CMS Price Transparency Data
Digestive disorders treatment (inpatient stay)
Facility: Mercy Hospital Springfield
Billing Code: 392 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 392
- Insurance Median: $6,939
- Cash Discount Price: $17,004
- vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Hospital Springfield is $6,939. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,004. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.22x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$17,004
Average discount available for prompt cash payment at this facility.
Insurance Median
$6,939
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$5,675.87
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $17,004 (300%)
Insurance Median: $6,939 (122%)
Cash: $17,004 (300% of Medicare)
Ins. Median: $6,939 (122% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $5,675.87 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 | $2,812 - $8,468 | 50% |
| Humana | $2,812 - $7,336 | 50% |
| Medicaid / KanCare | $2,812 - $3,910 | 50% |
| Multiplan Contracted [320270] | $3,112 | 55% |
| Private Health Care Systems Contracted [320320] | $3,112 | 55% |
| UnitedHealthcare | $3,112 - $11,123 | 55% |
| Ambetter / Centene | $3,263 | 57% |
| Home State Health Plan Contracted [320187] | $3,263 | 57% |
| Novasys Contracted [320285] | $3,263 | 57% |
| Blue Cross Blue Shield | $3,835 - $8,037 | 68% |
| Point C Contracted [320238] | $5,566 - $7,485 | 98% |
| Evolutions Health Care Contracted [320124] | $5,820 | 103% |
| Tricare | $5,878 | 104% |
| Providrs Care Network Contracted [320484] | $6,081 | 107% |
| Federal Medical Center Contracted [320127] | $6,395 | 113% |
| Mercy Benefit Admin Contracted [320251] | $6,489 - $7,200 | 114% |
| Benefit Management Contracted [320052] | $6,712 | 118% |
| United Medical Resources Contracted [320454] | $6,712 - $8,240 | 118% |
| 90 Degree Benefits Contracted [320436] | $6,857 | 121% |
| Show-Me Health Administrators Contracted [320483] | $6,857 - $7,200 | 121% |
| Aither Health Contracted [320449] | $6,884 | 121% |
| Auxiant Contracted [320462] | $6,884 | 121% |
| Ebms Contracted [320493] | $6,884 | 121% |
| Edison Health Solutions Contracted [320502] | $6,884 | 121% |
| Healthlink Contracted [320179] | $6,884 - $8,442 | 121% |
| Imagine 360 Contracted [320494] | $6,884 | 121% |
| Reflect Health Contracted [320492] | $6,884 | 121% |
| Yuzu Health Contracted [320521] | $6,884 | 121% |
| Health Systems Inc Contracted [320174] | $6,913 | 122% |
| Insurance System Inc Contracted [320465] | $6,913 | 122% |
| Point C [20238] | $6,965 | 123% |
| Medica Contracted [320239] | $7,133 | 126% |
| Medica [20239] | $7,133 | 126% |
| Centivo Contracted [320505] | $7,336 | 129% |
| Centurion Of Missouri [20459] | $7,336 | 129% |
| Champva [20065] | $7,336 | 129% |
| Cherokee Nation Health Serv Contracted [320066] | $7,336 | 129% |
| Cigna | $7,336 - $9,286 | 129% |
| Cross Timbers Hospice [20098] | $7,336 | 129% |
| Dept Of Veteran Affairs Contracted [320106] | $7,336 | 129% |
| Elara Caring Aspire Hospice [20433] | $7,336 | 129% |
| Globalhealth Contracted [320145] | $7,336 | 129% |
| Halo Hcr Inc Hospice Contracted [320432] | $7,336 | 129% |
| Halo Hcr Inc Hospice [20432] | $7,336 | 129% |
| Indian Health Service Contracted [320198] | $7,336 | 129% |
| Indian Health Service [20198] | $7,336 | 129% |
| Kindful Hospice Contracted [320434] | $7,336 | 129% |
| Kindful Hospice [20434] | $7,336 | 129% |
| Medicare (plans) | $7,336 - $7,564 | 129% |
| Mercy Hospice Okc [20252] | $7,336 | 129% |
| Mercy Mgd Behavioral Health Contracted [320259] | $7,336 | 129% |
| Mercy Rehab Hospital Contracted [320260] | $7,336 | 129% |
| Pace Of The Ozarks Contracted [320518] | $7,336 | 129% |
| Qual Choice Contracted [320325] | $7,336 | 129% |
| Provider Partners Health Plans Contracted [320450] | $7,931 | 140% |
| First Health Contracted [320128] | $8,321 | 147% |
| Healthscope Contracted [320182] | $9,031 | 159% |