Repair of shoulder at St. Joseph Health Grimes Hospital
210 South Judson Street, Navasota, TX · CommonSpirit Health · · NPI 1154317774
$237.13
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.
$1,355.00
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.
$491.33 with PGT vs $11,958.00 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 | $491.33 | ↑ +107% |
| AETNA | Medicare|All Plans | $501.35 | ↑ +111% |
| BCBS | Medicare|All Plans | $501.35 | ↑ +111% |
| UNITED | Medicare|All Plans | $511.38 | ↑ +116% |
| AMERIVANTAGE | Medicare|All Plans | $516.40 | ↑ +118% |
| SCANHealth | Medicare|All Plans | $536.45 | ↑ +126% |
| Wellpoint | Medicaid|All Other Plans | $640.24 | ↑ +170% |
| Ambetter | Commercial|All Plans | $726.96 | ↑ +207% |
| Health Smart | Commercial|All Plans | $745.25 | ↑ +214% |
| Wellpoint | Commercial|Exchange | $752.03 | ↑ +217% |
| Aetna | Commercial|All Plans | $758.80 | ↑ +220% |
| Wellpoint | Medicaid|STAR | $762.19 | ↑ +221% |
| Humana | Commercial|All Plans | $826.55 | ↑ +249% |
| Entrust | Commercial|All Plans | $948.50 | ↑ +300% |
| Bright Health | Commercial|All Plans | $1,037.12 | ↑ +337% |
| Multiplan | Commercial|All Plans | $1,151.75 | ↑ +386% |
| BCBS-TX | Commercial|Ref Lab | $1,355.00 | ↑ +471% |
| Ellwood | Commercial|All Plans | $1,504.05 | ↑ +534% |
| SUPERIOR | Medicaid|CHIP | $2,523.24 | ↑ +964% |
| UNITED | Medicaid|All Other Plans | $2,573.70 | ↑ +985% |
| UNITED | Medicaid|STARKIDS | $2,573.70 | ↑ +985% |
| BCBS | Medicaid|STARKIDS | $2,649.40 | ↑ +1017% |
| SUPERIOR | Medicaid|All Other Plans | $2,649.40 | ↑ +1017% |
| SUPERIOR | Medicaid|STAR | $3,154.05 | ↑ +1230% |
| United | Commercial|Exchange | $6,094.00 | ↑ +2470% |
| SUPERIOR | Medicaid|STARPLUS | $6,737.05 | ↑ +2741% |
| UNITED | Medicaid|STARPLUS | $6,863.21 | ↑ +2794% |
| Cigna | Commercial|Local Plus | $7,178.00 | ↑ +2927% |
| BCBS-TX | Commercial|Blue Premier | $8,374.73 | ↑ +3432% |
| BCBS-TX | Commercial|Blue Advantage HMO | $8,434.55 | ↑ +3457% |
| BCBS-TX | Commercial|HMO | $8,972.93 | ↑ +3684% |
| Cigna | Commercial|All Other Plans | $9,800.00 | ↑ +4033% |
| BCBS-TX | Commercial|PPO | $9,870.22 | ↑ +4062% |
| United | Commercial|All Other Plans | $11,958.00 | ↑ +4943% |
Visitor-reported prices
Comments
Repair of shoulder at other Texas hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM | Brenham | $7,250.26 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA | Suite 110 | $6,661.18 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - COLLEGE STATION | College Station | $7,250.26 | $85.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL | Temple | $7,250.26 | $2,398.52 – $17,722.46 |
| BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CENTER - CEDAR PARK | Cedar Park | $6,661.18 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST | Waco | $7,250.26 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MCLANE CHILDREN'S MEDICAL CENTER | Temple | $7,250.26 | $71.00 – $17,722.46 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE | Suite 100 | $6,661.18 | $71.00 – $17,722.46 |