CMS Price Transparency Data
MRI, brain (with and without contrast)
Facility: Mercy Hospital Carthage
Billing Code: 70553 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70553
- Insurance Median: $2,388
- Cash Discount Price: $2,828
- vs. Medicare Baseline: 6.70x Medicare
The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Mercy Hospital Carthage is $2,388. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,828. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.70x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$2,828
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,388
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$356.43
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $2,828 (793%)
Insurance Median: $2,388 (670%)
Cash: $2,828 (793% of Medicare)
Ins. Median: $2,388 (670% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $356.43 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 670% of the Medicare baseline (a markup of 570%). 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 |
|---|---|---|
| Aetna | $183 - $3,872 | 51% |
| Humana | $183 - $1,305 | 51% |
| Medicaid / KanCare | $183 - $2,388 | 51% |
| Blue Cross Blue Shield | $207 - $1,825 | 58% |
| Medicare (plans) | $334 - $1,287 | 94% |
| UnitedHealthcare | $469 - $3,784 | 132% |
| Cherokee Nation Health Serv Contracted [320066] | $1,195 | 335% |
| Cigna | $1,195 - $3,915 | 335% |
| Cross Timbers Hospice [20098] | $1,195 | 335% |
| Dept Of Veteran Affairs Contracted [320106] | $1,195 | 335% |
| Elara Caring Aspire Hospice [20433] | $1,195 | 335% |
| Globalhealth Contracted [320145] | $1,195 | 335% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,195 | 335% |
| Halo Hcr Inc Hospice [20432] | $1,195 | 335% |
| Indian Health Service Contracted [320198] | $1,195 | 335% |
| Kindful Hospice Contracted [320434] | $1,195 | 335% |
| Kindful Hospice [20434] | $1,195 | 335% |
| Medical Associates Health Contracted [320444] | $1,195 | 335% |
| Mercy Hospice Okc [20252] | $1,195 | 335% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,195 | 335% |
| Pace Of The Ozarks Contracted [320518] | $1,195 | 335% |
| Provider Partners Health Plans Contracted [320450] | $1,195 | 335% |
| Qual Choice Contracted [320325] | $1,195 | 335% |
| Tricare | $1,199 | 336% |
| Point C Contracted [320238] | $1,522 - $3,915 | 427% |
| United Medical Resources Contracted [320454] | $1,719 - $3,915 | 482% |
| Health Systems Inc Contracted [320174] | $1,870 | 525% |
| Insurance System Inc Contracted [320465] | $1,870 | 525% |
| Administrative Payor Contracted [320005] | $1,958 | 549% |
| Centivo Contracted [320505] | $2,001 | 561% |
| Healthscope Contracted [320182] | $2,266 | 636% |
| Ambetter / Centene | $2,388 | 670% |
| Home State Health Plan Contracted [320187] | $2,388 | 670% |
| Novasys Contracted [320285] | $2,388 | 670% |
| Benefit Management Contracted [320052] | $2,610 - $3,784 | 732% |
| Auxiant Contracted [320462] | $2,828 - $3,698 | 793% |
| Healthlink Contracted [320179] | $2,828 - $4,046 | 793% |
| Preferred Health Plan Contracted [320522] | $2,828 | 793% |
| Workers Comp [20426] | $3,480 - $4,350 | 976% |
| 90 Degree Benefits Contracted [320436] | $3,698 | 1038% |
| Aither Health Contracted [320449] | $3,698 | 1038% |
| Ebms Contracted [320493] | $3,698 | 1038% |
| Edison Health Solutions Contracted [320502] | $3,698 | 1038% |
| Imagine 360 Contracted [320494] | $3,698 | 1038% |
| Mercy Benefit Admin Contracted [320251] | $3,698 - $3,915 | 1038% |
| Reflect Health Contracted [320492] | $3,698 | 1038% |
| Show-Me Health Administrators Contracted [320483] | $3,698 | 1038% |
| Yuzu Health Contracted [320521] | $3,698 | 1038% |
| Medica Contracted [320239] | $3,767 | 1057% |
| Evolutions Health Care Contracted [320124] | $3,784 | 1062% |
| First Health Contracted [320128] | $3,784 | 1062% |
| Multiplan Contracted [320270] | $3,784 | 1062% |
| Private Health Care Systems Contracted [320320] | $3,784 | 1062% |
| American Healthcare Alliance Contracted [320020] | $3,915 | 1098% |
| Ppo Plus Contracted [320310] | $3,915 | 1098% |
| Usa Managed Care Org Contracted [320429] | $3,915 | 1098% |