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CMS Price Transparency Data Hospital file updated: 2026-03-31

C-section delivery (full package)

Facility: Saint Joseph Regional Medical Center

Billing Code: 59510 (CPT)

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
$828Fair BaseRate (0.92× Market)
Position vs. 1.00× Fair Price8% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

This hospital's typical commercial price is $762 compared to the $828 fair price benchmark.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Quality Benchmark
CMS Star Rating2/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score42/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

2-Star CMS clinical quality rating paired with 0.92× fair market pricing.

The BaseRate · fair price medium confidence
A fair price for this
$828
about 0.3× the $2,473 Medicare rate · typically $613–$2,996
modeled estimate · not a bill or quote
What this hospital charges insurers
$762
About the fair price
about $66 under the fair price · 0.3× Medicare
Medicare pays $2,473 Fair price $828 This hospital $762 Cash price $3,455 Hospital's list price $3,455

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Lowest price of the 9 IN hospitals we have prices for — a strong deal.

Cheapest $762 Priciest $2,263

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

Note: The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a C-section delivery (full package) is about $828 (about 0.3× the $2,473 Medicare rate). Saint Joseph Regional Medical Center charges insurers about $762, or about $3,455 in cash — about the fair price. Located in Mishawaka, IN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $299 - $1,866 12%
Blue Cross Blue Shieldmajor $1,079 - $1,324 44%
Aetnamajor $305 - $1,904 12%
Cignamajor $445 - $2,781 18%
Humanamajor $1,079 - $1,188 44%
Kaiser Permanentemajor $1,324 54%
Ambetter (Centene) $1,171 47%
CareSource $1,431 58%
Clover Health $1,079 44%
GEHA $299 - $1,866 12%
Health Net $445 - $3,074 18%
HealthPartners $1,171 47%
Meridian $1,079 - $1,171 44%
Molina $1,171 47%
Paramount $1,171 47%
Presbyterian $1,079 - $1,171 44%
Tufts Health Plan $1,171 47%
WellMed $1,079 44%
WellSense $1,171 47%
+ 347 smaller / regional plans $264 - $6,148
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 10 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: 2 / 5 Stars
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals

Other Procedures at Saint Joseph Regional Medical Center

Compare: C-section delivery (full package) at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at Saint Joseph Regional Medical Center (Zero PHI Required)

CMS CCN: 150012
CPT 59510
Fair BaseRate™ $828
Medicare Rate $2,473
Self-Pay Cash $3,455
Insurer Median $762
Pre-filled with Saint Joseph Regional Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $1,254 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,254

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,254).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $3,455

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Saint Joseph Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $3,455 (vs. $762 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,627 Above Fair BaseRate

Negotiate Toward $828 Fair BaseRate ($2,473 Medicare)

Your bill ($3,455) is $2,627 above the denoised Fair BaseRate ($828) and 1.4× the $2,473 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.
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall2/5 Stars (2/5)

Source: CMS Hospital Care Compare. 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

45 CFR § 180 Primary-Source Lineage & Federal Verification Verified CMS CCN 150012

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

MRF Portal Indexed (350868157_mishawaka-medical-center_standardcharges.zip!350868157_Mishawaka-Medical-Center_standardcharges.csv) Verify on CMS Medicare.gov (CCN 150012) ↗ CMS HCRIS Cost Reports ↗
Published MRF File350868157_mishawaka-medical-center_standardcharges.zip!350868157_Mishawaka-Medical-Center_standardcharges.csv
Publication / Vintage2026-03-31 · 138.23 MB
Validated Rate Rows13,208,302 (CMS v3.0.0)
File Integrity Digest3c9e62c80fcee154035d…

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