CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Mercy Hospital Carthage

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70551
Insurance Median: $1,587
Cash Discount Price: $1,879
vs. Medicare Baseline: 6.51x Medicare

The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Mercy Hospital Carthage is $1,587. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,879. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.51x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,879

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,587

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,879 (771%)

Insurance Median: $1,587 (651%)

Cash: $1,879 (771% of Medicare)

Ins. Median: $1,587 (651% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 651% of the Medicare baseline (a markup of 551%). 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
Aetna	$110 - $2,572	45%
Humana	$110 - $867	45%
Medicaid / KanCare	$110 - $1,587	45%
Blue Cross Blue Shield	$131 - $1,089	54%
Medicare (plans)	$226 - $855	93%
UnitedHealthcare	$317 - $2,514	130%
Cherokee Nation Health Serv Contracted [320066]	$794	326%
Cigna	$794 - $2,601	326%
Cross Timbers Hospice [20098]	$794	326%
Dept Of Veteran Affairs Contracted [320106]	$794	326%
Elara Caring Aspire Hospice [20433]	$794	326%
Globalhealth Contracted [320145]	$794	326%
Halo Hcr Inc Hospice Contracted [320432]	$794	326%
Halo Hcr Inc Hospice [20432]	$794	326%
Indian Health Service Contracted [320198]	$794	326%
Kindful Hospice Contracted [320434]	$794	326%
Kindful Hospice [20434]	$794	326%
Medical Associates Health Contracted [320444]	$794	326%
Mercy Hospice Okc [20252]	$794	326%
Mercy Mgd Behavioral Health Contracted [320259]	$794	326%
Pace Of The Ozarks Contracted [320518]	$794	326%
Provider Partners Health Plans Contracted [320450]	$794	326%
Qual Choice Contracted [320325]	$794	326%
Tricare	$797	327%
Point C Contracted [320238]	$1,012 - $2,601	415%
Health Systems Inc Contracted [320174]	$1,243	510%
Insurance System Inc Contracted [320465]	$1,243	510%
Administrative Payor Contracted [320005]	$1,300	533%
Centivo Contracted [320505]	$1,329	545%
Healthscope Contracted [320182]	$1,506	618%
Ambetter / Centene	$1,587	651%
Home State Health Plan Contracted [320187]	$1,587	651%
Novasys Contracted [320285]	$1,587	651%
United Medical Resources Contracted [320454]	$1,719 - $2,601	705%
Benefit Management Contracted [320052]	$1,734 - $2,514	711%
Auxiant Contracted [320462]	$1,878 - $2,456	770%
Healthlink Contracted [320179]	$1,878 - $2,688	770%
Preferred Health Plan Contracted [320522]	$1,878	770%
Workers Comp [20426]	$2,312 - $2,890	948%
90 Degree Benefits Contracted [320436]	$2,456	1008%
Aither Health Contracted [320449]	$2,456	1008%
Ebms Contracted [320493]	$2,456	1008%
Edison Health Solutions Contracted [320502]	$2,456	1008%
Imagine 360 Contracted [320494]	$2,456	1008%
Mercy Benefit Admin Contracted [320251]	$2,456 - $2,601	1008%
Reflect Health Contracted [320492]	$2,456	1008%
Show-Me Health Administrators Contracted [320483]	$2,456	1008%
Yuzu Health Contracted [320521]	$2,456	1008%
Medica Contracted [320239]	$2,503	1027%
Evolutions Health Care Contracted [320124]	$2,514	1031%
First Health Contracted [320128]	$2,514	1031%
Multiplan Contracted [320270]	$2,514	1031%
Private Health Care Systems Contracted [320320]	$2,514	1031%
American Healthcare Alliance Contracted [320020]	$2,601	1067%
Ppo Plus Contracted [320310]	$2,601	1067%
Usa Managed Care Org Contracted [320429]	$2,601	1067%

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 $1,879.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70551.

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 70551.
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.