CMS Price Transparency Data
Injection procedure for pain management
Facility: Mercy St Francis Hospital
Billing Code: G0260 (HCPCS)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: G0260
- Insurance Median: $1,834
- Cash Discount Price: $1,547
- vs. Medicare Baseline: 2.54x Medicare
The contracted insurance negotiated median rate for a Injection procedure for pain management at Mercy St Francis Hospital is $1,834. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,547. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 2.54x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$1,547
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,834
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$721.17
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $721.17 (100%)
Cash / Self-Pay: $1,547 (215%)
Insurance Median: $1,834 (254%)
Cash: $1,547 (215% of Medicare)
Ins. Median: $1,834 (254% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $721.17 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 254% of the Medicare baseline (a markup of 154%). 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.
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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 | $483 - $1,690 | 67% |
| UnitedHealthcare | $530 - $3,028 | 73% |
| Indian Health Service Contracted [320198] | $531 - $1,117 | 74% |
| Cigna | $531 - $3,093 | 74% |
| Provider Partners Health Plans Contracted [320450] | $531 - $1,117 | 74% |
| Medical Associates Health Contracted [320444] | $531 - $1,117 | 74% |
| Mercy Hospice Okc [20252] | $531 - $1,117 | 74% |
| Kindful Hospice Contracted [320434] | $531 - $1,117 | 74% |
| Humana | $531 - $2,930 | 74% |
| Mercy Mgd Behavioral Health Contracted [320259] | $531 - $1,117 | 74% |
| Cross Timbers Hospice [20098] | $531 - $1,117 | 74% |
| Elara Caring Aspire Hospice [20433] | $531 - $1,117 | 74% |
| Kindful Hospice [20434] | $531 - $1,117 | 74% |
| Globalhealth Contracted [320145] | $531 - $1,117 | 74% |
| Cherokee Nation Health Serv Contracted [320066] | $531 - $1,117 | 74% |
| Halo Hcr Inc Hospice [20432] | $531 - $1,117 | 74% |
| Medicare (plans) | $531 - $1,163 | 74% |
| Aetna | $531 - $2,898 | 74% |
| Blue Cross Blue Shield | $531 - $3,158 | 74% |
| Dept of Veteran Affairs Contracted [320106] | $531 - $1,117 | 74% |
| Pace of the Ozarks Contracted [320518] | $531 - $1,117 | 74% |
| Qual Choice Contracted [320325] | $531 - $1,117 | 74% |
| Halo Hcr Inc Hospice Contracted [320432] | $531 - $1,117 | 74% |
| Acentra Health Contracted [320527] | $531 - $895 | 74% |
| Tricare | $657 - $1,107 | 91% |
| Healthscope Contracted [320182] | $663 - $1,485 | 92% |
| Administrative Payor Contracted [320005] | $869 - $1,465 | 120% |
| Centivo Contracted [320505] | $875 - $1,888 | 121% |
| Private Health Care Systems Contracted [320320] | $1,000 - $1,834 | 139% |
| Multiplan Contracted [320270] | $1,000 - $1,834 | 139% |
| Novasys Contracted [320285] | $1,002 - $1,690 | 139% |
| Home State Health Plan Contracted [320187] | $1,002 - $1,690 | 139% |
| Ambetter / Centene | $1,002 - $1,690 | 139% |
| Preferred Health Plan Contracted [320522] | $1,255 - $2,116 | 174% |
| Healthlink Contracted [320179] | $1,255 - $3,093 | 174% |
| Workers Comp [20426] | $1,545 - $2,768 | 214% |
| Auxiant Contracted [320462] | $1,738 - $3,093 | 241% |
| Mercy Benefit Admin Contracted [320251] | $1,738 - $3,093 | 241% |
| Point C Contracted [320238] | $1,738 - $3,093 | 241% |
| United Medical Resources Contracted [320454] | $1,738 - $3,028 | 241% |
| Medica Contracted [320239] | $1,825 - $3,077 | 253% |
| Reflect Health Contracted [320492] | $1,834 - $3,093 | 254% |
| Yuzu Health Contracted [320521] | $1,834 - $3,093 | 254% |
| First Health Contracted [320128] | $1,834 - $3,093 | 254% |
| USA Managed Care Org Contracted [320429] | $1,834 - $3,093 | 254% |
| Aither Health Contracted [320449] | $1,834 - $3,093 | 254% |
| Evolutions Health Care Contracted [320124] | $1,834 - $3,093 | 254% |
| Ebms Contracted [320493] | $1,834 - $3,093 | 254% |
| Benefit Management Contracted [320052] | $1,834 - $3,093 | 254% |
| Health Systems Inc Contracted [320174] | $1,834 - $3,093 | 254% |
| Edison Health Solutions Contracted [320502] | $1,834 - $3,093 | 254% |
| 90 Degree Benefits Contracted [320436] | $1,834 - $3,093 | 254% |
| Insurance System Inc Contracted [320465] | $1,834 - $3,093 | 254% |
| Point C [20238] | $1,834 - $3,093 | 254% |
| Imagine 360 Contracted [320494] | $1,834 - $3,093 | 254% |
| Show-Me Health Administrators Contracted [320483] | $1,834 - $3,093 | 254% |