CMS Price Transparency Data
X-ray, hip
Facility: Mercy Hospital Springfield
Billing Code: 73502 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73502
- Insurance Median: $198
- Cash Discount Price: $311
- vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at Mercy Hospital Springfield is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.23x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$311
Average discount available for prompt cash payment at this facility.
Insurance Median
$198
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: $311 (350%)
Insurance Median: $198 (223%)
Cash: $311 (350% of Medicare)
Ins. Median: $198 (223% 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 223% of the Medicare baseline (a markup of 123%). 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.
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 |
|---|---|---|
| Medicaid / KanCare | $28 - $113 | 31% |
| Blue Cross Blue Shield | $30 - $365 | 34% |
| Aetna | $31 - $150 | 35% |
| Humana | $31 - $325 | 35% |
| Centurion Of Missouri [20459] | $78 | 88% |
| 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% |
| Indian Health Service Contracted [320198] | $78 | 88% |
| Indian Health Service [20198] | $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% |
| Mercy Rehab Hospital Contracted [320260] | $78 | 88% |
| Pace Of The Ozarks Contracted [320518] | $78 | 88% |
| Qual Choice Contracted [320325] | $78 | 88% |
| Tricare | $78 | 88% |
| UnitedHealthcare | $78 - $368 | 88% |
| Provider Partners Health Plans Contracted [320450] | $86 | 97% |
| Ambetter / Centene | $90 | 101% |
| Home State Health Plan Contracted [320187] | $90 | 101% |
| Novasys Contracted [320285] | $90 | 101% |
| Healthscope Contracted [320182] | $100 | 112% |
| Centivo Contracted [320505] | $132 | 148% |
| Providrs Care Network Contracted [320484] | $163 | 183% |
| United Medical Resources Contracted [320454] | $182 - $249 | 205% |
| Medica Contracted [320239] | $189 | 213% |
| Medica [20239] | $189 | 213% |
| Benefit Management Contracted [320052] | $191 | 215% |
| Health Systems Inc Contracted [320174] | $191 | 215% |
| Insurance System Inc Contracted [320465] | $191 | 215% |
| Point C Contracted [320238] | $205 - $358 | 231% |
| 90 Degree Benefits Contracted [320436] | $206 | 232% |
| Healthlink Contracted [320179] | $206 - $272 | 232% |
| Mercy Benefit Admin Contracted [320251] | $206 - $272 | 232% |
| Show-Me Health Administrators Contracted [320483] | $206 - $217 | 232% |
| Administrative Payor Contracted [320005] | $215 - $239 | 242% |
| Evolutions Health Care Contracted [320124] | $215 | 242% |
| Point C [20238] | $215 | 242% |
| Medical Destinations Contracted [320242] | $239 | 269% |
| Workers Comp [20426] | $239 - $406 | 269% |
| First Health Contracted [320128] | $268 | 301% |
| Aither Health Contracted [320449] | $272 | 306% |
| Auxiant Contracted [320462] | $272 - $311 | 306% |
| Ebms Contracted [320493] | $272 | 306% |
| Edison Health Solutions Contracted [320502] | $272 | 306% |
| Imagine 360 Contracted [320494] | $272 | 306% |
| Reflect Health Contracted [320492] | $272 | 306% |
| Yuzu Health Contracted [320521] | $272 | 306% |
| Federal Medical Center Contracted [320127] | $287 | 323% |
| Multiplan Contracted [320270] | $368 | 414% |
| Private Health Care Systems Contracted [320320] | $368 | 414% |
| Compcare Of The Ozarks Contracted [320437] | $378 | 425% |
| American Healthcare Alliance Contracted [320020] | $382 | 430% |
| Qual Choice Contracted [320324] | $382 | 430% |
| Municipal Health Plan Contracted [320271] | $387 | 435% |
| Usa Managed Care Org Contracted [320429] | $421 | 474% |
| Ppo Plus Contracted [320310] | $430 | 484% |