CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy Hospital Springfield
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $359
- Cash Discount Price: $512
- vs. Medicare Baseline: 4.04x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Springfield is $359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $512. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.04x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$512
Average discount available for prompt cash payment at this facility.
Insurance Median
$359
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: $512 (576%)
Insurance Median: $359 (404%)
Cash: $512 (576% of Medicare)
Ins. Median: $359 (404% 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 404% of the Medicare baseline (a markup of 304%). 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 | $20 - $113 | 22% |
| Blue Cross Blue Shield | $21 - $722 | 24% |
| Aetna | $22 - $97 | 25% |
| Humana | $22 - $643 | 25% |
| Ambetter / Centene | $66 | 74% |
| Home State Health Plan Contracted [320187] | $66 | 74% |
| Novasys Contracted [320285] | $66 | 74% |
| 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 - $728 | 88% |
| Provider Partners Health Plans Contracted [320450] | $86 | 97% |
| Healthscope Contracted [320182] | $100 | 112% |
| Centivo Contracted [320505] | $132 | 148% |
| 90 Degree Benefits Contracted [320436] | $134 | 151% |
| Mercy Benefit Admin Contracted [320251] | $134 - $539 | 151% |
| Point C Contracted [320238] | $134 - $709 | 151% |
| Show-Me Health Administrators Contracted [320483] | $134 - $141 | 151% |
| Healthlink Contracted [320179] | $143 - $539 | 161% |
| Providrs Care Network Contracted [320484] | $163 | 183% |
| United Medical Resources Contracted [320454] | $182 - $491 | 205% |
| Medica Contracted [320239] | $249 - $373 | 280% |
| Medica [20239] | $249 - $373 | 280% |
| Benefit Management Contracted [320052] | $252 - $378 | 283% |
| Health Systems Inc Contracted [320174] | $252 - $378 | 283% |
| Insurance System Inc Contracted [320465] | $252 - $378 | 283% |
| Administrative Payor Contracted [320005] | $284 - $472 | 319% |
| Evolutions Health Care Contracted [320124] | $284 - $425 | 319% |
| Point C [20238] | $284 - $425 | 319% |
| Medical Destinations Contracted [320242] | $315 - $472 | 354% |
| Workers Comp [20426] | $315 - $803 | 354% |
| First Health Contracted [320128] | $353 - $529 | 397% |
| Aither Health Contracted [320449] | $359 - $539 | 404% |
| Auxiant Contracted [320462] | $359 - $614 | 404% |
| Ebms Contracted [320493] | $359 - $539 | 404% |
| Edison Health Solutions Contracted [320502] | $359 - $539 | 404% |
| Imagine 360 Contracted [320494] | $359 - $539 | 404% |
| Reflect Health Contracted [320492] | $359 - $539 | 404% |
| Yuzu Health Contracted [320521] | $359 - $539 | 404% |
| Federal Medical Center Contracted [320127] | $378 - $567 | 425% |
| Multiplan Contracted [320270] | $485 - $728 | 545% |
| Private Health Care Systems Contracted [320320] | $485 - $728 | 545% |
| Compcare Of The Ozarks Contracted [320437] | $498 - $747 | 560% |
| American Healthcare Alliance Contracted [320020] | $504 - $756 | 567% |
| Qual Choice Contracted [320324] | $504 - $756 | 567% |
| Municipal Health Plan Contracted [320271] | $510 - $765 | 574% |
| Usa Managed Care Org Contracted [320429] | $554 - $832 | 623% |
| Ppo Plus Contracted [320310] | $567 - $850 | 638% |