CMS Price Transparency Data
X-ray, shoulder
Facility: Mercy St Francis Hospital
Billing Code: 73030 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73030
- Insurance Median: $386
- Cash Discount Price: $319
- vs. Medicare Baseline: 4.34x Medicare
The contracted insurance negotiated median rate for a X-ray, shoulder at Mercy St Francis Hospital is $386. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.34x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$319
Average discount available for prompt cash payment at this facility.
Insurance Median
$386
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: $319 (359%)
Insurance Median: $386 (434%)
Cash: $319 (359% of Medicare)
Ins. Median: $386 (434% 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 434% of the Medicare baseline (a markup of 334%). 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 |
|---|---|---|
| Medicaid / KanCare | $49 - $299 | 55% |
| Medicare (plans) | $82 - $206 | 92% |
| Blue Cross Blue Shield | $83 - $559 | 93% |
| UnitedHealthcare | $111 - $547 | 125% |
| Mercy Mgd Behavioral Health Contracted [320259] | $112 - $198 | 126% |
| Aetna | $112 - $513 | 126% |
| Acentra Health Contracted [320527] | $112 - $158 | 126% |
| Indian Health Service Contracted [320198] | $112 - $198 | 126% |
| Provider Partners Health Plans Contracted [320450] | $112 - $198 | 126% |
| Pace of the Ozarks Contracted [320518] | $112 - $198 | 126% |
| Halo Hcr Inc Hospice Contracted [320432] | $112 - $198 | 126% |
| Kindful Hospice Contracted [320434] | $112 - $198 | 126% |
| Halo Hcr Inc Hospice [20432] | $112 - $198 | 126% |
| Cigna | $112 - $547 | 126% |
| Mercy Hospice Okc [20252] | $112 - $198 | 126% |
| Cross Timbers Hospice [20098] | $112 - $198 | 126% |
| Qual Choice Contracted [320325] | $112 - $198 | 126% |
| Kindful Hospice [20434] | $112 - $198 | 126% |
| Dept of Veteran Affairs Contracted [320106] | $112 - $198 | 126% |
| Elara Caring Aspire Hospice [20433] | $112 - $198 | 126% |
| Medical Associates Health Contracted [320444] | $112 - $198 | 126% |
| Globalhealth Contracted [320145] | $112 - $198 | 126% |
| Cherokee Nation Health Serv Contracted [320066] | $112 - $198 | 126% |
| Humana | $112 - $518 | 126% |
| Tricare | $138 - $196 | 155% |
| Healthscope Contracted [320182] | $139 - $263 | 156% |
| Administrative Payor Contracted [320005] | $183 - $259 | 206% |
| Centivo Contracted [320505] | $184 - $334 | 207% |
| Ambetter / Centene | $211 - $299 | 237% |
| Home State Health Plan Contracted [320187] | $211 - $299 | 237% |
| Novasys Contracted [320285] | $211 - $299 | 237% |
| Healthlink Contracted [320179] | $264 - $547 | 297% |
| Preferred Health Plan Contracted [320522] | $264 - $374 | 297% |
| Workers Comp [20426] | $325 - $490 | 366% |
| Mercy Benefit Admin Contracted [320251] | $365 - $547 | 411% |
| Point C Contracted [320238] | $365 - $547 | 411% |
| Auxiant Contracted [320462] | $365 - $547 | 411% |
| United Medical Resources Contracted [320454] | $365 - $536 | 411% |
| Medica Contracted [320239] | $384 - $544 | 432% |
| USA Managed Care Org Contracted [320429] | $386 - $547 | 434% |
| Yuzu Health Contracted [320521] | $386 - $547 | 434% |
| Point C [20238] | $386 - $547 | 434% |
| Multiplan Contracted [320270] | $386 - $547 | 434% |
| 90 Degree Benefits Contracted [320436] | $386 - $547 | 434% |
| Aither Health Contracted [320449] | $386 - $547 | 434% |
| Show-Me Health Administrators Contracted [320483] | $386 - $547 | 434% |
| Benefit Management Contracted [320052] | $386 - $547 | 434% |
| First Health Contracted [320128] | $386 - $547 | 434% |
| Insurance System Inc Contracted [320465] | $386 - $547 | 434% |
| Ebms Contracted [320493] | $386 - $547 | 434% |
| Reflect Health Contracted [320492] | $386 - $547 | 434% |
| Imagine 360 Contracted [320494] | $386 - $547 | 434% |
| Evolutions Health Care Contracted [320124] | $386 - $547 | 434% |
| Edison Health Solutions Contracted [320502] | $386 - $547 | 434% |
| Health Systems Inc Contracted [320174] | $386 - $547 | 434% |
| Private Health Care Systems Contracted [320320] | $386 - $547 | 434% |