Cox Medical Centers
3801 South National Avenue, Springfield, MO 65807 · 108 Priced Procedures · 71% Patient Recommendation
Typical commercial prices here are +20% above the fair benchmark (1.20×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.20× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Cox Medical Centers prices routine shoppable procedures at 1.9× Medicare (median 0.93× Fair BaseRate) while upper-quartile commercial rates jump +87% to 1.74× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.86× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 56% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (65/100 safety score) with 71% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (32.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.4× markup over Medicare rates
- Commercial insurance median sits at 0.93× Fair BaseRate (1.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.74×) jump +87% above the median procedure ratio (Q50 0.93×)
- Consolidated metro market (HHI 4,250) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Cox Medical Centers
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 108 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $27,138 | 0.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $17,443 | 0.9× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $17,037 | 0.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $15,921 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,279 | 1.0× |
| Trauma team activation HCPCS Code: G0390 | $1,214 | 0.8× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,088 | 3.2× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,088 | 2.1× |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,088 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,088 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $870 | 0.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $821 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $821 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $783 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $799 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $799 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $799 | unverified |
| CT scan, pelvis CPT Code: 72192 | $799 | unverified |
| Injection procedure for pain management HCPCS Code: G0260 | $704 | 0.8× |
| CT scan, sinuses CPT Code: 70486 | $686 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $545 | 0.9× |
| Psychological testing by technician CPT Code: 96138 | $408 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $372 | 0.8× |
| Blood transfusion CPT Code: 36430 | $364 | 0.7× |
| Rabies immune globulin HCPCS Code: 90375 | $275 | 0.9× |
Audit a Bill or Quote at Cox Medical Centers (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $20,979
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (32.2% of gross = $20,979).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Cox Medical Centers's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($65,131) is $34,356 above the denoised Fair BaseRate ($30,775) and 2.8× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (32.2% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (1,243 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Cox Medical Centers.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.