CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Mercy Hospital Carthage

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $1,067
Cash Discount Price: $1,264
vs. Medicare Baseline: 9.99x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Mercy Hospital Carthage is $1,067. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,264. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.99x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,264

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,067

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: $1,264 (1183%)

Insurance Median: $1,067 (999%)

Cash: $1,264 (1183% of Medicare)

Ins. Median: $1,067 (999% 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 999% of the Medicare baseline (a markup of 899%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$60 - $534	56%
Medicaid / KanCare	$60 - $1,067	56%
Aetna	$71 - $1,730	66%
Humana	$71 - $583	66%
Medicare (plans)	$100 - $575	94%
UnitedHealthcare	$140 - $1,691	131%
Cherokee Nation Health Serv Contracted [320066]	$534	500%
Cigna	$534 - $1,750	500%
Cross Timbers Hospice [20098]	$534	500%
Dept Of Veteran Affairs Contracted [320106]	$534	500%
Elara Caring Aspire Hospice [20433]	$534	500%
Globalhealth Contracted [320145]	$534	500%
Halo Hcr Inc Hospice Contracted [320432]	$534	500%
Halo Hcr Inc Hospice [20432]	$534	500%
Indian Health Service Contracted [320198]	$534	500%
Kindful Hospice Contracted [320434]	$534	500%
Kindful Hospice [20434]	$534	500%
Medical Associates Health Contracted [320444]	$534	500%
Mercy Hospice Okc [20252]	$534	500%
Mercy Mgd Behavioral Health Contracted [320259]	$534	500%
Pace Of The Ozarks Contracted [320518]	$534	500%
Provider Partners Health Plans Contracted [320450]	$534	500%
Qual Choice Contracted [320325]	$534	500%
Tricare	$536	502%
Point C Contracted [320238]	$680 - $1,750	637%
Health Systems Inc Contracted [320174]	$836	783%
Insurance System Inc Contracted [320465]	$836	783%
Administrative Payor Contracted [320005]	$875	819%
Centivo Contracted [320505]	$894	837%
Healthscope Contracted [320182]	$1,013	948%
United Medical Resources Contracted [320454]	$1,031 - $1,750	965%
Ambetter / Centene	$1,067	999%
Home State Health Plan Contracted [320187]	$1,067	999%
Novasys Contracted [320285]	$1,067	999%
Benefit Management Contracted [320052]	$1,166 - $1,691	1092%
Auxiant Contracted [320462]	$1,264 - $1,652	1183%
Healthlink Contracted [320179]	$1,264 - $1,808	1183%
Preferred Health Plan Contracted [320522]	$1,264	1183%
Workers Comp [20426]	$1,555 - $1,944	1456%
90 Degree Benefits Contracted [320436]	$1,652	1547%
Aither Health Contracted [320449]	$1,652	1547%
Ebms Contracted [320493]	$1,652	1547%
Edison Health Solutions Contracted [320502]	$1,652	1547%
Imagine 360 Contracted [320494]	$1,652	1547%
Mercy Benefit Admin Contracted [320251]	$1,652 - $1,750	1547%
Reflect Health Contracted [320492]	$1,652	1547%
Show-Me Health Administrators Contracted [320483]	$1,652	1547%
Yuzu Health Contracted [320521]	$1,652	1547%
Medica Contracted [320239]	$1,684	1577%
Evolutions Health Care Contracted [320124]	$1,691	1583%
First Health Contracted [320128]	$1,691	1583%
Multiplan Contracted [320270]	$1,691	1583%
Private Health Care Systems Contracted [320320]	$1,691	1583%
American Healthcare Alliance Contracted [320020]	$1,750	1638%
Ppo Plus Contracted [320310]	$1,750	1638%
Usa Managed Care Org Contracted [320429]	$1,750	1638%

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 $1,264.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71250.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Carthage is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71250.
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.