Tympanostomy/ven tube/loc/top anes 69433 at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$54.25
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.
$310.00
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.
$39.50 with PGT vs $2,960.00 with United — 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 | $39.50 | ↓ -27% |
| BCBS | Medicare|All Plans | $40.30 | ↓ -26% |
| AETNA | Medicare|All Plans | $40.30 | ↓ -26% |
| UNITED | Medicare|All Plans | $41.11 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $41.51 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $43.13 | ↓ -20% |
| Ambetter | Commercial|All Plans | $58.44 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $60.45 | ↑ +11% |
| Wellpoint | Medicaid|All Other Plans | $78.12 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $107.42 | ↑ +98% |
| Bright Health | Commercial|All Plans | $115.88 | ↑ +114% |
| Ellwood | Commercial|All Plans | $120.90 | ↑ +123% |
| SUPERIOR | Medicaid|CHIP | $123.78 | ↑ +128% |
| UNITED | Medicaid|All Other Plans | $126.26 | ↑ +133% |
| UNITED | Medicaid|STARKIDS | $126.26 | ↑ +133% |
| SUPERIOR | Medicaid|All Other Plans | $129.97 | ↑ +140% |
| BCBS | Medicaid|STARKIDS | $129.97 | ↑ +140% |
| Entrust | Commercial|All Plans | $130.20 | ↑ +140% |
| NX Health | Commercial|All Plans | $130.98 | ↑ +141% |
| Health Smart | Commercial|All Plans | $170.50 | ↑ +214% |
| SUPERIOR | Medicaid|STAR | $179.48 | ↑ +231% |
| First Health | Commercial|All Plans | $186.00 | ↑ +243% |
| Humana | Commercial|All Plans | $189.10 | ↑ +249% |
| BCBS-TX | Commercial|Blue Premier | $193.51 | ↑ +257% |
| BCBS-TX | Commercial|Blue Advantage HMO | $194.89 | ↑ +259% |
| Cigna | Commercial|All Other Plans | $198.40 | ↑ +266% |
| Aetna | Commercial|All Plans | $204.60 | ↑ +277% |
| BCBS-TX | Commercial|HMO | $207.33 | ↑ +282% |
| BCBS-TX | Commercial|PPO | $228.06 | ↑ +320% |
| PHCS | Commercial|All Plans | $263.50 | ↑ +386% |
| Multiplan | Commercial|All Plans | $279.00 | ↑ +414% |
| SUPERIOR | Medicaid|STARPLUS | $306.97 | ↑ +466% |
| BCBS-TX | Commercial|Ref Lab | $310.00 | ↑ +471% |
| UNITED | Medicaid|STARPLUS | $313.16 | ↑ +477% |
| United | Commercial|Exchange | $1,508.00 | ↑ +2680% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +5224% |
| United | Commercial|All Other Plans | $2,960.00 | ↑ +5356% |
Visitor-reported prices
Comments
Tympanostomy/ven tube/loc/top anes 69433 at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $780.46 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $1,047.93 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $780.46 | $85.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $780.46 | $117.66 – $1,363.00 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $1,047.93 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $780.46 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $780.46 | $71.00 – $2,975.00 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $1,047.93 | $71.00 – $2,975.00 |