CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Hospital Carthage

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,043

about 1.2× the $5,676 Medicare rate · typically $4,416–$7,328

modeled estimate · not a bill or quote

What this hospital charges insurers

$4,984

Below the fair price — a good deal

about $2,059 under the fair price · 0.9× Medicare

Medicare pays $5,676 Fair price $7,043 This hospital $4,984 Cash price $9,693 Hospital's list price $14,913

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

A typical price — 3 charge more and 5 charge less, among the 9 MO hospitals compared.

Cheapest $3,902 Priciest $6,120

Black dot = this hospital, among the 9 MO hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,043 (about 1.2× the $5,676 Medicare rate). Mercy Hospital Carthage charges insurers about $4,984, or about $9,693 in cash — below the fair price — a good deal. Located in Carthage, MO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,835 - $4,108	32%
Blue Cross Blue Shieldmajor	$2,245 - $8,415	40%
Aetnamajor	$2,245 - $3,618	40%
Cignamajor	$2,245	40%
Humanamajor	$2,245 - $4,721	40%
Ambetter (Centene)	$5,737	101%
+ 23 smaller / regional plans	$2,245 - $10,080

Government programs also on file: Medicare, Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 9,693), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Mercy Hospital Carthage is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercy Hospital Carthage

Compare: Digestive disorders treatment (inpatient stay) at other MO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.