CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Saint Joseph Regional Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $878
  • Cash Discount Price: $4,243
  • vs. Medicare Baseline: 2.46x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Saint Joseph Regional Medical Center is $878. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,243. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.46x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$4,243

Average discount available for prompt cash payment at this facility.

Insurance Median
$878

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $4,243 (1190%)
Insurance Median: $878 (246%)
Cash: $4,243 (1190% of Medicare)
Ins. Median: $878 (246% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 246% of the Medicare baseline (a markup of 146%). 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 $191 - $4,152 54%
Blue Cross Blue Shield $191 - $1,303 54%
Medicaid / KanCare $191 - $632 54%
UnitedHealthcare $191 - $878 54%
Medicare (plans) $369 - $376 104%
Meridian Complete $369 104%
Pace-Trinity Health $369 104%
County Coroner $384 108%
Provider Partners Health Plan Of Indiana $406 114%
Auxiant $554 - $5,302 155%
Physicians Health Plan Northern Indiana Health Insurance $554 - $1,115 155%
St Joseph County Hlth Dpt $554 155%
Caresource $572 160%
Siho Insurance Services $591 166%
Managed Health Services - Indiana $632 177%
Mdwise $632 177%
Key Benefit Administrator $664 - $3,975 186%
Allied Benefit Systems $701 - $4,152 197%
Custom Design Benefits $794 223%
Geha $878 246%
Healthscope $878 246%
Student Insurance Cma $878 246%
Blue Benefit Administrators Of Massachusetts $1,303 366%
Blue Care Network $1,303 366%
Blue Distinction Transplant $1,303 366%
Blue Shield - Ca $1,303 366%
Blue Shield - Id (Regence) $1,303 366%
Blue Shield - Ny Highmark Northeastern $1,303 366%
Blue Shield - Ny Highmark Western $1,303 366%
Blue Shield - Pa (Highmark) $1,303 366%
Blue Shield - Wa (Regence) $1,303 366%
Hospice Of Marshall County $1,661 466%
Hospice Of St Joseph County $1,661 466%
Plain Church Group $1,725 484%
Notre Dame Athletic Association $3,513 986%
Wc Notre Dame $3,513 986%
Luminare Health (Detroit) $3,641 - $3,833 1022%
Encore Health $3,786 - $3,975 1062%
Ameriben $3,833 1075%
Indiana Criminal Justice Inst $3,975 1115%
Western & Southern Financial Group $3,975 1115%
Cigna $4,088 1147%
Group Administrators $4,088 1147%
Health Partners $4,088 1147%
Mvp $4,088 1147%
Prairie States $4,088 1147%
Priority Health $4,088 1147%
Professional Benefit Administrators $4,088 1147%
Sagamore Health Network $4,088 - $4,727 1147%
Sisco Benefits $4,088 1147%
Unified Group Services $4,088 1147%
Asr Health Benefits $4,152 1165%
Christian Brother Services $4,152 1165%
Employee Benefit Management $4,152 1165%
Medical Mutual $4,152 1165%
Meritain $4,152 1165%
Preferred One $4,152 1165%
Rural Carrier Health Benefit Plan $4,152 1165%
Webtpa $4,152 1165%
Goshen Preferred Network $4,919 - $5,494 1380%
Christian Brothers Holy Cross $5,110 1434%
Signature Care $5,110 1434%
Bankers Life Casualty $6,388 1792%
Bureau Of Disability $6,388 1792%
Wc Align Network $6,388 1792%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

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