CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Mercy Hospital Springfield
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $2,265
- Cash Discount Price: $3,229
- vs. Medicare Baseline: 9.29x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercy Hospital Springfield is $2,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,229. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.29x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$3,229
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,265
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$243.77
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $3,229 (1325%)
Insurance Median: $2,265 (929%)
Cash: $3,229 (1325% of Medicare)
Ins. Median: $2,265 (929% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $243.77 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 929% of the Medicare baseline (a markup of 829%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $117 - $4,553 | 48% |
| Aetna | $120 - $840 | 49% |
| Humana | $120 - $4,053 | 49% |
| Medicaid / KanCare | $120 - $380 | 49% |
| Centurion Of Missouri [20459] | $215 | 88% |
| Champva [20065] | $215 | 88% |
| Cherokee Nation Health Serv Contracted [320066] | $215 | 88% |
| Cigna | $215 - $935 | 88% |
| Cross Timbers Hospice [20098] | $215 | 88% |
| Dept Of Veteran Affairs Contracted [320106] | $215 | 88% |
| Elara Caring Aspire Hospice [20433] | $215 | 88% |
| Globalhealth Contracted [320145] | $215 | 88% |
| Halo Hcr Inc Hospice Contracted [320432] | $215 | 88% |
| Halo Hcr Inc Hospice [20432] | $215 | 88% |
| Indian Health Service Contracted [320198] | $215 | 88% |
| Indian Health Service [20198] | $215 | 88% |
| Kindful Hospice Contracted [320434] | $215 | 88% |
| Kindful Hospice [20434] | $215 | 88% |
| Medicare (plans) | $215 - $226 | 88% |
| Mercy Hospice Okc [20252] | $215 | 88% |
| Mercy Mgd Behavioral Health Contracted [320259] | $215 | 88% |
| Mercy Rehab Hospital Contracted [320260] | $215 | 88% |
| Pace Of The Ozarks Contracted [320518] | $215 | 88% |
| Qual Choice Contracted [320325] | $215 | 88% |
| Tricare | $215 | 88% |
| UnitedHealthcare | $215 - $4,589 | 88% |
| Provider Partners Health Plans Contracted [320450] | $237 | 97% |
| Healthscope Contracted [320182] | $274 | 112% |
| Centivo Contracted [320505] | $361 | 148% |
| Ambetter / Centene | $378 | 155% |
| Home State Health Plan Contracted [320187] | $378 | 155% |
| Novasys Contracted [320285] | $378 | 155% |
| Providrs Care Network Contracted [320484] | $447 | 183% |
| Workers Comp [20426] | $460 - $5,066 | 189% |
| United Medical Resources Contracted [320454] | $518 - $3,099 | 212% |
| Healthlink Contracted [320179] | $979 - $3,397 | 402% |
| Medica Contracted [320239] | $1,203 | 493% |
| Medica [20239] | $1,203 | 493% |
| Point C Contracted [320238] | $1,245 - $4,470 | 511% |
| 90 Degree Benefits Contracted [320436] | $1,249 | 512% |
| Mercy Benefit Admin Contracted [320251] | $1,249 - $3,397 | 512% |
| Show-Me Health Administrators Contracted [320483] | $1,249 - $1,313 | 512% |
| Benefit Management Contracted [320052] | $1,590 - $2,384 | 652% |
| Health Systems Inc Contracted [320174] | $1,590 - $2,384 | 652% |
| Insurance System Inc Contracted [320465] | $1,590 - $2,384 | 652% |
| Administrative Payor Contracted [320005] | $1,788 - $2,980 | 733% |
| Evolutions Health Care Contracted [320124] | $1,788 - $2,682 | 733% |
| Point C [20238] | $1,788 - $2,682 | 733% |
| Medical Destinations Contracted [320242] | $1,987 - $2,980 | 815% |
| First Health Contracted [320128] | $2,225 - $3,338 | 913% |
| Aither Health Contracted [320449] | $2,265 - $3,397 | 929% |
| Auxiant Contracted [320462] | $2,265 - $3,874 | 929% |
| Ebms Contracted [320493] | $2,265 - $3,397 | 929% |
| Edison Health Solutions Contracted [320502] | $2,265 - $3,397 | 929% |
| Imagine 360 Contracted [320494] | $2,265 - $3,397 | 929% |
| Reflect Health Contracted [320492] | $2,265 - $3,397 | 929% |
| Yuzu Health Contracted [320521] | $2,265 - $3,397 | 929% |
| Federal Medical Center Contracted [320127] | $2,384 - $3,576 | 978% |
| Multiplan Contracted [320270] | $3,060 - $4,589 | 1255% |
| Private Health Care Systems Contracted [320320] | $3,060 - $4,589 | 1255% |
| Compcare Of The Ozarks Contracted [320437] | $3,139 - $4,708 | 1288% |
| American Healthcare Alliance Contracted [320020] | $3,179 - $4,768 | 1304% |
| Qual Choice Contracted [320324] | $3,179 - $4,768 | 1304% |
| Municipal Health Plan Contracted [320271] | $3,219 - $4,828 | 1321% |
| Usa Managed Care Org Contracted [320429] | $3,497 - $5,245 | 1435% |
| Ppo Plus Contracted [320310] | $3,577 - $5,364 | 1467% |