CMS Price Transparency Data

X-ray, hand

Facility: Mercy Hospital Joplin

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $190
Cash Discount Price: $271
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Mercy Hospital Joplin is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $271. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.14x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$271

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $271 (305%)

Insurance Median: $190 (214%)

Cash: $271 (305% of Medicare)

Ins. Median: $190 (214% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$24 - $78	27%
Blue Cross Blue Shield	$24 - $364	27%
Humana	$24 - $150	27%
Indian Health Service Contracted [320198]	$24 - $325	27%
Medicaid / KanCare	$24 - $135	27%
Ambetter / Centene	$59	66%
Home State Health Plan Contracted [320187]	$59	66%
Novasys Contracted [320285]	$59	66%
Champva [20065]	$78	88%
Cherokee Nation Health Serv Contracted [320066]	$78	88%
Cigna	$78 - $248	88%
Cross Timbers Hospice [20098]	$78	88%
Dept Of Veteran Affairs Contracted [320106]	$78	88%
Elara Caring Aspire Hospice [20433]	$78	88%
Globalhealth Contracted [320145]	$78	88%
Halo Hcr Inc Hospice Contracted [320432]	$78	88%
Halo Hcr Inc Hospice [20432]	$78	88%
Kindful Hospice Contracted [320434]	$78	88%
Kindful Hospice [20434]	$78	88%
Medicare (plans)	$78 - $82	88%
Mercy Hospice Okc [20252]	$78	88%
Mercy Mgd Behavioral Health Contracted [320259]	$78	88%
Pace Of The Ozarks Contracted [320518]	$78	88%
Provider Partners Health Plans Contracted [320450]	$78	88%
Qual Choice Contracted [320325]	$78	88%
Tricare	$78	88%
UnitedHealthcare	$78 - $182	88%
Centivo Contracted [320505]	$80	90%
Healthscope Contracted [320182]	$100	112%
United Medical Resources Contracted [320454]	$112 - $182	126%
Point C Contracted [320238]	$117 - $400	132%
Medica Contracted [320239]	$122 - $182	137%
Benefit Management Contracted [320052]	$144 - $215	162%
Health Systems Inc Contracted [320174]	$144 - $215	162%
Insurance System Inc Contracted [320465]	$144 - $215	162%
Administrative Payor Contracted [320005]	$150 - $225	169%
Healthlink Contracted [320179]	$158 - $325	178%
90 Degree Benefits Contracted [320436]	$160	180%
Mercy Benefit Admin Contracted [320251]	$160 - $285	180%
Show-Me Health Administrators Contracted [320483]	$160 - $168	180%
Providrs Care Network Contracted [320484]	$163	183%
Health Choice Contracted [320166]	$176	198%
Aither Health Contracted [320449]	$190 - $285	214%
Auxiant Contracted [320462]	$190 - $325	214%
Ebms Contracted [320493]	$190 - $285	214%
Edison Health Solutions Contracted [320502]	$190 - $285	214%
Imagine 360 Contracted [320494]	$190 - $285	214%
Reflect Health Contracted [320492]	$190 - $285	214%
Yuzu Health Contracted [320521]	$190 - $285	214%
Preferred Health Plan Contracted [320522]	$217 - $325	244%
First Health Contracted [320128]	$227 - $340	255%
American Healthcare Alliance Contracted [320020]	$234 - $350	263%
Multiplan Contracted [320270]	$257 - $385	289%
Private Health Care Systems Contracted [320320]	$257 - $385	289%
Usable Contracted [320409]	$257 - $385	289%
Point C [20238]	$267 - $400	300%
Workers Comp [20426]	$267 - $500	300%
Usa Managed Care Org Contracted [320429]	$294 - $440	331%
Ppo Plus Contracted [320310]	$301 - $450	339%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $271.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Joplin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73130.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.