|All Plans | $30,713.90 | ↑ +386% |
| Multiplan | Commercial|All Plans | $32,520.60 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $36,134.00 | ↑ +471% |
Visitor-reported prices
Comments
Tib/per revasc stent & ather 37231 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $33,770.88 | $6,299.00 – $47,842.08 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $31,077.17 | $71.00 – $46,615.76 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $31,299.50 | $71.00 – $43,439.01 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $33,770.88 | $7,038.00 – $47,842.08 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $31,077.17 | $85.00 – $46,615.76 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $31,077.17 | $16,056.54 – $46,615.76 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $31,299.50 | $71.00 – $46,949.26 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $33,770.88 | $7,038.00 – $47,842.08 |