CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Hospital Carthage

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $2,245
  • Cash Discount Price: $9,693
  • vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Hospital Carthage is $2,245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,693. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.40x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$9,693

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,245

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: $9,693 (171%)
Insurance Median: $2,245 (40%)
Cash: $9,693 (171% of Medicare)
Ins. Median: $2,245 (40% 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.

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
United Medical Resources Contracted [320454] $1,835 32%
UnitedHealthcare $1,835 - $4,108 32%
Aetna $2,245 - $3,618 40%
Blue Cross Blue Shield $2,245 - $8,415 40%
Cherokee Nation Health Serv Contracted [320066] $2,245 40%
Cigna $2,245 40%
Cross Timbers Hospice [20098] $2,245 40%
Dept Of Veteran Affairs Contracted [320106] $2,245 40%
Elara Caring Aspire Hospice [20433] $2,245 40%
Globalhealth Contracted [320145] $2,245 40%
Halo Hcr Inc Hospice Contracted [320432] $2,245 40%
Halo Hcr Inc Hospice [20432] $2,245 40%
Humana $2,245 - $4,721 40%
Indian Health Service Contracted [320198] $2,245 40%
Kindful Hospice Contracted [320434] $2,245 40%
Kindful Hospice [20434] $2,245 40%
Medical Associates Health Contracted [320444] $2,245 40%
Medicare (plans) $2,245 - $6,984 40%
Mercy Hospice Okc [20252] $2,245 40%
Mercy Mgd Behavioral Health Contracted [320259] $2,245 40%
Pace Of The Ozarks Contracted [320518] $2,245 40%
Provider Partners Health Plans Contracted [320450] $2,245 40%
Qual Choice Contracted [320325] $2,245 40%
Medicaid / KanCare $3,618 - $5,737 64%
Multiplan Contracted [320270] $4,108 72%
Private Health Care Systems Contracted [320320] $4,108 72%
Healthscope Contracted [320182] $4,622 81%
Health Systems Inc Contracted [320174] $4,984 88%
Insurance System Inc Contracted [320465] $4,984 88%
Ambetter / Centene $5,737 101%
Home State Health Plan Contracted [320187] $5,737 101%
Novasys Contracted [320285] $5,737 101%
Health Choice Contracted [320166] $10,080 178%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3125 Dr Russell Smith Way, Carthage, MO 64836
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals