Transcath biopsy at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$2,128.00
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.
?
What you pay up front if you don't use insurance.
$12,160.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,549.19 with PGT vs $18,403.00 with United — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $1,549.19 | ↓ -27% |
| AETNA | Medicare|All Plans | $1,580.80 | ↓ -26% |
| BCBS | Medicare|All Plans | $1,580.80 | ↓ -26% |
| UNITED | Medicare|All Plans | $1,612.42 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $1,628.23 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $1,691.46 | ↓ -21% |
| SUPERIOR | Medicaid|CHIP | $2,039.99 | ↓ -4% |
| UNITED | Medicaid|All Other Plans | $2,080.79 | ↓ -2% |
| UNITED | Medicaid|STARKIDS | $2,080.79 | ↓ -2% |
| BCBS | Medicaid|STARKIDS | $2,141.99 | ↑ +1% |
| SUPERIOR | Medicaid|All Other Plans | $2,141.99 | ↑ +1% |
| Ambetter | Commercial|All Plans | $2,292.16 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $2,371.20 | ↑ +11% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +36% |
| SUPERIOR | Medicaid|STAR | $2,957.99 | ↑ +39% |
| Wellpoint | Medicaid|All Other Plans | $3,064.32 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $4,213.44 | ↑ +98% |
| Bright Health | Commercial|All Plans | $4,545.41 | ↑ +114% |
| Ellwood | Commercial|All Plans | $4,742.40 | ↑ +123% |
| SUPERIOR | Medicaid|STARPLUS | $5,059.18 | ↑ +138% |
| Entrust | Commercial|All Plans | $5,107.20 | ↑ +140% |
| NX Health | Commercial|All Plans | $5,137.60 | ↑ +141% |
| UNITED | Medicaid|STARPLUS | $5,161.17 | ↑ +143% |
| BCBS-TX | Commercial|Blue Premier | $6,434.67 | ↑ +202% |
| BCBS-TX | Commercial|Blue Advantage HMO | $6,480.63 | ↑ +205% |
| Health Smart | Commercial|All Plans | $6,688.00 | ↑ +214% |
| BCBS-TX | Commercial|HMO | $6,894.29 | ↑ +224% |
| First Health | Commercial|All Plans | $7,296.00 | ↑ +243% |
| Humana | Commercial|All Plans | $7,417.60 | ↑ +249% |
| BCBS-TX | Commercial|PPO | $7,583.71 | ↑ +256% |
| Cigna | Commercial|All Other Plans | $7,782.40 | ↑ +266% |
| Aetna | Commercial|All Plans | $8,025.60 | ↑ +277% |
| United | Commercial|Exchange | $9,379.00 | ↑ +341% |
| PHCS | Commercial|All Plans | $10,336.00 | ↑ +386% |
| Multiplan | Commercial|All Plans | $10,944.00 | ↑ +414% |
| BCBS-TX | Commercial|Ref Lab | $12,160.00 | ↑ +471% |
| United | Commercial|All Other Plans | $18,403.00 | ↑ +765% |
Visitor-reported prices
Comments
Transcath biopsy at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR UNIVERSITY MEDICAL CENTER | Dallas | $4,285.93 | $1,939.15 – $13,613.39 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $4,426.92 | $71.00 – $13,613.39 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $4,285.93 | $71.00 – $13,613.39 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL | Frisco | $4,285.93 | $1,939.15 – $13,613.39 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $4,426.92 | $85.00 – $13,613.39 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $4,426.92 | $1,939.15 – $13,613.39 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $4,285.93 | $71.00 – $13,613.39 |
| BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH | Fort Worth | $4,285.93 | $1,939.15 – $13,613.39 |