CMS Price Transparency Data
X-ray, lower back
Facility: Mercy Hospital Springfield
Billing Code: 72110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72110
- Insurance Median: $243
- Cash Discount Price: $545
- vs. Medicare Baseline: 2.28x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Mercy Hospital Springfield is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $545. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.28x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$545
Average discount available for prompt cash payment at this facility.
Insurance Median
$243
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$106.81
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $545 (510%)
Insurance Median: $243 (228%)
Cash: $545 (510% of Medicare)
Ins. Median: $243 (228% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $106.81 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 228% of the Medicare baseline (a markup of 128%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $32 - $641 | 30% |
| Aetna | $33 - $164 | 31% |
| Humana | $33 - $571 | 31% |
| Medicaid / KanCare | $33 - $136 | 31% |
| Centurion Of Missouri [20459] | $94 | 88% |
| Champva [20065] | $94 | 88% |
| Cherokee Nation Health Serv Contracted [320066] | $94 | 88% |
| Cigna | $94 - $467 | 88% |
| Cross Timbers Hospice [20098] | $94 | 88% |
| Dept Of Veteran Affairs Contracted [320106] | $94 | 88% |
| Elara Caring Aspire Hospice [20433] | $94 | 88% |
| Globalhealth Contracted [320145] | $94 | 88% |
| Halo Hcr Inc Hospice Contracted [320432] | $94 | 88% |
| Halo Hcr Inc Hospice [20432] | $94 | 88% |
| Indian Health Service Contracted [320198] | $94 | 88% |
| Indian Health Service [20198] | $94 | 88% |
| Kindful Hospice Contracted [320434] | $94 | 88% |
| Kindful Hospice [20434] | $94 | 88% |
| Medicare (plans) | $94 - $99 | 88% |
| Mercy Hospice Okc [20252] | $94 | 88% |
| Mercy Mgd Behavioral Health Contracted [320259] | $94 | 88% |
| Mercy Rehab Hospital Contracted [320260] | $94 | 88% |
| Pace Of The Ozarks Contracted [320518] | $94 | 88% |
| Qual Choice Contracted [320325] | $94 | 88% |
| Tricare | $94 | 88% |
| UnitedHealthcare | $94 - $646 | 88% |
| Ambetter / Centene | $99 | 93% |
| Home State Health Plan Contracted [320187] | $99 | 93% |
| Novasys Contracted [320285] | $99 | 93% |
| Provider Partners Health Plans Contracted [320450] | $104 | 97% |
| Healthscope Contracted [320182] | $120 | 112% |
| Centivo Contracted [320505] | $159 | 149% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Healthlink Contracted [320179] | $214 - $478 | 200% |
| Point C Contracted [320238] | $228 - $629 | 213% |
| 90 Degree Benefits Contracted [320436] | $229 | 214% |
| Mercy Benefit Admin Contracted [320251] | $229 - $478 | 214% |
| Show-Me Health Administrators Contracted [320483] | $229 - $241 | 214% |
| United Medical Resources Contracted [320454] | $245 - $436 | 229% |
| Medica Contracted [320239] | $331 | 310% |
| Medica [20239] | $331 | 310% |
| Benefit Management Contracted [320052] | $336 | 315% |
| Health Systems Inc Contracted [320174] | $336 | 315% |
| Insurance System Inc Contracted [320465] | $336 | 315% |
| Administrative Payor Contracted [320005] | $378 - $420 | 354% |
| Evolutions Health Care Contracted [320124] | $378 | 354% |
| Point C [20238] | $378 | 354% |
| Medical Destinations Contracted [320242] | $420 | 393% |
| Workers Comp [20426] | $420 - $713 | 393% |
| First Health Contracted [320128] | $470 | 440% |
| Aither Health Contracted [320449] | $478 | 448% |
| Auxiant Contracted [320462] | $478 - $545 | 448% |
| Ebms Contracted [320493] | $478 | 448% |
| Edison Health Solutions Contracted [320502] | $478 | 448% |
| Imagine 360 Contracted [320494] | $478 | 448% |
| Reflect Health Contracted [320492] | $478 | 448% |
| Yuzu Health Contracted [320521] | $478 | 448% |
| Federal Medical Center Contracted [320127] | $503 | 471% |
| Multiplan Contracted [320270] | $646 | 605% |
| Private Health Care Systems Contracted [320320] | $646 | 605% |
| Compcare Of The Ozarks Contracted [320437] | $663 | 621% |
| American Healthcare Alliance Contracted [320020] | $671 | 628% |
| Qual Choice Contracted [320324] | $671 | 628% |
| Municipal Health Plan Contracted [320271] | $680 | 637% |
| Usa Managed Care Org Contracted [320429] | $738 | 691% |
| Ppo Plus Contracted [320310] | $755 | 707% |