How many shoppable procedure prices are published for Mercy Hospital Carthage?

Mercy Hospital Carthage in Carthage, MO currently has 105 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mercy Hospital Carthage's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mercy Hospital Carthage's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Mercy Hospital Carthage's CMS Care Compare overall star rating?

CMS Care Compare assigns Mercy Hospital Carthage an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 6/9/2026

Mercy Hospital Carthage

3125 Dr Russell Smith Way, Carthage, MO 64836 · 105 Priced Procedures · 82% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.15×vs. Fair Market Price

Typical commercial prices here are +15% above the fair benchmark (1.15×) even after accounting for local nurse/doctor wages and patient complexity.

88/100 · Verified

88/100Self-Pay Cash Beats Insurance 65% of the Time

File Completeness95

Price Logic91

Peer Alignment66

Clean Billing86

Real Cash Discount100

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.15× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 4,406), Mercy Hospital Carthage commands a 1.15× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#46 of 79 in MO · 56th State Percentile#1,866 of 3,385 in U.S. · 55th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.75× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 65% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 82% patient recommendation (73/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (51.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.15× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (0.6×) & laboratory (1.2×) services average 1.30× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.34×) jump +22% above the median procedure ratio (Q50 1.10×)
Consolidated metro market (HHI 4,406) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.30× Divergence

1.3× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+22% Upper Tail

Q25 0.75× · Q50 1.10× · Q75 1.34×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.3× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.9× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

65% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 73/100Fair

Procedure Prices at Mercy Hospital Carthage

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 105 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$12,892	$17,340	$19,087	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$23,312	$17,218	$19,432	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$9,371	$6,959	$8,223	0.8×
Hepatitis B immune globulin HCPCS Code: `90371`	$3,339	$3,339	$151	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$5,934	$2,889	$3,372	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$5,683	$971	$6,109	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,828	$809	$511	1.6×
Inguinal hernia repair CPT Code: `49505`	$2,169	$748	$3,629	0.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,200	$656	$448	1.5×
Injection procedure for pain management HCPCS Code: `G0260`	$1,598	$649	$855	0.8×
MRI, knee or other leg joint CPT Code: `73721`	$1,922	$534	$369	1.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,811	$528	$1,021	0.5×
Breast lump removal CPT Code: `19120`	$1,078	$537	$3,875	0.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,879	$502	$343	1.5×
MRI, lower back (no contrast) CPT Code: `72148`	$1,863	$489	$338	1.4×
Blood transfusion CPT Code: `36430`	$590	$389	$498	0.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,530	$372	$1,256	0.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,464	$336	$258	1.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,926	$354	$303	1.2×
CT scan, head (with contrast) CPT Code: `70460`	$1,438	$299	$242	1.2×
CT scan, sinuses CPT Code: `70486`	$966	$238	$166	1.4×
CT scan, pelvis CPT Code: `72192`	$1,769	$227	$163	1.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,264	$228	$167	1.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,086	$228	$168	1.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,327	$229	$169	1.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,310	$233	$583	0.4×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,099	$242	$981	0.2×
Upper endoscopy with biopsy CPT Code: `43239`	$2,136	$234	$987	0.2×
CT scan, head (no contrast) CPT Code: `70450`	$859	$197	$160	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$165	$146	$148	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$802	$158	$272	0.6×
Screening mammogram (both breasts) CPT Code: `77067`	$99	$119	$123	1.0×
X-ray, hip CPT Code: `73502`	$214	$83	$93	0.9×
X-ray, lower back CPT Code: `72110`	$404	$92	$112	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$450	$100	$126	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$154	$86	$110	0.8×
Ultrasound, pelvis CPT Code: `76856`	$424	$100	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$476	$100	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$678	$100	$134	0.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$148	$87	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$1,067	$456	$347	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$809	$267	$203	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	$495	$195	$140	1.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$405	$139	$111	1.3×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$77	$77	$27	2.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$67	$50	$35	1.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$206	$58	$56	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$234	$73	$86	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$70	$69	$201	0.3×
Blood test, vitamin D CPT Code: `82306`	$110	$41	$31	1.3×
Orthotic fitting and training CPT Code: `97760`	$89	$43	$51	0.8×
X-ray, ankle CPT Code: `73610`	$315	$63	$93	0.7×
X-ray, chest (two views) CPT Code: `71046`	$185	$62	$93	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$275	$61	$93	0.7×
X-ray, hand CPT Code: `73130`	$292	$61	$93	0.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$120	$56	$87	0.6×
X-ray, foot CPT Code: `73630`	$305	$58	$92	0.6×
X-ray, shoulder CPT Code: `73030`	$260	$54	$92	0.6×
X-ray, chest (single view) CPT Code: `71045`	$138	$50	$92	0.5×
X-ray, pelvis CPT Code: `72170`	$166	$52	$110	0.5×
Hospital observation (per hour) HCPCS Code: `G0378`	$68	$68	$86	unverified
Flu vaccine injection HCPCS Code: `G0008`	$37	$37	$48	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$34	$34	$49	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$34	$6	$4	1.5×
Blood test, lipase CPT Code: `83690`	$54	$10	$7	1.4×
Blood test, calcium CPT Code: `82310`	$57	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$52	$7	$5	1.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$87	$14	$10	1.4×
Blood test, sodium CPT Code: `84295`	$50	$7	$5	1.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$73	$11	$8	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$137	$26	$19	1.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$77	$15	$11	1.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$85	$19	$14	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$117	$19	$14	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$62	$12	$9	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$41	$8	$6	1.3×
Hepatitis C antibody test CPT Code: `86803`	$118	$20	$15	1.3×
Culture, bacterial CPT Code: `87070`	$114	$12	$9	1.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$83	$33	$25	1.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$54	$4	$3	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$53	$21	$16	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$131	$26	$20	1.3×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$124	$43	$39	1.1×
Colorectal cancer screening HCPCS Code: `G0010`	$35	$35	$49	0.7×
Blood test, magnesium CPT Code: `83735`	$82	$9	$7	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$46	$23	$18	1.3×
Hepatitis B vaccine HCPCS Code: `90744`	$124	$46	$37	1.2×
Blood test, amylase CPT Code: `82150`	$79	$9	$7	1.3×
Culture, blood CPT Code: `87040`	$111	$14	$11	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$44	$5	$4	1.3×
Blood test, liver function panel CPT Code: `80076`	$64	$11	$9	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$78	$33	$40	0.8×
Prosthetic fitting and training CPT Code: `97761`	$83	$36	$45	0.8×
Blood test, potassium CPT Code: `84132`	$43	$6	$5	1.2×
Occupational therapy (self-care training) CPT Code: `97535`	$79	$30	$38	0.8×
Blood test, hemoglobin CPT Code: `85018`	$20	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$34	$5	$5	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$83	$28	$35	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$94	$30	$38	0.8×
Physical therapy (gait training) CPT Code: `97116`	$81	$26	$33	0.8×
Speech therapy (group session) CPT Code: `92508`	$88	$21	$27	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$88	$29	$38	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$87	$25	$34	0.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$157	$21	$64	0.3×
Blood antibody screen CPT Code: `86850`	$70	$15	$46	0.3×

Showing top 25 high-impact procedures of 105 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 51.5%

Audit a Bill or Quote at Mercy Hospital Carthage (Zero PHI Required)

CMS CCN: 261338

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $12,892

Insurer Median $17,340

1. Amount on Your Bill or Quote ($) Pre-filled with Mercy Hospital Carthage’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $10,209 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $10,209

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (51.5% of gross = $10,209).

Step 2 · Cash vs. Insurance Arbitrage Save $6,942 Paying Cash

Self-Pay Cash Rate ($12,892) Beats Your Bill

Mercy Hospital Carthage's published 45 CFR § 180 self-pay cash rate is $12,892 (vs. $17,340 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$747 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($19,834) is $747 above the denoised Fair BaseRate ($19,087) and 1.4× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 453808607

Filing Period: 194603

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (51.5% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite73/100

Would Recommend82%

Rated 9 or 10 (HCAHPS)82%

Median ER Wait85 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.5%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mercy Hospital Carthage. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-25·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (165 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mercy Hospital Carthage.

Price Index: 1.26× regional baseline

Quality: 71/100 CMS composite

Median Household Income$57,525U.S. Census ACS

Local Uninsured Share12.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 88/100 · Verified CMS CCN 261338 EIN 453808607

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 261338) ↗ Verify IRS Form 990 (EIN 453808607) ↗ CMS HCRIS Cost Reports ↗

Published MRF File453808607_mercy-hospital-carthage_standardcharges.zip!453808607_mercy-hospital-carthage_standardcharges.csv

Publication / Vintage6/9/2026 · 75.67 MB

Validated Rate Rows17,166 (CMS v3.0.0)

File Integrity Digestc2a9e96d53e7b310b262…

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.

Submit MRF Update Correction Policy