CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Hospital - Cassville

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $3,170
Cash Discount Price: $7,365
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Hospital - Cassville is $3,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,365. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.56x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$7,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,170

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: $7,365 (130%)

Insurance Median: $3,170 (56%)

Cash: $7,365 (130% of Medicare)

Ins. Median: $3,170 (56% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthscope Contracted [320182]	$3,068	54%
Aetna	$3,170 - $3,373	56%
Blue Cross Blue Shield	$3,170 - $18,417	56%
Cherokee Nation Health Serv Contracted [320066]	$3,170	56%
Cigna	$3,170	56%
Cross Timbers Hospice [20098]	$3,170	56%
Elara Caring Aspire Hospice [20433]	$3,170	56%
Globalhealth Contracted [320145]	$3,170	56%
Halo Hcr Inc Hospice Contracted [320432]	$3,170	56%
Halo Hcr Inc Hospice [20432]	$3,170	56%
Humana	$3,170 - $3,373	56%
Indian Health Service Contracted [320198]	$3,170	56%
Kindful Hospice Contracted [320434]	$3,170	56%
Kindful Hospice [20434]	$3,170	56%
Medical Associates Health Contracted [320444]	$3,170	56%
Medicare (plans)	$3,170 - $7,564	56%
Mercy Hospice Okc [20252]	$3,170	56%
Mercy Mgd Behavioral Health Contracted [320259]	$3,170	56%
Pace Of The Ozarks Contracted [320518]	$3,170	56%
Provider Partners Health Plans Contracted [320450]	$3,170	56%
Qual Choice Contracted [320325]	$3,170	56%
UnitedHealthcare	$3,170	56%
Medicaid / KanCare	$3,373 - $4,456	59%
Ambetter / Centene	$4,456	79%
Home State Health Plan Contracted [320187]	$4,456	79%
Novasys Contracted [320285]	$4,456	79%
United Medical Resources Contracted [320454]	$4,470	79%
Health Systems Inc Contracted [320174]	$4,655	82%
Insurance System Inc Contracted [320465]	$4,655	82%
Point C Contracted [320238]	$4,655	82%
Point C [20238]	$4,655	82%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7,365.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital - Cassville is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.