CMS Price Transparency Data

X-ray, lower back

Facility: Mercy Hospital Carthage

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $341
Cash Discount Price: $404
vs. Medicare Baseline: 3.19x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Mercy Hospital Carthage is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.19x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$404

Average discount available for prompt cash payment at this facility.

Insurance Median

$341

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $404 (378%)

Insurance Median: $341 (319%)

Cash: $404 (378% of Medicare)

Ins. Median: $341 (319% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 319% of the Medicare baseline (a markup of 219%). 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	$33 - $553	31%
Humana	$33 - $186	31%
Medicaid / KanCare	$33 - $341	31%
Blue Cross Blue Shield	$60 - $171	56%
United Medical Resources Contracted [320454]	$74 - $559	69%
UnitedHealthcare	$74 - $540	69%
Medicare (plans)	$100 - $184	94%
Cherokee Nation Health Serv Contracted [320066]	$171	160%
Cigna	$171 - $559	160%
Cross Timbers Hospice [20098]	$171	160%
Dept Of Veteran Affairs Contracted [320106]	$171	160%
Elara Caring Aspire Hospice [20433]	$171	160%
Globalhealth Contracted [320145]	$171	160%
Halo Hcr Inc Hospice Contracted [320432]	$171	160%
Halo Hcr Inc Hospice [20432]	$171	160%
Indian Health Service Contracted [320198]	$171	160%
Kindful Hospice Contracted [320434]	$171	160%
Kindful Hospice [20434]	$171	160%
Medical Associates Health Contracted [320444]	$171	160%
Mercy Hospice Okc [20252]	$171	160%
Mercy Mgd Behavioral Health Contracted [320259]	$171	160%
Pace Of The Ozarks Contracted [320518]	$171	160%
Provider Partners Health Plans Contracted [320450]	$171	160%
Qual Choice Contracted [320325]	$171	160%
Tricare	$171	160%
Point C Contracted [320238]	$217 - $559	203%
Health Systems Inc Contracted [320174]	$267	250%
Insurance System Inc Contracted [320465]	$267	250%
Administrative Payor Contracted [320005]	$279	261%
Centivo Contracted [320505]	$286	268%
Healthscope Contracted [320182]	$324	303%
Ambetter / Centene	$341	319%
Home State Health Plan Contracted [320187]	$341	319%
Novasys Contracted [320285]	$341	319%
Benefit Management Contracted [320052]	$373 - $540	349%
Auxiant Contracted [320462]	$404 - $528	378%
Healthlink Contracted [320179]	$404 - $578	378%
Preferred Health Plan Contracted [320522]	$404	378%
Workers Comp [20426]	$497 - $621	465%
90 Degree Benefits Contracted [320436]	$528	494%
Aither Health Contracted [320449]	$528	494%
Ebms Contracted [320493]	$528	494%
Edison Health Solutions Contracted [320502]	$528	494%
Imagine 360 Contracted [320494]	$528	494%
Mercy Benefit Admin Contracted [320251]	$528 - $559	494%
Reflect Health Contracted [320492]	$528	494%
Show-Me Health Administrators Contracted [320483]	$528	494%
Yuzu Health Contracted [320521]	$528	494%
Medica Contracted [320239]	$538	504%
Evolutions Health Care Contracted [320124]	$540	506%
First Health Contracted [320128]	$540	506%
Multiplan Contracted [320270]	$540	506%
Private Health Care Systems Contracted [320320]	$540	506%
American Healthcare Alliance Contracted [320020]	$559	523%
Ppo Plus Contracted [320310]	$559	523%
Usa Managed Care Org Contracted [320429]	$559	523%

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 $404.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

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 72110.
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.