CMS Price Transparency Data
X-ray, foot
Facility: Mercy Hospital Carthage
Billing Code: 73630 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73630
- Insurance Median: $300
- Cash Discount Price: $305
- vs. Medicare Baseline: 3.37x Medicare
The contracted insurance negotiated median rate for a X-ray, foot at Mercy Hospital Carthage is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.37x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$305
Average discount available for prompt cash payment at this facility.
Insurance Median
$300
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$88.91
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $305 (343%)
Insurance Median: $300 (337%)
Cash: $305 (343% of Medicare)
Ins. Median: $300 (337% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $88.91 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 337% of the Medicare baseline (a markup of 237%). 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.
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 | $22 - $500 | 25% |
| Humana | $22 - $169 | 25% |
| Medicaid / KanCare | $22 - $309 | 25% |
| United Medical Resources Contracted [320454] | $44 - $506 | 49% |
| UnitedHealthcare | $44 - $489 | 49% |
| Blue Cross Blue Shield | $49 - $154 | 55% |
| Medicare (plans) | $82 - $166 | 92% |
| Cherokee Nation Health Serv Contracted [320066] | $103 - $154 | 116% |
| Cigna | $103 - $506 | 116% |
| Cross Timbers Hospice [20098] | $103 - $154 | 116% |
| Dept Of Veteran Affairs Contracted [320106] | $103 - $154 | 116% |
| Elara Caring Aspire Hospice [20433] | $103 - $154 | 116% |
| Globalhealth Contracted [320145] | $103 - $154 | 116% |
| Halo Hcr Inc Hospice Contracted [320432] | $103 - $154 | 116% |
| Halo Hcr Inc Hospice [20432] | $103 - $154 | 116% |
| Indian Health Service Contracted [320198] | $103 - $154 | 116% |
| Kindful Hospice Contracted [320434] | $103 - $154 | 116% |
| Kindful Hospice [20434] | $103 - $154 | 116% |
| Medical Associates Health Contracted [320444] | $103 - $154 | 116% |
| Mercy Hospice Okc [20252] | $103 - $154 | 116% |
| Mercy Mgd Behavioral Health Contracted [320259] | $103 - $154 | 116% |
| Pace Of The Ozarks Contracted [320518] | $103 - $154 | 116% |
| Provider Partners Health Plans Contracted [320450] | $103 - $154 | 116% |
| Qual Choice Contracted [320325] | $103 - $154 | 116% |
| Tricare | $103 - $155 | 116% |
| Point C Contracted [320238] | $131 - $506 | 147% |
| Health Systems Inc Contracted [320174] | $161 - $242 | 181% |
| Insurance System Inc Contracted [320465] | $161 - $242 | 181% |
| Administrative Payor Contracted [320005] | $169 - $253 | 190% |
| Centivo Contracted [320505] | $172 - $259 | 193% |
| Healthscope Contracted [320182] | $195 - $293 | 219% |
| Ambetter / Centene | $206 - $309 | 232% |
| Home State Health Plan Contracted [320187] | $206 - $309 | 232% |
| Novasys Contracted [320285] | $206 - $309 | 232% |
| Benefit Management Contracted [320052] | $225 - $489 | 253% |
| Auxiant Contracted [320462] | $244 - $478 | 274% |
| Healthlink Contracted [320179] | $244 - $523 | 274% |
| Preferred Health Plan Contracted [320522] | $244 - $365 | 274% |
| Workers Comp [20426] | $300 - $562 | 337% |
| 90 Degree Benefits Contracted [320436] | $319 - $478 | 359% |
| Aither Health Contracted [320449] | $319 - $478 | 359% |
| Ebms Contracted [320493] | $319 - $478 | 359% |
| Edison Health Solutions Contracted [320502] | $319 - $478 | 359% |
| Imagine 360 Contracted [320494] | $319 - $478 | 359% |
| Mercy Benefit Admin Contracted [320251] | $319 - $506 | 359% |
| Reflect Health Contracted [320492] | $319 - $478 | 359% |
| Show-Me Health Administrators Contracted [320483] | $319 - $478 | 359% |
| Yuzu Health Contracted [320521] | $319 - $478 | 359% |
| Medica Contracted [320239] | $325 - $487 | 366% |
| Evolutions Health Care Contracted [320124] | $326 - $489 | 367% |
| First Health Contracted [320128] | $326 - $489 | 367% |
| Multiplan Contracted [320270] | $326 - $489 | 367% |
| Private Health Care Systems Contracted [320320] | $326 - $489 | 367% |
| American Healthcare Alliance Contracted [320020] | $338 - $506 | 380% |
| Ppo Plus Contracted [320310] | $338 - $506 | 380% |
| Usa Managed Care Org Contracted [320429] | $338 - $506 | 380% |