CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $233
  • Cash Discount Price: $291
  • vs. Medicare Baseline: 2.62x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Hospital Tishomingo Inc is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $291. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.62x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$291

Average discount available for prompt cash payment at this facility.

Insurance Median
$233

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: $291 (327%)
Insurance Median: $233 (262%)
Cash: $291 (327% of Medicare)
Ins. Median: $233 (262% 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 262% of the Medicare baseline (a markup of 162%). 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 $24 - $298 27%
Humana $24 - $358 27%
Medicaid / KanCare $24 - $134 27%
Ambetter / Centene $134 151%
Blue Cross Blue Shield $134 - $233 151%
Home State Health Plan Contracted [320187] $134 151%
Novasys Contracted [320285] $134 151%
Webtpa Contracted [320417] $188 211%
Health Choice Contracted [320166] $198 223%
Medicare (plans) $207 - $287 233%
Cherokee Nation Health Serv Contracted [320066] $215 242%
Cross Timbers Hospice [20098] $215 242%
Dept Of Veteran Affairs Contracted [320106] $215 242%
Elara Caring Aspire Hospice Contracted [320433] $215 242%
Elara Caring Aspire Hospice [20433] $215 242%
Halo Hcr Inc Hospice Contracted [320432] $215 242%
Halo Hcr Inc Hospice [20432] $215 242%
Independent Health [20197] $215 242%
Indian Health Service Contracted [320198] $215 242%
Kindful Hospice Contracted [320434] $215 242%
Kindful Hospice [20434] $215 242%
Medical Associates Health [20444] $215 242%
Mercy Hospice Okc [20252] $215 242%
Provider Partners Health Plans Contracted [320450] $215 242%
Qual Choice Contracted [320325] $215 242%
Tribute Health Plan Mcr Contracted [320338] $215 242%
Tricare $215 242%
UnitedHealthcare $215 - $353 242%
Globalhealth Contracted [320145] $220 247%
Cigna $222 - $336 250%
Aither Health Contracted [320449] $269 - $381 303%
Mercy Benefit Admin Contracted [320251] $269 - $381 303%
Quik Trip Contracted [320447] $269 303%
Show-Me Health Administrators Contracted [320483] $269 303%
Medica Contracted [320239] $287 323%
First Health Contracted [320128] $298 335%
Osma Health Contracted [320292] $314 353%
Benefit Management Contracted [320052] $336 - $403 378%
Healthcare Highways Plus Contracted [320175] $336 378%
Private Health Care Systems Contracted [320320] $336 - $358 378%
United Medical Resources Contracted [320454] $353 397%
Multiplan Contracted [320270] $358 - $403 403%
Auxiant Contracted [320462] $381 429%
Ebms Contracted [320493] $381 429%
Healthlink Contracted [320179] $381 429%
Imagine 360 Contracted [320494] $381 429%
Preferred Community Choice Contracted [320311] $381 429%
Reflect Health Contracted [320492] $381 429%
Yuzu Health Contracted [320521] $381 429%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals