Upper Endoscopy (EGD, diagnostic) at St. Joseph Health Madison Hospital
100 West Cross Street, Madisonville, TX · CommonSpirit Health · · NPI 1780731737
$393.75
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.
$2,250.00
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.
$286.65 with PGT vs $4,168.00 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 | $286.65 | ↓ -27% |
| AETNA | Medicare|All Plans | $292.50 | ↓ -26% |
| BCBS | Medicare|All Plans | $292.50 | ↓ -26% |
| UNITED | Medicare|All Plans | $298.35 | ↓ -24% |
| AMERIVANTAGE | Medicare|All Plans | $301.28 | ↓ -23% |
| SCANHealth | Medicare|All Plans | $312.98 | ↓ -21% |
| SUPERIOR | Medicaid|CHIP | $352.37 | ↓ -11% |
| UNITED | Medicaid|All Other Plans | $359.42 | ↓ -9% |
| UNITED | Medicaid|STARKIDS | $359.42 | ↓ -9% |
| BCBS | Medicaid|STARKIDS | $369.99 | ↓ -6% |
| SUPERIOR | Medicaid|All Other Plans | $369.99 | ↓ -6% |
| Ambetter | Commercial|All Plans | $424.13 | ↑ +8% |
| Wellpoint | Commercial|Exchange | $438.75 | ↑ +11% |
| SUPERIOR | Medicaid|STAR | $510.94 | ↑ +30% |
| Wellpoint | Medicaid|All Other Plans | $567.00 | ↑ +44% |
| Wellpoint | Medicaid|STAR | $779.63 | ↑ +98% |
| Bright Health | Commercial|All Plans | $841.05 | ↑ +114% |
| SUPERIOR | Medicaid|STARPLUS | $873.88 | ↑ +122% |
| Ellwood | Commercial|All Plans | $877.50 | ↑ +123% |
| UNITED | Medicaid|STARPLUS | $891.50 | ↑ +126% |
| Entrust | Commercial|All Plans | $945.00 | ↑ +140% |
| NX Health | Commercial|All Plans | $950.63 | ↑ +141% |
| BCBS-TX | Commercial|Blue Premier | $1,100.29 | ↑ +179% |
| BCBS-TX | Commercial|Blue Advantage HMO | $1,108.15 | ↑ +181% |
| BCBS-TX | Commercial|HMO | $1,178.88 | ↑ +199% |
| Health Smart | Commercial|All Plans | $1,237.50 | ↑ +214% |
| BCBS-TX | Commercial|PPO | $1,296.77 | ↑ +229% |
| First Health | Commercial|All Plans | $1,350.00 | ↑ +243% |
| Humana | Commercial|All Plans | $1,372.50 | ↑ +249% |
| Cigna | Commercial|All Other Plans | $1,440.00 | ↑ +266% |
| Aetna | Commercial|All Plans | $1,485.00 | ↑ +277% |
| PHCS | Commercial|All Plans | $1,912.50 | ↑ +386% |
| Multiplan | Commercial|All Plans | $2,025.00 | ↑ +414% |
| United | Commercial|Exchange | $2,124.00 | ↑ +439% |
| BCBS-TX | Commercial|Ref Lab | $2,250.00 | ↑ +471% |
| Cigna | Commercial|Local Plus | $2,888.00 | ↑ +633% |
| United | Commercial|All Other Plans | $4,168.00 | ↑ +959% |
Visitor-reported prices
Comments
Upper Endoscopy (EGD, diagnostic) at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Covenant Children's Hospital | Lubbock | $1,040.34 | $879.87 – $4,579.48 |
| St. Luke's Health - Patients Medical Center | Pasadena | $1,002.54 | $1,718.64 – $2,148.30 |
| St. Luke's Health Memorial Lufkin | Lufkin | $633.60 | $1,605.12 – $3,801.60 |
| St. Joseph Health College Station Hospital | College Station | $393.75 | $1,237.50 – $2,250.00 |
| St. Joseph Health Grimes Hospital | Navasota | $393.75 | $815.85 – $2,497.50 |
| St. Luke's Health Memorial Livingston | Livingston | $633.60 | $929.28 – $3,801.60 |
| Covenant Medical Center | Lubbock | $1,040.34 | $894.72 – $4,121.53 |
| St. Luke's Health Memorial San Augustine | San Augustine | $633.60 | $760.32 – $4,392.96 |