CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Saint Joseph Regional Medical Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $878
  • Cash Discount Price: $2,534
  • vs. Medicare Baseline: 4.90x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without 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 $2,534. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.90x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$2,534

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
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Cash / Self-Pay: $2,534 (1414%)
Insurance Median: $878 (490%)
Cash: $2,534 (1414% of Medicare)
Ins. Median: $878 (490% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 490% of the Medicare baseline (a markup of 390%). 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 $96 - $2,534 54%
Blue Cross Blue Shield $96 - $655 54%
Medicaid / KanCare $96 - $378 54%
UnitedHealthcare $96 - $878 54%
Medicare (plans) $186 - $189 104%
Meridian Complete $186 104%
Pace-Trinity Health $186 104%
County Coroner $193 108%
Provider Partners Health Plan Of Indiana $204 114%
Auxiant $278 - $3,235 155%
Physicians Health Plan Northern Indiana Health Insurance $278 - $560 155%
St Joseph County Hlth Dpt $278 155%
Caresource $288 161%
Siho Insurance Services $297 166%
Key Benefit Administrator $334 - $2,425 186%
Allied Benefit Systems $353 - $2,534 197%
Managed Health Services - Indiana $378 211%
Mdwise $378 211%
Custom Design Benefits $399 223%
Blue Benefit Administrators Of Massachusetts $655 366%
Blue Care Network $655 366%
Blue Distinction Transplant $655 366%
Blue Shield - Ca $655 366%
Blue Shield - Id (Regence) $655 366%
Blue Shield - Ny Highmark Northeastern $655 366%
Blue Shield - Ny Highmark Western $655 366%
Blue Shield - Pa (Highmark) $655 366%
Blue Shield - Wa (Regence) $655 366%
Geha $878 490%
Healthscope $878 490%
Student Insurance Cma $878 490%
Hospice Of Marshall County $1,013 565%
Hospice Of St Joseph County $1,013 565%
Plain Church Group $1,052 587%
Notre Dame Athletic Association $2,144 1196%
Wc Notre Dame $2,144 1196%
Luminare Health (Detroit) $2,222 - $2,339 1240%
Encore Health $2,310 - $2,425 1289%
Ameriben $2,339 1305%
Indiana Criminal Justice Inst $2,425 1353%
Western & Southern Financial Group $2,425 1353%
Cigna $2,495 1392%
Group Administrators $2,495 1392%
Health Partners $2,495 1392%
Mvp $2,495 1392%
Prairie States $2,495 1392%
Priority Health $2,495 1392%
Professional Benefit Administrators $2,495 1392%
Sagamore Health Network $2,495 - $2,885 1392%
Sisco Benefits $2,495 1392%
Unified Group Services $2,495 1392%
Asr Health Benefits $2,534 1414%
Christian Brother Services $2,534 1414%
Employee Benefit Management $2,534 1414%
Medical Mutual $2,534 1414%
Meritain $2,534 1414%
Preferred One $2,534 1414%
Rural Carrier Health Benefit Plan $2,534 1414%
Webtpa $2,534 1414%
Goshen Preferred Network $3,001 - $3,352 1675%
Christian Brothers Holy Cross $3,118 1740%
Signature Care $3,118 1740%
Bankers Life Casualty $3,898 2175%
Bureau Of Disability $3,898 2175%
Wc Align Network $3,898 2175%

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