CMS Price Transparency Data

X-ray, hip

Facility: Mercy Hospital Carthage

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $181
Cash Discount Price: $214
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Mercy Hospital Carthage is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.04x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$214

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $214 (241%)

Insurance Median: $181 (204%)

Cash: $214 (241% of Medicare)

Ins. Median: $181 (204% 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 204% of the Medicare baseline (a markup of 104%). 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	$31 - $293	35%
Humana	$31 - $99	35%
Medicaid / KanCare	$31 - $181	35%
Blue Cross Blue Shield	$49 - $125	55%
United Medical Resources Contracted [320454]	$61 - $296	69%
UnitedHealthcare	$61 - $286	69%
Medicare (plans)	$82 - $97	92%
Cherokee Nation Health Serv Contracted [320066]	$90	101%
Cigna	$90 - $296	101%
Cross Timbers Hospice [20098]	$90	101%
Dept Of Veteran Affairs Contracted [320106]	$90	101%
Elara Caring Aspire Hospice [20433]	$90	101%
Globalhealth Contracted [320145]	$90	101%
Halo Hcr Inc Hospice Contracted [320432]	$90	101%
Halo Hcr Inc Hospice [20432]	$90	101%
Indian Health Service Contracted [320198]	$90	101%
Kindful Hospice Contracted [320434]	$90	101%
Kindful Hospice [20434]	$90	101%
Medical Associates Health Contracted [320444]	$90	101%
Mercy Hospice Okc [20252]	$90	101%
Mercy Mgd Behavioral Health Contracted [320259]	$90	101%
Pace Of The Ozarks Contracted [320518]	$90	101%
Provider Partners Health Plans Contracted [320450]	$90	101%
Qual Choice Contracted [320325]	$90	101%
Tricare	$91	102%
Point C Contracted [320238]	$115 - $296	129%
Health Systems Inc Contracted [320174]	$141	159%
Insurance System Inc Contracted [320465]	$141	159%
Administrative Payor Contracted [320005]	$148	166%
Centivo Contracted [320505]	$151	170%
Healthscope Contracted [320182]	$171	192%
Ambetter / Centene	$181	204%
Home State Health Plan Contracted [320187]	$181	204%
Novasys Contracted [320285]	$181	204%
Benefit Management Contracted [320052]	$197 - $286	222%
Auxiant Contracted [320462]	$214 - $280	241%
Healthlink Contracted [320179]	$214 - $306	241%
Preferred Health Plan Contracted [320522]	$214	241%
Workers Comp [20426]	$263 - $329	296%
90 Degree Benefits Contracted [320436]	$280	315%
Aither Health Contracted [320449]	$280	315%
Ebms Contracted [320493]	$280	315%
Edison Health Solutions Contracted [320502]	$280	315%
Imagine 360 Contracted [320494]	$280	315%
Mercy Benefit Admin Contracted [320251]	$280 - $296	315%
Reflect Health Contracted [320492]	$280	315%
Show-Me Health Administrators Contracted [320483]	$280	315%
Yuzu Health Contracted [320521]	$280	315%
Medica Contracted [320239]	$285	321%
Evolutions Health Care Contracted [320124]	$286	322%
First Health Contracted [320128]	$286	322%
Multiplan Contracted [320270]	$286	322%
Private Health Care Systems Contracted [320320]	$286	322%
American Healthcare Alliance Contracted [320020]	$296	333%
Ppo Plus Contracted [320310]	$296	333%
Usa Managed Care Org Contracted [320429]	$296	333%

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 $214.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

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 73502.
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.