CMS Price Transparency Data

X-ray, shoulder

Facility: Mercy Hospital Lincoln

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73030
  • Insurance Median: $214
  • Cash Discount Price: $317
  • vs. Medicare Baseline: 2.41x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy Hospital Lincoln is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.41x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$317

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $317 (357%)
Insurance Median: $214 (241%)
Cash: $317 (357% of Medicare)
Ins. Median: $214 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Aetna $7 - $597 8%
Medicaid / KanCare $7 - $418 8%
Medicare (plans) $10 - $911 11%
Tricare $10 - $195 11%
UnitedHealthcare $10 - $601 11%
American Health Advantage Of Mo Mcr [10473] $11 - $214 12%
Blue Cross Blue Shield $11 - $701 12%
Cherokee Nation Health Serv Contracted [320066] $11 - $214 12%
Cigna $11 - $229 12%
Cross Timbers Hospice [20098] $11 - $214 12%
Dept Of Veteran Affairs Contracted [320106] $11 - $214 12%
Elara Caring Aspire Hospice Contracted [320433] $11 - $214 12%
Elara Caring Aspire Hospice [20433] $11 - $214 12%
Globalhealth Contracted [320145] $11 - $214 12%
Halo Hcr Inc Hospice Contracted [320432] $11 - $214 12%
Halo Hcr Inc Hospice [20432] $11 - $214 12%
Humana $11 - $820 12%
Indian Health Service Contracted [320198] $11 - $214 12%
Kindful Hospice Contracted [320434] $11 - $214 12%
Kindful Hospice [20434] $11 - $214 12%
Mercy Hospice Okc [20252] $11 - $214 12%
Pace Of The Ozarks Contracted [320518] $11 - $214 12%
Provider Partners Health Plans Contracted [320450] $11 - $213 12%
Qual Choice Contracted [320325] $11 - $214 12%
Centivo Contracted [320505] $16 - $331 18%
Medica Contracted [320239] $19 - $383 21%
Ambetter / Centene $21 - $418 24%
Home State Health Plan Contracted [320187] $21 - $418 24%
Novasys Contracted [320285] $21 - $418 24%
Hope Trust Contracted [320488] $22 - $451 25%
Health Choices Contracted [320448] $27 - $547 30%
Health Choices [20448] $27 - $547 30%
Medical Associates Health Contracted [320444] $27 - $547 30%
First Health Contracted [320128] $29 - $597 33%
United Medical Resources Contracted [320454] $30 - $601 34%
Mercy Mgd Behavioral Health Contracted [320259] $34 38%
Multiplan Contracted [320270] $34 - $683 38%
Private Health Care Systems Contracted [320320] $34 38%
Workers Comp [20426] $34 - $729 38%
Healthlink Contracted [320179] $36 - $811 40%
Aither Health Contracted [320449] $38 - $774 43%
Aither Health [20449] $38 - $774 43%
Auxiant Contracted [320462] $38 - $774 43%
Ebms Contracted [320493] $38 - $774 43%
Edison Health Solutions Contracted [320502] $38 - $774 43%
Federal Medical Center Contracted [320127] $38 - $774 43%
Imagine 360 Contracted [320494] $38 - $774 43%
Insurance System Inc Contracted [320465] $38 - $774 43%
Mercy Benefit Admin Contracted [320251] $38 - $774 43%
Mercy Benefit Admin [20251] $38 - $774 43%
Point C Contracted [320238] $38 - $774 43%
Preferred Health Plan Contracted [320522] $38 - $774 43%
Reflect Health Contracted [320492] $38 - $774 43%
Show-Me Health Administrators Contracted [320483] $38 - $774 43%
Tri State Healthcare Coalition Contracted [320379] $38 - $774 43%
Yuzu Health Contracted [320521] $38 - $774 43%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 East Cherry Street, Troy, MO 63379
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals